ATI Fluid Electrolyte and Acid-Base Regulation

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ATI Fluid Electrolyte and Acid-Base Regulation Questions

Question 1 of 5

A nurse assesses a client who is prescribed furosemide (Lasix) for hypertension. For which acid-base imbalance should the nurse assess to prevent complications of this therapy?

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.

Question 2 of 5

You are an emergency-room nurse caring for a trauma patient. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would you interpret these results?

Correct Answer: D

Rationale: To interpret the given ABG results: 1. pH <7.35 indicates acidosis. 2. PaCO2 <35 indicates respiratory alkalosis. 3. HCO3 <22 indicates metabolic acidosis. Therefore, the ABG results show metabolic acidosis (low pH, low HCO3) with compensatory respiratory alkalosis (low PaCO2). This means the body is trying to compensate for the metabolic acidosis by decreasing PaCO2 through hyperventilation. Option D is correct. Options A, B, and C are incorrect as they do not align with the ABG results and the principles of acid-base balance.

Question 3 of 5

A nurse assesses a client who was started on intraperitoneal therapy 5 days ago. The client reports abdominal pain and feeling warm. For which complication of this therapy should the nurse assess this client?

Correct Answer: D

Rationale: The correct answer is D, infection. The client's symptoms of abdominal pain and feeling warm are indicative of a potential infection, which is a common complication of intraperitoneal therapy. Step-by-step rationale: 1. Abdominal pain can be a sign of peritonitis, an infection of the peritoneal cavity. 2. Feeling warm may indicate a fever, a common symptom of infection. 3. Prompt assessment and treatment of infection are crucial to prevent complications. Summary of other choices: A, allergic reaction - unlikely given the symptoms described; B, bowel obstruction - does not align with the symptoms provided; C, catheter lumen occlusion - not typically associated with abdominal pain and feeling warm.

Question 4 of 5

A newly graduated nurse is admitting a patient with a long history of emphysema. The new nurses preceptor is going over the patients past lab reports with the new nurse. The nurse takes note that the patients PaCO2 has been between 56 and 64 mm Hg for several months. The preceptor asks the new nurse why they will be cautious administering oxygen. What is the new nurses best response?

Correct Answer: D

Rationale: The correct answer is D: Using oxygen may result in the patient developing carbon dioxide narcosis and hypoxemia. In patients with chronic emphysema, their respiratory drive is often triggered by low oxygen levels rather than high carbon dioxide levels. Administering supplemental oxygen can suppress their respiratory drive, leading to carbon dioxide retention (carbon dioxide narcosis) and worsening hypoxemia. This phenomenon is known as "hypoxic drive." Choice A is incorrect because administering oxygen does not lead to a dramatic rise in calcium levels due to pituitary stimulation. Choice B is incorrect because administering oxygen does not typically increase intracranial pressure or cause confusion. Choice C is incorrect because administering oxygen does not directly cause hyperventilation and acidosis in this scenario.

Question 5 of 5

You are called to your patients room by a family member who voices concern about the patients status. On assessment, you find the patient tachypnic, lethargic, weak, and exhibiting a diminished cognitive ability. You also find 3+ pitting edema. What electrolyte imbalance is the most plausible cause of this patients signs and symptoms?

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.

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