ATI RN
Fluid and Electrolytes ATI
1. A 73-year-old man who slipped on a small carpet in his home and fell on his hip is alert and oriented; PERRLA (pupils equally round and reactive to light and accommodation) is intact, and he has come by ambulance to the emergency department (ED). Heart rate elevated, he is anxious and thirsty. A Foley catheter is in place and 40mL of urine is present. The nurse's most likely explanation for the urine output is:
- A. The man urinated prior to his arrival in the ED and will probably not need to have the Foley catheter kept in place.
- B. The man has a brain injury, lacks ADH, and needs vasopressin.
- C. The man is in heart failure and is releasing atrial natriuretic peptide, which results in decreased urine output.
- D. He is having a sympathetic reaction, which has stimulated the renin-angiotensin-aldosterone system that results in diminished urine output.
Correct answer: D
Rationale: Renin is released by the juxtaglomerular cells of the kidneys in response to decreased renal perfusion. Angiotensin-converting enzyme converts angiotensin I to angiotensin II. Angiotensin II, with its vasoconstrictor properties, increases arterial perfusion pressure and stimulates thirst. As the sympathetic nervous system is stimulated, aldosterone is released in response to an increased release of renin, which decreases urine production. Based on the nursing assessment and mechanism of injury, this is the most likely cause of the lower urine output. Choices A, B, and C are incorrect because there is no indication of urination prior to arrival, brain injury, lack of ADH, or heart failure present in the scenario provided. The symptoms and context described point more towards a physiological response related to the sympathetic nervous system and the renin-angiotensin-aldosterone system rather than the other conditions mentioned.
2. What is one limitation of the ethnographic method?
- A. Investigators' cultural values sometimes lead them to misinterpret what they see.
- B. It provides little information on how children and adults actually behave.
- C. It relies on unobtrusive techniques, such as surveillance cameras and one-way mirrors.
- D. It provides little information about the reasoning behind participants' responses.
Correct answer: A
Rationale: The limitation of the ethnographic method is that investigators' cultural values sometimes lead them to misinterpret what they see. This can introduce bias into the observations and potentially impact the accuracy of the findings. It is important for researchers to be aware of their own biases and strive to minimize their influence when conducting ethnographic studies. Choice B is incorrect because ethnographic methods actually aim to provide rich information on how individuals behave within their cultural contexts. Choice C is incorrect as ethnographic methods typically involve direct observation and participation rather than unobtrusive techniques like surveillance cameras. Choice D is incorrect because one of the strengths of ethnographic research is its ability to uncover the reasoning behind participants' responses by immersing the researcher in the cultural setting.
3. A nurse assesses a client who is admitted for treatment of fluid overload. Which manifestations should the nurse expect to find? (Select all that do not apply.)
- A. Increased pulse rate
- B. . Distended neck veins
- C. Warm and pink skin
- D. Skeletal muscle weakness
Correct answer: Warm and pink skin
Rationale:
4. What is the term for the amount of blood ejected by the left ventricle into the aorta per beat, determined by preload, contractility, and afterload?
- A. Stroke volume
- B. Cardiac output
- C. End-diastolic volume
- D. Ejection fraction
Correct answer: A
Rationale: The correct answer is A: Stroke volume. Stroke volume refers to the volume of blood ejected by the left ventricle during each heartbeat. This is determined by preload (the degree of stretch of the cardiac muscle fibers at the end of diastole), contractility (the force of myocardial contraction), and afterload (the pressure or resistance that the ventricle must overcome to eject blood). Choice B, Cardiac output, is the volume of blood pumped by the heart per minute and is calculated by multiplying the heart rate by the stroke volume. Choice C, End-diastolic volume, is the volume of blood in the ventricle at the end of diastole before contraction. Choice D, Ejection fraction, is the proportion of blood pumped out of the ventricle with each contraction, calculated by dividing the stroke volume by the end-diastolic volume.
5. A healthcare professional is teaching a client who has a new prescription for Clopidogrel. Which of the following laboratory values should the healthcare professional monitor to assess for potential adverse effects?
- A. White blood cell count
- B. Platelet count
- C. Hemoglobin
- D. Blood glucose
Correct answer: B
Rationale: Clopidogrel is an antiplatelet medication that works by preventing blood clots. Monitoring the patient's platelet count is essential because a decrease in platelet count can increase the risk of bleeding. By assessing the platelet count, the healthcare professional can detect any potential adverse effects related to the medication and take appropriate actions to prevent complications. White blood cell count, hemoglobin, and blood glucose levels are not directly affected by Clopidogrel, so they are not the primary values to monitor for potential adverse effects of this medication.
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