ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 5
A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patients blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following?
Correct Answer: B
Rationale: The correct answer is B: Osmosis and osmolality. When a hypertonic solution is infused, it increases the number of dissolved particles in the blood, creating an osmotic pressure gradient. This causes fluids in the tissues to shift into the capillaries, increasing blood volume. Osmosis is the movement of solvent (water) across a semi-permeable membrane to equalize solute concentrations. Osmolality refers to the concentration of solutes in a solution.
Hydrostatic pressure (choice
A) is the force exerted by a fluid against a wall when it is under pressure, not related to the movement of solutes.
Diffusion (choice
C) is the movement of solute molecules from an area of high concentration to low concentration, not involving a semi-permeable membrane.
Active transport (choice
D) requires energy to move molecules across a membrane against their concentration gradient, not the mechanism described in the scenario.
Question 2 of 5
A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance should the nurse assess?
Correct Answer: B
Rationale: The correct answer is B: Kussmaul respirations. In acute pancreatitis, metabolic acidosis can occur due to the release of pancreatic enzymes. Kussmaul respirations are deep, rapid breaths that help to blow off excess carbon dioxide in response to acidosis, aiming to correct the pH imbalance. Agitation (
A) is a nonspecific symptom and not specific to acid-base imbalances. Seizures (
C) are more commonly associated with electrolyte imbalances such as hyponatremia or hypocalcemia. Positive Chvostek's sign (
D) is a clinical sign of hypocalcemia, not directly related to acid-base imbalances in acute pancreatitis.
Question 3 of 5
Diagnostic testing has been ordered to differentiate between normal anion gap acidosis and high anion gap acidosis in an acutely ill patient. What health problem typically precedes normal anion gap acidosis?
Correct Answer: D
Rationale: The correct answer is D: Excessive administration of chloride. Normal anion gap acidosis is commonly caused by an excessive intake of chloride-containing solutions like normal saline during treatment. This leads to an increase in the plasma chloride concentration, causing a decrease in the anion gap. Metastases (
A) are not typically associated with normal anion gap acidosis. Excessive potassium intake (
B) would not lead to normal anion gap acidosis but rather hyperkalemia. Water intoxication (
C) can lead to dilutional hyponatremia but not normal anion gap acidosis.
Question 4 of 5
A nurse assesses a client who is prescribed a medication that inhibits aldosterone secretion and release. For which potential complications should the nurse assess? (Select all that apply.)
Correct Answer: A
Rationale:
Step-by-step rationale for why option A is correct:
1. Inhibition of aldosterone secretion leads to decreased sodium reabsorption and increased water excretion.
2. Decreased aldosterone can result in decreased blood volume and BP, leading to decreased urine output.
3. Monitoring urine output is crucial to assess renal function and fluid balance.
4. A urine output of 25 mL/hr is considered inadequate and can indicate renal impairment or dehydration.
Summary:
Option A is correct as it directly relates to the mechanism of action of inhibiting aldosterone secretion. Options B, C, and D are incorrect as they do not align with the expected complications of aldosterone inhibition.
Question 5 of 5
A nurse develops a plan of care for a client who has a history of hypocalcemia. What interventions should the nurse include in this clients care plan? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B. Straining all urine output and assessing for urinary stones is important for a client with hypocalcemia as they are at risk for developing kidney stones due to increased calcium excretion. By straining urine, the nurse can monitor for the presence of stones.
A, using a draw sheet to reposition the client, is not directly related to hypocalcemia. C, providing nonslip footwear, is important for fall prevention but not specific to hypocalcemia. D, since it is not provided, cannot be evaluated.