a nurse in the neurologic icu has orders to infuse a hypertonic solution into a patient with increased intracranial pressure this solution will increa

ATI RN

ATI Fluid Electrolyte and Acid-Base Regulation

1. A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patients blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following?

A. Hydrostatic pressure
B. Osmosis and osmolality
C. Diffusion
D. Active transport

Correct answer: B

Rationale:

2. A nurse is caring for a client who is experiencing excessive diarrhea. The clients arterial blood gas values are pH 7.28, PaO2 98 mm Hg, PaCO2 45 mm Hg, and HCO3 16 mEq/L. Which provider order should the nurse expect to receive?

A. Furosemide (Lasix) 40 mg intravenous push
B. Sodium bicarbonate 100 mEq diluted in 1 L of D5W
C. Mechanical ventilation
D. Indwelling urinary catheter

Correct answer: B

Rationale:

3. What happens first in dehydration?

A. Intercellular fluid volume drops first.
B. Plasma volume drops first.
C. Interstitial fluid drops first.
D. Neither interstitial nor intracellular fluid volume are affected.

Correct answer: C

Rationale: In dehydration, the body first draws fluid from the interstitial space to maintain blood volume, leading to a decrease in interstitial fluid volume. This is why choice C is correct. Choice A is incorrect because intracellular fluid is not the first to be affected. Choice B is also incorrect as plasma volume reduction typically occurs after interstitial fluid loss. Choice D is incorrect as dehydration impacts both interstitial and intracellular fluid volumes.

4. A nurse is caring for a client who is receiving an epidural infusion for pain management. Which assessment finding requires immediate intervention from the nurse?

A. Redness at the catheter insertion site
B. Report of headache and stiff neck
C. Temperature of 100.1 F (37.8 C)
D. Pain rating of 8 on a scale of 0 to 10

Correct answer: B

Rationale:

5. A patient who is hospitalized with a possible electrolyte imbalance is disoriented and weak, has an irregular pulse, and takes hydrochlorothiazide. He most likely suffers from:

A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypokalemia

Correct answer: D

Rationale: The patient is displaying symptoms of hypokalemia, including weakness, disorientation, irregular pulse, which can lead to cardiac disturbances. Hydrochlorothiazide is a potassium-wasting diuretic that can cause hypokalemia if not accompanied by potassium replacement therapy. Hypernatremia (choice A) is characterized by high sodium levels, not potassium. Hyponatremia (choice B) is low sodium levels. Hyperkalemia (choice C) is high potassium levels, which is not consistent with the symptoms described in the question.