ATI RN
Fluid and Electrolytes ATI
1. A patient is in the hospital with heart failure. The nurse notes during the evening assessment that the patient's neck veins are distended and the patient has dyspnea. What action should the nurse take?
- A. Place the patient in low Fowler's position and notify the physician.
- B. Increase the patient's IV fluid and auscultate the lungs.
- C. Place the patient in semi-Fowler's position and prepare to give the PRN diuretic as ordered.
- D. Discontinue the patient's IV.
Correct answer: C
Rationale: The symptoms of distended neck veins and dyspnea indicate fluid overload in a patient with heart failure. Placing the patient in semi-Fowler's position helps with respiratory effort and administering diuretics, as ordered, can assist in reducing fluid volume. Placing the patient in low Fowler's position (Choice A) may not be as effective in improving breathing. Increasing IV fluid (Choice B) is contraindicated in fluid overload conditions. Discontinuing the IV (Choice D) is not the immediate intervention needed to address the symptoms of fluid overload.
2. A nurse is caring for a client who has acute pancreatitis. Which of the following interventions should the nurse take?
- A. Encourage oral intake of clear liquids
- B. Administer an antiemetic before meals
- C. Insert a nasogastric tube for suction
- D. Place the client in a supine position
Correct answer: C
Rationale: In acute pancreatitis, the gastrointestinal tract needs to rest to reduce pancreatic enzyme secretion. Inserting a nasogastric tube for suction helps decompress the stomach and reduce stimulation of the pancreas. Encouraging oral intake of clear liquids (Choice A) or administering an antiemetic before meals (Choice B) may aggravate the condition by stimulating the pancreas. Placing the client in a supine position (Choice D) may not directly address the underlying issue of reducing pancreatic stimulation.
3. A nurse is caring for a client who has a serum calcium level of 14 mg/dL. Which provider order should the nurse implement first?
- A. Encourage oral fluid intake.
- B. Connect the client to a cardiac monitor.
- C. Assess urinary output.
- D. Administer oral calcitonin (Calcimar).
Correct answer: Encourage oral fluid intake.
Rationale: The correct answer is to encourage oral fluid intake. With a serum calcium level of 14 mg/dL, the client is at risk of hypercalcemia. Encouraging oral fluid intake helps to promote hydration and can help prevent further elevation of calcium levels. Connecting the client to a cardiac monitor (Choice B) is important but not the first priority in this situation. Assessing urinary output (Choice C) is relevant but does not address the immediate concern of high serum calcium levels. Administering oral calcitonin (Calcimar) (Choice D) may be a treatment option later, but the first step should be to address hydration.
4. A nurse is planning a menu for a client with a folic acid deficiency anemia. Which food should the nurse recommend that is high in folate?
- A. 4 slices of roast beef
- B. ½ cup of asparagus
- C. 1 cup part-skim mozzarella cheese
- D. ¼ cup of olives
Correct answer: B
Rationale: The correct answer is B: ½ cup of asparagus. Asparagus is high in folate, making it a suitable recommendation for clients with folic acid deficiency anemia. Folate is essential in the production of red blood cells, which is crucial in managing anemia. Choices A, C, and D do not contain as much folate as asparagus and are not the best options for addressing a folic acid deficiency anemia.
5. What physiologic role does calcium play in the body?
- A. Blood clotting, transmission of nerve impulses, muscle contraction and relaxation
- B. Calcium homeostasis, structural integrity of heart muscle
- C. No known metabolic function, caries-preventing properties
- D. ATP energy release; metabolism of fats, carbohydrates, proteins; regulates acid-base balance.
Correct answer: A
Rationale: The correct answer is A: 'Blood clotting, transmission of nerve impulses, muscle contraction and relaxation.' Calcium plays a crucial role in various physiological functions such as blood clotting, transmission of nerve impulses, muscle contraction and relaxation, membrane permeability, and activation of certain enzymes. Choice B is incorrect because while calcium is involved in calcium homeostasis, it is not the only role it plays in the body. Choice C is incorrect as calcium indeed has several known metabolic functions, and it is not solely for preventing caries. Choice D is also incorrect as the functions mentioned are primarily carried out by other nutrients and not specifically by calcium.
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