ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 9
1.A nurse prepares to insert a peripheral venous catheter in an older adult client. Which action should the nurse take to protect the clients skin during this procedure?
Correct Answer: D
Rationale: The correct answer is D: Place a washcloth between the skin and tourniquet. This step helps protect the client's skin by providing a barrier between the tourniquet and the skin, reducing the risk of skin irritation or damage. Lowering the extremity below the heart (A) can increase venous pressure and make it harder to insert the catheter. Warm compresses (B) can dilate blood vessels and increase the risk of bruising. Tapping the skin lightly (C) can irritate the skin and is unnecessary for skin protection.
Question 2 of 9
A nurse educator is reviewing peripheral IV insertion with a group of novice nurses. How should these nurses be encouraged to deal with excess hair at the intended site?
Correct Answer: C
Rationale: The correct answer is C: Clip the hair in the area. Clipping the hair is the most appropriate option as it reduces the risk of infection during IV insertion by minimizing the presence of bacteria that may be trapped in the hair. Shaving (B) can cause micro-abrasions leading to increased infection risk. Leaving the hair intact (A) can also trap bacteria. Using a depilatory (D) can cause skin irritation and should be avoided. In summary, clipping the hair is the best option to maintain a clean and safe environment for IV insertion.
Question 3 of 9
After teaching a client to increase dietary potassium intake, a nurse assesses the client's understanding. Which dietary meal selection indicates the client correctly understands the teaching?
Correct Answer: C
Rationale: The correct answer is C because it includes foods high in potassium. Raisins, whole wheat toast, and milk are good sources of potassium. Sausage might contain some potassium as well. A: This option lacks potassium-rich foods. B: While strawberries have some potassium, the overall meal lacks a sufficient amount. D: While oatmeal and peaches have potassium, coffee can actually inhibit potassium absorption.
Question 4 of 9
A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm Hg, PaCO2 65 mm Hg, and HCO3 22 mEq/L. Which clinical situation should the nurse correlate with these values?
Correct Answer: A
Rationale: The correct answer is A: Diabetic ketoacidosis in a person with emphysema. The arterial blood values show a low pH (acidosis), high PaCO2 (respiratory acidosis), and normal HCO3 (compensatory metabolic alkalosis). This pattern is consistent with a mixed acid-base disorder seen in diabetic ketoacidosis where metabolic acidosis from ketone production is partially compensated by respiratory acidosis from decreased alveolar ventilation due to emphysema. The other choices do not align with the given blood values. Choice B is incorrect as it would typically show respiratory alkalosis. Choice C would show respiratory alkalosis with low PaCO2. Choice D would result in metabolic acidosis with low HCO3.
Question 5 of 9
You are caring for a patient who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. During your assessment, you note the patient complains of a new onset of weakness with abdominal pain. Further assessment suggests that the patient likely has a fluid volume deficit. You should recognize that this patient may be experiencing what electrolyte imbalance?
Correct Answer: D
Rationale: The correct answer is D: Hypercalcemia. Bone metastases in lung cancer can lead to increased release of calcium into the blood, causing hypercalcemia. The patient's symptoms of weakness and abdominal pain are consistent with hypercalcemia. Hypernatremia (choice A) is unlikely as the symptoms do not align with high sodium levels. Hypomagnesemia (choice B) and hypophosphatemia (choice C) are less likely as they are not typically associated with bone metastases in lung cancer. In summary, the patient's presentation of weakness and abdominal pain in the setting of lung cancer with bone metastases points to hypercalcemia as the most likely electrolyte imbalance.
Question 6 of 9
The baroreceptors, located in the left atrium and in the carotid and aortic arches, respond to changes in the circulating blood volume and regulate sympathetic and parasympathetic neural activity as well as endocrine activities. Sympathetic stimulation constricts renal arterioles, causing what effect?
Correct Answer: D
Rationale: The correct answer is D: Decrease in glomerular filtration. Sympathetic stimulation constricts renal arterioles, leading to decreased blood flow to the kidneys. This reduction in blood flow decreases the glomerular filtration rate, impacting the kidney's ability to filter blood and produce urine. The constriction of renal arterioles does not directly affect the release of aldosterone (choice A), filtration in the Loop of Henle (choice B), or the reabsorption of sodium (choice C). The primary effect of sympathetic stimulation on renal arterioles is to decrease glomerular filtration by reducing blood flow to the kidneys.
Question 7 of 9
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 8 of 9
A nurse teaches a client who is being discharged home with a peripherally inserted central catheter (PICC). Which statement should the nurse include in this clients teaching?
Correct Answer: A
Rationale: The correct answer is A: "Avoid carrying your grandchild with the arm that has the central catheter." This is important because carrying a child can put strain on the arm where the catheter is inserted, increasing the risk of dislodging or damaging the catheter. It is crucial to protect the integrity of the catheter site to prevent complications such as infection or bleeding. Choice B is incorrect because placing the arm with the central catheter in a sling during the day is unnecessary and could restrict the client's mobility and lead to discomfort. Choice C is incorrect because flushing the PICC line with normal saline should be done by a healthcare professional and not the client themselves. Choice D is incorrect because using the arm with the central catheter for most activities of daily living can increase the risk of accidental dislodgment or damage to the catheter. It is important to be cautious and limit certain activities to protect the catheter and maintain its function.
Question 9 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.