Nursing Elites

1. The term used to describe a blood sodium level of more than 145 mEq/L is:

• A. hyponatremia.
• B. hyperkalemia.
• C. hypernatremia.
• D. hypercalcemia.

Correct answer: C

Rationale: The correct answer is C: hypernatremia. Hypernatremia refers to an elevated level of sodium in the blood, specifically when it is more than 145 mEq/L. Choice A, hyponatremia, is incorrect as it refers to low sodium levels. Choice B, hyperkalemia, is incorrect as it refers to high potassium levels, not sodium. Choice D, hypercalcemia, is also incorrect as it relates to elevated calcium levels, not sodium.

2. You are performing an admission assessment on an older adult patient newly admitted for end-stage liver disease. What principle should guide your assessment of the patient's skin turgor?

• A. Overhydration is common among healthy older adults.
• B. Dehydration causes the skin to appear spongy.
• C. Inelastic skin turgor is a normal part of aging.
• D. Skin turgor cannot be assessed in patients over 70.

Correct answer: C

Rationale: Inelastic skin is a normal change of aging. However, this does not mean that skin turgor cannot be assessed in older patients. Dehydration, not overhydration, causes inelastic skin with tenting. Overhydration, not dehydration, causes the skin to appear edematous and spongy. Choice A is incorrect because overhydration is not common among healthy older adults. Choice B is incorrect because dehydration leads to inelastic skin, not sponginess. Choice D is incorrect as skin turgor assessment can be done in patients of any age, including those over 70.

3. An increase in capillary blood pressure would tend to:

• A. increase interstitial fluid volume.
• B. increase plasma volume.
• C. decrease interstitial fluid volume.
• D. increase plasma volume and decrease interstitial fluid volume.

Correct answer: A

Rationale: An increase in capillary blood pressure leads to a higher force pushing fluid out of the capillaries into the interstitial space, thereby increasing interstitial fluid volume. Choice B is incorrect because capillary blood pressure affects the movement of fluid into the interstitial space, not into the plasma. Choice C is incorrect as an increase in capillary blood pressure would not decrease interstitial fluid volume. Choice D is incorrect as it combines contradictory effects when capillary blood pressure increases.

4. . One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acutecare nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over 15 minutes. This intervention will achieve which of the following?

• A. Help distinguish hyponatremia from hypernatremia
• B. Help evaluate pituitary gland function
• C. Help distinguish reduced renal blood flow from decreased renal function
• D. Help provide an effective treatment for hypertension-induced oliguria

Correct answer: C

Rationale:

5. A nurse is caring for a client who has the following laboratory results: potassium 3.4 mEq/L, magnesium 1.8 mEq/L, calcium 8.5 mEq/L, sodium 144 mEq/L. Which assessment should the nurse complete first?

• A. Depth of respirations
• B. Bowel sounds
• C. Grip strength
• D. Electrocardiography

Correct answer: A

Rationale: The correct answer is 'Depth of respirations.' In a client with electrolyte imbalances like low potassium (hypokalemia) and low magnesium (hypomagnesemia), respiratory changes, such as shallow respirations or respiratory muscle weakness, can occur and lead to respiratory compromise. Assessing the depth of respirations is crucial to evaluate respiratory function in this client. Bowel sounds, grip strength, and electrocardiography are also important assessments in different situations, but in this case, respiratory assessment takes priority due to the potential impact of electrolyte imbalances on breathing.

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