ATI RN
Nutrition and Fluid Balance Chapter 14 Questions
Question 1 of 5
Chemical buffer systems are the most powerful mechanism available for defending against changes in [H+] because they respond the fastest.
Correct Answer: B
Rationale: The correct answer is B: FALSE. Chemical buffer systems are effective in defending against changes in [H+], but they are not the fastest mechanism. The fastest mechanism is the respiratory system, which can respond within minutes by adjusting the rate and depth of breathing to regulate CO2 levels and pH. The other choices (A, C, D) are marked as NA, indicating they are not applicable or do not contribute to the explanation of the correct answer.
Question 2 of 5
During acidosis, ammonia plays a key role in allowing for continued renal H+ secretion.
Correct Answer: A
Rationale: During acidosis, ammonia (NH3) can combine with H+ ions in the renal tubules to form ammonium (NH4+), which can be excreted in the urine to help buffer excess H+ ions and maintain acid-base balance. This process allows for continued renal H+ secretion, making choice A true. Choices C and D are not applicable as they do not provide any relevant information. Choice B is incorrect because ammonia does indeed play a key role in facilitating renal H+ secretion during acidosis.
Question 3 of 5
A patient who was involved in a motor vehicle crash has had a tracheostomy placed to allow for continued mechanical ventilation. How should the nurse interpret the following arterial blood gas results: pH 7.48, PaO 85 mm Hg, PaCO 32 mm Hg, and HCO 25 mEq/L? 2 2 3
Correct Answer: A
Rationale: The correct interpretation of the arterial blood gas results is Respiratory Alkalosis. 1. pH > 7.45 indicates alkalosis. 2. PaCO2 < 35 mm Hg indicates respiratory alkalosis. 3. HCO3 within normal range (22-26 mEq/L) rules out metabolic imbalance. Therefore, the primary abnormality is a low PaCO2 causing alkalosis. Other choices are incorrect because there is no evidence of metabolic alkalosis (HCO3 normal), respiratory acidosis (PaCO2 high), or base balance (not a specific acid-base imbalance).
Question 4 of 5
The nurse is caring for a patient who has a calcium level of 12.1 mg/dL. Which nursing action should the nurse include on the care plan?
Correct Answer: D
Rationale: The correct answer is D: Monitor for Trousseau's and Chvostek's signs. A calcium level of 12.1 mg/dL indicates hypercalcemia, which can lead to neuromuscular irritability. Trousseau's and Chvostek's signs are manifestations of hypocalcemia, but in the context of hypercalcemia, they may also present due to the calcium imbalance affecting neuromuscular function. Therefore, monitoring for these signs is crucial for early detection of potential complications. Choice A is incorrect because bed rest is not specifically indicated for hypercalcemia unless there are other medical reasons necessitating it. Choice B is incorrect because auscultating lung sounds every 4 hours is not directly related to managing hypercalcemia. Choice C is incorrect because encouraging fluid intake up to 4000 mL daily may not be appropriate without considering the patient's renal function and the potential risk of fluid overload in the context of hypercalcemia.
Question 5 of 5
A patient who had a transverse colectomy for diverticulosis 18 hours ago has nasogastric suction. The patient reports anxiety and incisional pain. The patient's respiratory rate is 32 breaths/min, and the arterial blood gases (ABGs) indicate respiratory alkalosis. Which action should the nurse take first?
Correct Answer: D
Rationale: The correct answer is D. Teaching the patient to take slow, deep breaths when anxious is the first action the nurse should take. The patient is experiencing respiratory alkalosis, likely due to hyperventilation from anxiety. Teaching the patient relaxation techniques can help normalize the respiratory rate and improve oxygenation. Checking the nasogastric tube (A) can be done later as it is not the priority. Giving morphine (B) may further depress respiratory drive and worsen the alkalosis. Notifying the health care provider (C) is not necessary at this moment as the nurse can address the situation effectively.