Nursing Elites

1. Electrolytes:

• A. do not form when glucose is added to water.
• B. dissociate in water solutions, but do not form ions.
• C. form ions in water solutions, but do not necessarily dissociate.
• D. dissociate in water solutions and form ions in water solutions.

Correct answer: D

Rationale: The correct answer is D. Electrolytes are substances that dissociate into ions when dissolved in water, allowing the solution to conduct electricity. Choice A is incorrect because glucose does not form electrolytes when added to water. Choice B is incorrect as it states that electrolytes dissociate but do not form ions, which is inaccurate as electrolytes do form ions in water solutions. Choice C is also incorrect as it states that electrolytes form ions but may not necessarily dissociate, which goes against the definition of electrolytes that must dissociate into ions for conductivity. Therefore, choice D is the most accurate as it correctly describes that electrolytes dissociate in water solutions and form ions, highlighting the essential characteristics of electrolytes.

2. When considering overhydration:

• A. occurs less often than dehydration.
• B. can strain the kidneys.
• C. can be caused by giving intravenous fluids too rapidly.
• D. less common than dehydration.

Correct answer: C

Rationale: The correct answer is C. Overhydration can occur when intravenous fluids are administered too quickly, overwhelming the body's ability to excrete the excess fluid. Choices A, B, and D are incorrect. Choice A is incorrect because overhydration is less common than dehydration. Choice B is incorrect because while overhydration can strain the kidneys, it is not due to the burden being too heavy. Choice D is incorrect because dehydration is more common than overhydration.

3. Which hormone reduces the amount of water in the body?

• A. ADH
• B. aldosterone
• C. ANH
• D. ADH and aldosterone

Correct answer: B

Rationale: The correct answer is 'aldosterone.' Aldosterone is the hormone that reduces the amount of water in the body by increasing the reabsorption of sodium and water from the kidney tubules. ANH (atrial natriuretic hormone) actually works to increase the excretion of sodium and water by the kidneys, leading to a reduction in blood volume and pressure. ADH (antidiuretic hormone) works to increase water reabsorption by the kidneys, thereby increasing blood volume. Therefore, choices A (ADH) and D (ADH and aldosterone) are incorrect in the context of reducing the amount of water in the body.

4. During a visit to an 84-year-old woman recovering from hip surgery, the nurse notices signs of confusion and poor skin turgor. The woman mentions she limits water intake to avoid nighttime bathroom trips. The nurse should explain to the woman that:

• A. She will need her medications adjusted and be readmitted for a complete workup.
• B. Limiting fluids can lead to body imbalances causing confusion; perhaps adjusting fluid intake timing is necessary.
• C. Post-surgical confusion is common, and it's safe not to urinate at night.
• D. Confusion after surgery is typical in the elderly due to sleep loss.

Correct answer: B

Rationale: The correct answer is B. In elderly patients, fluid and electrolyte imbalances can manifest with subtle signs like confusion. Limiting fluids can lead to such imbalances, affecting cognitive function. Adjusting the timing of fluid intake can help maintain hydration without causing nighttime disruptions. Choices A, C, and D are incorrect. Choice A suggests unnecessary hospital readmission and medication adjustments without addressing the root cause. Choice C wrongly normalizes the confusion and fails to address the potential issue of fluid restriction. Choice D incorrectly attributes confusion solely to sleep loss without considering the impact of fluid balance.

5. What is the main water-holding force in the blood capillaries?

• A. Capillary blood pressure
• B. Sodium in the blood plasma
• C. Protein in the blood plasma
• D. Chloride in the blood plasma

Correct answer: C

Rationale: The correct answer is C: Protein in the blood plasma. Plasma proteins, especially albumin, create oncotic pressure, which is the main force responsible for holding water within the blood capillaries. Capillary blood pressure (Choice A) is involved in pushing blood through the capillaries, while sodium and chloride in the blood plasma (Choices B and D) are electrolytes and do not play a significant role in the water-holding force within capillaries.

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