ATI RN
Nutrition and Fluid Balance Questions
Question 1 of 5
The critical care nurse knows that in critically ill patients, renal dysfunction
Correct Answer: B
Rationale: The correct answer is B because renal dysfunction is a common issue in critically ill patients due to factors like decreased perfusion and nephrotoxic medications. This can lead to acute kidney injury in nearly two thirds of patients. Choice A is incorrect as renal dysfunction is common, not rare. Choice C is incorrect because renal replacement therapy does not guarantee a low mortality rate. Choice D is incorrect as renal dysfunction can significantly impact morbidity, mortality, and quality of life in critically ill patients.
Question 2 of 5
Conditions that produce acute kidney injury by directly acting on functioning kidney tissue are classified as intrarenal. The most common intrarenal condition is
Correct Answer: C
Rationale: The correct answer is C, acute tubular necrosis (ATN). ATN is the most common intrarenal condition as it directly affects the functioning kidney tissue by causing damage to the renal tubules. This leads to impaired kidney function and acute kidney injury. Prolonged ischemia (choice A) can also cause intrarenal damage, but ATN is more common. Exposure to nephrotoxic substances (choice B) can lead to intrarenal damage, but ATN is still the most common cause. Hypotension for several hours (choice D) can result in prerenal acute kidney injury rather than intrarenal damage like ATN.
Question 3 of 5
The patient's serum creatinine level is 0.7 mg/dL. The expected BUN level should be
Correct Answer: B
Rationale: The correct answer is B (7 to 14 mg/dL) because the normal BUN (Blood Urea Nitrogen) to creatinine ratio is typically around 10:1. With a serum creatinine level of 0.7 mg/dL, the expected BUN level should be around 7 to 14 mg/dL. Choices A, C, and D are incorrect because they do not align with the normal BUN to creatinine ratio and would not be expected based on the given serum creatinine level.
Question 4 of 5
What is a minimally acceptable urine output for a patient weighing 75 kg?
Correct Answer: B
Rationale: The correct answer is B: 37 mL/hour. For a patient weighing 75 kg, the minimally acceptable urine output is typically around 0.5 mL/kg/hour. Therefore, for a 75 kg patient, the calculation would be 75 kg x 0.5 mL = 37.5 mL/hour, which can be rounded down to 37 mL/hour. This amount ensures adequate renal perfusion and function. Incorrect choices: A: Less than 30 mL/hour - This is too low and may indicate inadequate renal function. C: 80 mL/hour - This is higher than the recommended minimum output and may lead to overdiuresis. D: 150 mL/hour - This amount is excessive and may indicate fluid overload or other issues.
Question 5 of 5
The patient is diagnosed with acute kidney injury and has been getting dialysis 3 days per week. The patient complains of general malaise and is tachypneic. An arterial blood gas shows that the patient's pH is 7.19, with a PCO2 of 30 mm Hg and a bicarbonate level of 13 mEq/L. The nurse prepares to
Correct Answer: C
Rationale: The correct answer is C: administer intravenous sodium bicarbonate. In this case, the patient has metabolic acidosis (low pH, low bicarbonate), likely due to renal failure. Administering sodium bicarbonate can help correct the acidosis and improve the patient's condition. Choices A and B are incorrect because the primary issue is metabolic acidosis, not respiratory acidosis requiring intubation. Canceling dialysis, as in choice D, would not address the underlying metabolic acidosis and could worsen the patient's condition. Therefore, the most appropriate action is to administer intravenous sodium bicarbonate to correct the acid-base imbalance.