ATI RN
ATI Fluid and Electrolytes
1. Which hormones increase the amount of water in the body?
- A. ADH
- B. Aldosterone
- C. ANH
- D. ADH and aldosterone
Correct answer: D
Rationale: The correct answer is D, ADH and aldosterone. Both antidiuretic hormone (ADH) and aldosterone increase water retention by the kidneys, thereby increasing blood volume. ADH acts on the kidneys to increase water reabsorption, while aldosterone acts on the kidneys to promote sodium reabsorption, leading to water retention. Choice A, ADH, is partially correct as it alone increases water retention. Choice B, aldosterone, is also partially correct as it alone increases water retention. Choice C, ANH (atrial natriuretic hormone), actually decreases water retention by promoting sodium excretion and inhibiting aldosterone release.
2. You are the nurse evaluating a newly admitted patients laboratory results, which include several values that are outside of reference ranges. Which of the following would cause the release of antidiuretic hormone (ADH)?
- A. Increased serum sodium
- B. Decreased serum potassium
- C. Decreased hemoglobin
- D. Increased platelets
Correct answer: A
Rationale:
3. A patient with a longstanding diagnosis of generalized anxiety disorder presents to the emergency room. The triage nurse notes upon assessment that the patient is hyperventilating. The triage nurse is aware that hyperventilation is the most common cause of which acid-base imbalance?
- A. Respiratory acidosis
- B. Respiratory alkalosis
- C. Increased PaCO2
- D. CNS disturbances
Correct answer: B
Rationale: The correct answer is B: Respiratory alkalosis. Hyperventilation, which can be caused by extreme anxiety, is the most common cause of acute respiratory alkalosis. This leads to a decrease in PaCO2 levels. Respiratory acidosis, choice A, occurs in conditions like hypoventilation, leading to an increase in PaCO2 levels. Choice C, Increased PaCO2, is not the correct term for an acid-base imbalance related to hyperventilation. Choice D, CNS disturbances, is not directly related to the acid-base imbalance caused by hyperventilation.
4. A 73-year-old man who slipped on a small carpet in his home and fell on his hip is alert and oriented; PERRLA (pupils equally round and reactive to light and accommodation) is intact, and he has come by ambulance to the emergency department (ED). Heart rate elevated, he is anxious and thirsty. A Foley catheter is in place and 40mL of urine is present. The nurse's most likely explanation for the urine output is:
- A. The man urinated prior to his arrival in the ED and will probably not need to have the Foley catheter kept in place.
- B. The man has a brain injury, lacks ADH, and needs vasopressin.
- C. The man is in heart failure and is releasing atrial natriuretic peptide, which results in decreased urine output.
- D. He is having a sympathetic reaction, which has stimulated the renin-angiotensin-aldosterone system that results in diminished urine output.
Correct answer: D
Rationale: Renin is released by the juxtaglomerular cells of the kidneys in response to decreased renal perfusion. Angiotensin-converting enzyme converts angiotensin I to angiotensin II. Angiotensin II, with its vasoconstrictor properties, increases arterial perfusion pressure and stimulates thirst. As the sympathetic nervous system is stimulated, aldosterone is released in response to an increased release of renin, which decreases urine production. Based on the nursing assessment and mechanism of injury, this is the most likely cause of the lower urine output. Choices A, B, and C are incorrect because there is no indication of urination prior to arrival, brain injury, lack of ADH, or heart failure present in the scenario provided. The symptoms and context described point more towards a physiological response related to the sympathetic nervous system and the renin-angiotensin-aldosterone system rather than the other conditions mentioned.
5. Place a washcloth between the skin and tourniquet
- A. Provide a bed bath instead of letting the client take a shower
- B. Use sterile technique when changing the dressing.
- C. Disconnect the intravenous fluid tubing prior to the clients bath.
- D. Use a plastic bag to cover the extremity with the device
Correct answer: D
Rationale:
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