ATI RN
Chapter 14 Nutrition and Fluid Balance Answer Key Questions
Question 1 of 5
An older adult patient who is malnourished presents to the emergency department with a serum protein level of 5.2 g/dL. Which clinical manifestation should the nurse expect?
Correct Answer: B
Rationale: The correct answer is B: Edema. In a malnourished patient with low serum protein levels, particularly albumin, there is a decreased oncotic pressure, leading to fluid shifting into interstitial spaces and causing edema. Pallor (choice A) is associated with anemia, not malnutrition. Restlessness (choice C) is not a typical manifestation of malnutrition. Confusion (choice D) is more commonly seen in severe malnutrition or certain vitamin deficiencies, but it is not the most immediate clinical manifestation in this scenario.
Question 2 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 3 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 4 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.
Question 5 of 5
The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)
Correct Answer: C
Rationale: The correct answer is C: Volume overload. In acute kidney injury, impaired kidney function leads to fluid accumulation, causing volume overload. This is a common reason to initiate dialysis to remove excess fluid. Acidosis (choice A) and hyperkalemia (choice D) are also indications for dialysis, but volume overload is more common in acute kidney injury. Hypokalemia (choice B) is not a typical reason for initiating dialysis in acute kidney injury, as it involves low potassium levels rather than fluid overload.