ATI RN
ATI Fluid and Electrolytes
1. Under normal circumstances, the kidneys provide the greatest means of water loss. Which organ provides the second greatest means of water loss?
- A. Skin
- B. Lungs
- C. Intestines
- D. Muscles
Correct answer: A
Rationale: The correct answer is A: Skin. After the kidneys, the skin is the second largest route of water loss through perspiration. Choice B, Lungs, is incorrect as the lungs primarily exchange gases and do not play a significant role in water loss. Choice C, Intestines, is also incorrect as water loss through the intestines is minimal since most water is reabsorbed during digestion. Choice D, Muscles, is incorrect as muscles are not a major source of water loss in the body.
2. A nurse is visiting an 84-year-old woman living at home and recovering from hip surgery. The woman seems confused and has poor skin turgor, and she states that 'she stops drinking water early in the day because it is too difficult to get up during the night to go to the bathroom.' The nurse explains to the woman that:
- A. She will need to have her medications adjusted and be readmitted to the hospital for a complete workup.
- B. Limiting fluids can create imbalances in the body that can result in confusion; maybe we need to adjust the timing of your fluids.
- C. It is normal to be a little confused following surgery and it is safe not to urinate at night.
- D. Confusion following surgery is common in the elderly due to loss of sleep.
Correct answer: B
Rationale: The correct answer is B. In elderly patients, fluid deficits can lead to confusion and cognitive impairment. Limiting fluids can disrupt the body's balance, leading to such symptoms. Adjusting the timing of fluids can help maintain hydration without causing nighttime interruptions. Choices A, C, and D are incorrect because they do not address the underlying issue of fluid imbalance causing confusion. Choice A suggests unnecessary hospital readmission and medication adjustments. Choice C incorrectly normalizes confusion post-surgery and suggests it is safe not to urinate at night, which can exacerbate the issue. Choice D inaccurately attributes confusion to sleep loss rather than fluid imbalance.
3. A 65-year-old male patient was admitted to a medical-surgical unit 72 hours ago with pyloric stenosis; a nasogastric tube was inserted upon admission and has been on low intermittent suction since then. The nurse taking care of the patient notices that his potassium is very low and becomes concerned that the patient may be at risk for:
- A. Hypercalcemia
- B. Metabolic acidosis
- C. Metabolic alkalosis
- D. Respiratory acidosis
Correct answer: C
Rationale: The correct answer is C, metabolic alkalosis. The patient with pyloric stenosis has been on low intermittent suction, leading to the loss of hydrogen and chloride ions. This condition causes metabolic alkalosis due to the removal of these ions. Options A (Hypercalcemia) and D (Respiratory acidosis) are incorrect as they are not directly related to the scenario described. Option B (Metabolic acidosis) is also incorrect; in this case, the patient is at risk of metabolic alkalosis due to the loss of hydrogen and chloride ions through gastric suction.
4. What fluid is found in spaces between the cells?
- A. Intracellular fluid
- B. Interstitial fluid
- C. Plasma
- D. Electrolyte
Correct answer: B
Rationale: The correct answer is B, Interstitial fluid. Interstitial fluid is the fluid that surrounds and occupies the spaces between cells, providing them with nutrients and removing waste. Choices A, C, and D are incorrect because intracellular fluid refers to fluid inside cells, plasma refers to the liquid component of blood, and electrolyte refers to substances that dissociate into ions in solution, affecting fluid balance but not specifically found in spaces between cells.
5. What is the function of aldosterone?
- A. Regulates body temperature.
- B. Decreases blood pressure.
- C. Increases sodium reabsorption.
- D. Promotes water excretion.
Correct answer: C
Rationale: Aldosterone increases the reabsorption of sodium in the kidneys, which leads to an increase in blood volume and blood pressure. Choice A is incorrect as aldosterone does not regulate body temperature. Choice B is incorrect as aldosterone increases blood pressure by increasing sodium reabsorption. Choice D is incorrect as aldosterone promotes water retention by increasing sodium reabsorption.
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