ATI RN
ATI Fluid and Electrolytes
1. 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?
- A. Hypophosphatemia
- B. Hypocalcemia
- C. Hypermagnesemia
- D. Hyperkalemia
Correct answer: B
Rationale: The symptoms described, including tingling in the lips and fingers, intermittent spasms, and increased muscle tone, are indicative of tetany, which is a common manifestation of hypocalcemia. Hypocalcemia can lead to neuromuscular irritability, causing symptoms such as paresthesias and muscle spasms. Hypophosphatemia primarily affects the central nervous system, resulting in seizures and coma. Hypermagnesemia typically presents with hypoactive reflexes and somnolence. Hyperkalemia can cause paresthesias and anxiety, but in this case, the patient's symptoms are more suggestive of hypocalcemia.
2. Which hormone reduces the amount of water in the body?
- A. ADH
- B. aldosterone
- C. ANH
- D. ADH and aldosterone
Correct answer: B
Rationale: The correct answer is 'aldosterone.' Aldosterone is the hormone that reduces the amount of water in the body by increasing the reabsorption of sodium and water from the kidney tubules. ANH (atrial natriuretic hormone) actually works to increase the excretion of sodium and water by the kidneys, leading to a reduction in blood volume and pressure. ADH (antidiuretic hormone) works to increase water reabsorption by the kidneys, thereby increasing blood volume. Therefore, choices A (ADH) and D (ADH and aldosterone) are incorrect in the context of reducing the amount of water in the body.
3. Under normal circumstances, the kidneys provide the greatest means of water loss. Which organ provides the second greatest means of water loss?
- A. Skin
- B. Lungs
- C. Intestines
- D. Muscles
Correct answer: A
Rationale: The correct answer is A: Skin. After the kidneys, the skin is the second largest route of water loss through perspiration. Choice B, Lungs, is incorrect as the lungs primarily exchange gases and do not play a significant role in water loss. Choice C, Intestines, is also incorrect as water loss through the intestines is minimal since most water is reabsorbed during digestion. Choice D, Muscles, is incorrect as muscles are not a major source of water loss in the body.
4. Which organ has the greatest effect on fluid output?
- A. Kidneys
- B. Lungs
- C. Skin
- D. Intestines
Correct answer: A
Rationale: The correct answer is the kidneys. The kidneys are primarily responsible for regulating fluid balance by filtering blood and adjusting the volume and concentration of urine. The lungs primarily regulate gas exchange, not fluid balance. The skin plays a role in temperature regulation and protection but is not the primary organ for fluid output. The intestines are mainly involved in the absorption of nutrients and water, rather than fluid output.
5. Which of the following statements is correct?
- A. People with less body fat have more body water.
- B. Infants have more water per pound than adults.
- C. Females have more body water per pound than males.
- D. Infants have the same water content per pound as adults.
Correct answer: A
Rationale: The correct statement is that people with less body fat have more body water. This is because fat tissue contains less water compared to lean tissue, so individuals with less body fat generally have a higher percentage of body water. Choice B is incorrect as infants actually have more water per pound than adults due to their higher body water content. Choice C is incorrect as males typically have more body water per pound than females. Choice D is incorrect as infants have a higher water content per pound compared to adults.
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