ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 9
You are caring for a patient who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. During your assessment, you note the patient complains of a new onset of weakness with abdominal pain. Further assessment suggests that the patient likely has a fluid volume deficit. You should recognize that this patient may be experiencing what electrolyte imbalance?
Correct Answer: D
Rationale: The correct answer is D: Hypercalcemia. Bone metastases in lung cancer can lead to increased release of calcium into the blood, causing hypercalcemia. The patient's symptoms of weakness and abdominal pain are consistent with hypercalcemia. Hypernatremia (choice A) is unlikely as the symptoms do not align with high sodium levels. Hypomagnesemia (choice B) and hypophosphatemia (choice C) are less likely as they are not typically associated with bone metastases in lung cancer. In summary, the patient's presentation of weakness and abdominal pain in the setting of lung cancer with bone metastases points to hypercalcemia as the most likely electrolyte imbalance.
Question 2 of 9
You are doing discharge teaching with a patient who has hypophosphatemia during his time in hospital. The patient has a diet ordered that is high in phosphate. What foods would you teach this patient to include in his diet? Select all that do not apply
Correct Answer: B
Rationale: The correct answer is B: Beef. While beef is a good source of protein, it is not high in phosphate. Milk, poultry, and liver are high in phosphate and would be beneficial for a patient with hypophosphatemia. Beef is not typically a significant source of phosphate and therefore would not be as effective in increasing phosphate levels in the body compared to the other options. It is important for the patient to focus on consuming foods that are high in phosphate to help correct the hypophosphatemia.
Question 3 of 9
A nurse is assessing clients on a medical-surgical unit. Which clients are at increased risk for hypophosphatemia? (Select all that do not apply.)
Correct Answer: C
Rationale: The correct answer is C because antacids contain aluminum or magnesium, which can bind with phosphorus and decrease its absorption, leading to hypophosphatemia. Malnourishment (choice A) can cause hypophosphatemia due to inadequate intake, uncontrolled diabetes (choice B) is associated with hyperphosphatemia, and hyperparathyroidism (choice D) can lead to hyperphosphatemia due to increased calcium levels.
Question 4 of 9
A medical-surgical nurse is concerned about the incidence of complications related to IV therapy, including bloodstream infection. Which intervention should the nurse suggest to the management team to make the biggest impact on decreasing complications
Correct Answer: A
Rationale: The correct answer is A: Initiate a dedicated team to insert access devices. This intervention is the most effective in decreasing complications related to IV therapy because having a dedicated team specialized in inserting access devices ensures that the procedure is done correctly each time, reducing the risk of complications such as bloodstream infections. Choice B is not as effective because additional education for all nurses may not guarantee consistent skill levels in IV insertion. Choice C may limit access but does not address the root cause of complications. Choice D focuses on skin preparation, which is important but not as impactful as having a specialized team for IV insertion.
Question 5 of 9
You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect?
Correct Answer: B
Rationale: The correct answer is B: Hypocalcemia. Following a thyroidectomy, there is a risk of damaging the parathyroid glands, leading to hypocalcemia. Symptoms such as tingling in lips and fingers, muscle spasms, and increased muscle tone are classic signs of hypocalcemia. The initial concern should be hypocalcemia due to its potential to cause serious complications such as tetany and laryngospasm. Options A, C, and D are incorrect as they do not align with the symptoms described. Hypophosphatemia may present with weakness and respiratory failure, hypermagnesemia with hypotension and respiratory depression, and hyperkalemia with muscle weakness and cardiac arrhythmias.
Question 6 of 9
A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance should the nurse assess?
Correct Answer: B
Rationale: The correct answer is B: Kussmaul respirations. In acute pancreatitis, metabolic acidosis can occur due to the release of pancreatic enzymes. Kussmaul respirations are deep, rapid breaths that help to blow off excess carbon dioxide in response to acidosis, aiming to correct the pH imbalance. Agitation (A) is a nonspecific symptom and not specific to acid-base imbalances. Seizures (C) are more commonly associated with electrolyte imbalances such as hyponatremia or hypocalcemia. Positive Chvostek's sign (D) is a clinical sign of hypocalcemia, not directly related to acid-base imbalances in acute pancreatitis.
Question 7 of 9
You are caring for a patient with a secondary diagnosis of hypermagnesemia. What assessment finding would be most consistent with this diagnosis?
Correct Answer: D
Rationale: The correct answer is D: Shallow respirations. Hypermagnesemia can lead to respiratory depression due to its inhibitory effect on the central nervous system. Shallow respirations are a common respiratory manifestation of hypermagnesemia. Hypertension (choice A) is not typically associated with hypermagnesemia. Kussmaul respirations (choice B) are deep, rapid breathing patterns seen in metabolic acidosis, not hypermagnesemia. Increased deep tendon reflexes (DTRs) (choice C) are more indicative of hypomagnesemia, as magnesium deficiency can lead to hyperexcitability of nerves and muscles, resulting in increased DTRs.
Question 8 of 9
. One day after a patient is admitted to the medical unit, you note that the patient is oliguric. You notify the acutecare nurse practitioner who orders a fluid challenge of 200 mL of normal saline solution over 15 minutes. This intervention will achieve which of the following?
Correct Answer: C
Rationale: The correct answer is C: Help distinguish reduced renal blood flow from decreased renal function. Rationale: 1. Oliguria is a decrease in urine output. 2. Fluid challenge with normal saline can help determine the cause of oliguria by assessing the response of the kidneys. 3. If the oliguria improves after the fluid challenge, it suggests reduced renal blood flow as the cause. 4. If oliguria persists, it indicates decreased renal function. Summary: A. Fluid challenge does not directly help in distinguishing between hyponatremia and hypernatremia. B. Evaluating pituitary gland function requires specific tests, not just a fluid challenge. D. Treating hypertension-induced oliguria may involve different interventions, not just a fluid challenge.
Question 9 of 9
When planning the care of a patient with a fluid imbalance, the nurse understands that in the human body, water and electrolytes move from the arterial capillary bed to the interstitial fluid. What causes this to occur?
Correct Answer: D
Rationale: Rationale: The correct answer is D. Hydrostatic pressure resulting from the pumping action of the heart causes water and electrolytes to move from the arterial capillary bed to the interstitial fluid. This occurs due to the force exerted by the heart's pumping action, pushing fluid out of the capillaries into the interstitial space. This process is known as filtration and is essential for maintaining fluid balance in the body. Summary of other choices: A: Active transport of hydrogen ions does not directly cause the movement of water and electrolytes between capillaries and interstitial fluid. B: The pressure in renal capillaries specifically relates to the kidneys, not the general movement of water and electrolytes in the body. C: The dissolved particles in blood do not directly contribute to the movement of water and electrolytes between capillaries and interstitial fluid.