ATI RN
Fluid and Electrolytes ATI
1. A patient who is in renal failure partially loses the ability to regulate changes in pH because the kidneys:
- A. Regulate and reabsorb carbonic acid to change and maintain pH
- B. Buffer acids through electrolyte changes
- C. Regenerate and reabsorb bicarbonate to maintain a stable pH
- D. Combine carbonic acid and bicarbonate to maintain a stable pH
Correct answer: C
Rationale: The correct answer is C. In renal failure, the kidneys lose the ability to regulate pH by controlling bicarbonate levels in the extracellular fluid (ECF). The kidneys can regenerate and reabsorb bicarbonate ions to maintain a stable pH. Choices A, B, and D are incorrect because the kidneys do not primarily regulate or reabsorb carbonic acid, buffer acids through electrolyte changes, or combine carbonic acid and bicarbonate to maintain pH. The key function of the kidneys in maintaining pH balance lies in the control of bicarbonate levels.
2. What is the primary purpose of handwashing?
- A. To promote hand circulation
- B. To prevent the transfer of microorganisms
- C. To avoid touching the client with a dirty hand
- D. To provide comfort
Correct answer: B
Rationale: The primary purpose of handwashing is to prevent the transfer of microorganisms. Proper hand hygiene helps reduce the risk of spreading harmful bacteria and viruses, thus promoting overall health and preventing infections. Choice A is incorrect as handwashing primarily focuses on cleanliness rather than promoting circulation. Choice C is incorrect as it implies that the main concern is avoiding client discomfort rather than preventing infection. Choice D is incorrect as while handwashing can be comforting in some situations, its primary purpose is not to provide comfort but to maintain hygiene.
3. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?
- A. Focus communication on the child.
- B. Use easy analogies when possible.
- C. Explain experiences of others to the child
- D. Assure the child that communication is private
Correct answer: A
Rationale: Focusing communication directly on the child aligns with their egocentric nature and helps engage them in the conversation.
4. A patient with a history of hypertension is admitted for chest pain. What is the most appropriate action for the nurse to take first?
- A. Obtain a detailed medical history
- B. Administer nitroglycerin
- C. Conduct an ECG
- D. Administer morphine sulfate
Correct answer: B
Rationale: The correct answer is to administer nitroglycerin. Nitroglycerin is the priority intervention for a patient presenting with chest pain as it helps dilate blood vessels, reduce chest pain, and improve oxygen supply to the heart. Obtaining a detailed medical history, conducting an ECG, or administering morphine sulfate are important steps in the assessment and treatment process but are secondary to the immediate need to address chest pain and potential cardiac ischemia.
5. A client who is postoperative following a liver transplant and weighs 65 kg. Which of the following actions should the nurse plan to take?
- A. Keep the client NPO for the first week postoperative.
- B. Limit caloric content once the client resumes eating.
- C. Stress the importance of safe food-handling practices.
- D. Decrease foods high in carbohydrates once the client resumes eating.
Correct answer: Stress the importance of safe food-handling practices.
Rationale: After a liver transplant, it is crucial to stress the importance of safe food-handling practices to prevent foodborne illnesses, especially due to the client's altered immune system. Keeping the client NPO for the first week postoperative is not recommended as early nutrition support is essential for recovery. Limiting caloric content once the client resumes eating may not be appropriate as they need adequate nutrition for healing. Decreasing foods high in carbohydrates without a specific indication may lead to inadequate nutrient intake, which is not ideal for the client's recovery.
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