ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. The nurse in the medical ICU is caring for a patient who is in respiratory acidosis due to inadequate ventilation. What diagnosis could the patient have that could cause inadequate ventilation?
- A. Endocarditis
- B. Multiple myeloma
- C. Guillain-Barr syndrome
- D. Overdose of amphetamines
Correct answer: C
Rationale:
2. 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:
3. Where is the largest volume of water in the body located?
- A. Plasma
- B. The fluid inside the cells
- C. Interstitial fluid
- D. Lymph
Correct answer: B
Rationale: The correct answer is B. The largest volume of water in the body is found inside the cells, known as intracellular fluid. This fluid makes up the majority of the body's total water content. Choices A, C, and D are incorrect because while plasma, interstitial fluid, and lymph are important components of the body's fluid compartments, they do not contain the largest volume of water in the body.
4. A client at risk for mild hypernatremia is being taught by a nurse. Which statement should the nurse include in this client's teaching?
- A. Weigh yourself every morning and every night
- B. Check your radial pulse twice a day
- C. Read food labels to determine sodium content
- D. Bake or grill the meat rather than frying it
Correct answer: C
Rationale: The correct answer is to 'Read food labels to determine sodium content.' This is important for a client at risk for mild hypernatremia because monitoring sodium intake is crucial in managing this condition. Choice A is not directly related to managing hypernatremia. Choice B focuses on pulse monitoring, which is not specific to managing sodium levels. Choice D addresses cooking methods, which can be beneficial but is not as directly related to sodium intake monitoring as reading food labels.
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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