ATI Engage Fundamentals RN 2.0: Fluid, Electrolyte, and Acid-Base
Regulation Test Questions and Answers
A nurse is caring for a client who has a when using the airway, breathing, circulation
prescription to receives one unit of packed red approach to client care is to elevate the head of
blood cells. The client's blood type is AB+, and the client's bed. Placing the client in the Fowler's
the nurse receives a unit of A- blood from the or semi-Fowler's position will promote effective
blood bank. Which of the following actions breathing and chest expansion.
should the nurse take? - - Verify the unit of
blood with another nurse.
A nurse is reviewing a client's laboratory results.
Rationale: The unit of blood is compatible with Which of the following results should the nurse
the client's blood type. However, the nurse report to the provider? - - Magnesium 3
should ensure that the blood unit had been mEq/L
verified by two nurses before initiating the
transfusion. 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
A nurse is preparing to start an IV for a client finding to the provider.
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. A nurse is participating in blood drive and is
taking a donation from a client who has type O+
Rationale: Instead of using a tourniquet, the blood. The client asks the nurse what type of
nurse should apply a blood pressure cuff set to blood they can receive. Which of the following
30 mm Hg prior to starting an IV for this client. statements should the nurse make? - -
This will help protect the client's extremity from "You can receive a blood donation from donors
bruising and bleeding. with type O- and type O+ blood."
Rationale: Clients who have type O+ blood can
A nurse is participating in a blood drive and is only receive blood from donors who have type O-
taking a donation from a client who has type A- or type O+ blood. Clients who have type O- blood
blood. The client asks the nurse what blood are universal donors, meaning that anyone can
types can receive their blood donation. Which of receive their blood, regardless of blood type.
the following responses should the nurse make?
(Select all that apply.) - - A+
AB- A nurse is calculating a client's intake and output
AB+ for the last 4 hr. The client consumed 480 mL of
A- water and 240 mL of coffee. The client has also
received IV fluids for 4 hr infusing at 100 mL/hr.
Which of the following amounts represents the
A nurse is caring for a client who has an acid- client's intake over the last 4 hr? - - 1,120
base imbalance and is experiencing hypoxia. mL
Which of the following actions should the nurse
take first? - - Elevate the head of the Rationale: The client has taken in: 480 mL of
client's bed. water + 240 mL of coffee + (100 mL of fluids x 4
hr). 720 mL + 400 mL = 1,120 mL. The client's
Rationale: The first action the nurse should take total intake in 4 hr is 1,120 mL.
1/5
, ATI Engage Fundamentals RN 2.0: Fluid, Electrolyte, and Acid-Base
Regulation Test Questions and Answers
infuse the blood over which of the following
lengths of time? - - 4 hr
A nurse is reviewing the latest arterial blood gas
(ABG) values for a client who is experiencing Rationale: Blood can be administered over a
metabolic alkalosis. The nurse should identify period of 1 to 4 hr. For a client who is at risk for
that this action is part of which of the following circulatory overload, such as a client who has
steps of the nursing process? - - heart failure, a disorder in which compromised
Evaluation cardiac output results in poor tissue perfusion
and fluid overload, the transfusion should be
Rationale: Reviewing the client's ABG values is administered slowly (maximum time of 4 hr) to
part of the evaluation stage of the nursing avoid increasing the workload of the heart.
process. During the evaluation stage, the nurse
should determine if the actions taken in the
implementation stage were successful in meeting A nurse is caring for a client who is receiving
the goals in the client's plan of care. treatment for hyponatremia. The nurse should
identify that which of the following findings is an
indication that the treatment has been effective?
A nurse is receiving report on four clients. The (Select all that apply.) - - The client states
nurse should identify that which of the following their muscle spasms are absent.
clients may be experiencing hypomagnesemia? - The client denied being confused.
- A client who has vomited four times
during the last 8 hr. Rationale: The absence of muscle spasms
indicates that the treatment for hyponatremia has
Rationale: Nausea and vomiting are early been effective.
manifestations of hypomagnesemia.
The client reporting that they are not confused is
an indication of adequate sodium levels.
A nurse is caring for a client who is experiencing Therefore, this is an indication that the treatment
respiratory alkalosis. Which of the following for hyponatremia has been effective.
actions should be the goal of treatment for a
client? - - Increase the carbon dioxide
level. A nurse has completed assessing and analyzing
data for a client who has an acid-base imbalance.
Rationale: A state of respiratory alkalosis Which of the following steps of the nursing
indicates that the client's carbon dioxide level is process should the nurse take first? - -
currently below the expected reference range. Planning
The goal of treatment should be to raise the level
of carbon dioxide level back to within the Rationale: After assessing and analyzing data for
expected reference range for PaCO2 of 35 to 45 a client who has an acid-base imbalance, the
mm Hg. nurse should move into the planning stage of the
nursing process and establish goals and
outcomes for the client.
