you are caring for a patient with a diagnosis of pancreatitis the patient was admitted from a homeless shelter and is a vague historian the patient ap

ATI RN

ATI Fluid Electrolyte and Acid-Base Regulation

1. You are caring for a patient with a diagnosis of pancreatitis. The patient was admitted from a homeless shelter and is a vague historian. The patient appears malnourished and on day 3 of the patients admission total parenteral nutrition (TPN) has been started. Why would you know to start the infusion of TPN slowly?

A. Patients receiving TPN are at risk for hypercalcemia if calories are started too rapidly.
B. Malnourished patients receiving parenteral nutrition are at risk for hypophosphatemia if calories are started too aggressively.
C. Malnourished patients who receive fluids too rapidly are at risk for hypernatremia.
D. Patients receiving TPN need a slow initiation of treatment in order to allow digestive enzymes to accumulate

Correct answer: B

Rationale:

2. A nurse is caring for a client who has the following laboratory results: potassium 3.4 mEq/L, magnesium 1.8 mEq/L, calcium 8.5 mEq/L, sodium 144 mEq/L. Which assessment should the nurse complete first?

A. Assess the client's dietary intake of foods high in potassium.
B. Assess the client's neuromuscular status.
C. Assess the client's fluid intake and output.
D. Read food labels to determine sodium content.

Correct answer: D

Rationale: The correct answer is to read food labels to determine sodium content. The client's sodium level is crucial to monitor as it is on the higher side (144 mEq/L), which can indicate hypernatremia. Excessive sodium intake can lead to fluid retention and other complications. Assessing dietary sodium intake can help the nurse and client make necessary adjustments to prevent further sodium imbalances. Choices A, B, and C are not the priority in this situation as the client's sodium level needs immediate attention to prevent potential complications.

3. A nurse in the medical-surgical unit has a newly admitted patient who is oliguric; the acute care nurse practitioner orders a fluid challenge of 100 to 200 mL of normal saline solution over 15 minutes. The nurse is aware this intervention will help:

A. Distinguish hyponatremia from hypernatremia
B. Evaluate pituitary gland function
C. Distinguish reduced renal blood flow from decreased renal function
D. Provide an effective treatment for hypertension-induced oliguria

Correct answer: C

Rationale: Administering a fluid challenge in oliguric patients helps to distinguish reduced renal blood flow from decreased renal function. This intervention aids in determining whether the oliguria is due to reduced renal blood flow (such as in fluid volume deficit or prerenal azotemia) or decreased renal function (such as in acute tubular necrosis). The response to this challenge can indicate the underlying cause. Choices A, B, and D are incorrect as they do not align with the purpose of a fluid challenge in oliguric patients.

4. . A 73-year-old man comes into the emergency department (ED) by ambulance after slipping on a small carpet in his home. The patient fell on his hip with a resultant fracture. He is alert and oriented; his pupils are equal and reactive to light and accommodation. His heart rate is elevated, he is anxious and thirsty, a Foley catheter is placed, and 40 mL of urine is present. What is the nurses most likely explanation for the low urine output?

A. The man urinated prior to his arrival to the ED and will probably not need to have the Foley catheter kept in place.
B. The man likely has a traumatic brain injury, lacks antidiuretic hormone (ADH), and needs vasopressin.
C. The man is experiencing symptoms of heart failure and is releasing atrial natriuretic peptide that results in decreased urine output.
D. The man is having a sympathetic reaction, which has stimulated the reninangiotensinaldosterone system that results in diminished urine output.

Correct answer: D

Rationale: