ATI RN
Chapter 14 Nutrition and Fluid Balance Answer Key Questions
Question 1 of 5
A patient who has a small cell cancer of the lung develops syndrome of inappropriate antidiuretic hormone (SIADH). The nurse should notify the health care provider about which assessment finding?
Correct Answer: B
Rationale: The correct answer is B: Serum sodium of 120 mg/dL. In SIADH, there is excessive release of ADH, leading to water retention and dilutional hyponatremia. A serum sodium level of 120 mg/dL indicates severe hyponatremia and requires immediate intervention to prevent neurological complications. Choice A is incorrect because a serum hematocrit of 42% does not directly relate to SIADH. Choice C is incorrect because a urinary output of 280 mL in 8 hours is not a significant concern in SIADH as the condition leads to water retention and concentrated urine. Choice D is incorrect because a reported weight gain of 2.2 pounds could be related to fluid retention but is not as urgent as addressing severe hyponatremia in SIADH.
Question 2 of 5
An older adult patient receiving iso-osmolar continuous enteral nutrition develops restlessness, agitation, and weakness. Which laboratory result should the nurse report to the health care provider immediately?
Correct Answer: C
Rationale: The correct answer is C: Na+ 154 mEq/L (154 mmol/L). High sodium levels can indicate hypernatremia, which can lead to neurological symptoms like restlessness, agitation, and weakness in older adults. This condition can be life-threatening if not promptly addressed. A: K+ 3.4 mEq/L is slightly low but not an immediate concern for neurological symptoms. B: Ca+2 7.8 mg/dL is within the normal range, and low calcium levels typically do not present with the described symptoms. D: Base balance is not a specific laboratory result and is not directly related to the symptoms described.
Question 3 of 5
The nurse notes a serum calcium level of 7.9 mg/dL for a patient who has chronic malnutrition. Which action should the nurse expect to take first?
Correct Answer: A
Rationale: The correct answer is A: Monitor ionized calcium level. Step-by-step rationale: 1. Monitoring ionized calcium level is crucial to assess the patient's current calcium status accurately. 2. In chronic malnutrition, there may be alterations in protein binding of calcium, affecting total calcium levels. 3. Ionized calcium is the physiologically active form and provides a more accurate reflection of calcium status. 4. This action helps guide further interventions and treatment based on the actual calcium levels. Summary: - Choice B: Giving oral calcium citrate tablets may not be appropriate without knowing the patient's ionized calcium level. - Choice C: Checking parathyroid hormone level may be relevant but is not the immediate priority. - Choice D: Administering vitamin D supplements may be beneficial in the long term but does not address the immediate need to assess the patient's calcium status accurately.
Question 4 of 5
Rapid correction of the acidosis should be avoided, because tetany may occur as a result of
Correct Answer: B
Rationale: The correct answer is B because tachypnea is a compensatory mechanism for metabolic acidosis, helping to blow off excess CO2 and decrease the blood's acidity. Rapidly correcting acidosis can lead to a sudden decrease in CO2 levels, potentially causing tetany due to respiratory alkalosis. Choice A discusses renal replacement therapies, not directly related to the risk of tetany. Choice C mentions intubation, which is not the immediate concern for tetany. Choice D is blank.
Question 5 of 5
Continuous renal replacement therapy (CRRT) differs from conventional intermittent hemodialysis in that
Correct Answer: D
Rationale: The correct answer is D because CRRT removes solutes and water slowly over an extended period, providing gentler fluid and solute balance adjustments. A is incorrect because CRRT uses a hemofilter for filtration, not ultrafiltration. B is incorrect because CRRT actually removes solutes and water more slowly than intermittent hemodialysis. C is incorrect because diffusion does occur in CRRT, just at a slower rate compared to intermittent hemodialysis. Therefore, the slower solute and water removal process in CRRT distinguishes it from conventional intermittent hemodialysis.