Nursing Elites

1. When planning the care of a patient with a fluid imbalance, the nurse understands that in the human body, water and electrolytes move from the arterial capillary bed to the interstitial fluid. What causes this to occur?

• A. Active transport of hydrogen ions across the capillary walls
• B. Pressure of the blood in the renal capillaries
• C. Action of the dissolved particles contained in a unit of blood
• D. Hydrostatic pressure resulting from the pumping action of the heart

Correct answer: D

Rationale:

2. 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.

3. 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:

4. You are the nurse evaluating a newly admitted patients laboratory results, which include several values that are outside of reference ranges. Which of the following would cause the release of antidiuretic hormone (ADH)?

• A. Increased serum sodium
• B. Decreased serum potassium
• C. Decreased hemoglobin
• D. Increased platelets

Correct answer: A

Rationale:

5. When selecting a site on the hand or arm for insertion of an IV catheter, the nurse should:

• A. Choose a proximal site.
• B. Choose a distal site.
• C. Have the patient hold their arm in a dependent position.
• D. Leave the tourniquet on for no longer than 2 minutes.

Correct answer: B

Rationale: When selecting a site for insertion of an IV catheter, the nurse should choose a distal site, not a proximal site. Opting for a distal site ensures that upper veins remain available for future cannulations. Instructing the patient to hold their arm in a dependent position can enhance blood flow, aiding in the procedure. It is crucial never to leave a tourniquet on for more than 2 minutes as prolonged restriction can lead to complications. Choice A is incorrect because a proximal site is not preferred for IV insertion. Choice C is incorrect as having the patient hold their arm over their head is not necessary and may impede proper blood flow. Choice D is incorrect as leaving the tourniquet on for at least 5 minutes is excessive and can be harmful.

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