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ATI Fluid, Electrolyte, and Acid-Base Proctored Exam (2025/2026) — Updated Edition, Exams of Medicine

Pennsylvania State University - CarlisleMedicine

ATI Fluid, Electrolyte, and Acid-Base Proctored Exam (2025/2026) — Updated Edition (Verified Questions & Answers | NCLEX-RN Readiness)

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2025/2026

Available from 02/14/2026

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ATI Fluid, Electrolyte, and Acid-Base
Proctored Exam (2025/2026) — Updated
Edition (Verified Questions & Answers |
NCLEX®-RN® Readiness)
A nurse is assessing a client who has a serum calcium level of 8.1 mg/dL. Which of the
following findings is the priority for the nurse to assess?
-Deep tendon reflexes
-Cardiac rhythm
-Peripheral sensation
-Bowel sounds
Cardiac rhythm
When using the airway, breathing, circulation approach to client care, the nurse should first
assess the client's cardiac rhythm because this total serum calcium level is below the expected
reference range. Hypocalcemia can cause ECG changes, bradycardia, or tachycardia.
A nurse is caring for a client who requires nasogastric suctioning. Which of the following sets of
laboratory results indicates that the client has metabolic alkalosis?
-pH 7.51, PaO2 94 mmHg, PaCO2 36 mmHg, HCO3- 31 mEq/L
-pH 7.48, PaO2 89 mmHg, PaCO2 30 mmHg, HCO3- 26 mEq/L
-pH 7.31, PaO2 77 mmHg, PaCO2 52 mmHg, HCO3- 23 mEq/L
-pH 7.26, PaO2 84 mmHg, PaCO2 38 mmHg, HCO3- 20 mEq/L
pH 7.51, PaO2 94 mm Hg, PaCO2 36 mm Hg, HCO3- 31 mEq/L
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Download ATI Fluid, Electrolyte, and Acid-Base Proctored Exam (2025/2026) — Updated Edition and more Exams Medicine in PDF only on Docsity!

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

A nurse is assessing a client who has a serum calcium level of 8.1 mg/dL. Which of the following findings is the priority for the nurse to assess?

  • Deep tendon reflexes
  • Cardiac rhythm
  • Peripheral sensation
  • Bowel sounds Cardiac rhythm When using the airway, breathing, circulation approach to client care, the nurse should first assess the client's cardiac rhythm because this total serum calcium level is below the expected reference range. Hypocalcemia can cause ECG changes, bradycardia, or tachycardia. A nurse is caring for a client who requires nasogastric suctioning. Which of the following sets of laboratory results indicates that the client has metabolic alkalosis?
  • pH 7.51, PaO2 94 mmHg, PaCO2 36 mmHg, HCO3- 31 mEq/L
  • pH 7.48, PaO2 89 mmHg, PaCO2 30 mmHg, HCO3- 26 mEq/L
  • pH 7.31, PaO2 77 mmHg, PaCO2 52 mmHg, HCO3- 23 mEq/L
  • pH 7.26, PaO2 84 mmHg, PaCO2 38 mmHg, HCO3- 20 mEq/L pH 7.51, PaO2 94 mm Hg, PaCO2 36 mm Hg, HCO3- 31 mEq/L

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

An elevated pH and HCO3- with a PaCO2 either elevated or within the expected reference range indicates metabolic alkalosis. A nurse is caring for a client who has dehydration and is receiving IV fluids. When assessing for complications, the nurse should recognize which of the following manifestations as a sign of fluid overload?

  • Increased urine specific gravity
  • Hypoactive bowel sounds
  • Bounding peripheral pulses
  • Decreased respiratory rate Bounding peripheral pulses The nurse should recognize that increased vascular volume results in full, bounding peripheral pulses. A nurse is caring for a client who is experiencing respiratory distress as a result of pulmonary edema. Which of the following actions should the nurse take first?
  • Assist with intubation
  • Initiate high-flow oxygen therapy
  • Administer a rapid-acting diuretic

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

A nurse is admitting a client who has status asthmaticus. The client's ABG results are pH 7.32, PaO2 74 mmHg, PaCO2 56 mmHg, and HCO3- 26 mEq/L. The nurse should interpret these laboratory values as which of the following imbalances?

