Nursing Elites

1. You are the nurse caring for a 77-year-old male patient who has been involved in a motor vehicle accident. You and your colleague note that the patients labs indicate minimally elevated serum creatinine levels, which your colleague dismisses. What can this increase in creatinine indicate in older adults?

• A. Substantially reduced renal function
• B. Acute kidney injury
• C. Decreased cardiac output
• D. ) Alterations in ratio of body fluids to muscle mass

Correct answer: A

Rationale:

2. A patient who is being treated for pneumonia starts complaining of sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect?

• A. Respiratory acidosis
• B. Metabolic alkalosis
• C. Respiratory alkalosis
• D. Metabolic acidosis

Correct answer: A

Rationale:

3. The healthcare professional working in the PACU is aware that which of the following procedures may contribute to extracellular losses?

• A. Removal of an ingrown toenail
• B. Tooth extraction
• C. Abdominal surgery
• D. Cataract surgery

Correct answer: C

Rationale: Fluid loss from the extracellular compartment can be caused by abdominal surgery as it involves opening the abdominal cavity, potentially leading to significant fluid losses. Choices A, B, and D do not typically result in substantial extracellular losses compared to abdominal surgery.

4. You are an emergency-room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would you interpret these results?

• A. Respiratory acidosis with no compensation
• B. Metabolic alkalosis with a compensatory alkalosis
• C. Metabolic acidosis with no compensation
• D. Metabolic acidosis with a compensatory respiratory alkalosis

Correct answer: D

Rationale: A low pH indicates acidosis (normal pH is 7.35 to 7.45). The PaCO2 is also low, which causes alkalosis. The bicarbonate is low, which causes acidosis. The pH bicarbonate more closely corresponds with a decrease in pH, making the metabolic component the primary problem. Therefore, the correct interpretation of the arterial blood gas results is metabolic acidosis with a compensatory respiratory alkalosis. Choices A, B, and C are incorrect because they do not accurately reflect the primary acid-base disturbance and the compensatory response seen in the given results.

5. What percentage of body water can be as high as in a newborn?

• A. 80%.
• B. 70%.
• C. 60%.
• D. 90%.

Correct answer: A

Rationale: The correct answer is A: 80%. Newborns can have a body water content as high as 80% due to their higher total body water compared to adults. Choice B (70%) is incorrect because newborns typically have a higher body water percentage. Choice C (60%) is also incorrect as it underestimates the body water content in newborns. Choice D (90%) is incorrect as it overestimates the body water percentage in newborns.

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