ATI RN
Fluid and Electrolytes ATI
1. A patient is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this patient, the nurse's priority would be to assess her:
- A. Neuromuscular function
- B. Bowel sounds
- C. Respiratory rate
- D. Electrocardiogram (ECG) results
Correct answer: D
Rationale: In a patient with a serum potassium level of 6 mEq/L due to spironolactone use, the nurse's priority is to assess the Electrocardiogram (ECG) results. Hyperkalemia can lead to life-threatening arrhythmias, such as ventricular fibrillation, which can be detected on an ECG. While changes in neuromuscular function, bowel sounds, and respiratory rate can occur with hyperkalemia, the most critical assessment related to the patient's condition would be monitoring the ECG for signs of cardiac complications.
2. When educating a client with a new prescription for Losartan, which instruction should the nurse provide?
- A. Avoid consuming grapefruit juice.
- B. Take this medication with a full glass of water.
- C. Take this medication with food.
- D. Monitor for signs of dehydration.
Correct answer: D
Rationale: The correct answer is to instruct the client to monitor for signs of dehydration when taking Losartan. Losartan can lead to dehydration, so it is crucial for the client to watch out for symptoms like dry mouth, increased thirst, and reduced urine output. Monitoring for these signs can help prevent complications associated with dehydration while taking this medication. Choices A, B, and C are incorrect because Losartan is not known to have interactions with grapefruit juice, does not require a specific amount of water for intake, and can be taken with or without food.
3. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to
- A. give a bolus of 50% dextrose.
- B. insert a large-bore IV catheter.
- C. initiate oxygen via nasal cannula.
- D. administer glargine (Lantus) insulin.
Correct answer: B
Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.
4. Which of the following best describes the concept of interprofessional collaboration in healthcare?
- A. The process by which multiple healthcare professionals work together to improve patient outcomes
- B. A method for healthcare professionals to work independently within their scope of practice
- C. The use of standardized protocols to ensure consistent care
- D. A way for healthcare professionals to share patient information electronically
Correct answer: A
Rationale: The correct answer is A. Interprofessional collaboration in healthcare refers to the coordinated efforts of multiple healthcare professionals working together to enhance patient outcomes. This collaborative approach involves professionals from different disciplines contributing their expertise to provide comprehensive care and improve the overall quality of patient treatment. Choice B is incorrect because interprofessional collaboration emphasizes teamwork and collective efforts rather than working independently. Choice C is incorrect as it refers to standardization of care protocols, not collaboration among professionals. Choice D is incorrect as sharing patient information electronically is a component of information exchange but not the primary focus of interprofessional collaboration.
5. 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.
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