ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 5
Diagnostic testing has been ordered to differentiate between normal anion gap acidosis and high anion gap acidosis in an acutely ill patient. What health problem typically precedes normal anion gap acidosis?
Correct Answer: D
Rationale: The correct answer is D: Excessive administration of chloride. Normal anion gap acidosis is commonly caused by an excessive intake of chloride-containing solutions like normal saline during treatment. This leads to an increase in the plasma chloride concentration, causing a decrease in the anion gap. Metastases (A) are not typically associated with normal anion gap acidosis. Excessive potassium intake (B) would not lead to normal anion gap acidosis but rather hyperkalemia. Water intoxication (C) can lead to dilutional hyponatremia but not normal anion gap acidosis.
Question 2 of 5
You are making initial shift assessments on your patients. While assessing one patients peripheral IV site, you note edema around the insertion site. How should you document this complication related to IV therapy?
Correct Answer: C
Rationale: Correct Answer: C - Infiltration Rationale: 1. Infiltration occurs when IV fluid leaks into surrounding tissues, causing edema. 2. Documenting infiltration is important for appropriate management. 3. Air emboli, phlebitis, and fluid overload are unrelated to edema around IV site. Summary of Incorrect Choices: A. Air emboli: This is a serious condition caused by air entering the bloodstream, not related to edema. B. Phlebitis: Inflammation of the vein, usually presenting with redness and pain, not edema. D. Fluid overload: Excess fluid volume in the body, leading to symptoms like shortness of breath, not edema.
Question 3 of 5
. 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 4 of 5
A client with a serum potassium of 7.5 mEq/L and cardiovascular changes needs immediate intervention. Which prescription should the nurse implement first?
Correct Answer: C
Rationale: The correct answer is C. The client's high serum potassium level of 7.5 mEq/L can lead to serious cardiovascular complications like arrhythmias. The immediate priority is to lower potassium levels rapidly to prevent cardiac arrest. Administering dextrose 20% and regular insulin IV push helps shift potassium from extracellular to intracellular space, lowering serum levels quickly. Option A (Kayexalate) is not as rapid as insulin therapy. Option B (low-potassium diet) is not immediate. Option D (hemodialysis) is effective but not as quick as insulin therapy for urgent potassium reduction.
Question 5 of 5
. A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance. The clients arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3 18 mEq/L. Which manifestation should the nurse identify as an exam
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.
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