ATI RN
ATI Fundamental Exam Chapter 25 Candile Questions
Extract:
Question 1 of 5
A client has the following laboratory values: a pH of 7.55 an HCO3 level of 22 mEq/L and a PaCO2 of 30 mmHg. Which action would the nurse plan to take?
Correct Answer: D
Rationale: This is incorrect because normal saline is not indicated for this client. Normal saline is a isotonic solution that does not alter the acid-base balance. The client has respiratory alkalosis, which is caused by hyperventilation and results in a high pH and a low PaCO2. This is incorrect because Allen's test is not relevant for this client. Allen's test is a test to assess the patency of the radial and ulnar arteries before performing an arterial blood gas (ABG) sampling or cannulation. The client already has ABG results, so there is no need to perform Allen's test. This is incorrect because increasing breathing would worsen the client's condition. Increasing breathing would cause the client to exhale more carbon dioxide, which would lower the PaCO2 and raise the pH even more. This would increase the severity of respiratory alkalosis. This is correct because slowing down breathing would help the client to correct the respiratory alkalosis. Slowing down breathing would allow the client to retain more carbon dioxide, which would increase the PaCO2 and lower the pH. This would bring the acid-base balance closer to normal.
Question 2 of 5
The nurse is caring for a client with respiratory insufficiency. The arterial blood gas (ABG) results indicate a pH of 7.50 and a PaCO2 of 30 mm Hg and the nurse concludes that the client is experiencing respiratory alkalosis. Which additional laboratory value would the nurse expect to note in this client?
Correct Answer: D
Rationale: This is incorrect because sodium level of 145 mEq/L is within the normal range of 135 to 145 mEq/L. Sodium is not directly affected by respiratory alkalosis, but it may be altered by fluid balance or other conditions. This is incorrect because magnesium level of 1.3 mEq/L is within the normal range of 1.3 to 2.1 mEq/L. Magnesium is not directly affected by respiratory alkalosis, but it may be altered by renal function or other conditions. This is incorrect because phosphorus level of 3.0 mg/dL is within the normal range of 2.5 to 4.5 mg/dL. Phosphorus is not directly affected by respiratory alkalosis, but it may be altered by calcium balance or other conditions. This is correct because potassium level of 3.0 mEq/L is below the normal range of 3.5 to 5.0 mEq/L. Potassium is inversely related to hydrogen ions, which are decreased in respiratory alkalosis. As hydrogen ions move out of the cells to buffer the blood, potassium ions move into the cells to maintain electrical neutrality. This causes hypokalemia, or low potassium level.
Question 3 of 5
George Torres is admitted with a head injury. He is comatose and is breathing rapidly. His blood gases show a pH of 7.47 PaCO2 of 32 mm Hg and HCO3- of 26 mEq/L. Compare these gases to normal values. What type of imbalance does this patient have and is it being compensated or uncompensated?
Correct Answer: C
Rationale: Metabolic alkalosis is a condition where the pH and the HCO3- are both elevated, indicating a loss of acids or a gain of bases in the body. This is not the case for this patient, as his HCO3- is within the normal range of 22 to 26 mEq/L. Respiratory acidosis is a condition where the pH and the PaCO2 are both low, indicating a retention of carbon dioxide in the lungs due to hypoventilation. This is not the case for this patient, as his pH is high and his PaCO2 is low. Respiratory alkalosis is a condition where the pH and the PaCO2 are both high, indicating a loss of carbon dioxide in the lungs due to hyperventilation. This is the case for this patient, as his pH is above the normal range of 7.35 to 7.45 and his PaCO2 is below the normal range of 35 to 45 mm Hg. This condition is uncompensated, as his HCO3- is within the normal range and has not changed to counteract the pH imbalance. Metabolic acidosis is a condition where the pH and the HCO3- are both low, indicating a gain of acids or a loss of bases in the body. This is not the case for this patient, as his pH is high and his HCO3- is within the normal range.
Question 4 of 5
An isotonic state exists within a patient's body fluids when the solute concentration of:
Correct Answer: C
Rationale: This is incorrect because intracellular fluid is greater than extracellular fluid in a hypertonic state, not an isotonic state. A hypertonic state is when the solute concentration of the extracellular fluid is higher than the intracellular fluid, which causes water to move out of the cells and shrink them. This is incorrect because extracellular fluid is less than intracellular fluid in a hypotonic state, not an isotonic state. A hypotonic state is when the solute concentration of the extracellular fluid is lower than the intracellular fluid, which causes water to move into the cells and swell them. This is correct because intracellular and extracellular fluid is equal in an isotonic state. An isotonic state is when the solute concentration of the extracellular fluid is the same as the intracellular fluid, which causes no net movement of water across the cell membrane. This is incorrect because interstitial fluid is less than the transcellular fluid in a situation of fluid imbalance, not an isotonic state. Interstitial fluid is the fluid that surrounds the cells, while transcellular fluid is the fluid that is contained in specialized cavities, such as cerebrospinal fluid, synovial fluid, or pleural fluid.
Question 5 of 5
An isotonic solution contains equal solute concentration on both sides.
Correct Answer: A
Rationale: This is correct because an isotonic solution has equal solute concentration on both sides of a semipermeable membrane, resulting in no net movement of water.