ATI RN
Fluid and Electrolytes ATI
1. The triage nurse notes upon assessment in the emergency room that the patient with anxiety is hyperventilating. The nurse is aware that hyperventilation is the most common cause of which acid-base imbalance?
- A. Respiratory acidosis
- B. Respiratory alkalosis
- C. Metabolic acidosis
- D. Metabolic alkalosis
Correct answer: B
Rationale: The correct answer is B: Respiratory alkalosis. Hyperventilation is the most common cause of acute respiratory alkalosis. When a patient hyperventilates due to anxiety or other causes, they blow off excessive carbon dioxide, leading to a decrease in PaCO2 and a rise in pH. Choices A, C, and D are incorrect because hyperventilation leads to a decrease in PaCO2, causing respiratory alkalosis, not respiratory acidosis, metabolic acidosis, or metabolic alkalosis.
2. A client who has a new prescription for warfarin is being taught about the medication's adverse effects by a nurse. Which of the following client statements indicates an understanding of the teaching?
- A. ''I should expect mild bruising around my elbows.''
- B. ''I should report a red rash to my provider.''
- C. ''I should stop taking this medication if I develop a cough.''
- D. ''I should expect black, tarry stools.''
Correct answer: D
Rationale: The correct answer is D. Black, tarry stools can indicate gastrointestinal bleeding, a serious adverse effect of warfarin that requires immediate medical attention. Option A is incorrect because while bruising is a common side effect of warfarin, it is not limited to the elbows. Option B is incorrect as a red rash is not a typical adverse effect of warfarin. Option C is also incorrect because developing a cough is not a reason to discontinue warfarin unless advised by a healthcare provider.
3. Which of the following symptoms indicates diverticulosis?
- A. No symptoms exist
- B. Change in bowel habits
- C. Anorexia with low-grade fever
- D. Episodic, dull, or steady midabdominal pain
Correct answer: A
Rationale: Diverticulosis often has no symptoms and is usually found incidentally during tests for other conditions.
4. When reviewing the safe administration of antineoplastic agents, what action should the nurse emphasize?
- A. Adjust the dose based on the patient's present symptoms.
- B. Wash hands with an alcohol-based cleanser before and after administration.
- C. Use gloves and a lab coat when preparing and administering the medication.
- D. Dispose of the antineoplastic wastes in the hazardous waste receptacle.
Correct answer: D
Rationale: The correct answer is to dispose of the antineoplastic wastes in the hazardous waste receptacle. Antineoplastic agents are hazardous materials, and proper disposal is crucial to prevent harm to individuals and the environment. Option A is incorrect because adjusting the dose based on the patient's present symptoms may not be safe without proper authorization. Option B is incorrect as hand hygiene should be performed both before and after administering medications. Option C is incorrect as gloves and a lab coat should be worn primarily during handling and administration, not just during preparation.
5. What are the early signs of hypokalemia on an ECG?
- A. Flattened T waves
- B. Elevated ST segments
- C. Prominent U waves
- D. Widened QRS complex
Correct answer: A
Rationale: Flattened T waves are an early sign of hypokalemia on an ECG. In hypokalemia, the T waves may flatten and eventually invert. Elevated ST segments are not typically associated with hypokalemia. Prominent U waves are seen in conditions like hypokalemia, but they are not considered an early sign. A widened QRS complex is more commonly associated with hyperkalemia rather than hypokalemia.
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