a newly graduated nurse is admitting a patient with a long history of emphysema the new nurses preceptor is going over the patients past lab reports

ATI RN

ATI Fluid Electrolyte and Acid-Base Regulation

1. A newly graduated nurse is admitting a patient with a long history of emphysema. The new nurses preceptor is going over the patients past lab reports with the new nurse. The nurse takes note that the patients PaCO2 has been between 56 and 64 mm Hg for several months. The preceptor asks the new nurse why they will be cautious administering oxygen. What is the new nurses best response?

A. The patients calcium will rise dramatically due to pituitary stimulation.
B. Oxygen will increase the patients intracranial pressure and create confusion.
C. Oxygen may cause the patient to hyperventilate and become acidotic.
D. Using oxygen may result in the patient developing carbon dioxide narcosis and hypoxemia.

Correct answer: D

Rationale:

2. A nurse is caring for a client who is experiencing moderate metabolic alkalosis. Which action should the nurse take?

A. Monitor daily hemoglobin and hematocrit values.
B. Administer furosemide (Lasix) intravenously.
C. Encourage the client to take deep breaths.
D. Teach the client fall prevention measures.

Correct answer: D

Rationale:

3. When selecting a site on the hand or arm for insertion of an IV catheter, the nurse should:

A. Choose a proximal site.
B. Choose a distal site.
C. Have the patient hold their arm in a dependent position.
D. Leave the tourniquet on for no longer than 2 minutes.

Correct answer: B

Rationale: When selecting a site for insertion of an IV catheter, the nurse should choose a distal site, not a proximal site. Opting for a distal site ensures that upper veins remain available for future cannulations. Instructing the patient to hold their arm in a dependent position can enhance blood flow, aiding in the procedure. It is crucial never to leave a tourniquet on for more than 2 minutes as prolonged restriction can lead to complications. Choice A is incorrect because a proximal site is not preferred for IV insertion. Choice C is incorrect as having the patient hold their arm over their head is not necessary and may impede proper blood flow. Choice D is incorrect as leaving the tourniquet on for at least 5 minutes is excessive and can be harmful.

4. Which negative ion is most abundant in blood plasma?

A. Bicarbonate
B. Chloride
C. Hydroxide
D. Phosphate

Correct answer: B

Rationale: Chloride (Cl-) is the most abundant anion in blood plasma. It plays a crucial role in maintaining osmotic balance and acid-base homeostasis. Bicarbonate (Choice A) is important for buffering acids in the body but is not the most abundant negative ion in blood plasma. Hydroxide (Choice C) is not typically found in high concentrations in blood plasma. Phosphate (Choice D) is an important anion in the body but is not as abundant as chloride in blood plasma.