ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. . A medical nurse educator is reviewing a patients recent episode of metabolic acidosis with members of the nursing staff. What should the educator describe about the role of the kidneys in metabolic acidosis?
- A. The kidneys retain hydrogen ions and excrete bicarbonate ions to help restore balance.
- B. The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance
- C. The kidneys react rapidly to compensate for imbalances in the body
- D. The kidneys regulate the bicarbonate level in the intracellular fluid.
Correct answer: The kidneys excrete hydrogen ions and conserve bicarbonate ions to help restore balance
Rationale:
2. A nurse is preparing to perform tracheostomy care for a client. Which of the following actions should the nurse take first?
- A. Apply a sterile dressing.
- B. Suction the tracheostomy.
- C. Remove the inner cannula.
- D. Clean the stoma with sterile saline.
Correct answer: B
Rationale: Suctioning the tracheostomy should be performed first to clear the airway of secretions and ensure proper oxygenation before proceeding with other care. This helps maintain a patent airway and prevent complications such as aspiration. Applying a sterile dressing, removing the inner cannula, or cleaning the stoma can follow after ensuring adequate airway clearance through suctioning.
3. After organizing, follow-up visits are also necessary. What should you do first?
- A. Explain the purpose of the visit
- B. Wash your hands and perform the necessary procedure
- C. Conduct environmental surveillance
- D. Greet the patient/resident and introduce yourself
Correct answer: A
Rationale: Explaining the purpose of the visit is the first step in a follow-up visit as it establishes the reason for the interaction. This communication helps set expectations for both the provider and the patient/resident, ensuring that the visit is focused and productive. It allows the patient/resident to understand the goals of the follow-up and promotes a patient-centered approach to care.
4. Physiologically, the child compensates for fluid volume losses by which mechanism?
- A. Inhibition of aldosterone secretion
- B. Hemoconcentration to reduce cardiac workload
- C. Fluid shift from interstitial space to intravascular space
- D. Vasodilation of peripheral arterioles to increase perfusion
Correct answer: C
Rationale: In response to dehydration, the body compensates by shifting fluids from the interstitial spaces to the intravascular space to maintain blood pressure and perfusion to vital organs. Hemoconcentration and vasoconstriction are other compensatory mechanisms but are less immediate.
5. A male patient is being treated with sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?
- A. Peptic ulcer disease
- B. History of myocardial infarction
- C. Recent use of antihypertensive medications
- D. Use of nitrates
Correct answer: D
Rationale: The correct answer is D: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, and the combination can lead to a dangerous drop in blood pressure. Choice A, peptic ulcer disease, is not a contraindication for sildenafil use. Choice B, a history of myocardial infarction, is not a contraindication unless the patient is also taking nitrates. Choice C, recent use of antihypertensive medications, is not a contraindication but requires caution as the combination can lead to additive effects lowering blood pressure.
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