ATI RN
ATI Fluid and Electrolytes
1. A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patient's blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following?
- A. Hydrostatic pressure
- B. Osmosis and osmolality
- C. Diffusion
- D. Active transport
Correct answer: B
Rationale: The correct answer is B: Osmosis and osmolality. Osmosis is the movement of fluid from a region of low solute concentration to a region of high solute concentration across a semipermeable membrane. In this case, the hypertonic solution increases the number of dissolved particles in the blood, causing fluids to shift into the capillaries due to the osmotic pressure gradient. Osmolality refers to the concentration of solutes in a solution. Hydrostatic pressure refers to changes in water or volume related to water pressure, not the movement of fluids due to solute concentration differences. Diffusion is the movement of solutes from an area of greater concentration to lesser concentration; in an intact vascular system, solutes are unable to move freely, so diffusion does not play a significant role in this scenario. Active transport involves the movement of molecules against the concentration gradient with the use of energy, typically at the cellular level, and is not related to the vascular volume changes described in the question.
2. What can cause dehydration?
- A. Prolonged vomiting.
- B. Prolonged diarrhea.
- C. Too little fluid intake.
- D. Prolonged vomiting, diarrhea, and too little fluid intake.
Correct answer: D
Rationale: Dehydration can result from significant fluid loss due to vomiting, diarrhea, or inadequate fluid intake. Prolonged vomiting and diarrhea lead to excessive fluid loss from the body, contributing to dehydration. Similarly, not consuming enough fluids can also result in dehydration. Choice A and B are too specific as they only mention one cause each, while choice C is also correct but does not encompass all the potential causes of dehydration as mentioned in choice D.
3. What is the most abundant positive ion in blood plasma?
- A. Potassium.
- B. Calcium.
- C. Sodium.
- D. Both potassium and sodium are in equal concentrations.
Correct answer: C
Rationale: The correct answer is C: Sodium. Sodium (Na+) is the most abundant cation in the extracellular fluid, including blood plasma. It plays a crucial role in maintaining fluid balance, nerve function, and is essential for various physiological processes. Choice A, Potassium, is also an important ion in the body but is predominantly found intracellularly. Choice B, Calcium, is an essential mineral in the body but is not the most abundant positive ion in blood plasma. Choice D is incorrect as sodium is the primary positive ion in blood plasma, with a much higher concentration compared to potassium.
4. 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.
5. The physician has ordered a peripheral IV to be inserted before the patient goes for computed tomography. What should the nurse do when selecting a site on the hand or arm for insertion of an IV catheter?
- A. Choose a site with minimal hair if available.
- B. Consider potential effects on the patient's mobility when selecting a site.
- C. Instruct the patient to hold his arm in a dependent position before insertion.
- D. Remove the tourniquet after 2 minutes.
Correct answer: B
Rationale: When selecting a site for IV insertion on the hand or arm, it is important to consider the potential effects on the patient's mobility. The chosen site should not interfere with the patient's movement. Instructing the patient to hold his arm in a dependent position helps increase blood flow, aiding in vein visualization and insertion. It is advisable to choose a site with minimal hair if possible for better adhesion of the dressing. Removing the tourniquet after 2 minutes is recommended to prevent complications like hemoconcentration and potential vein damage. Therefore, option B is the correct choice as it aligns with best practices for IV insertion.
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