ATI RN
ATI Fluid and Electrolytes
1. Extracellular fluid includes:
- A. plasma and intracellular fluid.
- B. interstitial and intracellular fluids.
- C. plasma and interstitial fluid.
- D. plasma, interstitial fluid, and intracellular fluid.
Correct answer: C
Rationale: The correct answer is C: 'plasma and interstitial fluid.' Extracellular fluid consists of all body fluids outside the cells, primarily including plasma (the liquid component of blood) and interstitial fluid (the fluid between cells). Choices A, B, and D are incorrect because intracellular fluid is located within the cells, not in the extracellular fluid compartment.
2. Your patient has the following arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would the nurse interpret the results?
- A. Respiratory acidosis with no compensation
- B. Metabolic alkalosis with a compensatory alkalosis
- C. Metabolic acidosis with no compensation
- D. Metabolic acidosis with a compensatory respiratory alkalosis
Correct answer: D
Rationale: The given arterial blood gas results show a low pH, indicating acidosis, with normal pH range being 7.35 to 7.45. The low PaCO2 suggests alkalosis, while the low bicarb level indicates acidosis. In this scenario, the primary issue is the metabolic acidosis, as the pH bicarb relationship supports this. The compensatory response to metabolic acidosis is a decrease in PaCO2, leading to a respiratory alkalosis. Therefore, the correct interpretation is 'Metabolic acidosis with a compensatory respiratory alkalosis.' Choices A, B, and C are incorrect as they do not accurately reflect the relationship between the pH, PaCO2, and HCO3 levels in the arterial blood gas results provided.
3. A nurse in the neurologic ICU has orders to infuse a hypertonic solution into a patient with increased intracranial pressure. This solution will increase the number of dissolved particles in the patients blood, creating pressure for fluids in the tissues to shift into the capillaries and increase the blood volume. This process is best described as which of the following?
- A. Hydrostatic pressure
- B. Osmosis and osmolality
- C. Diffusion
- D. Active transport
Correct answer: B
Rationale:
4. 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.
5. A nurse is caring for a client who is experiencing moderate metabolic alkalosis. Which action should the nurse take?
- A. Monitor daily hemoglobin and hematocrit values.
- B. Administer furosemide (Lasix) intravenously.
- C. Encourage the client to take deep breaths.
- D. Teach the client fall prevention measures.
Correct answer: D
Rationale:
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