ATI RN
ATI Fluid and Electrolytes
1. What is the most abundant positive ion in blood plasma?
- A. Potassium.
- B. Calcium.
- C. Sodium.
- D. Both potassium and sodium are in equal concentrations.
Correct answer: C
Rationale: The correct answer is C: Sodium. Sodium (Na+) is the most abundant cation in the extracellular fluid, including blood plasma. It plays a crucial role in maintaining fluid balance, nerve function, and is essential for various physiological processes. Choice A, Potassium, is also an important ion in the body but is predominantly found intracellularly. Choice B, Calcium, is an essential mineral in the body but is not the most abundant positive ion in blood plasma. Choice D is incorrect as sodium is the primary positive ion in blood plasma, with a much higher concentration compared to potassium.
2. 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.
3. A nurse in the medical-surgical unit has a newly admitted patient who is oliguric; the acute care nurse practitioner orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. The nurse is aware this intervention will help:
- A. Distinguish hyponatremia from hypernatremia
- B. Evaluate pituitary gland function
- C. Distinguish reduced renal blood flow from decreased renal function
- D. Provide an effective treatment for hypertension-induced oliguria
Correct answer: C
Rationale: Administering a fluid challenge in oliguric patients helps to distinguish reduced renal blood flow from decreased renal function. This intervention aids in determining whether the oliguria is due to reduced renal blood flow (such as in fluid volume deficit or prerenal azotemia) or decreased renal function (such as in acute tubular necrosis). The response to this challenge can indicate the underlying cause. Choices A, B, and D are incorrect as they do not align with the purpose of a fluid challenge in oliguric patients.
4. A nurse is caring for a client who has just had a central venous access line inserted. Which action should the nurse take next?
- A. Begin the prescribed infusion via the new access
- B. Ensure an x-ray is completed to confirm placement.
- C. Check medication calculations with a second RN.
- D. Make sure the solution is appropriate for a central line
Correct answer: B
Rationale:
5. A nurse is caring for a patient who requires measurement of specific gravity every 4 hours. What does this test detect?
- A. Nutritional deficit
- B. Hyperkalemia
- C. Hypercalcemia
- D. Fluid volume status
Correct answer: D
Rationale: Specific gravity is a test used to determine the concentration of solutes in the urine, reflecting the kidney's ability to concentrate urine. Changes in specific gravity can indicate fluid volume status, such as dehydration (fluid volume deficit) or overhydration (fluid volume excess). Options A, B, and C are incorrect as specific gravity does not directly detect nutritional deficits, hyperkalemia, or hypercalcemia.
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