ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 5
The ICU nurse is caring for a patient who experienced trauma in a workplace accident. The patient is complaining of having trouble breathing with abdominal pain. An ABG reveals the following results: pH 7.28, PaCO2 50 mm Hg, HCO3 23 mEq/L. The nurse should recognize the likelihood of what acidbase disorder?
Correct Answer: D
Rationale: The correct answer is D: Mixed acid-base disorder. The ABG results show a pH within the acidic range (7.28), indicating acidosis. The PaCO2 is elevated (50 mm Hg), suggesting respiratory acidosis as the primary disorder. However, the HCO3 level is within normal range (23 mEq/L), which is not consistent with compensatory metabolic alkalosis. Therefore, the presence of both respiratory acidosis and normal HCO3 levels indicates a mixed acid-base disorder. Choice A (Respiratory acidosis) is incorrect because although the patient has an elevated PaCO2, the normal HCO3 level rules out a pure respiratory acidosis. Choice B (Metabolic alkalosis) and C (Respiratory alkalosis) are incorrect as the ABG results do not support these diagnoses.
Question 2 of 5
1.A nurse prepares to insert a peripheral venous catheter in an older adult client. Which action should the nurse take to protect the clients skin during this procedure?
Correct Answer: D
Rationale: The correct answer is D: Place a washcloth between the skin and tourniquet. This step helps protect the client's skin by providing a barrier between the tourniquet and the skin, reducing the risk of skin irritation or damage. Lowering the extremity below the heart (A) can increase venous pressure and make it harder to insert the catheter. Warm compresses (B) can dilate blood vessels and increase the risk of bruising. Tapping the skin lightly (C) can irritate the skin and is unnecessary for skin protection.
Question 3 of 5
After administering 40 mEq of potassium chloride, a nurse evaluates the clients response. Which manifestations indicate that treatment is improving the clients hypokalemia? (Select all tha do not t apply.)
Correct Answer: C
Rationale: The correct answer is C: U waves present on the electrocardiogram (ECG). U waves are indicative of hypokalemia, and their presence indicates that the potassium chloride treatment is improving the condition. Explanation: 1. A: Strong productive cough - This manifestation is not related to potassium levels and does not indicate improvement in hypokalemia. 2. B: Active bowel sounds - While hypokalemia can cause gastrointestinal issues, active bowel sounds alone do not specifically indicate improvement in potassium levels. 3. C: U waves present on ECG - U waves are a classic ECG finding in hypokalemia. The presence of U waves indicates a positive response to potassium chloride treatment. 4. D: No response provided - Not applicable. In summary, the presence of U waves on the ECG is a key indicator of improvement in hypokalemia, while the other manifestations do not directly relate to potassium levels.
Question 4 of 5
. A medical nurse educator is reviewing a patients recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?
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.
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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