ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 9
After providing discharge teaching, a nurse assesses the clients understanding regarding increased risk for metabolic alkalosis. Which statement indicates the client needs additional teaching?
Correct Answer: C
Rationale: The correct answer is C because taking sodium bicarbonate after every meal can actually increase the risk of metabolic alkalosis due to its alkaline nature. Sodium bicarbonate can lead to an excessive build-up of bicarbonate in the bloodstream, causing alkalosis. Choice A is not directly related to metabolic alkalosis. Choice B, taking digoxin, is unrelated to metabolic alkalosis as well. Choice D, drinking six glasses of water due to sweating, does not contribute to metabolic alkalosis as it helps maintain hydration and electrolyte balance.
Question 2 of 9
. You are caring for a patient who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Your patients plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow the nurse to as
Correct Answer: D
Rationale: The correct answer is D: Fluid volume status. Assessment of specific gravity helps to determine the concentration of solutes in the urine, indicating the degree of hydration or dehydration. In SIADH, there is water retention leading to diluted urine, resulting in low specific gravity. Monitoring specific gravity every 4 hours is crucial in assessing the patient's fluid volume status and response to treatment. A: Nutritional status is not directly assessed by specific gravity. B: Potassium balance is not directly assessed by specific gravity. C: Calcium balance is not directly assessed by specific gravity.
Question 3 of 9
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.
Question 4 of 9
You are caring for a 65-year-old male patient admitted to your medical unit 72 hours ago with pyloric stenosis. A nasogastric tube placed upon admission has been on low intermittent suction ever since. Upon review of the mornings blood work, you notice that the patients potassium is below reference range. You should recognize that the patient may be at risk for what imbalance?
Correct Answer: C
Rationale: The correct answer is C: Metabolic alkalosis. Pyloric stenosis can lead to vomiting, causing loss of gastric acid and chloride ions, leading to metabolic alkalosis. Low potassium levels are common in metabolic alkalosis due to potassium shifting into cells to compensate for the alkalosis. Hypercalcemia (choice A) is not associated with pyloric stenosis. Metabolic acidosis (choice B) typically presents with low pH and bicarbonate levels. Respiratory acidosis (choice D) is caused by impaired gas exchange in the lungs, not related to pyloric stenosis.
Question 5 of 9
You are caring for a patient with a diagnosis of pancreatitis. The patient was admitted from a homeless shelter and is a vague historian. The patient appears malnourished and on day 3 of the patients admission total parenteral nutrition (TPN) has been started. Why would you know to start the infusion of TPN slowly?
Correct Answer: B
Rationale: The correct answer is B: Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively. Patient with pancreatitis may have depleted levels of phosphorus due to malnutrition, and rapid initiation of TPN can further decrease phosphorus levels, leading to hypophosphatemia. This can result in respiratory failure, muscle weakness, and arrhythmias. Choice A is incorrect because patients receiving TPN are not specifically at risk for hypercalcemia due to rapid initiation of calories. Choice C is incorrect because rapid fluid infusion can lead to hypernatremia, not related to TPN initiation. Choice D is incorrect because the rationale provided for slow initiation is not related to digestive enzymes but rather to prevent hypophosphatemia in malnourished patients.
Question 6 of 9
You are an emergency-room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would you interpret these results?
Correct Answer: D
Rationale: To interpret the given ABG results: 1. pH <7.35 indicates acidosis. 2. PaCO2 <35 indicates respiratory alkalosis. 3. HCO3 <22 indicates metabolic acidosis. Therefore, the ABG results show metabolic acidosis (low pH, low HCO3) with compensatory respiratory alkalosis (low PaCO2). This means the body is trying to compensate for the metabolic acidosis by decreasing PaCO2 through hyperventilation. Option D is correct. Options A, B, and C are incorrect as they do not align with the ABG results and the principles of acid-base balance.
Question 7 of 9
After teaching a client who was malnourished and is being discharged, a nurse assesses the clients understanding. Which statement indicates the client correctly understood teaching to decrease risk for the development of metabolic acidosis?
Correct Answer: A
Rationale: The correct answer is A: "I will drink at least three glasses of milk each day." Milk is a good source of calcium and bicarbonate, which can help buffer excess acids in the body and prevent metabolic acidosis. Calcium also plays a role in maintaining the acid-base balance. Option B is incorrect because while eating well-balanced meals is important for overall health, it does not specifically address the prevention of metabolic acidosis. Option C is irrelevant to the prevention of metabolic acidosis. Option D is incorrect because avoiding salting food does not directly address the underlying issue of metabolic acidosis related to malnutrition.
Question 8 of 9
When planning the care of a patient with a fluid imbalance, the nurse understands that in the human body, water and electrolytes move from the arterial capillary bed to the interstitial fluid. What causes this to occur?
Correct Answer: D
Rationale: Rationale: The correct answer is D. Hydrostatic pressure resulting from the pumping action of the heart causes water and electrolytes to move from the arterial capillary bed to the interstitial fluid. This occurs due to the force exerted by the heart's pumping action, pushing fluid out of the capillaries into the interstitial space. This process is known as filtration and is essential for maintaining fluid balance in the body. Summary of other choices: A: Active transport of hydrogen ions does not directly cause the movement of water and electrolytes between capillaries and interstitial fluid. B: The pressure in renal capillaries specifically relates to the kidneys, not the general movement of water and electrolytes in the body. C: The dissolved particles in blood do not directly contribute to the movement of water and electrolytes between capillaries and interstitial fluid.
Question 9 of 9
You are making initial shift assessments on your patients. While assessing one patients peripheral IV site, you note edema around the insertion site. How should you document this complication related to IV therapy?
Correct Answer: C
Rationale: Correct Answer: C - Infiltration Rationale: 1. Infiltration occurs when IV fluid leaks into surrounding tissues, causing edema. 2. Documenting infiltration is important for appropriate management. 3. Air emboli, phlebitis, and fluid overload are unrelated to edema around IV site. Summary of Incorrect Choices: A. Air emboli: This is a serious condition caused by air entering the bloodstream, not related to edema. B. Phlebitis: Inflammation of the vein, usually presenting with redness and pain, not edema. D. Fluid overload: Excess fluid volume in the body, leading to symptoms like shortness of breath, not edema.