ATI RN
Nutrition and Fluid Balance Questions
Question 1 of 5
The patient who has had diarrhea for the last 3 days has blood gases of pH of 7.1, HCO3- of 20 mEq/L, and PCO2 of 36 mm Hg. These laboratory values are consistent with which acid-base imbalance?
Correct Answer: D
Rationale: The given pH of 7.1 indicates acidemia. The low HCO3- of 20 mEq/L points to metabolic acidosis. The PCO2 of 36 mm Hg is normal, ruling out respiratory acidosis or alkalosis. In metabolic acidosis, the kidneys cannot excrete enough acid or retain enough bicarbonate. This leads to a decrease in serum HCO3- levels causing an acidotic state. Choices A, B, and C do not align with the provided blood gas values, making them incorrect.
Question 2 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 3 of 5
The nurse is caring for an elderly patient who was admitted with renal insufficiency. An expected laboratory finding for this patient may be
Correct Answer: B
Rationale: The correct answer is B: a normal serum creatinine level. In renal insufficiency, the kidneys are unable to effectively filter waste products like creatinine, leading to elevated serum levels. A normal creatinine level indicates the kidneys are functioning properly. A: Increased GFR would not be expected in renal insufficiency as GFR typically decreases. C: In renal insufficiency, the ability to excrete drugs may be impaired due to decreased kidney function. D: Hypokalemia is not a typical laboratory finding in renal insufficiency; instead, hyperkalemia is more common due to reduced excretion of potassium.
Question 4 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 5 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.