ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. You are caring for a patient admitted with a diagnosis of acute kidney injury. When you review your patients most recent laboratory reports, you note that the patients magnesium levels are high. You should prioritize assessment for which of the followin
- A. Diminished deep tendon reflexes
- B. Tachycardia
- C. Cool, clammy skin
- D. Acute flank pain
Correct answer: Diminished deep tendon reflexes
Rationale:
2. According to ecological systems theory, interactions between Marina and her child, Tyler, occur in the __________. Copyright © 2018 Laura E. Berk. All Rights Reserved. 20 Test Bank for Berk, Development Through the Lifespan, 7e
- A. microsystem
- B. mesosystem
- C. exosystem
- D. macrosystem Answer: A Page Ref: 23 Skill Level: Apply Topic: Recent Theoretical Perspectives Difficulty Level: Moderate
Correct answer: A
Rationale: According to ecological systems theory, interactions between Marina and her child, Tyler, occur in the microsystem. The microsystem refers to the immediate social context in which an individual lives, such as interactions with family members, friends, and teachers. Marina and Tyler's interactions within their family unit would be considered part of the microsystem.
3. A healthcare provider is planning care for a client who has fluid overload. Which of the following actions should the provider plan to take first?
- A. Assess for edema
- B. Evaluate electrolytes
- C. Restrict fluid intake
- D. Administer diuretics
Correct answer: B
Rationale: Evaluating electrolytes is crucial when addressing fluid overload as it helps determine the severity of the imbalance and guides treatment. Assessing for edema (Choice A) is important but not the priority over evaluating electrolytes. Restricting fluid intake (Choice C) and administering diuretics (Choice D) are interventions that may be necessary but should be based on the electrolyte evaluation to ensure safe and effective care.
4. A client with breast cancer is being taught by a nurse about the adverse effects of chemotherapy. Which of the following statements should the nurse include?
- A. You should use a soft-bristled toothbrush to prevent bleeding.
- B. You should avoid contact with individuals who recently received live virus vaccines.
- C. You should take aspirin for minor aches and pains.
- D. You should consume a diet low in protein to reduce the risk of renal damage.
Correct answer: A
Rationale: The nurse should instruct the client to use a soft-bristled toothbrush to prevent bleeding, which can occur due to chemotherapy-induced thrombocytopenia. Chemotherapy can decrease platelet counts, leading to an increased risk of bleeding. Using a soft-bristled toothbrush can help prevent gum bleeding and oral trauma. Choices B, C, and D are incorrect. Avoiding contact with individuals who recently received live virus vaccines is crucial to prevent infections in immunocompromised clients. Aspirin should be avoided due to its blood-thinning effects that can increase the risk of bleeding. A diet low in protein is not recommended as cancer clients often require adequate protein intake for healing and recovery.
5. A nurse is caring for a client who is in labor and receiving electronic fetal monitoring. The nurse is reviewing the monitor tracing and notes early decelerations. What should the nurse expect?
- A. Fetal hypoxia
- B. Abruptio placentae
- C. Post maturity
- D. Head compression
Correct answer: D
Rationale: Corrected Rationale: Early decelerations are caused by head compression resulting from the fetal head being compressed during contractions. They are considered benign and do not indicate fetal distress. Choice A, fetal hypoxia, is incorrect because early decelerations are not associated with fetal hypoxia. Choice B, abruptio placentae, is incorrect as it is a condition where the placenta prematurely separates from the uterine wall. Choice C, post maturity, is incorrect as it refers to a fetus that remains in the uterus past the due date.
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