ATI RN
Fluid and Electrolytes ATI Questions
Question 1 of 5
A nurse in the medical-surgical unit is giving a patient with low blood pressure a hypertonic solution, which will increase the number of dissolved particles in his blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. Which of the following terms is associated with this process?
Correct Answer: B
Rationale: Osmosis is the movement of fluid from a region of low solute concentration to a region of high solute concentration across a semipermeable membrane. The number of dissolved particles contained in a unit of fluid determines the osmolality of a solution, which influences the movement of fluid between the fluid compartments. Giving a patient who has a low blood pressure a hypertonic solution will increase the number of dissolved particles in the blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. Option A is incorrect; hydrostatic pressure refers to changes in water or volume related to water pressure. Option C is incorrect; diffusion is the movement of solutes from an area of greater concentration to lesser concentration. The solutes in an intact vascular system are unable to move, so diffusion should not normally take place. Option D is incorrect; active transport is the movement of molecules against the concentration gradient and requires ATP as an energy source. This process typically takes place at the cellular level and is not involved in vascular volume changes.
Question 2 of 5
A nurse is visiting an 84-year-old woman living at home and recovering from hip surgery. The woman seems confused and has poor skin turgor, and she states that ¢â‚¬Å“she stops drinking water early in the day because it is too difficult to get up during the night to go to the bathroom.¢â‚¬ The nurse explains to the woman that:
Correct Answer: B
Rationale: The correct answer is option B: Limiting fluids can create imbalances in the body that can result in confusion; maybe we need to adjust the timing of your fluids. This answer is correct because it addresses the woman's symptoms and provides an appropriate explanation for her confusion and poor skin turgor. Dehydration, especially in the elderly, can lead to electrolyte imbalances and cognitive impairment. Adjusting the timing of fluids can help the woman stay hydrated without disrupting her sleep. Option A is incorrect because it jumps to the conclusion of readmission and medication adjustment without considering a simpler solution like fluid management. Option C is incorrect as it dismisses the woman's symptoms as normal post-surgery confusion and condones not urinating at night, which can further contribute to dehydration. Option D is incorrect as it oversimplifies the issue by attributing confusion solely to loss of sleep post-surgery without addressing the underlying dehydration and electrolyte imbalance issues. In an educational context, this question highlights the importance of understanding the impact of fluid and electrolyte balance on a patient's overall health, especially in vulnerable populations like the elderly. It emphasizes the role of nurses in assessing and managing fluid intake to prevent complications such as dehydration-related confusion.
Question 3 of 5
A nurse in the medical-surgical unit has a newly admitted patient who is oliguric; the acute care nurse practitioner orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. The nurse is aware this intervention will help:
Correct Answer: C
Rationale: If a patient is not excreting enough urine, the health care provider needs to determine whether the depressed renal function is the result of reduced renal blood flow, which is a fluid Volume deficit (FVD) or prerenal azotemia, or acute tubular necrosis that results in necrosis or cellular death from prolonged FVD. A typical example of a fluid challenge involves administering 100 to 200 mL of normal saline solution over 15 minutes. The response by a patient with FVD but normal renal function is increased urine output and increased blood pressure.
Question 4 of 5
A nurse is taking care of a 65-year-old female patient in a medical-surgical unit who is in renal failure; during the assessment the patient complains of tingling in her lips and fingers. When the nurse takes her blood pressure, she has a spasm in her wrist and hand. The nurse suspects:
Correct Answer: B
Rationale: Tetany is the most characteristic manifestation of hypocalcemia and hypomagnesemia. Sensations of tingling may occur in the tips of the fingers, around the mouth, and less commonly in the feet. Taking a normal blood pressure could illicit a carpal spasm if it creates slight ischemia of the ulnar nerve.
Question 5 of 5
A patient who is in renal failure partially loses the ability to regulate changes in pH because the kidneys:
Correct Answer: C
Rationale: In renal failure, the kidneys are unable to effectively excrete metabolic acids, leading to acid-base imbalances. The correct answer is C) Regenerate and reabsorb bicarbonate to maintain a stable pH. Bicarbonate is a key buffer in the body that helps regulate pH by neutralizing excess acids. In renal failure, impaired kidney function results in decreased bicarbonate reabsorption, leading to metabolic acidosis. Option A is incorrect because the kidneys do not regulate carbonic acid to change pH; rather, they regulate bicarbonate levels. Option B is incorrect as the primary role of the kidneys in acid-base balance is through bicarbonate regulation, not electrolyte changes. Option D is incorrect as carbonic acid and bicarbonate are part of the bicarbonate buffering system, not directly combined by the kidneys to regulate pH. Understanding the role of the kidneys in acid-base balance is crucial for nurses caring for patients, especially those with renal failure. By grasping how impaired kidney function affects pH regulation, nurses can anticipate and manage acid-base imbalances effectively to provide optimal patient care.