ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. You are the surgical nurse caring for a 65-year-old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What electrolyte imbalance should you first suspect?
- A. Hypophosphatemia
- B. Hypocalcemia
- C. Hypermagnesemia
- D. Hyperkalemia
Correct answer: Hypocalcemia
Rationale:
2. While assessing clients on a medical-surgical unit, which client is at risk for hypokalemia?
- A. Client with pancreatitis who has continuous nasogastric suctioning
- B. Client who is prescribed an angiotensin-converting enzyme (ACE) inhibitor
- C. Client in a motor vehicle crash who is receiving 6 units of packed red blood cells
- D. Client with uncontrolled diabetes and a serum pH level of 7.33
Correct answer: Client with pancreatitis who has continuous nasogastric suctioning
Rationale: Continuous nasogastric suctioning can lead to hypokalemia due to the loss of gastric contents rich in potassium. Therefore, a client with pancreatitis who has continuous nasogastric suctioning is at risk for hypokalemia. Option B is incorrect because ACE inhibitors may lead to hyperkalemia, not hypokalemia. Option C is incorrect as receiving packed red blood cells can lead to hyperkalemia due to the potassium content in the blood product. Option D is incorrect because a serum pH level of 7.33 indicates acidosis, which is not directly associated with hypokalemia.
3. Place a washcloth between the skin and tourniquet
- A. Provide a bed bath instead of letting the client take a shower
- B. Use sterile technique when changing the dressing.
- C. Disconnect the intravenous fluid tubing prior to the clients bath.
- D. Use a plastic bag to cover the extremity with the device
Correct answer: Use a plastic bag to cover the extremity with the device
Rationale:
4. A nurse educator is reviewing peripheral IV insertion with a group of novice nurses. How should these nurses be encouraged to deal with excess hair at the intended site?
- A. Leave the hair intact
- B. Shave the area.
- C. Clip the hair in the area.
- D. Remove the hair with a depilatory.
Correct answer: Clip the hair in the area.
Rationale:
5. A nurse is caring for clients with electrolyte imbalances on a medical-surgical unit. Which clinical manifestations are correctly paired with the contributing electrolyte imbalance? (Select all that do not apply.)
- A. Hypokalemia Flaccid paralysis with respiratory depression
- B. Hyperphosphatemia Paresthesia with sensations of tingling and numbness
- C. . Hyponatremia Decreased level of consciousness
- D.
Correct answer: Hyperphosphatemia Paresthesia with sensations of tingling and numbness
Rationale:
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