ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 5
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 5
A nurse evaluates a clients arterial blood gas values (ABGs): pH 7.30, PaO2 86 mm Hg, PaCO2 55 mm Hg, and HCO3 22 mEq/L. Which intervention should the nurse implement first?
Correct Answer: A
Rationale: The correct answer is A: Assess the airway. The nurse should prioritize airway assessment as the client's ABGs indicate respiratory acidosis (low pH, high PaCO2). This suggests potential airway obstruction or inadequate ventilation. Ensuring a patent airway is crucial for adequate oxygenation. Administering bronchodilators (B) or mucolytics (D) may help with airway clearance but should come after ensuring a clear airway. Providing oxygen (C) is important, but addressing the underlying respiratory acidosis by first assessing the airway is the priority in this situation to prevent further deterioration.
Question 3 of 5
A nurse is planning care for a client who is hyperventilating. The clients arterial blood gas values are pH 7.30, PaO2 94 mm Hg, PaCO2 31 mm Hg, and HCO3 26 mEq/L. Which question should the nurse ask when developing this clients plan of care?
Correct Answer: B
Rationale: The correct answer is B: "You appear anxious. What is causing your distress?" because hyperventilation can be triggered by emotional distress or anxiety. By addressing the underlying cause of the hyperventilation, the nurse can provide appropriate interventions to help the client manage their anxiety and subsequently reduce the hyperventilation episodes. A: "Do you take any over-the-counter medications?" - This question is not directly related to addressing the client's anxiety or distress, which is the primary concern in hyperventilation. C: "Do you have a history of anxiety attacks?" - While relevant to understanding the client's medical history, this question does not address the immediate cause of hyperventilation in this specific situation. D: "You are breathing fast. Is this causing you to feel light-headed?" - This question focuses on the physical symptoms of hyperventilation rather than exploring the emotional or psychological triggers, which are essential in managing hyperventilation caused by anxiety.
Question 4 of 5
A nurse is caring for a client who has just had a central venous access line inserted. Which action should the nurse take next?
Correct Answer: B
Rationale: The correct answer is B: Ensure an x-ray is completed to confirm placement. This is crucial to prevent complications such as pneumothorax or incorrect placement. X-ray confirmation is the gold standard to verify the central line's proper positioning before initiating any infusions. Option A is incorrect because starting the infusion without confirming placement can lead to serious complications. Option C is unnecessary for central line insertion. Option D is important but not the immediate next step as confirming placement takes precedence for patient safety.
Question 5 of 5
A nurse assesses a client who has a radial artery catheter. Which assessment should the nurse complete first?
Correct Answer: D
Rationale: The correct answer is D: Presence of an ulnar pulse. This is the most important assessment to complete first because the presence of an ulnar pulse indicates adequate circulation in the hand, ensuring that the radial artery catheter is not compromising blood flow. If the ulnar pulse is absent, it may signify impaired circulation and potential complications such as ischemia. Choice A is incorrect because the amount of pressure in the fluid container is not directly related to the assessment of the radial artery catheter. Choice B is incorrect because the date of catheter tubing change is important for infection control but not the immediate priority in this situation. Choice C is incorrect as the percent of heparin in the infusion container is important for anticoagulation therapy but does not take precedence over assessing circulation in the hand.