  • Respiratory acidosis
  • Respiratory alkalosis
  • Metabolic acidosis
  • Metabolic alkalosis Respiratory acidosis Status asthmaticus causes inadequate gas exchange, resulting in a low pH and PaO2, an elevated PaCO2, and an HCO3- within the expected reference range. These laboratory values indicate respiratory acidosis. A nurse is assessing a client who has dehydration. Which of the following assessments is the priority?
  • Skin turgor
  • Urine output
  • Weight
  • Mental status Mental status

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

The greatest risk to this client is injury from a fall due to a decline in the client's mental status. Therefore, assessing the client's mental status is the nurse's priority. A nurse is caring for a client who requires continuous cardiac monitoring. The nurse identifies a prolonged PR interval and a widened QRS complex. Which of the following laboratory values supports this finding?

  • Sodium 152 mEq/L
  • Chloride 102 mEq/L
  • Magnesium 1.8 mEq/L
  • Potassium 6.1 mEq/L Potassium 6.1 mEq/L Hyperkalemia, defined as a potassium level above 5.0 mEq/L, can cause a prolonged PR interval, a wide QRS complex, flat or absent P waves, and tall, peaked T waves. While reviewing a client's laboratory results, a nurse notes a serum calcium level of 8.0 mg/dL. Which of the following actions should the nurse take?
  • Implement seizure precautions
  • Administer phosphate
  • Initiate diuretic therapy

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

  • Hyperactive deep-tendon reflexes
  • Increased bowel sounds
  • Drowsiness
  • Decreased blood pressure Hyperactive deep-tendon reflexes Hyperactive deep-tendon reflexes is an expected finding for a client who has hypomagnesemia. Other expected findings include muscle cramps, numbness, and tingling. A nurse is reviewing the medical record of a client who has diabetes mellitus and is receiving regular insulin by continuous IV infusion to treat diabetic ketoacidosis. Which of the following findings should the nurse report to the provider?
  • Urine output of 30 mL/hr
  • Blood glucose of 19=80 mg/dL
  • Serum potassium 3.0 mEq/L
  • BUN 18 mg/dL Serum potassium 3.0 mEq/L This serum potassium level is below the expected reference range. Hypokalemia is a serious complication that can occur when a client who has diabetic ketoacidosis is receiving insulin to treat the condition. The nurse should report this finding to the provider.

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

A nurse is reviewing the ABG results for four clients. Which of the following findings should the nurse identify as metabolic acidosis?

  • pH 7.51, PaO2 94 mm Hg, PaCO2 38 mm Hg, HCO3- 29 mEq/L
  • pH 7.48, PaO2 89 mm Hg, PaCO2 30 mm Hg, HCO3- 24 mEq/L
  • pH 7.36, PaO2 77 mm Hg, PaCO2 52 mm Hg, HCO3- 26 mEq/L
  • pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L pH 7.26, PaO2 84 mm Hg, PaCO2 38 mm Hg, HCO3- 20 mEq/L A pH below 7.35 is an indication of acidosis. HCO3- below 22 mEq/L is an indication of metabolic acidosis. A nurse is providing teaching for a client who has venous insufficiency of the lower extremities. Which of the following statements by the client indicates an understanding of the teaching?
  • "If my stockings feel tight, I'll just roll them down for a while."
  • "I'll put on my elastic stockings at the first sign of swelling."
  • "When I sit down to watch television, I'll be sure to put my feet up."
  • "It's okay to cross my legs as long as it's for less than an hour." "When I sit down to watch television, I'll be sure to put my feet up."

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

  • 0.45% sodium chloride 0.45% sodium chloride A sodium level of 155 mEq/L is an indication of hypernatremia. The nurse should anticipate a prescription for a hypotonic solution. The 0.45% sodium chloride is a hypotonic solution used to provide free water and treat cellular dehydration, which promotes waste elimination by the kidneys. A nurse is assessing a client who has a phosphorus level of 2.4 mg/dL. Which of the following findings should the nurse expect?
  • Hepatic failure
  • Abdominal pain
  • Slow peripheral pulses
  • Increase in cardiac output Slow peripheral pulses This phosphorus level is below the expected reference range. The nurse should expect the client to have slow peripheral pulses. The nurse might also find that the client's pulses are difficult to find and easy to block.

