ATI RN
Chapter 14 Nutrition and Fluid Balance Answer Key Questions
Question 1 of 5
A normal urine output is considered to be
Correct Answer: D
Rationale: The correct answer is D (1 to 2 L/day) because it reflects the normal range of urine output in adults, which is typically around 1 to 2 liters per day. This range ensures adequate elimination of waste products while maintaining proper hydration levels. A (80 to 125 mL/min) is incorrect because it represents an hourly output rather than a daily output, and it is too low for a normal daily urine output. B (180 L/day) is incorrect as it is an extremely high value that does not align with normal physiological urine production rates. C (80 mL/min) is also incorrect because it is too low for a normal urine output and is not representative of the typical daily volume.
Question 2 of 5
Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who
Correct Answer: C
Rationale: The correct answer is C because the patient who was discharged 2 weeks earlier after aminoglycoside therapy is at the greatest risk of developing acute kidney injury. Aminoglycosides are known nephrotoxic drugs, and prolonged exposure increases the risk of kidney damage. The 2-week course followed by discharge indicates a high cumulative dose, which further elevates the risk. Choice A is incorrect because although aminoglycosides are nephrotoxic, a shorter duration of therapy compared to the patient in choice C reduces the risk. Choice B is incorrect as controlled hypertension with a blood pressure of 138/88 mm Hg does not directly increase the risk of acute kidney injury. Choice D is incorrect because while fluid overload can strain the kidneys, the direct nephrotoxic effects of aminoglycosides in choice C pose a higher immediate risk.
Question 3 of 5
The patient is admitted with complaints of general malaise and fatigue, along with a decreased urinary output. The patient's urinalysis shows coarse, muddy brown granular casts and hematuria. The nurse determines that the patient has:
Correct Answer: C
Rationale: The correct answer is C: intrarenal disease, probably acute tubular necrosis. This is indicated by the presence of coarse, muddy brown granular casts and hematuria in the urinalysis. 1. Coarse, muddy brown granular casts suggest renal tubular damage, characteristic of acute tubular necrosis (ATN). 2. Hematuria indicates damage to the glomerulus or tubules, supporting an intrarenal cause. 3. General malaise, fatigue, and decreased urinary output are common symptoms of ATN due to impaired kidney function. 4. Choices A and B are incorrect because prerenal conditions and postrenal obstruction would not typically present with the specific urinalysis findings seen in this case. 5. Choice D is incorrect as a urinary tract infection typically presents with different symptoms and urinalysis findings. In summary, the presence of specific urinalysis findings and symptoms points towards an intrarenal cause, specifically acute tubular necrosis.
Question 4 of 5
A 100-kg patient gets hemodialysis 3 days a week. In planning the care for this patient, the nurse recommends
Correct Answer: A
Rationale: The correct answer is A because a patient undergoing hemodialysis requires a higher caloric intake to meet their energy needs and prevent malnutrition. Hemodialysis can lead to protein loss, so a diet high in calories helps maintain muscle mass. Choices B, C, and D are incorrect because protein intake is usually increased to prevent malnutrition, potassium restrictions are individualized based on lab values, and fluid restrictions are typically based on the patient's weight and urine output.
Question 5 of 5
The nurse is admitting an older adult patient to the acute care medical unit. Which assessment factor alerts the nurse that this patient has a risk for
Correct Answer: C
Rationale: The correct answer is C: Chronic renal insufficiency. Older adults with chronic renal insufficiency are at risk for base imbalances due to impaired kidney function affecting acid-base balance. This condition can lead to metabolic acidosis or alkalosis. Choice A, base imbalances, is not a direct assessment factor but rather a consequence of underlying conditions like chronic renal insufficiency. Choice B, history of myocardial infarction 1 year ago, may increase the risk of cardiac complications but is not directly related to base imbalances. Choice D, shortness of breath with extreme exertion, may indicate respiratory or cardiac issues but does not directly correlate with base imbalances.