ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. 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: C
Rationale:
2. Your patient has alcoholism, and you may suspect during your assessment that his serum magnesium is low. What will the nurse potentially expect to assess related to hypomagnesemia?
- A. Tremor
- B. Pruritus
- C. Edema
- D. Decreased blood pressure
Correct answer: A
Rationale: The correct answer is A: Tremor. Signs and symptoms of hypomagnesemia primarily affect the neuromuscular system and can include tremors, confusion, tetany, laryngeal stridor, and ataxia. Pruritus (choice B) refers to itching and is not typically associated with hypomagnesemia. Edema (choice C) is swelling caused by fluid retention and is not a common manifestation of hypomagnesemia. Decreased blood pressure (choice D) is not a typical sign of hypomagnesemia; instead, low magnesium levels are more likely to cause hypertension.
3. Which of the following are sources of water intake?
- A. Drinking fluids.
- B. Consuming water from the food we eat.
- C. Water from metabolic processes.
- D. Drinking fluids, consuming water from the food we eat, and water from metabolic processes.
Correct answer: D
Rationale: The correct answer is D. The sources of water intake include drinking fluids, consuming water from the food we eat, and water from metabolic processes. Water intake is not solely from the liquids we drink but also from the water content present in the food we consume and the water produced during metabolic processes such as cellular respiration. Therefore, option D is the correct answer as it covers all the sources of water intake. Options A, B, and C alone do not encompass all the sources of water intake, making them incorrect choices.
4. Which organ has the greatest effect on fluid output?
- A. Kidneys
- B. Lungs
- C. Skin
- D. Intestines
Correct answer: A
Rationale: The correct answer is the kidneys. The kidneys are primarily responsible for regulating fluid balance by filtering blood and adjusting the volume and concentration of urine. The lungs primarily regulate gas exchange, not fluid balance. The skin plays a role in temperature regulation and protection but is not the primary organ for fluid output. The intestines are mainly involved in the absorption of nutrients and water, rather than fluid output.
5. 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:
- A. Hypertension
- B. Bradycardia
- C. Hypervolemia
- D. Hypovolemia
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.
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