Nursing Elites

1. 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:

2. A nurse is caring for a client who is having a subclavian central venous catheter inserted. The client begins to report chest pain and difficulty breathing. After administering oxygen, which action should the nurse take next?

• A. Administer a sublingual nitroglycerin tablet
• B. Prepare to assist with chest tube insertion.
• C. . Place a sterile dressing over the IV site
• D. Re-position the client into the Trendelenburg position.

Correct answer: B

Rationale:

3. 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.

4. 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.

5. A nurse is caring for a patient who requires measurement of specific gravity every 4 hours. What does this test detect?

• A. Nutritional deficit
• B. Hyperkalemia
• C. Hypercalcemia
• D. Fluid volume status

Correct answer: D

Rationale: Specific gravity is a test used to determine the concentration of solutes in the urine, reflecting the kidney's ability to concentrate urine. Changes in specific gravity can indicate fluid volume status, such as dehydration (fluid volume deficit) or overhydration (fluid volume excess). Options A, B, and C are incorrect as specific gravity does not directly detect nutritional deficits, hyperkalemia, or hypercalcemia.

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