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. Which of the following might the nurse assess in a patient diagnosed with hypermagnesemia?

A. Diminished deep tendon reflexes
B. Tachycardia
C. Cool clammy skin
D. Increased serum magnesium

Correct answer: A

Rationale: The correct answer is A: Diminished deep tendon reflexes. In a patient with hypermagnesemia, the nurse would assess for diminished deep tendon reflexes. Hypermagnesemia can lead to neuromuscular depression, causing a decrease in deep tendon reflexes. Tachycardia (choice B) is more commonly associated with hypomagnesemia. Cool clammy skin (choice C) is not typically a direct symptom of hypermagnesemia. While hypermagnesemia does involve increased serum magnesium levels (choice D), assessing serum levels is a laboratory test and not a clinical assessment like checking deep tendon reflexes.

3. What can cause dehydration?

A. Prolonged vomiting.
B. Prolonged diarrhea.
C. Too little fluid intake.
D. Prolonged vomiting, diarrhea, and too little fluid intake.

Correct answer: D

Rationale: Dehydration can result from significant fluid loss due to vomiting, diarrhea, or inadequate fluid intake. Prolonged vomiting and diarrhea lead to excessive fluid loss from the body, contributing to dehydration. Similarly, not consuming enough fluids can also result in dehydration. Choice A and B are too specific as they only mention one cause each, while choice C is also correct but does not encompass all the potential causes of dehydration as mentioned in choice D.

4. A nurse is caring for a client who has just experienced a 90-second tonic-clonic seizure. The clients arterial blood gas values are pH 6.88, PaO2 50 mm Hg, PaCO2 60 mm Hg, and HCO3 22 mEq/L. Which action should the nurse take first?

A. . Apply oxygen by mask or nasal cannula
B. Apply a paper bag over the clients nose and mouth.
C. Administer 50 mL of sodium bicarbonate intravenously.
D. Administer 50 mL of 20% glucose and 20 units of regular insulin.

Correct answer: A

Rationale:

5. A patient admitted with a gastrointestinal bleed and anemia is receiving a blood transfusion. Based on the patient's hypotensive blood pressure, the nurse anticipates an order for IV fluids from the physician. Which of the following IV solutions may be administered with blood products?

A. D5 and 0.45% Normal Saline
B. Lactated Ringer's
C. 5% dextrose in water
D. 0.9% NaCl

Correct answer: D

Rationale: The correct answer is D: 0.9% NaCl. The only IV solution that can be administered with blood products is normal saline (0.9% NaCl). This solution is compatible with most blood products and is commonly used during transfusions to maintain hemodynamic stability. Choices A, B, and C are incorrect. Choice A, D5 and 0.45% Normal Saline, contains dextrose and is not recommended to be given simultaneously with blood products. Choice B, Lactated Ringer's, contains calcium, which can cause coagulation and should not be mixed with blood. Choice C, 5% dextrose in water, is hypotonic and not suitable to be administered with blood products.