ATI RN
Fluid and Electrolytes ATI
1. The nurse is caring for a postthyroidectomy patient at risk for hypocalcemia. What action should the nurse take when assessing for hypocalcemia?
- A. Monitor laboratory values daily for an elevated thyroid-stimulating hormone.
- B. Observe for swelling of the neck, tracheal deviation, and severe pain.
- C. Evaluate the quality of the patient's voice postoperatively, noting any drastic changes.
- D. Observe for muscle twitching and numbness or tingling of the lips, fingers, and toes.
Correct answer: D
Rationale: Muscle twitching and numbness or tingling of the lips, fingers, and toes are signs of hyperirritability of the nervous system due to hypocalcemia. The other options describe complications the nurse should also be observing for; however, tetany and neurologic alterations are primary indications of hypocalcemia. Monitoring for an elevated thyroid-stimulating hormone (choice A) is not relevant in assessing for hypocalcemia. Observing for swelling of the neck, tracheal deviation, and severe pain (choice B) are more related to airway compromise. Evaluating the quality of the patient's voice postoperatively (choice C) is important but not a primary sign of hypocalcemia.
2. A manager is working on the personnel budget for the year. The manager anticipates needing to replace 832 benefit hours. How many FTEs (Full-Time Equivalents) will be needed for replacement?
- A. 0.40 FTEs
- B. 17.0 FTEs
- C. 0.05 FTEs
- D. 1.0 FTEs
Correct answer: A
Rationale: To calculate the number of Full-Time Equivalents (FTEs) needed for replacement, divide the number of benefit hours (832) by the standard number of hours in a full-time work year (2,080). Therefore, 832 benefit hours ÷ 2,080 = 0.4 FTEs, which is equivalent to 0.40 FTEs. Choice B (17.0 FTEs) is incorrect as it is a significantly high number that does not align with the calculation. Choice C (0.05 FTEs) is incorrect because it is too low for the given number of benefit hours. Choice D (1.0 FTEs) is incorrect as it represents a full-time position, which is not the correct calculation for replacing 832 benefit hours.
3. While caring for a client receiving an opioid analgesic for pain management, which assessment should the nurse prioritize?
- A. Monitor the client's urinary output.
- B. Check the client's blood pressure.
- C. Assess the client for constipation.
- D. Monitor the client's respiratory rate.
Correct answer: D
Rationale: The correct answer is to monitor the client's respiratory rate. When a client is receiving opioids, the priority assessment is the respiratory rate since opioids can lead to respiratory depression. Monitoring urinary output, blood pressure, and constipation are also important but not the priority in this scenario.
4. The community health nurse is involved in public health work. Which of these statements by the nurse reflects an understanding of upstream interventions?
- A. I will engage in policy initiatives in my urban area.
- B. I will administer the flu shot to interested seniors.
- C. I will help manage a senior's diabetes needs at home.
- D. I will work with a local school to provide asthma education.
Correct answer: A
Rationale: The correct answer is A because engaging in policy initiatives reflects an understanding of upstream interventions. Upstream interventions focus on influencing broader determinants of health, such as policies and social factors, to prevent health issues before they occur. This approach addresses the root causes of health problems rather than just treating symptoms or providing individual care.
5. What is the best way to assess for fluid overload in a patient with heart failure?
- A. Check daily weight
- B. Check blood pressure
- C. Monitor heart sounds
- D. Assess for jugular vein distention
Correct answer: A
Rationale: The correct answer is to 'Check daily weight.' Monitoring daily weight is the most accurate method to assess for fluid overload in patients with heart failure. Weight gain can indicate fluid retention, a common issue in heart failure patients. Checking blood pressure (Choice B) can provide information about hemodynamic status but may not be as specific for fluid overload as monitoring weight. Monitoring heart sounds (Choice C) can provide information about cardiac function but may not directly assess fluid overload. Assessing for jugular vein distention (Choice D) can be a sign of increased central venous pressure but may not always correlate with fluid overload as accurately as daily weight checks.
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