Comprehensive ATI Adult Medical
Surgical Nursing.
Latest Updated Exam Study Guide
with 100% Verified Answers.
Current Updated Edition 2026/2027.
aseptic technique - ansmeans clean technique
-hand hygiene, sterile gloves not used
bacterial meningitis - ansis an emergency and IV antibitoics are needed ASAP
stress fracture - ansa small crack in the bone that often develops from chronic, excessive
impact
adults body fluids - ans50-60% of total body weight is water
infants body fluids - ans15-80% of total body wt is water
2/3 body weight - ansis intracellular
1/3 body weight - ansis extracellular
1 kg (2.2 lb) of body weight - ansis approximately 1 L of fluid
older adults - anshave less body water and decreased thirst sensation
fluid volume deficit factors - ansexcess GI and/or renal loss
diaphoresis
fever
long term NPO
hemorrhage
burns
fluid volume deficit manifestations - answeight loss, dry mucus membranes, increased HR
and RR, thready pulse, capillary refill less than 3 seconds, weakness, fatigue, orthostatic
hypotension, poor skin turgor
-urine output less than 25 mL/hr
-high hematocrit (>45%)
-BUN >20
-tenting of skin
fluid volume deficit LATE signs - ansoliguria, decreased CVP, flattened neck veins
hypertonic dehydration - ansless sodium than water is lost
-sodium >145
-spec graph >1.03
high urine specific gravity - ansbody is dehydrated and conserving water
-concentrated urine
mild to moderate dehydration - ansdry skin and increased thirst
severe dehydration - anspulse >100
cold extremities
central venous pressure - ansvenous blood pressure within the right atrium that influences the
pressure in the large peripheral veins
normal output - ans0.5 mL/kg/hr
no more than 2000mL/day
isotonic IVF - anstreatment of vascular system fluid deficit
,Comprehensive ATI Adult Medical
Surgical Nursing.
Latest Updated Exam Study Guide
with 100% Verified Answers.
Current Updated Edition 2026/2027.
-concentration = to plasma
-prevent fluid shift between compartments
isotonic solutions - ansnormal saline
lactated ringer's
5% dextrose in water
hypotonic IVF - anstreatment of intracellular dehydration
-lower osmolality than the ECF
-shift fluid from ECF to ICF
hypotonic solutions - ans0.45% NS
2.5% dextrose in 0.45% saline
small numbers --> big cells
hypertonic IVF - ansused only when serum osmolality is critically low
-osmolality higher than the ECF
-shift fluid from ICF to ECF
hypertonic solutions - ans10% Dextrose in Water, 5% Dextrose in 0.45% Saline, 5%
Dextrose in 0.9% Saline
-big numbers --> shink cells
fluid volume excess - ansFluid intake or fluid retention that EXCEEDS the fluid needs of the
body
fluid volume excess factors - anskidney failure (late phase), heart failure, cirrhosis,
hypertonic fluids, burns, excessive water intake, long term *corticosteroid therapy*
fluid volume excess manifestations - ans• Pitting edema, sacral edema.
• Dyspnea, crackles, possible pulmonary edema.
• Bounding pulse, weight gain.
• Lethargy, dizziness, headache, confusion, weakness
• Increased CVP, jugular vein distention.
• Increased blood pressure, *tachycardia*, tachypenia
-decrease spec graph
-BUN <7
-Decreased hemoglobin and hematocrit
urine specific gravity - ans1.010-1.030
pitting edema scale - ans1+ (minimal) to 4+ (severe)
fluid volume excess NI - ans*first evaluate electrolytes*
measure abdominal girth
daily weights
strict I/O
,Comprehensive ATI Adult Medical
Surgical Nursing.
Latest Updated Exam Study Guide
with 100% Verified Answers.
Current Updated Edition 2026/2027.
maintain skin integrity
use semi-Fowler's position; reposition q 2hr
Major intracellular electrolytes - anspotassium, phosphate, magnesium
major extracellular electrolytes - ansSodium, Chloride, Calcium, and Bicarbonate.
