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: B
Rationale:
2. The healthcare professional working in the PACU is aware that which of the following procedures may contribute to extracellular losses?
- A. Removal of an ingrown toenail
- B. Tooth extraction
- C. Abdominal surgery
- D. Cataract surgery
Correct answer: C
Rationale: Fluid loss from the extracellular compartment can be caused by abdominal surgery as it involves opening the abdominal cavity, potentially leading to significant fluid losses. Choices A, B, and D do not typically result in substantial extracellular losses compared to abdominal surgery.
3. A patient is taking spironolactone (Aldactone) to control her hypertension. Her serum potassium level is 6 mEq/L. For this patient, the nurse's priority would be to assess her:
- A. Neuromuscular function
- B. Bowel sounds
- C. Respiratory rate
- D. Electrocardiogram (ECG) results
Correct answer: D
Rationale: In a patient with a serum potassium level of 6 mEq/L due to spironolactone use, the nurse's priority is to assess the Electrocardiogram (ECG) results. Hyperkalemia can lead to life-threatening arrhythmias, such as ventricular fibrillation, which can be detected on an ECG. While changes in neuromuscular function, bowel sounds, and respiratory rate can occur with hyperkalemia, the most critical assessment related to the patient's condition would be monitoring the ECG for signs of cardiac complications.
4. Where is the largest volume of water in the body located?
- A. Plasma
- B. The fluid inside the cells
- C. Interstitial fluid
- D. Lymph
Correct answer: B
Rationale: The correct answer is B. The largest volume of water in the body is found inside the cells, known as intracellular fluid. This fluid makes up the majority of the body's total water content. Choices A, C, and D are incorrect because while plasma, interstitial fluid, and lymph are important components of the body's fluid compartments, they do not contain the largest volume of water in the body.
5. Which organ has the greatest effect on fluid output?
- A. Kidneys
- B. Lungs
- C. Skin
- D. Intestines
Correct answer: A
Rationale: The correct answer is the kidneys. The kidneys are primarily responsible for regulating fluid balance by filtering blood and adjusting the volume and concentration of urine. The lungs primarily regulate gas exchange, not fluid balance. The skin plays a role in temperature regulation and protection but is not the primary organ for fluid output. The intestines are mainly involved in the absorption of nutrients and water, rather than fluid output.
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