ATI RN
Fluid and Electrolytes ATI
1. A nurse is taking care of a 65-year-old female patient in a medical-surgical unit who is in renal failure; during the assessment, the patient complains of tingling in her lips and fingers. When the nurse takes her blood pressure, she has a spasm in her wrist and hand. The nurse suspects:
- A. Hypophosphatemia
- B. Hypocalcemia
- C. Hypermagnesemia
- D. Hyperkalemia
Correct answer: B
Rationale: The patient's symptoms of tingling in the lips and fingers along with the wrist and hand spasm are indicative of tetany, a characteristic manifestation of hypocalcemia. Hypocalcemia and hypomagnesemia can present with sensations of tingling in the extremities and around the mouth. The spasm in the wrist and hand when taking blood pressure could be due to slight ischemia of the ulnar nerve, further supporting the suspicion of hypocalcemia in this patient. Hypophosphatemia, hypermagnesemia, and hyperkalemia do not typically present with these specific symptoms and manifestations.
2. A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication?
- A. Propranolol (Inderal)
- B. Calcium gluconate
- C. Mannitol (Osmitrol) or furosemide (Lasix)
- D. Sodium, chloride, and potassium
Correct answer: C
Rationale: Mannitol and furosemide are diuretics commonly used to induce diuresis in acute renal failure, helping to provoke urine flow and manage fluid overload. Calcium gluconate and electrolyte supplementation are used for other specific conditions and not primarily for diuresis.
3. Distinguish between assimilation and accommodation.
- A. Assimilation refers to adjusting our mental frameworks to incorporate new information.
- B. Assimilation is when new experiences are interpreted in terms of existing schemas.
- C. Assimilation is adapting our behaviors to match societal norms.
- D. Assimilation and accommodation are unrelated to cognitive development.
Correct answer: B
Rationale: The correct answer is B. Assimilation is when new experiences are interpreted in terms of existing schemas, meaning individuals try to fit new information into their pre-existing understanding of the world. Accommodation, on the other hand, involves adjusting our schemas to fit new information, which means changing our existing mental frameworks when new information doesn't fit. Choice A is incorrect because it describes accommodation rather than assimilation. Choice C is incorrect as it confuses assimilation with social adaptation. Choice D is incorrect as assimilation and accommodation are fundamental processes in cognitive development, as described by Piaget.
4. The nurse is caring for a client with a diagnosis of cirrhosis and is monitoring the client for signs of portal hypertension. Which initial sign, if noted in the client, indicates the presence of portal hypertension?
- A. Flat neck veins
- B. Hypotension
- C. Weak pulse
- D. Crackles on auscultation of the lungs
Correct answer: D
Rationale: Clinical signs and symptoms or portal hypertension are identical to those of heart failure and include jugular vein distention, lung crackles, and decreased perfusion to all organs. Initially, the client may have hypertension, flushed skin, and a bounding pulse.
5. A client with multiple sclerosis (MS) is experiencing a relapse. Which of the following factors is most likely contributing to the relapse?
- A. Taking an over-the-counter multivitamin
- B. Experiencing high levels of emotional stress
- C. Getting a flu shot
- D. Engaging in strenuous physical activity
Correct answer: B
Rationale: Emotional stress can trigger a relapse in multiple sclerosis by exacerbating symptoms. While taking an over-the-counter multivitamin and getting a flu shot are generally safe, they are not typically known to trigger MS relapses. Engaging in strenuous physical activity, if done carefully, can actually have benefits for individuals with MS by improving strength and mobility, so it is less likely to be the cause of a relapse.
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