ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 5
A nurse is caring for a client who has a serum calcium level of 14 mg/dL. Which provider order should the nurse implement first?
Correct Answer: A
Rationale: The correct answer is A: Encourage oral fluid intake. When a client has hypercalcemia (serum calcium level of 14 mg/dL), the priority is to increase fluid intake to promote renal calcium excretion. This helps prevent complications such as renal calculi. The first step is to dilute the serum calcium by increasing fluid intake, which can help lower the serum calcium level. Connecting the client to a cardiac monitor (B) is not the priority as hypercalcemia affects the kidneys more than the heart. Assessing urinary output (C) is important but encouraging fluid intake is more immediate. Administering oral calcitonin (Calcimar) (D) is not the first action as it is a medication used for long-term management of hypercalcemia, not the immediate priority.
Question 2 of 5
A nurse assesses a client who is admitted for treatment of fluid overload. Which manifestations should the nurse expect to find? (Select all that do not apply.)
Correct Answer: C
Rationale: Step 1: Fluid overload leads to increased fluid volume in the body, causing skin to appear pale, cool, and clammy due to poor circulation. Step 2: "Warm and pink skin" is not a typical manifestation of fluid overload. Step 3: Therefore, the correct answer is C. Summary: A: Increased pulse rate - Possible in fluid overload due to increased volume causing increased workload on the heart. B: Distended neck veins - Common in fluid overload due to increased venous pressure. C: Warm and pink skin - Incorrect, as skin is usually pale, cool, and clammy. D: Skeletal muscle weakness - Not directly related to fluid overload.
Question 3 of 5
A nurse is assessing clients on a medical-surgical unit. Which clients are at increased risk for hypophosphatemia? (Select all that do not apply.)
Correct Answer: C
Rationale: The correct answer is C because antacids contain aluminum or magnesium, which can bind with phosphorus and decrease its absorption, leading to hypophosphatemia. Malnourishment (choice A) can cause hypophosphatemia due to inadequate intake, uncontrolled diabetes (choice B) is associated with hyperphosphatemia, and hyperparathyroidism (choice D) can lead to hyperphosphatemia due to increased calcium levels.
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 is assessing a client who has an electrolyte imbalance related to renal failure. For which potential complications of this electrolyte imbalance should the nurse assess? (Select all that do mot apply.)
Correct Answer: B
Rationale: Correct Answer: B - Slow, shallow respirations Rationale: 1. Electrolyte imbalance in renal failure often leads to respiratory alkalosis, causing rapid and deep respirations, not slow and shallow. 2. Electrocardiogram changes (A) are common with electrolyte imbalances, particularly potassium and calcium. 3. Paralytic ileus (C) is a complication of electrolyte imbalances, affecting gastrointestinal motility. 4. Skeletal muscle weakness (D) is a common manifestation of electrolyte imbalances, especially potassium and magnesium deficiencies. Summary: Choice B is incorrect because slow, shallow respirations are not typically associated with electrolyte imbalances related to renal failure. Choices A, C, and D are commonly seen complications of electrolyte imbalances and should be assessed by the nurse.