ATI RN
ATI Fluid and Electrolytes
1. Which electrolyte is important in the formation of the thyroid hormones?
- A. Sodium
- B. Iodine
- C. Iron
- D. Chloride
Correct answer: B
Rationale: Iodine is the correct answer because it is essential for the synthesis of thyroid hormones. The thyroid gland incorporates iodine into thyroid hormones such as thyroxine (T4) and triiodothyronine (T3). These hormones are crucial for regulating metabolism, growth, and development. Sodium, iron, and chloride are not directly involved in the formation of thyroid hormones, making them incorrect choices.
2. A nurse is assessing a client with hypokalemia and notes that the client's handgrip strength has diminished since the previous assessment 1 hour ago. Which action should the nurse take first?
- A. Assess the client's respiratory rate, rhythm, and depth.
- B. Measure the client's pulse and blood pressure.
- C. Document findings and monitor the client.
- D. Call the healthcare provider.
Correct answer: A
Rationale: In a client with hypokalemia experiencing diminished handgrip strength, the priority action for the nurse is to assess the client's respiratory rate, rhythm, and depth. Hypokalemia can lead to muscle weakness, including respiratory muscles, potentially causing respiratory distress. Assessing the respiratory status is crucial to determine if immediate interventions are needed to maintain adequate oxygenation. Measuring the client's pulse and blood pressure (Choice B) is important but should come after assessing the respiratory status. Simply documenting findings and monitoring the client (Choice C) may delay necessary interventions. Calling the healthcare provider (Choice D) is not the first action indicated in this situation; assessing the client's respiratory status takes precedence.
3. How would a decrease in blood protein concentration impact the fluid volumes?
- A. increase interstitial fluid volume.
- B. decrease blood plasma volume.
- C. decrease interstitial fluid volume.
- D. increase interstitial fluid volume and decrease blood plasma volume.
Correct answer: D
Rationale: A decrease in blood protein concentration would lead to a reduction in osmotic pressure, which is responsible for drawing fluid back into the capillaries. This decrease in osmotic pressure would result in an increase in interstitial fluid volume as fluid moves out of the capillaries, and a decrease in blood plasma volume as less fluid is drawn back into the circulation. Therefore, the correct answer is to increase interstitial fluid volume and decrease blood plasma volume. Choices A, B, and C are incorrect because they do not reflect the impact of decreased blood protein concentration on fluid volumes.
4. A nurse is planning care for a client who is hyperventilating. The clients arterial blood gas values are pH 7.30, PaO2 94 mm Hg, PaCO2 31 mm Hg, and HCO3 26 mEq/L. Which question should the nurse ask when developing this clients plan of care?
- A. Do you take any over-the-counter medications?
- B. You appear anxious. What is causing your distress?
- C. Do you have a history of anxiety attacks?
- D. You are breathing fast. Is this causing you to feel light-headed?
Correct answer: B
Rationale:
5. A patient admitted with a gastrointestinal bleed and anemia is receiving a blood transfusion. Based on the patient's hypotensive blood pressure, the nurse anticipates an order for IV fluids from the physician. Which of the following IV solutions may be administered with blood products?
- A. D5 and 0.45% Normal Saline
- B. Lactated Ringer's
- C. 5% dextrose in water
- D. 0.9% NaCl
Correct answer: D
Rationale: The correct answer is D: 0.9% NaCl. The only IV solution that can be administered with blood products is normal saline (0.9% NaCl). This solution is compatible with most blood products and is commonly used during transfusions to maintain hemodynamic stability. Choices A, B, and C are incorrect. Choice A, D5 and 0.45% Normal Saline, contains dextrose and is not recommended to be given simultaneously with blood products. Choice B, Lactated Ringer's, contains calcium, which can cause coagulation and should not be mixed with blood. Choice C, 5% dextrose in water, is hypotonic and not suitable to be administered with blood products.
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