a nurse assesses a client who is prescribed a medication that inhibits aldosterone secretion and release for which potential complications should the

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. A nurse is assessing clients who have intravenous therapy prescribed. Which assessment finding for a client with a peripherally inserted central catheter (PICC) requires immediate attention?

A. The initial site dressing is 3 days old.
B. The PICC was inserted 4 weeks ago.
C. A securement device is absent.
D. Upper extremity swelling is noted.

Correct answer: D

Rationale:

3. Which of the following is not considered an extracellular fluid?

A. Cerebrospinal fluid
B. The humors of the eye
C. Lymph
D. Cerebrospinal fluid and the humors of the eye

Correct answer: D

Rationale: The correct answer is D. Cerebrospinal fluid and the humors of the eye are not considered extracellular fluids. Extracellular fluids are fluids found outside the cells, such as interstitial fluid and lymph. Cerebrospinal fluid is found within the central nervous system, while the humors of the eye (aqueous humor and vitreous humor) are located within the eyeball, making them distinct from extracellular fluids.

4. Which hormones increase the amount of water in the body?

A. ADH
B. Aldosterone
C. ANH
D. ADH and aldosterone

Correct answer: D

Rationale: The correct answer is D, ADH and aldosterone. Both antidiuretic hormone (ADH) and aldosterone increase water retention by the kidneys, thereby increasing blood volume. ADH acts on the kidneys to increase water reabsorption, while aldosterone acts on the kidneys to promote sodium reabsorption, leading to water retention. Choice A, ADH, is partially correct as it alone increases water retention. Choice B, aldosterone, is also partially correct as it alone increases water retention. Choice C, ANH (atrial natriuretic hormone), actually decreases water retention by promoting sodium excretion and inhibiting aldosterone release.

5. When selecting a site on the hand or arm for insertion of an IV catheter, the nurse should:

A. Choose a proximal site.
B. Choose a distal site.
C. Have the patient hold their arm in a dependent position.
D. Leave the tourniquet on for no longer than 2 minutes.

Correct answer: B

Rationale: When selecting a site for insertion of an IV catheter, the nurse should choose a distal site, not a proximal site. Opting for a distal site ensures that upper veins remain available for future cannulations. Instructing the patient to hold their arm in a dependent position can enhance blood flow, aiding in the procedure. It is crucial never to leave a tourniquet on for more than 2 minutes as prolonged restriction can lead to complications. Choice A is incorrect because a proximal site is not preferred for IV insertion. Choice C is incorrect as having the patient hold their arm over their head is not necessary and may impede proper blood flow. Choice D is incorrect as leaving the tourniquet on for at least 5 minutes is excessive and can be harmful.