ATI RN
clinical skills exam questions Questions
Question 1 of 5
The patient is diagnosed with acute kidney injury and has been getting dialysis 3 days per week. The patient complains of general malaise and is tachypneic. An arterial blood gas shows that the patient’s pH is 19, with a PCO of 30 mm Hg and a bicarbonate level of 13 mEq/L. The nurse prepares to
Correct Answer: B
Rationale: The correct answer is B: prepare for intubation and mechanical ventilation. The patient's arterial blood gas results indicate metabolic acidosis (low pH, low bicarbonate) with respiratory compensation (low PCO). In this scenario, the patient is likely experiencing respiratory fatigue due to tachypnea from metabolic acidosis. Intubation and mechanical ventilation are needed to support the patient's respiratory effort and correct the acid-base imbalance. Administering morphine (choice
A) can further depress the respiratory drive. Administering intravenous sodium bicarbonate (choice
C) can temporarily correct the pH but does not address the underlying respiratory distress. Canceling dialysis (choice
D) is not indicated as it does not address the acute respiratory compromise.
Question 2 of 5
The patient has been admitted to the hospital with nausea and vomiting that started 5 days earlier. Blood pressure is 80/44 mm Hg and heart rate is 122 beats/min; the patient has not voided in 8 hours, and the bladder is not distended. The nurse anticipates a prescription for “stat” administration of
Correct Answer: B
Rationale: The correct answer is B: fluid replacement with 0.45% saline. The patient's symptoms suggest dehydration and hypovolemia, indicated by low blood pressure, elevated heart rate, and lack of urine output. Fluid replacement with isotonic saline would help restore intravascular volume and improve blood pressure. Blood transfusion (
A) is not indicated without evidence of significant blood loss. Inotropic agents (
C) are used to improve cardiac function, which is not the primary issue in this case. Antiemetics (
D) may help with nausea and vomiting but do not address the underlying cause of hypovolemia.
Question 3 of 5
Renin plays a role in blood pressure regulation by
Correct Answer: A
Rationale: The correct answer is A because renin activates the renin-angiotensin-aldosterone cascade. Renin is released by the kidneys in response to low blood pressure or low sodium levels. It acts on angiotensinogen to form angiotensin I, which is then converted to angiotensin II by angiotensin-converting enzyme. Angiotensin II causes vasoconstriction, leading to increased blood pressure, and stimulates aldosterone release, promoting sodium and water retention.
Choice B is incorrect because renin does not suppress angiotensin production; it actually initiates the process.
Choice C is incorrect because renin's action leads to increased sodium reabsorption by stimulating aldosterone release.
Choice D is incorrect because renin does not inhibit aldosterone release; it promotes it as part of the renin-angiotensin-aldosterone cascade.
Question 4 of 5
The nurse has been assigned the following patients. Which patients require assessment of blood glucose control as a nursing priority? (Select all that apply.)
Correct Answer: C
Rationale: The correct answer is C because the patient with acute pancreatitis receiving TPN is at risk for hyperglycemia due to the high glucose content in TPN. Monitoring blood glucose levels is crucial to prevent complications.
Explanation for why other choices are incorrect:
A: The 18-year-old male post-surgery for a fractured femur does not have a direct correlation to blood glucose control assessment.
B: The 29-year-old female undergoing evaluation for pheochromocytoma is not directly related to blood glucose control assessment.
D: The 62-year-old morbidly obese female post-hysterectomy for ovarian cancer does not specifically require immediate blood glucose control assessment.
Question 5 of 5
Conditions that produce acute kidney injury by directly acting on functioning kidney tissue are classified as intrarenal. The most common intrarenal condition is
Correct Answer: C
Rationale:
Rationale: Acute tubular necrosis (ATN) is the most common intrarenal condition causing acute kidney injury. ATN is characterized by damage to the renal tubules due to ischemia or nephrotoxic substances. Prolonged ischemia (choice
A) and exposure to nephrotoxic substances (choice
B) can lead to ATN. Hypotension for several hours (choice
D) can result in ischemic injury, which may lead to ATN but is not the direct cause.
Therefore, choice C is correct as it directly relates to the primary intrarenal condition of ATN.