ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. You are caring for a patient with a diagnosis of pancreatitis. The patient was admitted from a homeless shelter and is a vague historian. The patient appears malnourished and on day 3 of the patients admission total parenteral nutrition (TPN) has been started. Why would you know to start the infusion of TPN slowly?
- A. Patients receiving TPN are at risk for hypercalcemia if calories are started too rapidly.
- B. Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively.
- C. Malnourished patients who receive fluids too rapidly are at risk for hypernatremia.
- D. Patients receiving TPN need a slow initiation of treatment in order to allow digestive enzymes to accumulate
Correct answer: Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively.
Rationale:
2. Which of the following bones is a component of the appendicular skeleton?
- A. Xiphoid process
- B. Symphysis pubis
- C. Sacrum
- D. Sternum
Correct answer: Symphysis pubis
Rationale: The correct answer is B: Symphysis pubis. The symphysis pubis is a component of the appendicular skeleton, specifically part of the pelvic girdle. The xiphoid process (Choice A) is part of the axial skeleton, located at the lower end of the sternum. The sacrum (Choice C) is also part of the axial skeleton, forming the posterior part of the pelvis. The sternum (Choice D) is part of the axial skeleton, located in the center of the chest.
3. How should a nurse respond to a client with terminal cancer who has requested a change in the level of pain medication?
- A. Increase the dosage without consulting the healthcare provider.
- B. Consult with the healthcare provider to adjust the medication.
- C. Ignore the request as the client is near the end of life.
- D. Increase the medication to reduce pain faster.
Correct answer: B
Rationale: The correct answer is to consult with the healthcare provider to adjust the medication. It is crucial for the healthcare provider to be involved in changing pain medication for a client with terminal cancer to ensure that the new dosage is appropriate and safe. Option A is incorrect because adjusting medication without consulting the healthcare provider can be dangerous and is not within the scope of the nurse's practice. Option C is incorrect because ignoring the client's request goes against the principles of patient-centered care. Option D is incorrect as the primary goal should be to provide effective pain relief with the appropriate dosage, not to increase the medication arbitrarily.
4. Generally, patients who wear dentures have reduced masticatory efficiency. Mandibular implant-supported dentures can have positive effects on the clinical aspects of mastication and swallowing.
- A. Both statements are true
- B. Both statements are false
- C. The first statement is true; the second is false
- D. The first statement is false; the second is true
Correct answer: A
Rationale: Both statements are true. Patients who wear dentures typically experience reduced masticatory efficiency. Mandibular implant-supported dentures are known to have positive effects on the clinical aspects of mastication and swallowing, significantly improving chewing function. Option A is correct because both statements align with these facts. Option B is incorrect as both statements are true. Option C is incorrect as the second statement is also true. Option D is incorrect as the first statement is true.
5. Which of the following complications of gastric resection should the nurse teach the client to watch for?
- A. Constipation
- B. Dumping syndrome
- C. Gastric spasm
- D. Intestinal spasms
Correct answer: B
Rationale: Clients should be taught to watch for symptoms of dumping syndrome, a common complication after gastric resection.
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