ATI RN
Nutrition and Fluid Balance Questions
Question 1 of 5
Which of the following is normally the major source of hydrogen ions in the body?
Correct Answer: D
Rationale: The correct answer is D, carbonic acid generated from metabolically produced CO2. This is because carbonic acid is a major source of hydrogen ions in the body through the dissociation of CO2 in the blood, contributing to the regulation of blood pH. Option A is incorrect as phosphoric and sulfuric acids from dietary proteins are not major contributors to hydrogen ions. Option B is incorrect as lactic acid production by muscles does not significantly impact overall body pH. Option C is incorrect as natural acids found in foods, such as citric acid, do not play a major role in hydrogen ion production within the body.
Question 2 of 5
A client is brought to the emergency department with complaints of shortness of breath. Assessment reveals a full, bounding pulse, severe edema, and audible crackles in lower lung fields bilaterally. What is the client's most likely diagnosis?
Correct Answer: B
Rationale: The correct answer is B: Fluid volume excess. The client's symptoms of full, bounding pulse, severe edema, and crackles in the lung fields suggest fluid overload. A full, bounding pulse indicates increased circulating volume. Severe edema and crackles in the lungs are classic signs of fluid overload leading to pulmonary congestion. Hyponatremia (A) presents with different symptoms like confusion and muscle cramps. Electrolyte imbalance: hypocalcemia (C) would not typically present with the described symptoms. Hyperkalemia (D) would manifest with cardiac arrhythmias and muscle weakness, not the symptoms described.
Question 3 of 5
A 52-year-old patient has just passed a kidney stone and has high levels of calcium in her urine. Blood tests show high levels of calcium in her blood as well. What subsequent lab results would be most likely to distinguish between primary hyperparathyroidism and hypercalcemia of malignancy?
Correct Answer: A
Rationale: The correct answer is A: Parathyroid hormone level. In this scenario, distinguishing between primary hyperparathyroidism and hypercalcemia of malignancy is crucial. Primary hyperparathyroidism is characterized by high calcium levels due to overproduction of parathyroid hormone, while hypercalcemia of malignancy is caused by the release of parathyroid hormone-related protein by cancer cells. Measuring the parathyroid hormone level will help differentiate between the two conditions. Bone scan (B) is not specific for these conditions. Plasma phosphate levels (C) may be elevated in primary hyperparathyroidism but are not as specific as parathyroid hormone levels. Serum magnesium level (D) is not directly related to distinguishing between the two conditions.
Question 4 of 5
A patient with chronic kidney disease is experiencing severe pruritus and signs of hypocalcemia. What intervention would address both the symptoms and underlying cause?
Correct Answer: A
Rationale: Rationale: Administering vitamin D supplements is the correct intervention for a patient with chronic kidney disease experiencing pruritus and signs of hypocalcemia. Vitamin D helps in calcium absorption and regulation, addressing the underlying cause of hypocalcemia. By increasing calcium levels, pruritus can also be alleviated. Summary: A: Administering vitamin D supplements is correct as it addresses both symptoms and the underlying cause. B: Prescribing a high-phosphate diet would worsen the condition as excess phosphate can further decrease calcium levels. C: Providing diuretics to reduce fluid retention does not address the hypocalcemia or pruritus. D: Increasing oral calcium intake through supplements may be harmful without addressing the underlying cause of hypocalcemia.
Question 5 of 5
A patient with hypokalemia is prescribed oral potassium supplements. What instruction should the nurse provide?
Correct Answer: C
Rationale: The correct answer is C: Take the medication with a full glass of water or food. This instruction is important because potassium supplements can irritate the stomach lining and cause gastrointestinal upset. Taking it with water or food helps to minimize these side effects. Option A is incorrect because potassium supplements should be taken with food to reduce gastric irritation. Option B is incorrect as crushing potassium tablets can lead to local irritation or damage to the esophagus. Option D is incorrect because diarrhea is a common side effect of potassium supplements and does not necessarily warrant discontinuation of the medication.