ATI RN
ATI Pathophysiology Exam 1
1. What is the primary function of the kidneys in acid-base balance?
- A. The kidneys remove hydrogen ions and retain bicarbonate ions.
- B. The kidneys convert ammonia into urea, which is excreted in the urine.
- C. The kidneys produce aldosterone to regulate sodium levels.
- D. The kidneys secrete renin to regulate blood pressure.
Correct answer: A
Rationale: The correct answer is A. The kidneys are crucial in maintaining acid-base balance by removing hydrogen ions to decrease acidity and retaining bicarbonate ions to increase alkalinity. Choice B is incorrect because the conversion of ammonia into urea is related to nitrogen waste excretion, not acid-base balance. Choice C is incorrect as aldosterone regulates sodium levels, not acid-base balance. Choice D is also incorrect as renin is involved in regulating blood pressure, not acid-base balance.
2. The HCP orders cultures of the urethral urine, bladder urine, and prostatic fluid. Which instructions would the nurse teach to achieve the first two (2) specimens?
- A. Collect the first 15 mL in one jar and then the next 50 mL in another
- B. Collect three (3) early morning, clean voided urine specimens
- C. Collect the specimens after the HCP massages the prostate
- D. Collect a routine urine specimen for analysis
Correct answer: A
Rationale: To obtain accurate cultures of urethral and bladder urine, the nurse should instruct the patient to collect the first 15 mL of urine in one container and the subsequent 50 mL in another. This method ensures that the specimens are separated appropriately for analysis. Choices B, C, and D are incorrect because collecting three early morning urine specimens, massaging the prostate, or collecting a routine urine specimen would not provide the specific separation of urethral and bladder urine required for this particular test.
3. An older adult client has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity?
- A. Phenytoin
- B. Verapamil
- C. Warfarin
- D. Aluminum hydroxide
Correct answer: B
Rationale: Verapamil, a calcium-channel blocker, can increase digoxin levels, leading to toxicity. When given together, the digoxin dosage may need adjustment, and the nurse should closely monitor the client's digoxin levels to prevent toxicity symptoms such as nausea, vomiting, visual disturbances, and arrhythmias. The other choices, Phenytoin, Warfarin, and Aluminum hydroxide, do not significantly interact with Digoxin to cause toxicity. Phenytoin may reduce Digoxin levels, while Warfarin and Aluminum hydroxide have minimal interactions with Digoxin.
4. What is the best way to monitor fluid balance in a patient with kidney disease?
- A. Monitor daily weight
- B. Monitor input and output
- C. Check for edema
- D. Check urine output
Correct answer: A
Rationale: The correct answer is to monitor daily weight. This method is the most accurate way to assess fluid balance in patients with kidney disease. Daily weight monitoring can detect even small changes in fluid balance, such as fluid retention or loss, which may not be evident through other methods. Monitoring input and output (choice B) is also important but may not provide a complete picture of fluid balance as it doesn't consider factors like insensible losses. Checking for edema (choice C) is a sign of fluid retention but may not always be present or may be difficult to assess accurately. Checking urine output (choice D) is important but may not reflect the overall fluid balance status of the patient.
5. A nurse is caring for a client who has a pulmonary embolism. The nurse should identify which finding as an indication of effective treatment?
- A. A chest x-ray reveals increased density in all lung fields.
- B. The client reports feeling less anxious.
- C. Diminished breath sounds are auscultated bilaterally.
- D. ABG results include a pH of 7.48, PaO2 77 mm Hg, and PaCO2 47 mm Hg.
Correct answer: B
Rationale: The correct answer is B. The client reporting feeling less anxious is a positive indication of effective treatment for a pulmonary embolism. This suggests that the client's condition is improving psychologically. Option A is incorrect because increased density in all lung fields on a chest x-ray may indicate unresolved issues related to the embolism. Option C is incorrect as diminished breath sounds bilaterally suggest a complication or worsening of the condition. Option D is incorrect as ABG results within normal range do not necessarily indicate effective treatment for a pulmonary embolism, as other complications may still be present.
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