ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 9
A patient who is being treated for pneumonia starts complaining of sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect?
Correct Answer: A
Rationale: The correct answer is A: Respiratory acidosis. A low pH (7.21) indicates acidosis. The elevated PaCO2 (64 mm Hg) indicates respiratory acidosis, as high CO2 levels lead to carbonic acid formation, decreasing pH. The normal HCO3 (24 mm Hg) suggests compensation for the respiratory acidosis. Other choices are incorrect as they do not align with the ABG values provided. Metabolic alkalosis (B) would have a high pH and HCO3, respiratory alkalosis (C) would have a high pH and low PaCO2, and metabolic acidosis (D) would have a low pH and HCO3.
Question 2 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 3 of 9
A nurse teaches a client who is prescribed a central vascular access device. Which statement should the nurse include in this clients teaching?
Correct Answer: C
Rationale: Correct Answer: C Rationale: 1. Choice C is correct because it emphasizes the importance of cleaning connections before accessing the device to prevent infection. 2. Sterile technique during insertion cannot guarantee no risk of infection (Choice B). 3. Wearing a sling is unnecessary for a central vascular access device (Choice A). 4. The statement about not being able to take a bath is not accurate and is not a common restriction (Choice D).
Question 4 of 9
.A nurse assesses a clients peripheral IV site, and notices edema and tenderness above the site. Which action should the nurse take next?
Correct Answer: D
Rationale: The correct action is to stop the infusion of intravenous fluids. Edema and tenderness above the IV site suggest infiltration, where fluid leaks into surrounding tissues. Stopping the infusion prevents further damage and helps prevent complications. Applying cold compresses (A) may not address the underlying issue. Elevating the extremity (B) is helpful for other conditions like swelling due to dependent edema, not infiltration. Flushing the catheter (C) can exacerbate the issue by pushing more fluid into the tissue.
Question 5 of 9
The nurse is caring for a patient in metabolic alkalosis. The patient has an NG tube to low intermittent suction for a diagnosis of bowel obstruction. What drug would the nurse expect to find on the medication orders?
Correct Answer: A
Rationale: The correct answer is A: Cimetidine. In metabolic alkalosis, the blood pH is elevated due to excess bicarbonate. Cimetidine is a histamine-2 receptor antagonist that can help decrease gastric acid production, which can contribute to alkalosis. Maalox (B) is an antacid used to treat acid-related conditions, not alkalosis. Potassium chloride elixir (C) is used to correct potassium imbalances, not directly related to alkalosis. Furosemide (D) is a loop diuretic used to treat fluid retention and edema, not specifically indicated for metabolic alkalosis.
Question 6 of 9
You are making initial shift assessments on your patients. While assessing one patients peripheral IV site, you note edema around the insertion site. How should you document this complication related to IV therapy?
Correct Answer: C
Rationale: Correct Answer: C - Infiltration Rationale: 1. Infiltration occurs when IV fluid leaks into surrounding tissues, causing edema. 2. Documenting infiltration is important for appropriate management. 3. Air emboli, phlebitis, and fluid overload are unrelated to edema around IV site. Summary of Incorrect Choices: A. Air emboli: This is a serious condition caused by air entering the bloodstream, not related to edema. B. Phlebitis: Inflammation of the vein, usually presenting with redness and pain, not edema. D. Fluid overload: Excess fluid volume in the body, leading to symptoms like shortness of breath, not edema.
Question 7 of 9
. One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acutecare nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over 15 minutes. This intervention will achieve which of the following?
Correct Answer: C
Rationale: The correct answer is C: Help distinguish reduced renal blood flow from decreased renal function. Rationale: 1. Oliguria is a decrease in urine output. 2. Fluid challenge with normal saline can help determine the cause of oliguria by assessing the response of the kidneys. 3. If the oliguria improves after the fluid challenge, it suggests reduced renal blood flow as the cause. 4. If oliguria persists, it indicates decreased renal function. Summary: A. Fluid challenge does not directly help in distinguishing between hyponatremia and hypernatremia. B. Evaluating pituitary gland function requires specific tests, not just a fluid challenge. D. Treating hypertension-induced oliguria may involve different interventions, not just a fluid challenge.
Question 8 of 9
You are caring for a 65-year-old male patient admitted to your medical unit 72 hours ago with pyloric stenosis. A nasogastric tube placed upon admission has been on low intermittent suction ever since. Upon review of the mornings blood work, you notice that the patients potassium is below reference range. You should recognize that the patient may be at risk for what imbalance?
Correct Answer: C
Rationale: The correct answer is C: Metabolic alkalosis. Pyloric stenosis can lead to vomiting, causing loss of gastric acid and chloride ions, leading to metabolic alkalosis. Low potassium levels are common in metabolic alkalosis due to potassium shifting into cells to compensate for the alkalosis. Hypercalcemia (choice A) is not associated with pyloric stenosis. Metabolic acidosis (choice B) typically presents with low pH and bicarbonate levels. Respiratory acidosis (choice D) is caused by impaired gas exchange in the lungs, not related to pyloric stenosis.
Question 9 of 9
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.