ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. A nurse assesses a client who is prescribed a medication that inhibits aldosterone secretion and release. For which potential complications should the nurse assess? (Select all that apply.)
- A. Urine output of 25 mL/hr
- B. Serum potassium level of 5.4 mEq/L
- C. Blood osmolality of 250 mOsm/L
- D.
Correct answer: A
Rationale:
2. You are caring for a patient who is being treated on the oncology unit with a diagnosis of lung cancer with bone metastases. During your assessment, you note the patient complains of a new onset of weakness with abdominal pain. Further assessment suggests that the patient likely has a fluid volume deficit. You should recognize that this patient may be experiencing what electrolyte imbalance?
- A. Hypernatremia
- B. Hypomagnesemia
- C. Hypophosphatemia
- D. Hypercalcemia
Correct answer: D
Rationale:
3. A client with a serum potassium of 7.5 mEq/L and cardiovascular changes needs immediate intervention. Which prescription should the nurse implement first?
- A. Prepare to administer sodium polystyrene sulfate (Kayexalate) 15 g by mouth.
- B. Provide a heart-healthy, low-potassium diet.
- C. Prepare to administer dextrose 20% and 10 units of regular insulin IV push.
- D. Prepare the client for hemodialysis treatment.
Correct answer: C
Rationale: In a client with a serum potassium level of 7.5 mEq/L and cardiovascular changes, the priority intervention is to lower the potassium level quickly to prevent life-threatening complications like arrhythmias. The correct answer is to prepare to administer dextrose 20% and 10 units of regular insulin IV push. This combination helps shift potassium from the extracellular to the intracellular space, reducing serum potassium levels rapidly. Administering sodium polystyrene sulfate (Kayexalate) by mouth may take several hours to work, making it a less effective immediate intervention. Providing a heart-healthy, low-potassium diet is important for long-term management but is not the most urgent action in this situation. While hemodialysis is a definitive treatment for hyperkalemia, it is not the first-line intervention for acute management of high potassium levels with cardiovascular manifestations.
4. Diagnostic testing has been ordered to differentiate between normal anion gap acidosis and high anion gap acidosis in an acutely ill patient. What health problem typically precedes normal anion gap acidosis?
- A. Metastases
- B. Excessive potassium intake
- C. Water intoxication
- D. Excessive administration of chloride
Correct answer: D
Rationale:
5. A nurse is planning care for a client who is hyperventilating. The clients arterial blood gas values are pH 7.30, PaO2 94 mm Hg, PaCO2 31 mm Hg, and HCO3 26 mEq/L. Which question should the nurse ask when developing this clients plan of care?
- A. Do you take any over-the-counter medications?
- B. You appear anxious. What is causing your distress?
- C. Do you have a history of anxiety attacks?
- D. You are breathing fast. Is this causing you to feel light-headed?
Correct answer: B
Rationale:
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