Nursing Elites

1. Who would have the greatest percentage of body water?

• A. an obese male
• B. a nonobese male
• C. a nonobese female
• D. a newborn

Correct answer: D

Rationale: Newborns have a higher percentage of body water compared to adults due to their higher body fluid content. Factors such as the higher ratio of body surface area to body volume and lower body fat content contribute to this. This is why a newborn would have the greatest percentage of body water. Choices A, B, and C are incorrect because obesity and gender do not determine the percentage of body water in individuals. Therefore, the correct answer is a newborn.

2. You are caring for a patient who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. During your assessment, you note the patient complains of a new onset of weakness with abdominal pain. Further assessment suggests that the patient likely has a fluid volume deficit. You should recognize that this patient may be experiencing what electrolyte imbalance?

• A. Hypernatremia
• B. Hypomagnesemia
• C. Hypophosphatemia
• D. Hypercalcemia

Correct answer: D

Rationale:

3. . A nurse assesses a client who had an intraosseous catheter placed in the left leg. Which assessment finding is of greatest concern?

• A. The catheter has been in place for 20 hours.
• B. . The client has poor vascular access in the upper extremities.
• C. The catheter is placed in the proximal tibia.
• D. The clients left lower extremity is cool to the touch.

Correct answer: D

Rationale:

4. A female patient is discharged from the hospital after having an episode of heart failure. She's prescribed daily oral doses of digoxin (Lanoxin) and furosemide (Lasix). Two days later, she tells her community health nurse that she feels weak and her heart 'flutters' frequently. What action should the nurse take?

• A. Tell the patient to rest more often.
• B. Tell the patient to stop taking the digoxin and call the physician.
• C. Call the physician, report the symptoms, and request to draw a blood sample to determine the patient's potassium level.
• D. Tell the patient to avoid foods that contain caffeine.

Correct answer: C

Rationale: The correct action for the nurse to take is to call the physician, report the symptoms, and request to draw a blood sample to determine the patient's potassium level. Furosemide is a potassium-wasting diuretic, and low potassium levels can lead to weakness and palpitations. Resting more often won't address the underlying issue of hypokalemia caused by furosemide. While digoxin can have side effects, it is not causing the symptoms described by the patient. Avoiding caffeine may be beneficial, but addressing the potassium level is more critical in this situation.

5. Which hormones increase the amount of water in the body?

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

Correct answer: D

Rationale: The correct answer is D, ADH and aldosterone. Both antidiuretic hormone (ADH) and aldosterone increase water retention by the kidneys, thereby increasing blood volume. ADH acts on the kidneys to increase water reabsorption, while aldosterone acts on the kidneys to promote sodium reabsorption, leading to water retention. Choice A, ADH, is partially correct as it alone increases water retention. Choice B, aldosterone, is also partially correct as it alone increases water retention. Choice C, ANH (atrial natriuretic hormone), actually decreases water retention by promoting sodium excretion and inhibiting aldosterone release.

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