the nurse assessing skin turgor in an elderly patient should remember that
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Nursing Elites

ATI RN

Fluid and Electrolytes ATI

1. The nurse assessing skin turgor in an elderly patient should remember that:

Correct answer: C

Rationale: Inelastic skin turgor is a normal part of aging. Dehydration, not overhydration, causes inelastic skin with tenting. Overhydration, not dehydration, causes the skin to appear edematous and spongy. Normal skin turgor is dry and firm. Choice A is incorrect because overhydration does not cause the skin to tent; it is dehydration that leads to tenting. Choice B is incorrect because dehydration, not overhydration, causes the skin to appear edematous and spongy. Choice D is incorrect because normal skin turgor is dry and firm, not moist and boggy.

2. A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance should the nurse assess?

Correct answer: B

Rationale:

3. A client at risk for mild hypernatremia is being taught by a nurse. Which statement should the nurse include in this client's teaching?

Correct answer: C

Rationale: The correct answer is to 'Read food labels to determine sodium content.' This is important for a client at risk for mild hypernatremia because monitoring sodium intake is crucial in managing this condition. Choice A is not directly related to managing hypernatremia. Choice B focuses on pulse monitoring, which is not specific to managing sodium levels. Choice D addresses cooking methods, which can be beneficial but is not as directly related to sodium intake monitoring as reading food labels.

4. Diagnostic testing has been ordered to differentiate between normal anion gap acidosis and high anion gap acidosis in an acutely ill patient. What health problem typically precedes normal anion gap acidosis?

Correct answer: D

Rationale:

5. Which of the following organs does not contribute to fluid output from the body?

Correct answer: D

Rationale: The correct answer is D. All the listed organs (lungs, skin, and intestines) contribute to fluid loss from the body. Lungs contribute to fluid loss through respiration, skin through sweating, and intestines through excretion. Therefore, none of the organs listed in the options retain fluids within the body. Choices A, B, and C are incorrect because all of these organs play a role in fluid output from the body.

Similar Questions

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