ATI RN
Fluid and Electrolytes ATI
1. A nurse preparing to start an IV on a newly admitted patient teaches the patient about the procedure and begins to prepare the site. The nurse should always start by:
- A. Leaving one hand ungloved to assess the site
- B. Preparing the skin with an iodine solution
- C. Asking the patient if they are allergic to latex or iodine
- D. Removing excessive hair at the selected site
Correct answer: C
Rationale: Before preparing the skin, the nurse should ask the patient if they are allergic to latex or iodine, which are commonly used in IV therapy setup. This is crucial to prevent potential allergic reactions at the IV site or even life-threatening anaphylaxis. Leaving one hand ungloved (choice A) is not a recommended practice as both hands should be gloved for infection control. While preparing the skin with an iodine solution (choice B) is a step in the process, ensuring the patient's safety by checking for allergies comes first. Removing excessive hair at the selected site (choice D) is not necessary and can lead to skin irritation.
2. A nurse is caring for a client who has just experienced a 90-second tonic-clonic seizure. The clients arterial blood gas values are pH 6.88, PaO2 50 mm Hg, PaCO2 60 mm Hg, and HCO3 22 mEq/L. Which action should the nurse take first?
- A. . Apply oxygen by mask or nasal cannula
- B. Apply a paper bag over the clients nose and mouth.
- C. Administer 50 mL of sodium bicarbonate intravenously.
- D. Administer 50 mL of 20% glucose and 20 units of regular insulin.
Correct answer: A
Rationale:
3. A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause
- A. Respiratory acidosis
- B. Respiratory alkalosis
- C. Increased PaCO2
- D. CNS disturbances
Correct answer: B
Rationale:
4. You are the nurse caring for a patient who is to receive IV daunorubicin, a chemotherapeutic agent. You start the infusion and check the insertion site as per protocol. During your most recent check, you note that the IV has infiltrated so you stop the infusion. What is your main concern with this infiltration?
- A. Extravasation of the medication
- B. Discomfort to the patient
- C. Blanching at the site
- D. Hypersensitivity reaction to the medication
Correct answer: A
Rationale:
5. Which electrolyte is important in the formation of the thyroid hormones?
- A. Sodium
- B. Iodine
- C. Iron
- D. Chloride
Correct answer: B
Rationale: Iodine is the correct answer because it is essential for the synthesis of thyroid hormones. The thyroid gland incorporates iodine into thyroid hormones such as thyroxine (T4) and triiodothyronine (T3). These hormones are crucial for regulating metabolism, growth, and development. Sodium, iron, and chloride are not directly involved in the formation of thyroid hormones, making them incorrect choices.
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