A nurse is caring for a client who has heart
failure and a prescription to receive a unit of
packed red blood cells. The nurse should plan to A nurse is reviewing prescriptions for a client who
2/5
Regulation Test Questions and Answers
A nurse is caring for a client who has a when using the airway, breathing, circulation
prescription to receives one unit of packed red approach to client care is to elevate the head of
blood cells. The client's blood type is AB+, and the client's bed. Placing the client in the Fowler's
the nurse receives a unit of A- blood from the or semi-Fowler's position will promote effective
blood bank. Which of the following actions breathing and chest expansion.
should the nurse take? - - Verify the unit of
blood with another nurse.
A nurse is reviewing a client's laboratory results.
Rationale: The unit of blood is compatible with Which of the following results should the nurse
the client's blood type. However, the nurse report to the provider? - - Magnesium 3
should ensure that the blood unit had been mEq/L
verified by two nurses before initiating the
transfusion. 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
A nurse is preparing to start an IV for a client finding to the provider.
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. A nurse is participating in blood drive and is
taking a donation from a client who has type O+
Rationale: Instead of using a tourniquet, the blood. The client asks the nurse what type of
nurse should apply a blood pressure cuff set to blood they can receive. Which of the following
30 mm Hg prior to starting an IV for this client. statements should the nurse make? - -
This will help protect the client's extremity from "You can receive a blood donation from donors
bruising and bleeding. with type O- and type O+ blood."
Rationale: Clients who have type O+ blood can
A nurse is participating in a blood drive and is only receive blood from donors who have type O-
taking a donation from a client who has type A- or type O+ blood. Clients who have type O- blood
blood. The client asks the nurse what blood are universal donors, meaning that anyone can
types can receive their blood donation. Which of receive their blood, regardless of blood type.
the following responses should the nurse make?
(Select all that apply.) - - A+
AB- A nurse is calculating a client's intake and output
AB+ for the last 4 hr. The client consumed 480 mL of
A- water and 240 mL of coffee. The client has also
received IV fluids for 4 hr infusing at 100 mL/hr.
Which of the following amounts represents the
A nurse is caring for a client who has an acid- client's intake over the last 4 hr? - - 1,120
base imbalance and is experiencing hypoxia. mL
Which of the following actions should the nurse
take first? - - Elevate the head of the Rationale: The client has taken in: 480 mL of
client's bed. water + 240 mL of coffee + (100 mL of fluids x 4
hr). 720 mL + 400 mL = 1,120 mL. The client's
Rationale: The first action the nurse should take total intake in 4 hr is 1,120 mL.
1/5
, ATI Engage Fundamentals RN 2.0: Fluid, Electrolyte, and Acid-Base
Regulation Test Questions and Answers
infuse the blood over which of the following
lengths of time? - - 4 hr
A nurse is reviewing the latest arterial blood gas
(ABG) values for a client who is experiencing Rationale: Blood can be administered over a
metabolic alkalosis. The nurse should identify period of 1 to 4 hr. For a client who is at risk for
that this action is part of which of the following circulatory overload, such as a client who has
steps of the nursing process? - - heart failure, a disorder in which compromised
Evaluation cardiac output results in poor tissue perfusion
and fluid overload, the transfusion should be
Rationale: Reviewing the client's ABG values is administered slowly (maximum time of 4 hr) to
part of the evaluation stage of the nursing avoid increasing the workload of the heart.
process. During the evaluation stage, the nurse
should determine if the actions taken in the
implementation stage were successful in meeting A nurse is caring for a client who is receiving
the goals in the client's plan of care. treatment for hyponatremia. The nurse should
identify that which of the following findings is an
indication that the treatment has been effective?
A nurse is receiving report on four clients. The (Select all that apply.) - - The client states
nurse should identify that which of the following their muscle spasms are absent.
clients may be experiencing hypomagnesemia? - The client denied being confused.
- A client who has vomited four times
during the last 8 hr. Rationale: The absence of muscle spasms
indicates that the treatment for hyponatremia has
Rationale: Nausea and vomiting are early been effective.
manifestations of hypomagnesemia.
The client reporting that they are not confused is
an indication of adequate sodium levels.
A nurse is caring for a client who is experiencing Therefore, this is an indication that the treatment
respiratory alkalosis. Which of the following for hyponatremia has been effective.
actions should be the goal of treatment for a
client? - - Increase the carbon dioxide
level. A nurse has completed assessing and analyzing
data for a client who has an acid-base imbalance.
Rationale: A state of respiratory alkalosis Which of the following steps of the nursing
indicates that the client's carbon dioxide level is process should the nurse take first? - -
currently below the expected reference range. Planning
The goal of treatment should be to raise the level
of carbon dioxide level back to within the Rationale: After assessing and analyzing data for
expected reference range for PaCO2 of 35 to 45 a client who has an acid-base imbalance, the
mm Hg. nurse should move into the planning stage of the
nursing process and establish goals and
outcomes for the client.
A nurse is caring for a client who has heart
failure and a prescription to receive a unit of
packed red blood cells. The nurse should plan to A nurse is reviewing prescriptions for a client who
2/5