hypokalemia risk factors - ansadverse effects: *corticosteroids*, diuretics (thiazide), laxative
abuse, terbutaline
body fluid loss: vomiting, diarrhea, wound drainage, NG suction
excessive diaphoresis, kidney disease, alkalosis
bulimia
hypokalemia symptoms - ansmuscle weakness, cramps, *ileus*, hyporeflexia, *parasthesias
(numbness/tinging)*, flaccid paralysis, constipation, *flat/inverted T waves*, dysrhythmias,
fatigue
shallow respirations, orthostatic hypotension
hypokalemia interventions - ansmonitor cardiovascular, respiratory, neuromuscular,
gastrointestinal, and *renal status*, and place on a cardiac monitor
monitor electrolytes values
administer potassium supplements *(not on empty stomach)* --> may need to be
discontinued if client complains of abdominal pain, distention, nausea, vomiting, diarrhea, or
gastrointestional bleeding; IV bolus must be diluted
Liquid potassium chloride has an unpleasant taste and should be taken with juice or another
liquid
*--do not administer K if patient is not peeing*
KCl administrationn - ansmust not exceed 10 mEq per hr
hyperkalemia risk factors - ansdecreased potassium excretion due to renal failure,
hypoaldosteronism, potassium-conserving diuretics or ACE inhibitors; high potassium intake
due to excessive use of potassium containing salt substitutes, excessive or rapid IV potassium
infusion, *potassium shift out of the tissue cells into the plasma due to burns*, infections, or
acidosis *(DKA specifically)*
hyperkalemia manifestations - ans* PEAKED T WAVES and WIDENED QRS *
- Ventricular dysrhythmias
- muscle twitching & paresthesia - numbness/tingling (EARLY)
- Ascending muscle weakness (LATE)
- Increased bowel motility - diarrhea
- bradycardia and hypotension
hyperkalemia interventions - ansmonitor ECG, bowel sounds
initiate dialysis
meds: Kayexalate, *50% glucose* with *insulin*, calcium gluconate, bicarbonate, loop
diuretics, lactulose
, Comprehensive ATI Adult Medical
Surgical Nursing.
Latest Updated Exam Study Guide
with 100% Verified Answers.
Current Updated Edition 2026/2027.
sodium polystyrene or tap water enema
hyponatremia risk factors - ansGI loss; NG tube with suctioning
SIADH
Adrenal insufficiency
Diuretics - *mannitol*
Water intoxication
Decreased intake/NPO - *mechanical vent*
Excessive diaphoresis
Burns
Meds: diuretics, anti-convulsants, SSRIs, lithium
hyponatremia manifestation - answeakness, lethargy, confusion, seizures
headache, anorexia, N/V, muscle cramps, twitching, hypotension, tachycardia, wt gain,
edema
hyponatremia interventions - anssodium replacement
restrict oral intake
daily weight
I&O
*risk with hypertonic solutions - used for cerebral edema*
hypernatremia risk factors - ansGI loss, dehydration
hyperaldosteronism
hypertonic tube feedings
diabetes insipidus
kidney failure
burns
heatstroke
corticosteroids
hypernatremia manifestations - ansfever
swollen, dry tongue
sticky mucus membranes
hallucinations
lethargy, restlessness, irritability
seizures
tachycardia
HTN
hyperreflexia, twitching
pul edema
hypernatremia interventions - ansdaily wt
I.O.s
Surgical Nursing.
Latest Updated Exam Study Guide
with 100% Verified Answers.
Current Updated Edition 2026/2027.
aseptic technique - ansmeans clean technique
-hand hygiene, sterile gloves not used
bacterial meningitis - ansis an emergency and IV antibitoics are needed ASAP
stress fracture - ansa small crack in the bone that often develops from chronic, excessive
impact
adults body fluids - ans50-60% of total body weight is water
infants body fluids - ans15-80% of total body wt is water
2/3 body weight - ansis intracellular
1/3 body weight - ansis extracellular
1 kg (2.2 lb) of body weight - ansis approximately 1 L of fluid
older adults - anshave less body water and decreased thirst sensation
fluid volume deficit factors - ansexcess GI and/or renal loss
diaphoresis
fever
long term NPO
hemorrhage
burns
fluid volume deficit manifestations - answeight loss, dry mucus membranes, increased HR
and RR, thready pulse, capillary refill less than 3 seconds, weakness, fatigue, orthostatic
hypotension, poor skin turgor
-urine output less than 25 mL/hr
-high hematocrit (>45%)
-BUN >20
-tenting of skin
fluid volume deficit LATE signs - ansoliguria, decreased CVP, flattened neck veins
hypertonic dehydration - ansless sodium than water is lost
-sodium >145
-spec graph >1.03
high urine specific gravity - ansbody is dehydrated and conserving water
-concentrated urine
mild to moderate dehydration - ansdry skin and increased thirst
severe dehydration - anspulse >100
cold extremities
central venous pressure - ansvenous blood pressure within the right atrium that influences the
pressure in the large peripheral veins
normal output - ans0.5 mL/kg/hr
no more than 2000mL/day
isotonic IVF - anstreatment of vascular system fluid deficit
,Comprehensive ATI Adult Medical
Surgical Nursing.
Latest Updated Exam Study Guide
with 100% Verified Answers.
Current Updated Edition 2026/2027.
