Nursing Elites

1. A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults. What factors contribute to this phenomenon? Select all that do not apply.

• A. Decreased kidney mass
• B. Decreased renal blood flow
• C. Decreased excretion of potassium
• D. Increased conservation of sodium

Correct answer: D

Rationale:

2. 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.

3. Which negative ion is most important in intracellular fluid?

• A. Phosphate ions.
• B. Protein molecules.
• C. Chlorine.
• D. Phosphate ions and protein molecules.

Correct answer: D

Rationale: Intracellular fluid contains phosphate ions and protein molecules as essential anions. Phosphate ions play a crucial role in various cellular processes, including energy transfer. Proteins, being large molecules with negative charges, also contribute significantly to the negative ion concentration within cells. Chlorine is primarily an extracellular anion and is not as prominent as phosphate ions and proteins within intracellular fluid, making it a less important negative ion in this context. Therefore, the correct answer is D because both phosphate ions and protein molecules are crucial negative ions in intracellular fluid.

4. A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm Hg, PaCO2 65 mm Hg, and HCO3 22 mEq/L. Which clinical situation should the nurse correlate with these values?

• A. . Diabetic ketoacidosis in a person with emphysema
• B. Bronchial obstruction related to aspiration of a hot dog
• C. Anxiety-induced hyperventilation in an adolescen
• D. Diarrhea for 36 hours in an older, frail woman

Correct answer: A

Rationale:

5. A patient admitted with a gastrointestinal bleed and anemia is receiving a blood transfusion. Based on the patient's hypotensive blood pressure, the nurse anticipates an order for IV fluids from the physician. Which of the following IV solutions may be administered with blood products?

• A. D5 and 0.45% Normal Saline
• B. Lactated Ringer's
• C. 5% dextrose in water
• D. 0.9% NaCl

Correct answer: D

Rationale: The correct answer is D: 0.9% NaCl. The only IV solution that can be administered with blood products is normal saline (0.9% NaCl). This solution is compatible with most blood products and is commonly used during transfusions to maintain hemodynamic stability. Choices A, B, and C are incorrect. Choice A, D5 and 0.45% Normal Saline, contains dextrose and is not recommended to be given simultaneously with blood products. Choice B, Lactated Ringer's, contains calcium, which can cause coagulation and should not be mixed with blood. Choice C, 5% dextrose in water, is hypotonic and not suitable to be administered with blood products.

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