Nursing Elites

1. Retention of electrolytes (especially sodium) in the interstitial fluid can result from:

• A. decreased aldosterone secretion.
• B. increased ADH secretion.
• C. increased aldosterone secretion.
• D. decreased ADH secretion.

Correct answer: C

Rationale: The correct answer is C: increased aldosterone secretion. Aldosterone, a hormone produced by the adrenal glands, increases sodium reabsorption in the kidneys, leading to retention of sodium and water in the interstitial fluid. Increased aldosterone secretion enhances the reabsorption of sodium, thereby increasing its retention. Choice A is incorrect because decreased aldosterone secretion would lead to less sodium reabsorption and increased excretion. Choice B is incorrect because increased ADH secretion primarily affects water reabsorption rather than sodium. Choice D is incorrect because decreased ADH secretion would lead to increased water excretion but not necessarily affect sodium retention.

2. A nurse assesses a client who has a radial artery catheter. Which assessment should the nurse complete first?

• A. . Amount of pressure in fluid container
• B. Date of catheter tubing change
• C. Percent of heparin in infusion container
• D. . Presence of an ulnar pulse

Correct answer: D

Rationale:

3. The baroreceptors, located in the left atrium and in the carotid and aortic arches, respond to changes in the circulating blood volume and regulate sympathetic and parasympathetic neural activity as well as endocrine activities. Sympathetic stimulation constricts renal arterioles, causing what effect?

• A. Decrease in the release of aldosterone
• B. Increase of filtration in the Loop of Henle
• C. Decrease in the reabsorption of sodium
• D. Decrease in glomerular filtration

Correct answer: D

Rationale:

4. Diagnostic testing has been ordered to differentiate between normal anion gap acidosis and high anion gap acidosis in an acutely ill patient. What health problem typically precedes normal anion gap acidosis?

• A. Metastases
• B. Excessive potassium intake
• C. Water intoxication
• D. Excessive administration of chloride

Correct answer: D

Rationale:

5. A nurse sees a variety of patients in the community health clinic. Which of the following patients would be at the greatest risk of dehydration?

• A. An 18-year-old basketball player with a stress fracture of the right foot
• B. An infant with diarrhea
• C. A 45-year-old with stomach flu
• D. An elderly patient living alone

Correct answer: B

Rationale: The correct answer is B. Infants are particularly vulnerable to dehydration due to diarrhea because they have a higher fluid turnover and less reserve. Option A, the 18-year-old basketball player with a stress fracture, is less likely to be at the greatest risk of dehydration compared to an infant with diarrhea. Option C, the 45-year-old with stomach flu, may experience dehydration but is not at the same level of risk as an infant with diarrhea. Option D, the elderly patient living alone, could be at risk of dehydration, but infants with diarrhea are at the greatest risk due to their unique physiological characteristics.

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