Recognizing the prevalence and incidence of dehydration among older adults, a care aide at a long-term care facility is in the habit of encouraging residents to drink even though they may not feel thirsty at the time. Which of the following facts underlies the care aide's advice?

Correct Answer: A

Rationale: The correct answer is A because older adults often experience a decrease in the sensation of thirst, even when their serum sodium levels are high. This means that they may not feel thirsty even when they are dehydrated, leading to a higher risk of dehydration. This fact underscores the importance of encouraging older adults to drink fluids regularly, even if they don't feel thirsty. Choice B is incorrect because it focuses on metabolic needs rather than the sensation of thirst. Choice C is incorrect as it pertains to kidney function rather than the sensation of thirst. Choice D is incorrect as it discusses the RAAS system's role in sodium clearance, which is not directly related to the sensation of thirst in older adults.

Correct Answer: A

Rationale: The correct answer is A: Parathyroid hormone level. In this scenario, distinguishing between primary hyperparathyroidism and hypercalcemia of malignancy is crucial. Primary hyperparathyroidism is characterized by high calcium levels due to overproduction of parathyroid hormone, while hypercalcemia of malignancy is caused by the release of parathyroid hormone-related protein by cancer cells. Measuring the parathyroid hormone level will help differentiate between the two conditions. Bone scan (B) is not specific for these conditions. Plasma phosphate levels (C) may be elevated in primary hyperparathyroidism but are not as specific as parathyroid hormone levels. Serum magnesium level (D) is not directly related to distinguishing between the two conditions.

Correct Answer: A

Rationale: Rationale: Administering vitamin D supplements is the correct intervention for a patient with chronic kidney disease experiencing pruritus and signs of hypocalcemia. Vitamin D helps in calcium absorption and regulation, addressing the underlying cause of hypocalcemia. By increasing calcium levels, pruritus can also be alleviated. Summary: A: Administering vitamin D supplements is correct as it addresses both symptoms and the underlying cause. B: Prescribing a high-phosphate diet would worsen the condition as excess phosphate can further decrease calcium levels. C: Providing diuretics to reduce fluid retention does not address the hypocalcemia or pruritus. D: Increasing oral calcium intake through supplements may be harmful without addressing the underlying cause of hypocalcemia.

Correct Answer: C

Rationale: The correct answer is C: Take the medication with a full glass of water or food. This instruction is important because potassium supplements can irritate the stomach lining and cause gastrointestinal upset. Taking it with water or food helps to minimize these side effects. Option A is incorrect because potassium supplements should be taken with food to reduce gastric irritation. Option B is incorrect as crushing potassium tablets can lead to local irritation or damage to the esophagus. Option D is incorrect because diarrhea is a common side effect of potassium supplements and does not necessarily warrant discontinuation of the medication.

Correct Answer: D

Rationale: For a 5'9" female, the rule-of-thumb method (100 lb for 5 ft + 5 lb per inch over) gives 145 lb (100 + 9*5 = 145).