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

A nurse is teaching nutritional strategies to a client who has a low serum calcium level and an allergy to milk. Which of the following statements by the client indicates an understanding of the teaching?

  • "I will eat more cheese because I can't drink milk."
  • "I need to avoid foods with vitamin D because I am allergic to milk."
  • "I will stop taking my calcium supplements if they irritate my stomach."
  • "I will add broccoli and kale to my diet." "I will add broccoli and kale to my diet." The nurse should recommend that the client consume broccoli and kale, which are good sources of calcium, as alternatives to dairy products. A nurse is reviewing the laboratory report of a client who has fluid volume excess. Which of the following laboratory values should the nurse expect?
  • Hemoglobin 20 g/dL
  • Hematocrit 34%
  • BUN 25 mg/dL Urine specific gravity 1. Hematocrit 34%

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

  • Increased heart rate
  • Increased blood pressure Decreased muscle strength The nurse should expect the client to experience muscle weakness, fatigue, paresthesia, and nausea. A nurse is evaluating a client who is receiving IV fluids to treat isotonic dehydration. Which of the following laboratory findings indicates that the fluid therapy has been effective?
  • BUN 26 mg/dL
  • Serum sodium 138 mEq/L
  • Hct 56%
  • Urine specific gravity 1. Serum sodium 138 mEq/L Isotonic dehydration includes loss of water and electrolytes due to a decrease in oral intake of water and salt. A serum sodium level of 138 mEq/L is within the expected reference range and indicates that the fluid therapy has been effective. A nurse is caring for a client who reports difficulty breathing and tingling in both hands. His respiratory rate is 36/min and he appears very restless. Which of the following values should the

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

nurse anticipate to be outside the expected reference range if the client is experiencing respiratory alkalosis?

  • PaO
  • PaCO
  • Sodium
  • Bicarbonate PaCO The nurse should anticipate that a client who has respiratory alkalosis will have a decreased PaCO2 level due to hyperventilation. A nurse is assessing a client who is using PCA following a thoracotomy. The client is short of breath, appears restless, and has a respiratory rate of 28/min. The client's ABG results are pH 7.52, PaO2 89 mm Hg, PaCO2 28 mm Hg, and HCO3- 24 mEq/L. Which of the following actions should the nurse take?
  • Instruct the client to cough forcefully
  • Assist the client with ambulation
  • Provide calming interventions
  • Discontinue the PCA Provide calming interventions.

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

  • Encourage the client to rise slowly when standing up
  • Weigh the client every 8 hr
  • Administer IV fluids to the client evenly over 24 hr
  • Encourage the client to rise slowly when standing up
  • Weigh the client every 8 hr A nurse is planning care for a client who has a serum potassium level of 3.0 mEq/L. The nurse should plan to monitor the client for which of the following findings?
  • Hyperactive deep-tendon reflexes
  • Orthostatic hypotension
  • Rapid, deep respirations
  • Strong, bounding pulse Orthostatic hypotension The nurse should plan to monitor the client for orthostatic hypotension, which places him at risk for falls. Orthostatic hypotension is a manifestation of hypokalemia. A nurse is assessing a client who is receiving hydrochlorothiazide and notes that the client is confused and lethargic. Which of the following laboratory values should the nurse report to the provider?

Proctored Exam (2025/2026) — Updated

Edition (Verified Questions & Answers |

NCLEX®-RN® Readiness)

  • Sodium 128 mEq/L
  • Potassium 4.8 mEq/L
  • Calcium 9.1 mg/dL
  • Magnesium 2.0 mEq/L Sodium 128 mEq/L This level is below the expected reference range and is the likely cause of the client's altered mental status. The nurse should report this finding to the provider and monitor the client for weakened respiratory effort. A nurse is preparing to administer oral potassium for a client who has a potassium level of 5.5 mEq/L. Which of the following actions should the nurse take first?
  • Administer a hypertonic solution
  • Repeat the potassium level
  • Withhold the medication
  • Monitor for paresthesia Withhold the medication. The greatest risk to the client is bradycardia, hypotension, and life-threatening cardiac complications due to hyperkalemia, defined as a potassium level above 5.0 mEq/L. Therefore, the nurse's priority action is to withhold the oral potassium and notify the provider.