ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 5
A nurse assesses a client who is prescribed furosemide (Lasix) for hypertension. For which acid-base imbalance should the nurse assess to prevent complications of this therapy?
Correct Answer: D
Rationale: The correct answer is D: Metabolic alkalosis. Furosemide, a loop diuretic, can lead to potassium depletion and metabolic alkalosis due to excessive loss of chloride and hydrogen ions. The nurse should assess for signs of metabolic alkalosis such as confusion, muscle weakness, and dysrhythmias to prevent complications. Respiratory acidosis and alkalosis are not directly related to furosemide therapy. Metabolic acidosis is less likely due to furosemide's mechanism of action.
Question 2 of 5
A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance should the nurse assess?
Correct Answer: B
Rationale: The correct answer is B: Kussmaul respirations. In acute pancreatitis, metabolic acidosis can occur due to the release of pancreatic enzymes. Kussmaul respirations are deep, rapid breaths that help to blow off excess carbon dioxide in response to acidosis, aiming to correct the pH imbalance. Agitation (A) is a nonspecific symptom and not specific to acid-base imbalances. Seizures (C) are more commonly associated with electrolyte imbalances such as hyponatremia or hypocalcemia. Positive Chvostek's sign (D) is a clinical sign of hypocalcemia, not directly related to acid-base imbalances in acute pancreatitis.
Question 3 of 5
A nurse assesses a client who is admitted with an acid-base imbalance. The clients arterial blood gas values are pH 7.32, PaO2 85 mm Hg, PaCO2 34 mm Hg, and HCO3 16 mEq/L. What action should the nurse take next?
Correct Answer: A
Rationale: The correct answer is A: Assess clients rate, rhythm, and depth of respiration. The arterial blood gas values indicate a respiratory acidosis due to low pH and low PaCO2. The nurse should assess the respiratory status to determine if the client is hypoventilating, which is causing the retention of CO2 and subsequent acidosis. Assessing the rate, rhythm, and depth of respiration will help determine if the client requires immediate intervention such as oxygen therapy, mechanical ventilation, or respiratory treatment. Choice B is incorrect because measuring pulse and blood pressure does not directly address the underlying cause of the acid-base imbalance. Choice C is incorrect as the nurse should take immediate action to address the imbalance rather than passively monitoring. Choice D is incorrect as immediate intervention is needed to address the respiratory acidosis.
Question 4 of 5
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 5
A nurse is caring for a client who has just experienced a 90-second tonic-clonic seizure. The clients arterial blood gas values are pH 6.88, PaO2 50 mm Hg, PaCO2 60 mm Hg, and HCO3 22 mEq/L. Which action should the nurse take first?
Correct Answer: A
Rationale: The correct answer is A: Apply oxygen by mask or nasal cannula. The client is experiencing respiratory acidosis due to inadequate ventilation and oxygenation during the seizure. Providing oxygen will help improve oxygenation and correct the respiratory acidosis. This is the priority to address the immediate physiological need. Choice B is incorrect as applying a paper bag can lead to rebreathing of carbon dioxide, worsening the respiratory acidosis. Choice C is incorrect as sodium bicarbonate is not indicated in this situation and can potentially worsen the acid-base imbalance. Choice D is incorrect as administering glucose and insulin is not relevant to correcting the respiratory acidosis.