Nursing Elites

1. The renin and angiotensin systems help to maintain the balance of sodium and water in the body. What other functions do these systems serve?

• A. Regulating hemoglobin levels
• B. Maintaining a healthy blood volume
• C. Releasing platelets when tissues are injured
• D. Lowering blood volumes

Correct answer: B

Rationale: The correct answer is B: Maintaining a healthy blood volume. The renin and angiotensin systems not only help to regulate sodium and water balance in the body but also play a crucial role in maintaining an adequate blood volume. This is essential for normal blood pressure regulation and overall cardiovascular health. Choices A, C, and D are incorrect because hemoglobin levels are primarily regulated by the bone marrow and erythropoietin, platelets are released in response to blood vessel injury by a different mechanism, and the systems do not focus on lowering blood volumes but rather on maintaining them.

2. 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.

3. A nurse is visiting an 84-year-old woman living at home and recovering from hip surgery. The woman seems confused and has poor skin turgor, and she states that 'she stops drinking water early in the day because it is too difficult to get up during the night to go to the bathroom.' The nurse explains to the woman that:

• A. She will need to have her medications adjusted and be readmitted to the hospital for a complete workup.
• B. Limiting fluids can create imbalances in the body that can result in confusion; maybe we need to adjust the timing of your fluids.
• C. It is normal to be a little confused following surgery and it is safe not to urinate at night.
• D. Confusion following surgery is common in the elderly due to loss of sleep.

Correct answer: B

Rationale: The correct answer is B. In elderly patients, fluid deficits can lead to confusion and cognitive impairment. Limiting fluids can disrupt the body's balance, leading to such symptoms. Adjusting the timing of fluids can help maintain hydration without causing nighttime interruptions. Choices A, C, and D are incorrect because they do not address the underlying issue of fluid imbalance causing confusion. Choice A suggests unnecessary hospital readmission and medication adjustments. Choice C incorrectly normalizes confusion post-surgery and suggests it is safe not to urinate at night, which can exacerbate the issue. Choice D inaccurately attributes confusion to sleep loss rather than fluid imbalance.

4. Which of the following might the nurse assess in a patient diagnosed with hypermagnesemia?

• A. Diminished deep tendon reflexes
• B. Tachycardia
• C. Cool clammy skin
• D. Increased serum magnesium

Correct answer: A

Rationale: The correct answer is A: Diminished deep tendon reflexes. In a patient with hypermagnesemia, the nurse would assess for diminished deep tendon reflexes. Hypermagnesemia can lead to neuromuscular depression, causing a decrease in deep tendon reflexes. Tachycardia (choice B) is more commonly associated with hypomagnesemia. Cool clammy skin (choice C) is not typically a direct symptom of hypermagnesemia. While hypermagnesemia does involve increased serum magnesium levels (choice D), assessing serum levels is a laboratory test and not a clinical assessment like checking deep tendon reflexes.

5. A client at risk for mild hypernatremia is being taught by a nurse. Which statement should the nurse include in this client's teaching?

• A. Weigh yourself every morning and every night
• B. Check your radial pulse twice a day
• C. Read food labels to determine sodium content
• D. Bake or grill the meat rather than frying it

Correct answer: C

Rationale: The correct answer is to 'Read food labels to determine sodium content.' This is important for a client at risk for mild hypernatremia because monitoring sodium intake is crucial in managing this condition. Choice A is not directly related to managing hypernatremia. Choice B focuses on pulse monitoring, which is not specific to managing sodium levels. Choice D addresses cooking methods, which can be beneficial but is not as directly related to sodium intake monitoring as reading food labels.

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