Nursing Elites

1. Under normal circumstances, the kidneys provide the greatest means of water loss. Which organ provides the second greatest means of water loss?

• A. Skin
• B. Lungs
• C. Intestines
• D. Muscles

Correct answer: A

Rationale: The correct answer is A: Skin. After the kidneys, the skin is the second largest route of water loss through perspiration. Choice B, Lungs, is incorrect as the lungs primarily exchange gases and do not play a significant role in water loss. Choice C, Intestines, is also incorrect as water loss through the intestines is minimal since most water is reabsorbed during digestion. Choice D, Muscles, is incorrect as muscles are not a major source of water loss in the body.

2. You are working on a burns unit, and one of your acutely ill patients is exhibiting signs and symptoms of third spacing. Based on this change in status, you should expect the patient to exhibit signs and symptoms of what imbalance?

• A. Metabolic alkalosis
• B. Hypermagnesemia
• C. Hypercalcemia
• D. Hypovolemia

Correct answer: D

Rationale: Third spacing refers to the loss of fluid from the intravascular space into the interstitial or third space, leading to a decrease in circulating blood volume. This condition results in hypovolemia, which is characterized by decreased blood volume. Metabolic alkalosis, hypermagnesemia, and hypercalcemia are not directly associated with third spacing. Metabolic alkalosis is an acid-base imbalance, hypermagnesemia is an excess of magnesium in the blood, and hypercalcemia is an excess of calcium in the blood, none of which are the primary concerns in cases of third spacing.

3. . A nurse is planning care for a nephrology patient with a new nursing graduate. The nurse states, A patient in renal failure partially loses the ability to regulate changes in pH. What is the cause of this partial inability?

• A. The kidneys regulate and reabsorb carbonic acid to change and maintain pH.
• B. The kidneys buffer acids through electrolyte changes
• C. The kidneys regenerate and reabsorb bicarbonate to maintain a stable pH.
• D. The kidneys combine carbonic acid and bicarbonate to maintain a stable pH.

Correct answer: C

Rationale:

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. The nurse assessing skin turgor in an elderly patient should remember that:

• A. Overhydration causes the skin to tent.
• B. Dehydration causes the skin to appear edematous and spongy.
• C. Inelastic skin turgor is a normal part of aging.
• D. Normal skin turgor is moist and boggy.

Correct answer: C

Rationale: Inelastic skin turgor is a normal part of aging. Dehydration, not overhydration, causes inelastic skin with tenting. Overhydration, not dehydration, causes the skin to appear edematous and spongy. Normal skin turgor is dry and firm. Choice A is incorrect because overhydration does not cause the skin to tent; it is dehydration that leads to tenting. Choice B is incorrect because dehydration, not overhydration, causes the skin to appear edematous and spongy. Choice D is incorrect because normal skin turgor is dry and firm, not moist and boggy.

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