ATI Fluid Electrolyte and Acid-Base Regulation

Correct Answer: A

Rationale: The correct answer is A because electrolyte-free water, such as sterile water, can rapidly enter red blood cells due to osmotic differences, causing them to swell and potentially rupture, leading to hemolysis. This can result in severe harm to the patient. Choice B is incorrect because electrolyte-free water is not indicated for severely dehydrated patients with neurologic signs and symptoms. They require electrolytes to correct their imbalances. Choice C is incorrect as administering electrolyte-free water would not address excess calcium and/or magnesium ions in the body. Specific treatments for hypercalcemia or hypermagnesemia are needed. Choice D is incorrect because patients with fluid deficits due to renal failure require electrolyte-balanced solutions to manage their condition effectively. Electrolyte-free water would not address the electrolyte imbalances associated with renal failure.

Correct Answer: A

Rationale: The correct answer is A: Increased rate and depth of respirations. In this case, the client's arterial blood gas values show a pH within normal range (7.36), PaCO2 below normal (33 mm Hg), and HCO3 below normal (18 mEq/L), indicating a metabolic acidosis. To compensate for the acidosis, the client will hyperventilate, leading to increased rate and depth of respirations to blow off excess CO2 and attempt to normalize the pH. Options B, C, and D are incorrect because increased urinary output, thirst, hunger, and release of acids from the kidneys are not direct compensatory mechanisms for metabolic acidosis.

Correct Answer: C

Rationale: Rationale: Option C is correct because berries, cherries, apples, and peaches are indeed low in potassium compared to other fruits. This response acknowledges the client's love for fruits while providing suitable alternatives to manage potassium levels. By choosing these low-potassium fruits, the client can continue enjoying fruits without exacerbating hyperkalemia. Incorrect options: A: Potatoes and avocados are high in potassium, so they are not suitable substitutes. B: Cooking fruit does not significantly reduce its potassium content. D: This option lacks guidance and does not offer a solution to the client's concern about high potassium levels.

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: Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively. Patient with pancreatitis may have depleted levels of phosphorus due to malnutrition, and rapid initiation of TPN can further decrease phosphorus levels, leading to hypophosphatemia. This can result in respiratory failure, muscle weakness, and arrhythmias. Choice A is incorrect because patients receiving TPN are not specifically at risk for hypercalcemia due to rapid initiation of calories. Choice C is incorrect because rapid fluid infusion can lead to hypernatremia, not related to TPN initiation. Choice D is incorrect because the rationale provided for slow initiation is not related to digestive enzymes but rather to prevent hypophosphatemia in malnourished patients.