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The rate of health complications for patients on intravenous (IV) therapy at a Kalemic Hospital was higher than usual. Government inspectors found that the typical IV solutions used at Kalemic had somewhat high concentrations of sodium and potassium, which could raise patients' blood pressure and tax their kidneys. The government inspectors mandated lowering the sodium and potassium in these IV preparations, threatening a costly government fine. Accordingly, doctors at Kalemic Hospital lowered the sodium and potassium levels in the IV solutions to the correct levels, but patients on IV therapy there continued to have a high rate of health complications.

Which of the following, if true, most helps to explain why acting on the government inspectors' recommendations failed to achieve its goal?

When sodium and potassium levels in the blood fall below their baseline level, it can damage cells throughout the body by reverse osmosis. Kalemic Hospital recently implemented a new computerized diagnostic system to monitor patients’ health statistics and reveal underlying patterns. Patients receiving intravenous medications regularly are, on average, more at risk than other hospitalized patients. A high proportion of patients at Kalemic Hospital are older, and older patients are more vulnerable to infections that can accompany IVs. When high blood pressure is sustained over the course of years, it compromises several important organ systems.

Title

Intravenous Therapy

Your Result

Correct

Difficulty

Hard

Your Pace

0:12

Others' Pace

2:01

Video Explanation

Text Explanation

This is a paradox question. Kalemic Hospital has implemented the recommendations of the government inspectors, but IV patients still have a high rate of health complications. What would explain this?

The credited answer is (D). If a high proportion of patients at this hospital are older, then it seems reasonable that a correspondingly high proportion of them would be receiving IV therapy. Since older patients are more vulnerable to infections that can accompany IVs, this would account for the fact that IV patients here continue to have a high rate of health complications even after the issues cited by the government inspectors were addressed.

It may be true that excessively low levels of sodium (Na) and potassium (K) can cause problems, but we have no evidence that the folks at Kalemic Hospital overshot and went from way too high to way too low. Furthermore, the prompt says that these are at the “correct levels” now—presumably, this means not so low as to cause major health complications in the other direction. Choice (A) is incorrect.

If Kalemic Hospital recently implemented a new computerized diagnostic system, then that might make these folks more aware of what’s happening and maybe they could even figure out what’s driving patterns, but right now, the pattern is that folks getting IVs are getting sick, and the bare fact that they have this computerized diagnostic system doesn’t itself explain anything. Choice (B) is incorrect.

Choice (C) is tricky. The prompt is about comparing patients on IVs at Kalemic to patients on IVs elsewhere: the former is higher. Choice (C) compares patients on IVs to patients not on IVs—that’s a totally different comparison, and it sheds no light on the first comparison. Choice (C) is incorrect.

It’s true that hypertension (high blood pressure) is bad, especially sustained over years, and hypertension can result from high levels of Na & K, but those were already addressed and those are now at the “correct levels.” It’s not clear whether hypertension would play any role in the continued health complications of IV patients at Kalemic. Choice (E) is incorrect.

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