ATI RN
Fluid and Electrolytes ATI Questions
Question 1 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.
Question 2 of 5
A nurse admitting a patient with a history of emphysema reviews her past lab reports and notes that the patient's PaCO2 has been 56 to 64 mmHg. The nurse will be cautious administering oxygen because:
Correct Answer: D
Rationale: In this scenario, option D is correct because administering oxygen to a patient with a high PaCO2 can potentially lead to carbon dioxide narcosis and hypoxemia. Patients with chronic respiratory conditions like emphysema have adapted to high levels of carbon dioxide in their blood, and giving them supplemental oxygen can suppress their respiratory drive, leading to a dangerous buildup of carbon dioxide and worsening hypoxemia. Options A, B, and C are incorrect for this situation. Option A is unrelated to the effects of oxygen administration on a patient with emphysema. Option B is not directly associated with the interaction of oxygen and high PaCO2 levels. Option C is inaccurate because administering oxygen to a patient with emphysema and high PaCO2 levels is more likely to cause respiratory depression than hyperventilation. Educationally, understanding the relationship between oxygen therapy and respiratory conditions like emphysema is crucial for nurses caring for these patients. It is essential for nurses to recognize the potential risks of oxygen therapy in patients with chronic respiratory diseases to prevent adverse outcomes and provide safe, individualized care. This knowledge enhances clinical reasoning skills and promotes evidence-based practice in managing patients with complex respiratory issues.
Question 3 of 5
A nurse preparing to start an IV on a newly admitted patient teaches the patient about the procedure and begins to prepare the site. The nurse should always start by:
Correct Answer: C
Rationale: Before preparing the skin, the nurse should ask the patient if he or she is allergic to latex or iodine, which are products commonly used in setting up for IV therapy. A local reaction could result in irritation to the IV site or, in the extreme, it could result in anaphylaxis, which can be life threatening.
Question 4 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 'she stops drinking water early in the day because it is too difficult to get up during the night to go to the bathroom.' The nurse explains to the woman that:
Correct Answer: B
Rationale: The correct answer is B. In elderly patients, fluid deficits can lead to confusion and cognitive impairment. Limiting fluids can disrupt the body's balance, leading to such symptoms. Adjusting the timing of fluids can help maintain hydration without causing nighttime interruptions. Choices A, C, and D are incorrect because they do not address the underlying issue of fluid imbalance causing confusion. Choice A suggests unnecessary hospital readmission and medication adjustments. Choice C incorrectly normalizes confusion post-surgery and suggests it is safe not to urinate at night, which can exacerbate the issue. Choice D inaccurately attributes confusion to sleep loss rather than fluid imbalance.
Question 5 of 5
The nurse in the intensive care unit receives arterial blood gases (ABG) with a patient who is complaining of being 'short of breath.' The ABG has the following values: pH = 7.21, PaCO2 = 64 mm Hg, HCO3 = 24 mm Hg. The labs reflect:
Correct Answer: A
Rationale: In this scenario, the correct answer is A) Respiratory acidosis. The ABG values indicate a low pH (acidosis) along with an elevated PaCO2, which is indicative of respiratory acidosis. To explain further, in respiratory acidosis, there is an excess of carbon dioxide (PaCO2) in the blood due to inadequate ventilation, leading to an accumulation of carbonic acid and a decrease in pH. The normal range for PaCO2 is 35-45 mm Hg, so a value of 64 mm Hg is elevated. Now, let's discuss why the other options are incorrect: - Option B) Metabolic alkalosis is incorrect because the ABG values do not indicate an elevated HCO3 (bicarbonate) level, which would be present in metabolic alkalosis. - Option C) Respiratory alkalosis is incorrect because in respiratory alkalosis, the PaCO2 would be low (<35 mm Hg), not elevated as seen in this case. - Option D) Metabolic acidosis is incorrect as there is no indication of a decreased HCO3 level in the ABG results, which would be present in metabolic acidosis. Educationally, understanding ABG values and their interpretation is crucial for nurses caring for patients with respiratory or metabolic imbalances. Recognizing and interpreting ABGs allows nurses to provide appropriate interventions and monitor the effectiveness of treatments to maintain optimal patient outcomes.