ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. . A nurse assesses a client with diabetes mellitus who is admitted with an acid-base imbalance. The clients arterial blood gas values are pH 7.36, PaO2 98 mm Hg, PaCO2 33 mm Hg, and HCO3 18 mEq/L. Which manifestation should the nurse identify as an exam
- A. Increased rate and depth of respirations
- B. ncreased urinary output
- C. Increased thirst and hunger
- D. ncreased release of acids from the kidneys
Correct answer: A
Rationale:
2. A nurse teaches a client who is prescribed a central vascular access device. Which statement should the nurse include in this clients teaching?
- A. You will need to wear a sling on your arm while the device is in place
- B. There is no risk of infection because sterile technique will be used during insertion.
- C. . Ask all providers to vigorously clean the connections prior to accessing the device.
- D. You will not be able to take a bath with this vascular access device.
Correct answer: C
Rationale:
3. While assessing a clients peripheral IV site, the nurse observes a streak of red along the vein path and palpates a 4-cm venous cord. How should the nurse document this finding?
- A. Grade 3 phlebitis at IV site
- B. infection at IV site
- C. Thrombosed area at IV site
- D. infiltration at IV site
Correct answer: A
Rationale:
4. What is the fluid inside the cell called?
- A. Plasma
- B. Intracellular fluid
- C. Interstitial fluid
- D. Plasma and intracellular fluid
Correct answer: B
Rationale: The correct answer is 'Intracellular fluid.' Intracellular fluid refers to the fluid contained within the cells, constituting a significant portion of the body's total water content. Choices A, C, and D are incorrect. Plasma is the liquid component of blood outside the cells, interstitial fluid is the fluid surrounding cells in tissues, and the combination of plasma and intracellular fluid is not the specific term for the fluid inside the cell.
5. A nurse is taking care of a 65-year-old female patient in a medical-surgical unit who is in renal failure; during the assessment, the patient complains of tingling in her lips and fingers. When the nurse takes her blood pressure, she has a spasm in her wrist and hand. The nurse suspects:
- A. Hypophosphatemia
- B. Hypocalcemia
- C. Hypermagnesemia
- D. Hyperkalemia
Correct answer: B
Rationale: The patient's symptoms of tingling in the lips and fingers along with the wrist and hand spasm are indicative of tetany, a characteristic manifestation of hypocalcemia. Hypocalcemia and hypomagnesemia can present with sensations of tingling in the extremities and around the mouth. The spasm in the wrist and hand when taking blood pressure could be due to slight ischemia of the ulnar nerve, further supporting the suspicion of hypocalcemia in this patient. Hypophosphatemia, hypermagnesemia, and hyperkalemia do not typically present with these specific symptoms and manifestations.
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