Nursing Elites

1. Which of the following are sources of water intake?

• A. Drinking fluids.
• B. Consuming water from the food we eat.
• C. Water from metabolic processes.
• D. Drinking fluids, consuming water from the food we eat, and water from metabolic processes.

Correct answer: D

Rationale: The correct answer is D. The sources of water intake include drinking fluids, consuming water from the food we eat, and water from metabolic processes. Water intake is not solely from the liquids we drink but also from the water content present in the food we consume and the water produced during metabolic processes such as cellular respiration. Therefore, option D is the correct answer as it covers all the sources of water intake. Options A, B, and C alone do not encompass all the sources of water intake, making them incorrect choices.

2. The healthcare provider is evaluating a patient's laboratory results. Based on the laboratory findings, what results will cause the release of an antidiuretic hormone (ADH)?

• A. Increased serum sodium
• B. Decreased serum sodium
• C. Decrease in serum osmolality
• D. Decrease in thirst

Correct answer: A

Rationale: The correct answer is A: Increased serum sodium. When serum sodium levels increase, it triggers the release of ADH by the posterior pituitary gland. ADH helps in retaining water, reducing urine output, and maintaining fluid balance. Choices B, C, and D are incorrect because decreased serum sodium, decrease in serum osmolality, and decrease in thirst do not stimulate the release of ADH.

3. While assessing clients on a medical-surgical unit, which client is at risk for hypokalemia?

• A. Client with pancreatitis who has continuous nasogastric suctioning
• B. Client who is prescribed an angiotensin-converting enzyme (ACE) inhibitor
• C. Client in a motor vehicle crash who is receiving 6 units of packed red blood cells
• D. Client with uncontrolled diabetes and a serum pH level of 7.33

Correct answer: A

Rationale: Continuous nasogastric suctioning can lead to hypokalemia due to the loss of gastric contents rich in potassium. Therefore, a client with pancreatitis who has continuous nasogastric suctioning is at risk for hypokalemia. Option B is incorrect because ACE inhibitors may lead to hyperkalemia, not hypokalemia. Option C is incorrect as receiving packed red blood cells can lead to hyperkalemia due to the potassium content in the blood product. Option D is incorrect because a serum pH level of 7.33 indicates acidosis, which is not directly associated with hypokalemia.

4. 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:

5. A patient who is hospitalized with a possible electrolyte imbalance is disoriented and weak, has an irregular pulse, and takes hydrochlorothiazide. He most likely suffers from:

• A. Hypernatremia
• B. Hyponatremia
• C. Hyperkalemia
• D. Hypokalemia

Correct answer: D

Rationale: The patient is displaying symptoms of hypokalemia, including weakness, disorientation, irregular pulse, which can lead to cardiac disturbances. Hydrochlorothiazide is a potassium-wasting diuretic that can cause hypokalemia if not accompanied by potassium replacement therapy. Hypernatremia (choice A) is characterized by high sodium levels, not potassium. Hyponatremia (choice B) is low sodium levels. Hyperkalemia (choice C) is high potassium levels, which is not consistent with the symptoms described in the question.

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