a nurse is caring for a client with a peripheral vascular access device who is experiencing pain redness and swelling at the site after removing the d

ATI RN

ATI Fluid Electrolyte and Acid-Base Regulation

1. A nurse is caring for a client with a peripheral vascular access device who is experiencing pain, redness, and swelling at the site. After removing the device, which action should the nurse take to relieve pain?

A. Administer topical lidocaine to the site.
B. Place warm compresses on the site.
C. . Administer prescribed oral pain medication.
D. Massage the site with scented oils.

Correct answer: B

Rationale:

2. The nurse caring for a patient post colon resection is assessing the patient on the second postoperative day. The nasogastric tube (NG) remains patent and continues at low intermittent wall suction. The IV is patent and infusing at 125 mL/hr. The patient reports pain at the incision site rated at a 3 on a 0-to-10 rating scale. During your initial shift assessment, the patient complains of cramps in her legs and a tingling sensation in her feet. Your assessment indicates decreased deep tendon reflexes (DTRs) and you suspect the patient has hypokalemia. What other sign or symptom would you expect this patient to exhibit

A. Diarrhea
B. Dilute urine
C. Increased muscle tone
D. Joint pain

Correct answer: B

Rationale:

3. The nurse is preparing to insert a peripheral IV catheter into a patient who will require fluids and IV antibiotics. How should the nurse always start the process of insertion?

A. Leave one hand ungloved to assess the site.
B. Cleanse the skin with normal saline.
C. Ask the patient about allergies to latex or iodine.
D. Remove excessive hair from the selected site.

Correct answer: C

Rationale:

4. Which of the following is not considered an extracellular fluid?

A. Cerebrospinal fluid
B. The humors of the eye
C. Lymph
D. Cerebrospinal fluid and the humors of the eye

Correct answer: D

Rationale: The correct answer is D. Cerebrospinal fluid and the humors of the eye are not considered extracellular fluids. Extracellular fluids are fluids found outside the cells, such as interstitial fluid and lymph. Cerebrospinal fluid is found within the central nervous system, while the humors of the eye (aqueous humor and vitreous humor) are located within the eyeball, making them distinct from extracellular fluids.

5. Which condition can result from prolonged vomiting or diarrhea?

A. Intracellular fluid
B. Interstitial fluid
C. Dehydration
D. Electrolyte

Correct answer: C

Rationale: The correct answer is C: Dehydration. Prolonged vomiting or diarrhea can lead to significant fluid loss, causing dehydration. Intracellular fluid (choice A) and interstitial fluid (choice B) refer to specific compartments of body fluid and are not conditions resulting from vomiting or diarrhea. Electrolytes (choice D) are minerals that help maintain fluid balance in the body but are not the condition directly resulting from prolonged vomiting or diarrhea.