ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 5
. A medical nurse educator is reviewing a patients recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?
Correct Answer: B
Rationale: Correct Answer: B - The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. Rationale: 1. In metabolic acidosis, the blood pH is low due to excess acid in the body. 2. To restore pH balance, the kidneys excrete hydrogen ions (acid) and conserve bicarbonate ions (a base). 3. By excreting acid and retaining base, the kidneys help neutralize the excess acid in the body. 4. Option B accurately describes the role of the kidneys in metabolic acidosis. Incorrect Choices: A: Incorrect. The kidneys do not retain hydrogen ions in metabolic acidosis; they excrete them. C: Incorrect. While the kidneys do play a role in correcting imbalances, they do not react rapidly in metabolic acidosis. D: Incorrect. The kidneys do regulate bicarbonate levels, but this is not the primary action in metabolic acidosis.
Question 2 of 5
The ICU nurse is caring for a patient who experienced trauma in a workplace accident. The patient is complaining of having trouble breathing with abdominal pain. An ABG reveals the following results: pH 7.28, PaCO2 50 mm Hg, HCO3 23 mEq/L. The nurse should recognize the likelihood of what acidbase disorder?
Correct Answer: D
Rationale: The correct answer is D: Mixed acid-base disorder. The ABG results show a pH within the acidic range (7.28), indicating acidosis. The PaCO2 is elevated (50 mm Hg), suggesting respiratory acidosis as the primary disorder. However, the HCO3 level is within normal range (23 mEq/L), which is not consistent with compensatory metabolic alkalosis. Therefore, the presence of both respiratory acidosis and normal HCO3 levels indicates a mixed acid-base disorder. Choice A (Respiratory acidosis) is incorrect because although the patient has an elevated PaCO2, the normal HCO3 level rules out a pure respiratory acidosis. Choice B (Metabolic alkalosis) and C (Respiratory alkalosis) are incorrect as the ABG results do not support these diagnoses.
Question 3 of 5
A patient has questioned the nurses administration of IV normal saline, asking whether sterile water would be a more appropriate choice than saltwater. Under what circumstances would the nurse administer electrolyte-free water intravenously?
Correct Answer: A
Rationale: The correct answer is A because electrolyte-free water, such as sterile water, can rapidly enter red blood cells due to osmotic differences, causing them to swell and potentially rupture, leading to hemolysis. This can result in severe harm to the patient. Choice B is incorrect because electrolyte-free water is not indicated for severely dehydrated patients with neurologic signs and symptoms. They require electrolytes to correct their imbalances. Choice C is incorrect as administering electrolyte-free water would not address excess calcium and/or magnesium ions in the body. Specific treatments for hypercalcemia or hypermagnesemia are needed. Choice D is incorrect because patients with fluid deficits due to renal failure require electrolyte-balanced solutions to manage their condition effectively. Electrolyte-free water would not address the electrolyte imbalances associated with renal failure.
Question 4 of 5
A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults. What factors contribute to this phenomenon? Select all that do not apply.
Correct Answer: D
Rationale: The correct answer is D: Increased conservation of sodium. Older adults tend to have an increased conservation of sodium, leading to fluid retention and decreased fluid intake, which can contribute to dehydration. A: Decreased kidney mass is incorrect because it is a factor that can contribute to decreased kidney function but not directly linked to dehydration. B: Decreased renal blood flow can impact kidney function but is not a direct cause of dehydration in older adults. C: Decreased excretion of potassium is not a factor that directly contributes to dehydration in older adults.
Question 5 of 5
You are called to your patients room by a family member who voices concern about the patients status. On assessment, you find the patient tachypnic, lethargic, weak, and exhibiting a diminished cognitive ability. You also find 3+ pitting edema. What electrolyte imbalance is the most plausible cause of this patients signs and symptoms?
Correct Answer: C
Rationale: The correct answer is C: Hyperchloremia. In this scenario, the patient's symptoms point towards fluid overload, which can lead to hyperchloremia due to excessive chloride intake. 3+ pitting edema suggests fluid retention, a common symptom of hyperchloremia. Additionally, tachypnea can occur as a compensatory mechanism for metabolic acidosis seen in hyperchloremia. Lethargy, weakness, and diminished cognitive ability can be attributed to electrolyte imbalances impacting nerve and muscle function. Choice A: Hypocalcemia is less likely as it typically presents with neuromuscular irritability, not lethargy. Choice B: Hyponatremia usually presents with neurological symptoms like confusion and seizures, not the symptoms described. Choice D: Hypophosphatemia typically presents with muscle weakness, not the full constellation of symptoms described.