ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. A nurse is assessing clients for fluid and electrolyte imbalances. Which client should the nurse assess first for potential hyponatremia?
- A. A 34-year-old on NPO status who is receiving intravenous D5W
- B. A 50-year-old with an infection who is prescribed a sulfonamide antibiotic
- C. A 67-year-old who is experiencing pain and is prescribed ibuprofen (Motrin)
- D. A 73-year-old with tachycardia who is receiving digoxin (Lanoxin)
Correct answer: A 34-year-old on NPO status who is receiving intravenous D5W
Rationale: The correct answer is the 34-year-old on NPO status receiving intravenous D5W because D5W is a hypotonic solution that can dilute the blood's sodium levels, leading to hyponatremia. Patients on NPO status rely solely on intravenous fluids for hydration, making them more susceptible to electrolyte imbalances. Choices B, C, and D are less likely to cause hyponatremia. Choice B, the 50-year-old with an infection on a sulfonamide antibiotic, is at risk for allergic reactions or renal issues. Choice C, the 67-year-old taking ibuprofen, is at risk for gastrointestinal bleeding or kidney problems. Choice D, the 73-year-old on digoxin with tachycardia, is more likely to experience digoxin toxicity, affecting the heart's rhythm.
2. A nurse is assessing a client who has acute pancreatitis and is at risk for an acid-base imbalance. For which manifestation of this acid-base imbalance should the nurse assess?
- A. Agitation
- B. Kussmaul respirations
- C. Seizures
- D. Positive Chvosteks sign
Correct answer: Kussmaul respirations
Rationale:
3. A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:
- A. administer a psychotropic medication to help the client cope with the sensation of his amputated leg.
- B. explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
- C. call the physician and request an order for a psychological consult.
- D. educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.
Correct answer: B
Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.
4. A healthcare professional is preparing to administer Haloperidol 2 mg PO every 12 hr. The available medication is haloperidol 1 mg/tablet. How many tablets should the healthcare professional administer?
- A. 1 tablet
- B. 2 tablets
- C. 3 tablets
- D. 4 tablets
Correct answer: B
Rationale: To calculate the number of tablets needed, divide the desired dose by the dose per tablet. In this case, (2 mg / 1 mg/tablet) = 2 tablets required to administer the correct dosage of Haloperidol.
5. While reviewing notes from a previous shift, a nurse finds incomplete documentation. What is the most appropriate action?
- A. Complete the missing documentation
- B. Notify the nurse manager of the issue
- C. Ask the nurse to complete the documentation
- D. Confront the nurse about the incomplete notes
Correct answer: B
Rationale: The most appropriate action when finding incomplete documentation is to notify the nurse manager of the issue. This ensures that accurate records are maintained and the situation can be addressed properly. Completing the missing documentation on behalf of someone else may lead to inaccuracies, asking the nurse to complete it may not guarantee timely correction, and confronting the nurse could create a confrontational situation that is not conducive to effective teamwork.
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