Nursing Elites

1. What happens first in dehydration?

• A. Intercellular fluid volume drops first.
• B. Plasma volume drops first.
• C. Interstitial fluid drops first.
• D. Neither interstitial nor intracellular fluid volume are affected.

Correct answer: C

Rationale: In dehydration, the body first draws fluid from the interstitial space to maintain blood volume, leading to a decrease in interstitial fluid volume. This is why choice C is correct. Choice A is incorrect because intracellular fluid is not the first to be affected. Choice B is also incorrect as plasma volume reduction typically occurs after interstitial fluid loss. Choice D is incorrect as dehydration impacts both interstitial and intracellular fluid volumes.

2. The nurse is caring for a postthyroidectomy patient at risk for hypocalcemia. What action should the nurse take when assessing for hypocalcemia?

• A. Monitor laboratory values daily for an elevated thyroid-stimulating hormone.
• B. Observe for swelling of the neck, tracheal deviation, and severe pain.
• C. Evaluate the quality of the patient's voice postoperatively, noting any drastic changes.
• D. Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.

Correct answer: D

Rationale: Muscle twitching and numbness or tingling of the lips, fingers, and toes are signs of hyperirritability of the nervous system due to hypocalcemia. The other options describe complications the nurse should also be observing for; however, tetany and neurologic alterations are primary indications of hypocalcemia. Monitoring for an elevated thyroid-stimulating hormone (choice A) is not relevant in assessing for hypocalcemia. Observing for swelling of the neck, tracheal deviation, and severe pain (choice B) are more related to airway compromise. Evaluating the quality of the patient's voice postoperatively (choice C) is important but not a primary sign of hypocalcemia.

3. You are the nurse caring for a patient who is to receive IV daunorubicin, a chemotherapeutic agent. You start the infusion and check the insertion site as per protocol. During your most recent check, you note that the IV has infiltrated so you stop the infusion. What is your main concern with this infiltration?

• A. Extravasation of the medication
• B. Discomfort to the patient
• C. Blanching at the site
• D. Hypersensitivity reaction to the medication

Correct answer: A

Rationale:

4. Which mineral is important in hemoglobin production?

• A. Sodium
• B. Iodine
• C. Iron
• D. Chloride

Correct answer: C

Rationale: Iron (Fe) is a critical mineral in hemoglobin production. Hemoglobin is a protein found in red blood cells that is essential for transporting oxygen throughout the body. Sodium (Choice A), Iodine (Choice B), and Chloride (Choice D) are not directly involved in hemoglobin production. Sodium is an electrolyte that helps maintain fluid balance, Iodine is essential for thyroid hormone production, and Chloride is an electrolyte that helps regulate fluid balance and acidity in the body.

5. A nurse is planning care for a client who is hyperventilating. The clients arterial blood gas values are pH 7.30, PaO2 94 mm Hg, PaCO2 31 mm Hg, and HCO3 26 mEq/L. Which question should the nurse ask when developing this clients plan of care?

• A. Do you take any over-the-counter medications?
• B. You appear anxious. What is causing your distress?
• C. Do you have a history of anxiety attacks?
• D. You are breathing fast. Is this causing you to feel light-headed?

Correct answer: B

Rationale:

Similar Questions