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. 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.
3. Electrolytes:
- A. do not form when glucose is added to water.
- B. dissociate in water solutions, but do not form ions.
- C. form ions in water solutions, but do not necessarily dissociate.
- D. dissociate in water solutions and form ions in water solutions.
Correct answer: D
Rationale: The correct answer is D. Electrolytes are substances that dissociate into ions when dissolved in water, allowing the solution to conduct electricity. Choice A is incorrect because glucose does not form electrolytes when added to water. Choice B is incorrect as it states that electrolytes dissociate but do not form ions, which is inaccurate as electrolytes do form ions in water solutions. Choice C is also incorrect as it states that electrolytes form ions but may not necessarily dissociate, which goes against the definition of electrolytes that must dissociate into ions for conductivity. Therefore, choice D is the most accurate as it correctly describes that electrolytes dissociate in water solutions and form ions, highlighting the essential characteristics of electrolytes.
4. You are caring for a patient who has a diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH). Your patient's plan of care includes assessment of specific gravity every 4 hours. The results of this test will allow the nurse to assess what aspect of the patient's health?
- A. Nutritional status
- B. Potassium balance
- C. Calcium balance
- D. Fluid volume status
Correct answer: D
Rationale: Assessing the specific gravity in a patient with SIADH helps the nurse evaluate the patient's fluid volume status. Specific gravity indicates the concentration of solutes in the urine and can detect if the patient has a fluid volume deficit or excess. Nutritional status, potassium balance, and calcium balance are not directly assessed through specific gravity testing. Nutritional status is typically evaluated through dietary intake and anthropometric measurements. Potassium balance is assessed through blood tests and ECG monitoring. Calcium balance is evaluated through blood tests and bone density scans. Therefore, the correct answer is assessing fluid volume status through specific gravity testing.
5. You are called to your patients room by a family member who voices concern about the patients status. On assessment, you find the patient tachypnic, lethargic, weak, and exhibiting a diminished cognitive ability. You also find 3+ pitting edema. What electrolyte imbalance is the most plausible cause of this patients signs and symptoms?
- A. Hypocalcemia
- B. Hyponatremia
- C. Hyperchloremia
- D. Hypophosphatemia
Correct answer: C
Rationale:
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