ATI Fluid Electrolyte and Acid-Base Regulation

Correct Answer: B

Rationale: Correct Answer: B - The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance. Rationale: 1. In metabolic acidosis, the blood pH is low due to excess acid in the body. 2. To restore pH balance, the kidneys excrete hydrogen ions (acid) and conserve bicarbonate ions (a base). 3. By excreting acid and retaining base, the kidneys help neutralize the excess acid in the body. 4. Option B accurately describes the role of the kidneys in metabolic acidosis. Incorrect Choices: A: Incorrect. The kidneys do not retain hydrogen ions in metabolic acidosis; they excrete them. C: Incorrect. While the kidneys do play a role in correcting imbalances, they do not react rapidly in metabolic acidosis. D: Incorrect. The kidneys do regulate bicarbonate levels, but this is not the primary action in metabolic acidosis.

Correct Answer: A

Rationale: Step-by-step rationale for why option A is correct: 1. Inhibition of aldosterone secretion leads to decreased sodium reabsorption and increased water excretion. 2. Decreased aldosterone can result in decreased blood volume and BP, leading to decreased urine output. 3. Monitoring urine output is crucial to assess renal function and fluid balance. 4. A urine output of 25 mL/hr is considered inadequate and can indicate renal impairment or dehydration. Summary: Option A is correct as it directly relates to the mechanism of action of inhibiting aldosterone secretion. Options B, C, and D are incorrect as they do not align with the expected complications of aldosterone inhibition.

Correct Answer: D

Rationale: The correct answer is D: Metabolic alkalosis. Furosemide, a loop diuretic, can lead to potassium depletion and metabolic alkalosis due to excessive loss of chloride and hydrogen ions. The nurse should assess for signs of metabolic alkalosis such as confusion, muscle weakness, and dysrhythmias to prevent complications. Respiratory acidosis and alkalosis are not directly related to furosemide therapy. Metabolic acidosis is less likely due to furosemide's mechanism of action.

Correct Answer: C

Rationale: The correct answer is C: Hyperchloremia. In this scenario, the patient's symptoms point towards fluid overload, which can lead to hyperchloremia due to excessive chloride intake. 3+ pitting edema suggests fluid retention, a common symptom of hyperchloremia. Additionally, tachypnea can occur as a compensatory mechanism for metabolic acidosis seen in hyperchloremia. Lethargy, weakness, and diminished cognitive ability can be attributed to electrolyte imbalances impacting nerve and muscle function. Choice A: Hypocalcemia is less likely as it typically presents with neuromuscular irritability, not lethargy. Choice B: Hyponatremia usually presents with neurological symptoms like confusion and seizures, not the symptoms described. Choice D: Hypophosphatemia typically presents with muscle weakness, not the full constellation of symptoms described.

Correct Answer: B

Rationale: The correct answer is B: "You appear anxious. What is causing your distress?" because hyperventilation can be triggered by emotional distress or anxiety. By addressing the underlying cause of the hyperventilation, the nurse can provide appropriate interventions to help the client manage their anxiety and subsequently reduce the hyperventilation episodes. A: "Do you take any over-the-counter medications?" - This question is not directly related to addressing the client's anxiety or distress, which is the primary concern in hyperventilation. C: "Do you have a history of anxiety attacks?" - While relevant to understanding the client's medical history, this question does not address the immediate cause of hyperventilation in this specific situation. D: "You are breathing fast. Is this causing you to feel light-headed?" - This question focuses on the physical symptoms of hyperventilation rather than exploring the emotional or psychological triggers, which are essential in managing hyperventilation caused by anxiety.