a home care nurse prepares to administer intravenous medication to a client the nurse assesses the site and reviews the clients chart prior to adminis
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Nursing Elites

ATI RN

ATI Fluid Electrolyte and Acid-Base Regulation

1. A home care nurse prepares to administer intravenous medication to a client. The nurse assesses the site and reviews the clients chart prior to administering the medication: Client: Thomas Jackson DOB: 5/3/1936 Gender: Male January 23 (Today): Right uppe

Correct answer: B

Rationale:

2. The patient asks the nurse if he will die if air bubbles get into the IV tubing. What is the nurse's best response?

Correct answer: B

Rationale: The correct answer is B because air emboli are more commonly associated with central vein access. Usually, only relatively large volumes of air administered rapidly are dangerous. It is a significant concern when air enters a central venous access line. Choice A is incorrect as it downplays the risk and is not entirely accurate. Choice C is too general and does not specifically address the patient's concern. Choice D is dismissive and does not provide any relevant information regarding the risk of air bubbles in IV tubing.

3. You are performing an admission assessment on an older adult patient newly admitted for end-stage liver disease. What principle should guide your assessment of the patients skin turgor?

Correct answer: C

Rationale:

4. Third spacing occurs when fluid moves out of the intravascular space but not into the intracellular space. Based on this fluid shift, the nurse will expect the patient to demonstrate:

Correct answer: D

Rationale: In the scenario of third-spacing fluid shift, where fluid moves out of the intravascular space but not into the intracellular space, the patient is expected to demonstrate hypovolemia. Hypertension (Choice A) is unlikely as hypovolemia typically leads to decreased blood pressure. Bradycardia (Choice B) is not a common manifestation of hypovolemia, as the body often tries to compensate by increasing heart rate. Hypervolemia (Choice C) indicates an excess of fluid, which is the opposite of what occurs in third spacing.

5. A nurse assesses a client who is admitted for treatment of fluid overload. Which manifestations should the nurse expect to find? (Select all that do not apply.)

Correct answer: C

Rationale:

Similar Questions

The healthcare professional working in the PACU is aware that which of the following procedures may contribute to extracellular losses?
The triage nurse notes upon assessment in the emergency room that the patient with anxiety is hyperventilating. The nurse is aware that hyperventilation is the most common cause of which acid-base imbalance?
Which negative ion is most important in intracellular fluid?
The renin and angiotensin systems help to maintain the balance of sodium and water in the body. What other functions do these systems serve?
A nurse develops a plan of care for a client who has a history of hypocalcemia. What interventions should the nurse include in this clients care plan? (Select all that apply.)

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