ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation Questions
Question 1 of 5
You are doing discharge teaching with a patient who has hypophosphatemia during his time in hospital. The patient has a diet ordered that is high in phosphate. What foods would you teach this patient to include in his diet? Select all that do not apply
Correct Answer: B
Rationale: The correct answer is B: Beef. While beef is a good source of protein, it is not high in phosphate. Milk, poultry, and liver are high in phosphate and would be beneficial for a patient with hypophosphatemia. Beef is not typically a significant source of phosphate and therefore would not be as effective in increasing phosphate levels in the body compared to the other options. It is important for the patient to focus on consuming foods that are high in phosphate to help correct the hypophosphatemia.
Question 2 of 5
A nurse is caring for a client who has the following arterial blood values: pH 7.12, PaO2 56 mm Hg, PaCO2 65 mm Hg, and HCO3 22 mEq/L. Which clinical situation should the nurse correlate with these values?
Correct Answer: A
Rationale: The correct answer is A: Diabetic ketoacidosis in a person with emphysema. The arterial blood values show a low pH (acidosis), high PaCO2 (respiratory acidosis), and normal HCO3 (compensatory metabolic alkalosis). This pattern is consistent with a mixed acid-base disorder seen in diabetic ketoacidosis where metabolic acidosis from ketone production is partially compensated by respiratory acidosis from decreased alveolar ventilation due to emphysema. The other choices do not align with the given blood values. Choice B is incorrect as it would typically show respiratory alkalosis. Choice C would show respiratory alkalosis with low PaCO2. Choice D would result in metabolic acidosis with low HCO3.
Question 3 of 5
A patient has questioned the nurses administration of IV normal saline, asking whether sterile water would be a more appropriate choice than saltwater. Under what circumstances would the nurse administer electrolyte-free water intravenously?
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.
Question 4 of 5
A gerontologic nurse is teaching students about the high incidence and prevalence of dehydration in older adults. What factors contribute to this phenomenon? Select all that do not apply.
Correct Answer: D
Rationale: The correct answer is D: Increased conservation of sodium. Older adults tend to have an increased conservation of sodium, leading to fluid retention and decreased fluid intake, which can contribute to dehydration. A: Decreased kidney mass is incorrect because it is a factor that can contribute to decreased kidney function but not directly linked to dehydration. B: Decreased renal blood flow can impact kidney function but is not a direct cause of dehydration in older adults. C: Decreased excretion of potassium is not a factor that directly contributes to dehydration in older adults.
Question 5 of 5
You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect?
Correct Answer: B
Rationale: The correct answer is B: Hypocalcemia. Following a thyroidectomy, there is a risk of damaging the parathyroid glands, leading to hypocalcemia. Symptoms such as tingling in lips and fingers, muscle spasms, and increased muscle tone are classic signs of hypocalcemia. The initial concern should be hypocalcemia due to its potential to cause serious complications such as tetany and laryngospasm. Options A, C, and D are incorrect as they do not align with the symptoms described. Hypophosphatemia may present with weakness and respiratory failure, hypermagnesemia with hypotension and respiratory depression, and hyperkalemia with muscle weakness and cardiac arrhythmias.
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