ATI RN
Fluid and Electrolytes ATI Questions
Question 1 of 5
The nurse in the intensive care unit receives arterial blood gases (ABG) with a patient who is complaining of being 'short of breath.' The ABG has the following values: pH = 7.21, PaCO2 = 64 mm Hg, HCO3 = 24 mm Hg. The labs reflect:
Correct Answer: A
Rationale: A pH of less than 7.40, a PaCO2 greater than 40, and an HCO3 of 24 are normal; therefore, it is a respiratory acidosis. Compensation by the kidneys has not begun, which indicates this was probably an acute event.
Question 2 of 5
A nurse in the medical-surgical unit has a newly admitted patient who is oliguric; the acute care nurse practitioner orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. The nurse is aware this intervention will help:
Correct Answer: C
Rationale: If a patient is not excreting enough urine, the health care provider needs to determine whether the depressed renal function is the result of reduced renal blood flow, which is a fluid Volume deficit (FVD) or prerenal azotemia, or acute tubular necrosis that results in necrosis or cellular death from prolonged FVD. A typical example of a fluid challenge involves administering 100 to 200 mL of normal saline solution over 15 minutes. The response by a patient with FVD but normal renal function is increased urine output and increased blood pressure.
Question 3 of 5
The nurse preparing a site for the insertion of an IV catheter should treat excess hair at the site by:
Correct Answer: C
Rationale: Hair can be a source of infection and should be removed by clipping. Shaving the area can cause skin abrasions, and depilatories can irritate the skin.
Question 4 of 5
A nurse is visiting an 84-year-old woman living at home and recovering from hip surgery. The woman seems confused and has poor skin turgor, and she states that �€œshe stops drinking water early in the day because it is too difficult to get up during the night to go to the bathroom.�€ The nurse explains to the woman that:
Correct Answer: B
Rationale: In elderly patients, the clinical manifestations of fluid and electrolyte disturbances may be subtle or atypical. For example, fluid deficit may cause confusion or cognitive impairment in the elderly person.
Question 5 of 5
When selecting a site on the hand or arm for insertion of an IV catheter, the nurse should:
Correct Answer: B
Rationale: When selecting a site for insertion of an IV catheter, the nurse should choose a distal site, not a proximal site. Selection of a distal site leaves the upper veins available for subsequent cannulations. Instruct the patient to hold his arm in a dependent position to increase blood flow. Never leave a tourniquet in place longer than 2 minutes.
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