ATI Fluid and Electrolytes Exam 4 2026
A nurse is caring for a client who has a prescription to receives one unit of packed
red blood cells. The client's blood type is AB+, and the nurse receives a unit of A-
blood from the blood bank. Which of the following actions should the nurse take? -
Verify the unit of blood with another nurse.
Rationale: The unit of blood is compatible with the client's blood type. However,
the nurse should ensure that the blood unit had been verified by two nurses before
initiating the transfusion.
A nurse is preparing to start an IV for a client who has a high risk for bleeding.
Which of the following actions should the nurse take? - Apply a blood pressure
cuff set to 30 mm Hg.
Rationale: Instead of using a tourniquet, the nurse should apply a blood pressure
cuff set to 30 mm Hg prior to starting an IV for this client. This will help protect
the client's extremity from bruising and bleeding.
A nurse is participating in a blood drive and is taking a donation from a client who
has type A-blood. The client asks the nurse what blood types can receive their
blood donation. Which of the following responses should the nurse make? (Select
all that apply.) - A+
AB
-
AB
+
A-
A nurse is caring for a client who has an acid-base imbalance and is experiencing
hypoxia. Which of the following actions should the nurse take first? - Elevate the
head of the client's bed.
Rationale: The first action the nurse should take when using the airway, breathing,
circulation approach to client care is to elevate the head of the client's bed. Placing
the client in the Fowler's or semi-Fowler's position will promote effective
breathing and chest expansion.
A nurse is reviewing a client's laboratory results. Which of the following results
should the nurse report to the provider? - Magnesium 3 mEq/L
, Rationale: A magnesium level of 3 mEq/L is above the expected reference range
of 1.3 to 2.1 mEq/L. Therefore, the nurse should report this finding to the
provider.
A nurse is participating in blood drive and is taking a donation from a client who
z z z z z z z z z z z z z z z
has type O+ blood. The client asks the nurse what type of blood they can receive.
z z z z z z z z z z z z z z z z
Which of the following statements should the nurse make? - "You can receive a
z z z z z z z z z z z z z z
blood donation from donors with type O- and type O+ blood."
z z z z z z z z z z z
Rationale: Clients who have type O+ blood can only receive blood from donors
z z z z z z z z z z z z
who have type O- or type O+ blood. Clients who have type O- blood are universal
z z z z z z z z z z z z z z z z
donors, meaning that anyone can receive their blood, regardless of blood type.
z z z z z z z z z z z z
A nurse is calculating a client's intake and output for the last 4 hr. The client
z z z z z z z z z z z z z z z
consumed 480 mL of water and 240 mL of coffee. The client has also received IV
z z z z z z z z z z z z z z z z
fluids for 4 hr infusing at 100 mL/hr. Which of the following amounts represents
z z z z z z z z z z z z z z
the client's intake over the last 4 hr? - 1,120 mL
z z z z z z z z z z z
Rationale: The client has taken in: 480 mL of water + 240 mL of coffee + (100 mL of
z z z z z z z z z z z z z z z z z z
fluids x 4 hr). 720 mL + 400 mL = 1,120 mL. The client's total intake in 4 hr is
z z z z z z z z z z z z z z z z z z z z
1,120 mL.
z z
A nurse is reviewing the latest arterial blood gas (ABG) values for a client who is
z z z z z z z z z z z z z z z
experiencing metabolic alkalosis. The nurse should identify that this action is part
z z z z z z z z z z z z
of which of the following steps of the nursing process? - Evaluation
z z z z z z z z z z z z
Rationale: Reviewing the client's ABG values is part of the evaluation stage of
z z z z z z z z z z z z
the nursing process. During the evaluation stage, the nurse should determine if
z z z z z z z z z z z z
the actions taken in the implementation stage were successful in meeting the
z z z z z z z z z z z z
goals in the client's plan of care.
z z z z z z z
A nurse is receiving report on four clients. The nurse should identify that which of
z z z z z z z z z z z z z z
the following clients may be experiencing hypomagnesemia? - A client who has
z z z z z z z z z z z z
vomited four times during the last 8 hr.
z z z z z z z z
Rationale: Nausea and vomiting are early manifestations of hypomagnesemia.
z z z z z z z z
A nurse is caring for a client who is experiencing respiratory alkalosis. Which of the
z z z z z z z z z z z z z z
following actions should be the goal of treatment for a client? - Increase the carbon
z z z z z z z z z z z z z z z
dioxide level.
z z
Rationale: A state of respiratory alkalosis indicates that the client's carbon dioxide
z z z z z z z z z z z
level is currently below the expected reference range. The goal of treatment should
z z z z z z z z z z z z z
be to raise the level of carbon dioxide level back to within the expected reference
z z z z z z z z z z z z z z z
A nurse is caring for a client who has a prescription to receives one unit of packed
red blood cells. The client's blood type is AB+, and the nurse receives a unit of A-
blood from the blood bank. Which of the following actions should the nurse take? -
Verify the unit of blood with another nurse.
