ATI RN
Chapter 14 Nutrition and Fluid Balance Answer Key Questions
Question 1 of 5
Because there are no IV pumps available for the immediate infusion of an IV medication, the nurse must calculate the flow rate for 500 mL to run for 4 h, using a set that delivers 15 gtt/mL. Which flow rate is correct?
Correct Answer: A
Rationale: The correct answer is A (30 gtt/min). To calculate the flow rate, first determine the total drops needed (500 mL x 15 gtt/mL = 7500 gtt) for 4 hours. Then, divide total drops by total time in minutes (4 hours x 60 min/hr = 240 min) to get 31.25 gtt/min. Since IV pumps deliver whole drops, round down to the nearest whole number, giving a flow rate of 30 gtt/min. Choice B, C, and D are incorrect as they do not reflect the accurate calculation based on the given information.
Question 2 of 5
A normal urine output is considered to be
Correct Answer: D
Rationale: The correct answer is D (1 to 2 L/day) because it reflects the normal range of urine output in adults, which is typically around 1 to 2 liters per day. This range ensures adequate elimination of waste products while maintaining proper hydration levels. A (80 to 125 mL/min) is incorrect because it represents an hourly output rather than a daily output, and it is too low for a normal daily urine output. B (180 L/day) is incorrect as it is an extremely high value that does not align with normal physiological urine production rates. C (80 mL/min) is also incorrect because it is too low for a normal urine output and is not representative of the typical daily volume.
Question 3 of 5
The nurse is caring for a patient who has undergone major abdominal surgery. The nurse notices that the patient's urine output has been less than 20 mL/hour for the past 2 hours. The patient's blood pressure is 100/60 mm Hg, and the pulse is 110 beats/min. Previously, the pulse was 90 beats/min with a blood pressure of 120/80 mm Hg. The nurse should
Correct Answer: A
Rationale: The correct answer is A: contact the provider and expect a prescription for a normal saline bolus. The patient is showing signs of hypovolemia, indicated by decreased urine output, tachycardia, and hypotension. Administering a normal saline bolus can help restore intravascular volume and improve perfusion. Waiting for the provider to make rounds (choice B) can delay necessary intervention. Continuing to evaluate urine output (choice C) without addressing the underlying issue of hypovolemia can worsen the patient's condition. Ignoring the urine output (choice D) is not appropriate as it can lead to serious complications.
Question 4 of 5
Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who
Correct Answer: C
Rationale: The correct answer is C because the patient who was discharged 2 weeks earlier after aminoglycoside therapy is at the greatest risk of developing acute kidney injury. Aminoglycosides are known nephrotoxic drugs, and prolonged exposure increases the risk of kidney damage. The 2-week course followed by discharge indicates a high cumulative dose, which further elevates the risk. Choice A is incorrect because although aminoglycosides are nephrotoxic, a shorter duration of therapy compared to the patient in choice C reduces the risk. Choice B is incorrect as controlled hypertension with a blood pressure of 138/88 mm Hg does not directly increase the risk of acute kidney injury. Choice D is incorrect because while fluid overload can strain the kidneys, the direct nephrotoxic effects of aminoglycosides in choice C pose a higher immediate risk.
Question 5 of 5
The patient is admitted with complaints of general malaise and fatigue, along with a decreased urinary output. The patient's urinalysis shows coarse, muddy brown granular casts and hematuria. The nurse determines that the patient has:
Correct Answer: C
Rationale: The correct answer is C: intrarenal disease, probably acute tubular necrosis. This is indicated by the presence of coarse, muddy brown granular casts and hematuria in the urinalysis. 1. Coarse, muddy brown granular casts suggest renal tubular damage, characteristic of acute tubular necrosis (ATN). 2. Hematuria indicates damage to the glomerulus or tubules, supporting an intrarenal cause. 3. General malaise, fatigue, and decreased urinary output are common symptoms of ATN due to impaired kidney function. 4. Choices A and B are incorrect because prerenal conditions and postrenal obstruction would not typically present with the specific urinalysis findings seen in this case. 5. Choice D is incorrect as a urinary tract infection typically presents with different symptoms and urinalysis findings. In summary, the presence of specific urinalysis findings and symptoms points towards an intrarenal cause, specifically acute tubular necrosis.