-concentration = to plasma
-prevent fluid shift between compartments
isotonic solutions - ansnormal saline
lactated ringer's
5% dextrose in water
hypotonic IVF - anstreatment of intracellular dehydration
-lower osmolality than the ECF
-shift fluid from ECF to ICF
hypotonic solutions - ans0.45% NS
2.5% dextrose in 0.45% saline
small numbers --> big cells
hypertonic IVF - ansused only when serum osmolality is critically low
-osmolality higher than the ECF
-shift fluid from ICF to ECF
hypertonic solutions - ans10% Dextrose in Water, 5% Dextrose in 0.45% Saline, 5%
Dextrose in 0.9% Saline
-big numbers --> shink cells
fluid volume excess - ansFluid intake or fluid retention that EXCEEDS the fluid needs of the
body
fluid volume excess factors - anskidney failure (late phase), heart failure, cirrhosis,
hypertonic fluids, burns, excessive water intake, long term *corticosteroid therapy*
fluid volume excess manifestations - ans• Pitting edema, sacral edema.
• Dyspnea, crackles, possible pulmonary edema.
• Bounding pulse, weight gain.
• Lethargy, dizziness, headache, confusion, weakness
• Increased CVP, jugular vein distention.
• Increased blood pressure, *tachycardia*, tachypenia
-decrease spec graph
-BUN <7
-Decreased hemoglobin and hematocrit
urine specific gravity - ans1.010-1.030
pitting edema scale - ans1+ (minimal) to 4+ (severe)
fluid volume excess NI - ans*first evaluate electrolytes*
measure abdominal girth
daily weights
strict I/O
,Comprehensive ATI Adult Medical
Surgical Nursing.
Latest Updated Exam Study Guide
with 100% Verified Answers.
Current Updated Edition 2026/2027.
maintain skin integrity
use semi-Fowler's position; reposition q 2hr
Major intracellular electrolytes - anspotassium, phosphate, magnesium
major extracellular electrolytes - ansSodium, Chloride, Calcium, and Bicarbonate.
hypokalemia risk factors - ansadverse effects: *corticosteroids*, diuretics (thiazide), laxative
abuse, terbutaline
body fluid loss: vomiting, diarrhea, wound drainage, NG suction
excessive diaphoresis, kidney disease, alkalosis
bulimia
hypokalemia symptoms - ansmuscle weakness, cramps, *ileus*, hyporeflexia, *parasthesias
(numbness/tinging)*, flaccid paralysis, constipation, *flat/inverted T waves*, dysrhythmias,
fatigue
shallow respirations, orthostatic hypotension
hypokalemia interventions - ansmonitor cardiovascular, respiratory, neuromuscular,
gastrointestinal, and *renal status*, and place on a cardiac monitor
monitor electrolytes values
administer potassium supplements *(not on empty stomach)* --> may need to be
discontinued if client complains of abdominal pain, distention, nausea, vomiting, diarrhea, or
gastrointestional bleeding; IV bolus must be diluted
Liquid potassium chloride has an unpleasant taste and should be taken with juice or another
liquid
*--do not administer K if patient is not peeing*
KCl administrationn - ansmust not exceed 10 mEq per hr
hyperkalemia risk factors - ansdecreased potassium excretion due to renal failure,
hypoaldosteronism, potassium-conserving diuretics or ACE inhibitors; high potassium intake
due to excessive use of potassium containing salt substitutes, excessive or rapid IV potassium
infusion, *potassium shift out of the tissue cells into the plasma due to burns*, infections, or
acidosis *(DKA specifically)*
hyperkalemia manifestations - ans* PEAKED T WAVES and WIDENED QRS *
- Ventricular dysrhythmias
- muscle twitching & paresthesia - numbness/tingling (EARLY)
- Ascending muscle weakness (LATE)
- Increased bowel motility - diarrhea
- bradycardia and hypotension
hyperkalemia interventions - ansmonitor ECG, bowel sounds
initiate dialysis
meds: Kayexalate, *50% glucose* with *insulin*, calcium gluconate, bicarbonate, loop
diuretics, lactulose
, Comprehensive ATI Adult Medical
Surgical Nursing.
Latest Updated Exam Study Guide
with 100% Verified Answers.
Current Updated Edition 2026/2027.
sodium polystyrene or tap water enema
hyponatremia risk factors - ansGI loss; NG tube with suctioning
SIADH
Adrenal insufficiency
Diuretics - *mannitol*
Water intoxication
Decreased intake/NPO - *mechanical vent*
Excessive diaphoresis
Burns
Meds: diuretics, anti-convulsants, SSRIs, lithium
hyponatremia manifestation - answeakness, lethargy, confusion, seizures
headache, anorexia, N/V, muscle cramps, twitching, hypotension, tachycardia, wt gain,
edema
hyponatremia interventions - anssodium replacement
restrict oral intake
daily weight
I&O
*risk with hypertonic solutions - used for cerebral edema*
hypernatremia risk factors - ansGI loss, dehydration
hyperaldosteronism
hypertonic tube feedings
diabetes insipidus
kidney failure
burns
heatstroke
corticosteroids
hypernatremia manifestations - ansfever
swollen, dry tongue
sticky mucus membranes
hallucinations
lethargy, restlessness, irritability
seizures
tachycardia
HTN
hyperreflexia, twitching
pul edema
hypernatremia interventions - ansdaily wt
I.O.s
