Question I got wrong on my test!

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Mr. A came into the hospital with naseau and vomiting for the past 4 days. What is the most accurate way to determine the extent of his fluid loss?

1) Weight him daily

2) skin turgor

I do understand your point and even acknowledged it was valid - but my point is that the tugor test is no more a valid answer than is weight, regardless of how the question was structured (sans baseline for weight)...If I understand correctly, you're saying that without a baseline (and hence, nothing to base a 'new' weight with), the skin tugor test would set off a chain of decisions by the nurse which could better result in finding out the answer to the question of how much fluid loss...and I fully trust that is correct in practice. My point is in regards to the way I read the question - it doesn't ask which action can lead to finding out how much fluid is lost, but rather it's simply asking which action by itself will answer that question direction.

My point about 'best answer' applies here in my opinion because weight can give you the answer being sought (even if you have to add some 'ifs and buts' - re:baseline) while the skin tugor can never give you a measurable number.

Specializes in Emergency Dept. Trauma. Pediatrics.
I do understand your point and even acknowledged it was valid - but my point is that the tugor test is no more a valid answer than is weight, regardless of how the question was structured (sans baseline for weight)...If I understand correctly, you're saying that without a baseline (and hence, nothing to base a 'new' weight with), the skin tugor test would set off a chain of decisions by the nurse which could better result in finding out the answer to the question of how much fluid loss...and I fully trust that is correct in practice. My point is in regards to the way I read the question - it doesn't ask which action can lead to finding out how much fluid is lost, but rather it's simply asking which action by itself will answer that question direction.

My point about 'best answer' applies here in my opinion because weight can give you the answer being sought (even if you have to add some 'ifs and buts' - re:baseline) while the skin tugor can never give you a measurable number.

My saying why weight wouldn't work is by people saying that some are reading to much into the question for the turgor answer. In order to say that weight would be Ok, you would HAVE to read into the question because you would have to make a few assumptions for that answer to be right. You have to assume the pt was already in the hospital prior to the N&V where they had a baseline and where daily weights would give you the extent of the loss. That would be exactly what we are told not to do, not to read into the question. So as I said. I would answer weight on the test because I get nursing tests and what they are MEANING to say most of the time. But that it's a poorly worded question and would have validation to throw it out or except both answers.

Anyway, I am not going to keep repeating the same thing. I have made my opinion clear. We can agree to disagree :)

Every book I have read says that daily weights are more accurate for assessing fluid & electrolyte imbalances...dehydration. I took a nursing test and I don't see why your post had to be on the nursing assistance post, whatever was meant by that response :uhoh3:

always look for key words in test qts. the "most accurate" answer is daily weights. and don't read more into it than what is there. all the information you need will be provided. if its not there then it is information you don't need-so don't waste time trying to think it up.

Specializes in Emergency Dept. Trauma. Pediatrics.
I hate that "you read too much into the question" comments form instructors. Really? You don't want us to develop critical thinking skills, analyzing all angles? You just want us to look at one little aspect of a situation? Great instruction.

Wait, you mean as a nurse, we need to look at the big picture and not just do what we are told to do. If the pt. said they weighed 150 lbs, then we need to use that to give us accurate knowledge of the extent of things. :rolleyes::rolleyes: :p

Specializes in Peds/outpatient FP,derm,allergy/private duty.

I'm not reading too much of anything into anything. The wording of that question is so screwy I don't see how there can be a "right" answer. If Mr. A, just arrived after having had nausea and vomiting for 4 days, and he is admitted, then daily weights are more accurate than skin turgor.

As it is written though, he just came in, and you need to assess his level of dehydration. It is impossible to have "daily weights" on a guy that just came in! As far as I know, there is no Back to the Future assessment tool that will tell you what the man will weigh that night, the next day or the next.

We shouldn't "read too much into a question", but we should also not feel there's a magical unseen secret everytime something appears to be nonsensical. Sometimes, it actually is nonsensical!

Specializes in Emergency Dept. Trauma. Pediatrics.
I'm not reading too much of anything into anything. The wording of that question is so screwy I don't see how there can be a "right" answer. If Mr. A, just arrived after having had nausea and vomiting for 4 days, and he is admitted, then daily weights are more accurate than skin turgor.

As it is written though, he just came in, and you need to assess his level of dehydration. It is impossible to have "daily weights" on a guy that just came in! As far as I know, there is no Back to the Future assessment tool that will tell you what the man will weigh that night, the next day or the next.

We shouldn't "read too much into a question", but we should also not feel there's a magical unseen secret everytime something appears to be nonsensical. Sometimes, it actually is nonsensical!

I guess even though he has had N&V for 4 days and was just admitted we need to give it a few more days so we can get a baseline and get daily weights so we can really get the extent of the fluid loss (or should I say, FURTHER extent since we will never know what he lost on those 4 days) and then treat him. It's ok if he goes into renal failure and various other things we need to get those daily weights first to see where we stand :| Kudos to the writer of that question. ;)

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