ATI RN
Fluid and Electrolytes ATI
1. The healthcare provider is evaluating a patient's laboratory results. Based on the laboratory findings, what results will cause the release of an antidiuretic hormone (ADH)?
- A. Increased serum sodium
- B. Decreased serum sodium
- C. Decrease in serum osmolality
- D. Decrease in thirst
Correct answer: A
Rationale: The correct answer is A: Increased serum sodium. When serum sodium levels increase, it triggers the release of ADH by the posterior pituitary gland. ADH helps in retaining water, reducing urine output, and maintaining fluid balance. Choices B, C, and D are incorrect because decreased serum sodium, decrease in serum osmolality, and decrease in thirst do not stimulate the release of ADH.
2. A patient with diabetes insipidus is admitted to the intensive care unit after a motor vehicle accident that resulted in head trauma and damage to the pituitary gland. Diabetes insipidus can occur when there is a decreased production of which of the following?
- A. ADH
- B. Estrogen
- C. Aldosterone
- D. Renin
Correct answer: A
Rationale: The correct answer is A: ADH. Diabetes insipidus is characterized by a deficiency in antidiuretic hormone (ADH), leading to excessive urine output and thirst. In this scenario, the head trauma and damage to the pituitary gland can result in decreased production or release of ADH. Estrogen (Choice B) is not directly related to diabetes insipidus. Aldosterone (Choice C) is a hormone that regulates sodium and potassium levels, not water balance like ADH. Renin (Choice D) is an enzyme involved in the regulation of blood pressure and fluid balance but not directly related to diabetes insipidus.
3. 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 mmol/L. The labs reflect:
- A. Respiratory acidosis
- B. Metabolic alkalosis
- C. Respiratory alkalosis
- D. Metabolic acidosis
Correct answer: A
Rationale: The ABG values indicate respiratory acidosis. A pH below 7.40, a PaCO2 above 40 mm Hg, and a normal HCO3 level (24 mmol/L) suggest respiratory acidosis. In this case, the patient has an acidic pH (7.21) and an elevated PaCO2 (64 mm Hg), indicating inadequate ventilation. The normal HCO3 level suggests that compensation by the kidneys has not occurred, implying an acute event. Choices B, C, and D can be ruled out based on the given ABG values and the criteria for acid-base disorders.
4. What electrolyte value should be monitored when a patient is receiving a loop diuretic?
- A. Calcium levels
- B. Phosphorus levels
- C. Potassium levels
- D. Magnesium levels
Correct answer: C
Rationale: When a patient is receiving a loop diuretic like furosemide (Lasix), potassium levels should be monitored closely. Loop diuretics act on the ascending loop of Henle to inhibit the reabsorption of sodium and water, leading to potassium loss. Monitoring potassium levels is crucial to prevent hypokalemia, which can result in serious complications such as cardiac arrhythmias. Calcium levels (Choice A), phosphorus levels (Choice B), and magnesium levels (Choice D) are not typically affected directly by loop diuretics and do not require routine monitoring in this context.
5. The patient asks the nurse if he will die if air bubbles get into the IV tubing. What is the nurse's best response?
- A. The system is closed, and that scenario is highly unlikely.
- B. Only relatively large volumes of air administered rapidly are dangerous.
- C. There is a risk of complications associated with IV administration.
- D. You have been influenced by movies too much.
Correct answer: B
Rationale: The correct answer is B because air emboli are more commonly associated with central vein access. Usually, only relatively large volumes of air administered rapidly are dangerous. It is a significant concern when air enters a central venous access line. Choice A is incorrect as it downplays the risk and is not entirely accurate. Choice C is too general and does not specifically address the patient's concern. Choice D is dismissive and does not provide any relevant information regarding the risk of air bubbles in IV tubing.
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