ATI RN
Chapter 14 Nutrition and Fluid Balance Answer Key Questions
Question 1 of 5
Respiratory acidosis is caused by which of the following?
Correct Answer: A
Rationale: Respiratory acidosis is caused by an increase in CO2 levels due to inadequate ventilation (A). Hypoventilation decreases the removal of CO2, leading to its accumulation and respiratory acidosis. Hyperventilation (B) reduces CO2 levels, causing respiratory alkalosis. Diarrhea (C) and excessive vomiting (D) result in metabolic acidosis due to loss of bicarbonate, not respiratory acidosis.
Question 2 of 5
A patient presents with confusion, muscle cramps, and a serum potassium of 2.9 mEq/L. What is the most appropriate intervention?
Correct Answer: A
Rationale: The correct answer is A: Administer IV potassium chloride. The patient has hypokalemia (low potassium levels) which can lead to serious complications like cardiac arrhythmias. IV potassium chloride is the fastest way to increase potassium levels in severe cases. Choice B is not appropriate as oral potassium may be too slow. Choice C, calcium gluconate, is used for hyperkalemia, not hypokalemia. Choice D, sodium bicarbonate, does not address the potassium deficiency. Administering IV potassium chloride is the most appropriate and urgent intervention to quickly correct the low potassium levels and prevent further complications.
Question 3 of 5
A patient is found unconscious with a blood pH of 7.20, PaCO₂ of 50 mmHg, and HCO₃⻠of 25 mEq/L. What is the most likely cause of this condition?
Correct Answer: C
Rationale: The correct answer is C: Diabetic ketoacidosis. In DKA, the body produces excess ketones due to lack of insulin, leading to metabolic acidosis. The low blood pH (acidosis), elevated PaCO2 (due to compensatory respiratory response), and low HCO3- levels are consistent with this condition. Sedative overdose (A) would not cause metabolic acidosis. Hyperventilation (B) would lead to respiratory alkalosis, not acidosis. Excessive vomiting (D) would result in metabolic alkalosis, not acidosis. Thus, the most likely cause in this scenario is diabetic ketoacidosis.
Question 4 of 5
A patient is admitted with a serum phosphate level of 2.1 mg/dL and reports muscle weakness. Which intervention should the nurse prioritize?
Correct Answer: A
Rationale: The correct answer is A: Administer calcium supplements. In hypophosphatemia, low phosphate levels can lead to low calcium levels due to reciprocal relationship between the two minerals. This can cause muscle weakness. Administering calcium supplements helps maintain calcium-phosphate balance, improving muscle function. Administering potassium or phosphate supplements can worsen the imbalance. Encouraging sodium intake is unrelated to correcting the issue.
Question 5 of 5
The nurse uses a diagram to demonstrate how in dehydration the water is drawn into the plasma from the cells by which process?
Correct Answer: D
Rationale: In dehydration, water moves from cells to plasma to maintain osmotic balance. Osmosis is the process of water moving from an area of lower solute concentration (cells) to higher solute concentration (plasma). This maintains the body's fluid balance. Distillation involves separating substances by boiling and condensing, not relevant here. Diffusion is the movement of solutes from high to low concentration, not specific to water movement. Filtration involves passing a liquid through a filter to separate particles, not applicable to cellular water movement. Therefore, osmosis is the correct process in dehydration.