ATI RN
Chapter 14 Nutrition and Fluid Balance Answer Key Questions
Question 1 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 2 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.
Question 3 of 5
A 100-kg patient gets hemodialysis 3 days a week. In planning the care for this patient, the nurse recommends
Correct Answer: A
Rationale: The correct answer is A because a patient undergoing hemodialysis requires a higher caloric intake to meet their energy needs and prevent malnutrition. Hemodialysis can lead to protein loss, so a diet high in calories helps maintain muscle mass. Choices B, C, and D are incorrect because protein intake is usually increased to prevent malnutrition, potassium restrictions are individualized based on lab values, and fluid restrictions are typically based on the patient's weight and urine output.
Question 4 of 5
The nurse is admitting an older adult patient to the acute care medical unit. Which assessment factor alerts the nurse that this patient has a risk for
Correct Answer: C
Rationale: The correct answer is C: Chronic renal insufficiency. Older adults with chronic renal insufficiency are at risk for base imbalances due to impaired kidney function affecting acid-base balance. This condition can lead to metabolic acidosis or alkalosis. Choice A, base imbalances, is not a direct assessment factor but rather a consequence of underlying conditions like chronic renal insufficiency. Choice B, history of myocardial infarction 1 year ago, may increase the risk of cardiac complications but is not directly related to base imbalances. Choice D, shortness of breath with extreme exertion, may indicate respiratory or cardiac issues but does not directly correlate with base imbalances.
Question 5 of 5
The nurse is completing a history for an older patient at risk for an acidosis
Correct Answer: A
Rationale: The correct answer is A because it includes relevant questions to assess risk factors related to acidosis in an older patient. Asking about breathing problems, medications, activity intolerance, drowsiness, decreased alertness, dizziness, and tinnitus helps identify potential causes or symptoms of acidosis. Choices B and C do not cover all key areas of concern for acidosis assessment, such as breathing problems and dizziness. Choice D is incorrect because drowsiness and bowel movements can be relevant to acidosis evaluation in older adults.