Rationale: The unit of blood is compatible with the client's blood type. However,
the nurse should ensure that the blood unit had been verified by two nurses before
initiating the transfusion.
A nurse is preparing to start an IV for a client who has a high risk for bleeding.
Which of the following actions should the nurse take? - Apply a blood pressure
cuff set to 30 mm Hg.
Rationale: Instead of using a tourniquet, the nurse should apply a blood pressure
cuff set to 30 mm Hg prior to starting an IV for this client. This will help protect
the client's extremity from bruising and bleeding.
A nurse is participating in a blood drive and is taking a donation from a client who
has type A-blood. The client asks the nurse what blood types can receive their
blood donation. Which of the following responses should the nurse make? (Select
all that apply.) - A+
AB
-
AB
+
A-
A nurse is caring for a client who has an acid-base imbalance and is experiencing
hypoxia. Which of the following actions should the nurse take first? - Elevate the
head of the client's bed.
Rationale: The first action the nurse should take when using the airway, breathing,
circulation approach to client care is to elevate the head of the client's bed. Placing
the client in the Fowler's or semi-Fowler's position will promote effective
breathing and chest expansion.
A nurse is reviewing a client's laboratory results. Which of the following results
should the nurse report to the provider? - Magnesium 3 mEq/L
, Rationale: A magnesium level of 3 mEq/L is above the expected reference range
of 1.3 to 2.1 mEq/L. Therefore, the nurse should report this finding to the
provider.
A nurse is participating in blood drive and is taking a donation from a client who
z z z z z z z z z z z z z z z
has type O+ blood. The client asks the nurse what type of blood they can receive.
z z z z z z z z z z z z z z z z
Which of the following statements should the nurse make? - "You can receive a
z z z z z z z z z z z z z z
blood donation from donors with type O- and type O+ blood."
z z z z z z z z z z z
Rationale: Clients who have type O+ blood can only receive blood from donors
z z z z z z z z z z z z
who have type O- or type O+ blood. Clients who have type O- blood are universal
z z z z z z z z z z z z z z z z
donors, meaning that anyone can receive their blood, regardless of blood type.
z z z z z z z z z z z z
A nurse is calculating a client's intake and output for the last 4 hr. The client
z z z z z z z z z z z z z z z
consumed 480 mL of water and 240 mL of coffee. The client has also received IV
z z z z z z z z z z z z z z z z
fluids for 4 hr infusing at 100 mL/hr. Which of the following amounts represents
z z z z z z z z z z z z z z
the client's intake over the last 4 hr? - 1,120 mL
z z z z z z z z z z z
Rationale: The client has taken in: 480 mL of water + 240 mL of coffee + (100 mL of
z z z z z z z z z z z z z z z z z z
fluids x 4 hr). 720 mL + 400 mL = 1,120 mL. The client's total intake in 4 hr is
z z z z z z z z z z z z z z z z z z z z
1,120 mL.
z z
A nurse is reviewing the latest arterial blood gas (ABG) values for a client who is
z z z z z z z z z z z z z z z
experiencing metabolic alkalosis. The nurse should identify that this action is part
z z z z z z z z z z z z
of which of the following steps of the nursing process? - Evaluation
z z z z z z z z z z z z
Rationale: Reviewing the client's ABG values is part of the evaluation stage of
z z z z z z z z z z z z
the nursing process. During the evaluation stage, the nurse should determine if
z z z z z z z z z z z z
the actions taken in the implementation stage were successful in meeting the
z z z z z z z z z z z z
goals in the client's plan of care.
z z z z z z z
A nurse is receiving report on four clients. The nurse should identify that which of
z z z z z z z z z z z z z z
the following clients may be experiencing hypomagnesemia? - A client who has
z z z z z z z z z z z z
vomited four times during the last 8 hr.
z z z z z z z z
Rationale: Nausea and vomiting are early manifestations of hypomagnesemia.
z z z z z z z z
A nurse is caring for a client who is experiencing respiratory alkalosis. Which of the
z z z z z z z z z z z z z z
following actions should be the goal of treatment for a client? - Increase the carbon
z z z z z z z z z z z z z z z
dioxide level.
z z
Rationale: A state of respiratory alkalosis indicates that the client's carbon dioxide
z z z z z z z z z z z
level is currently below the expected reference range. The goal of treatment should
z z z z z z z z z z z z z
be to raise the level of carbon dioxide level back to within the expected reference
z z z z z z z z z z z z z z z
