a nurse is caring for a client who is experiencing excessive diarrhea the clients arterial blood gas values are ph 728 pao2 98 mm hg paco2 45 mm hg an

ATI RN

ATI Fluid Electrolyte and Acid-Base Regulation

1. 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: Sodium bicarbonate 100 mEq diluted in 1 L of D5W

Rationale:

2. A nurse teaches a client who is being discharged home with a peripherally inserted central catheter (PICC). Which statement should the nurse include in this clients teaching?

A. avoid carrying your grandchild with the arm that has the central catheter.
B. Be sure to place the arm with the central catheter in a sling during the day
C. Flush the peripherally inserted central catheter line with normal saline daily.
D. You can use the arm with the central catheter for most activities of daily living.

Correct answer: avoid carrying your grandchild with the arm that has the central catheter.

Rationale:

3. While assessing clients on a medical-surgical unit, which client is at risk for hypokalemia?

A. Client with pancreatitis who has continuous nasogastric suctioning
B. Client who is prescribed an angiotensin-converting enzyme (ACE) inhibitor
C. Client in a motor vehicle crash who is receiving 6 units of packed red blood cells
D. Client with uncontrolled diabetes and a serum pH level of 7.33

Correct answer: Client with pancreatitis who has continuous nasogastric suctioning

Rationale: Continuous nasogastric suctioning can lead to hypokalemia due to the loss of gastric contents rich in potassium. Therefore, a client with pancreatitis who has continuous nasogastric suctioning is at risk for hypokalemia. Option B is incorrect because ACE inhibitors may lead to hyperkalemia, not hypokalemia. Option C is incorrect as receiving packed red blood cells can lead to hyperkalemia due to the potassium content in the blood product. Option D is incorrect because a serum pH level of 7.33 indicates acidosis, which is not directly associated with hypokalemia.

4. Which substance dissociates into ions in a water solution?

A. Intracellular fluid
B. Interstitial fluid
C. Plasma
D. Electrolyte

Correct answer: D

Rationale: The correct answer is 'Electrolyte.' Electrolytes are substances that dissociate into ions when dissolved in water. Intracellular fluid, interstitial fluid, and plasma are not substances that dissociate into ions in a water solution. Intracellular fluid is the fluid inside cells, interstitial fluid is the fluid between cells, and plasma is the liquid component of blood. These choices do not dissociate into ions in a water solution, unlike electrolytes.

5. Who would have the greatest percentage of body water?

A. an obese male
B. a nonobese male
C. a nonobese female
D. a newborn

Correct answer: D

Rationale: Newborns have a higher percentage of body water compared to adults due to their higher body fluid content. Factors such as the higher ratio of body surface area to body volume and lower body fat content contribute to this. This is why a newborn would have the greatest percentage of body water. Choices A, B, and C are incorrect because obesity and gender do not determine the percentage of body water in individuals. Therefore, the correct answer is a newborn.