ATI Med Surg test questions Fluid and Electrolytes: Balance and Disturbance 100% Correct Answers,

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1. You are caring for a patient who has a diagnosis of syndrome of inappropriate antidiuretic hormone

secretion (SIADH). Your patients plan of care includes assessment of specific gravity every 4 hours.

The results of this test will allow the nurse to assess what aspect of the patients health?

a. Nutritional status

b. Potassium balance

c. Calcium balance

d. Fluid volume status

Ans: D

Feedback:

A specific gravity will detect if the patient has a fluid volume deficit or fluid volume excess. Nutrition,

potassium, and calcium levels are not directly indicated.

2. You are caring for a patient admitted with a diagnosis of acute kidney injury. When you review your

patients most recent laboratory reports, you note that the patients magnesium levels are high. You

should prioritize assessment for which of the following health problems?

a. Diminished deep tendon reflexes

b. Tachycardia

c. Cool, clammy skin

d. Acute flank pain

Ans: A

Feedback:

To gauge a patients magnesium status, the nurse should check deep tendon reflexes. If the reflex is

absent, this may indicate high serum magnesium. Tachycardia, flank pain, and cool, clammy skin are not

typically associated with hypermagnesemia.

3. You are working on a burns unit and one of your acutely ill patients is exhibiting signs and symptoms

of third spacing. Based on this change in status, you should expect the patient to exhibit signs and

symptoms of what imbalance?

a. Metabolic alkalosis

b. Hypermagnesemia

c. Hypercalcemia

d. Hypovolemia

Ans: D

Feedback:

Third-spacing fluid shift, which occurs when fluid moves out of the intravascular space but not into the

intracellular space, can cause hypovolemia. Increased calcium and magnesium levels are not indicators

of third-spacing fluid shift. Burns typically cause acidosis, not alkalosis.

4. 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 acidbase imbalance?

a. Respiratory acidosis

b. Respiratory alkalosis

c. Increased PaCO2

d. CNS disturbances

Ans: B

Feedback:

The most common cause of acute respiratory alkalosis is hyperventilation. Extreme anxiety can lead to

hyperventilation. Acute respiratory acidosis occurs in emergency situations, such as pulmonary edema,

and is exhibited by hypoventilation and decreased PaCO2. CNS disturbances are found in extreme

hyponatremia and fluid overload.

5. You are an emergency-room nurse caring for a trauma patient. Your patient has the following

arterial blood gas results: pH 7.26, PaCO2 28, HCO3 11 mEq/L. How would you interpret these

results?

a. Respiratory acidosis with no compensation

b. Metabolic alkalosis with a compensatory alkalosis

c. Metabolic acidosis with no compensation

d. Metabolic acidosis with a compensatory respiratory alkalosis

Ans: D

Feedback:

A low pH indicates acidosis (normal pH is 7.35 to 7.45). The PaCO3 is also low, which causes alkalosis.

The bicarbonate is low, which causes acidosis. The pH bicarbonate more closely corresponds with a

decrease in pH, making the metabolic component the primary problem.

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