Nursing Elites

1. What is the main force that pushes fluid in blood capillaries?

• A. Blood pressure.
• B. Sodium in the blood plasma.
• C. Sodium in the interstitial fluid.
• D. Protein in the blood plasma.

Correct answer: A

Rationale: The correct answer is A, blood pressure. Blood pressure is the primary force that pushes fluid out of the capillaries into the surrounding tissues. This pressure difference is essential for the exchange of nutrients, gases, and waste products between the blood and tissues. Choices B, C, and D are incorrect as they do not represent the primary force responsible for pushing fluid in blood capillaries.

2. You are called to your patients room by a family member who voices concern about the patients status. On assessment, you find the patient tachypnic, lethargic, weak, and exhibiting a diminished cognitive ability. You also find 3+ pitting edema. What electrolyte imbalance is the most plausible cause of this patients signs and symptoms?

• A. Hypocalcemia
• B. Hyponatremia
• C. Hyperchloremia
• D. Hypophosphatemia

Correct answer: C

Rationale:

3. 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.

4. What would be the best initial nursing action prior to inserting an IV?

• A. Instruct the patient to wash their hands.
• B. Prepare the IV insertion site with povidone iodine.
• C. Verify the order for IV therapy.
• D. Identify a suitable vein.

Correct answer: C

Rationale: The best initial nursing action prior to inserting an IV is to verify the order for IV therapy. This step ensures that the IV insertion is appropriate and necessary based on the physician's orders. Instructing the patient to wash their hands (Choice A) is important for infection control but not the immediate priority before IV insertion. While preparing the IV insertion site with povidone iodine (Choice B) and identifying a suitable vein (Choice D) are crucial steps in the process, confirming the order for IV therapy (Choice C) takes precedence to ensure the correct intervention is being performed.

5. A patient who is in renal failure partially loses the ability to regulate changes in pH because the kidneys:

• A. Regulate and reabsorb carbonic acid to change and maintain pH
• B. Buffer acids through electrolyte changes
• C. Regenerate and reabsorb bicarbonate to maintain a stable pH
• D. Combine carbonic acid and bicarbonate to maintain a stable pH

Correct answer: C

Rationale: The correct answer is C. In renal failure, the kidneys lose the ability to regulate pH by controlling bicarbonate levels in the extracellular fluid (ECF). The kidneys can regenerate and reabsorb bicarbonate ions to maintain a stable pH. Choices A, B, and D are incorrect because the kidneys do not primarily regulate or reabsorb carbonic acid, buffer acids through electrolyte changes, or combine carbonic acid and bicarbonate to maintain pH. The key function of the kidneys in maintaining pH balance lies in the control of bicarbonate levels.

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