Questions 29

ATI RN

ATI RN Test Bank

clinical skills exam questions Questions

Question 1 of 5

The patient is admitted to the unit with the diagnosis of rhabdomyolysis. The patient is started on intravenous (IV) fluids and IV mannitol. What action by the nurse is best?

Correct Answer: B

Rationale: The correct answer is B: Assess the patient's lungs. In rhabdomyolysis, muscle breakdown releases myoglobin which can cause kidney damage. Mannitol is given to prevent kidney damage by promoting diuresis. However, mannitol can also cause fluid overload and pulmonary edema.
Therefore, assessing the patient's lungs is crucial to monitor for signs of fluid overload and prevent complications.

A: Assessing the patient's hearing is not directly related to the management of rhabdomyolysis and mannitol administration.
C: Decreasing IV fluids after administering a diuretic like mannitol can lead to inadequate fluid resuscitation and worsening kidney injury.
D: Giving extra doses before radiological contrast agents is not necessary in the context of rhabdomyolysis and mannitol administration.

Question 2 of 5

Which of the following is a high-priority nursing diagnosis for both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome?

Correct Answer: B

Rationale: The correct answer is B: Fluid volume deficient. Both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome can lead to severe dehydration and electrolyte imbalances. Addressing fluid volume deficiency is crucial to stabilize the patient's condition.
Choice A is not the priority as the main concern is the fluid imbalance, not activity intolerance. Hyperthermia (choice
C) may be present but is not the primary concern compared to fluid volume deficit. Impaired nutrition (choice
D) is not the immediate priority in these emergency situations. In summary, maintaining fluid balance is essential to manage both conditions effectively.

Question 3 of 5

The patient is in the critical care unit and will receive dialysis this morning. The nurse will (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A. By evaluating the morning laboratory results and reporting abnormal results, the nurse can ensure the patient's safety during dialysis by addressing any concerning findings promptly. This step is crucial in monitoring the patient's condition and adjusting the treatment plan as needed.

Incorrect choices:
B: Administering antihypertensive medications is not directly related to the patient's dialysis procedure and does not address the immediate needs of the patient in the critical care unit.
C: While assessing the dialysis access site is important, reporting abnormalities alone may not be sufficient without a comprehensive evaluation of the patient's laboratory results.
D: Weighing the patient to monitor fluid status is important in the context of dialysis, but it is not as critical as evaluating laboratory results for immediate intervention.

Question 4 of 5

Which of the following patients is at the greatest risk of developing acute kidney injury? A patient who

Correct Answer: C

Rationale: The correct answer is C because the patient was recently discharged after a prolonged course of aminoglycoside therapy, which is a known risk factor for acute kidney injury due to its nephrotoxic effects.
Choice A is incorrect because although aminoglycosides can cause kidney injury, the duration of therapy is shorter in this case.
Choice B is incorrect because controlled hypertension is not a significant risk factor for acute kidney injury.
Choice D is incorrect because fluid overload from heart failure may lead to other complications but is not directly associated with acute kidney injury.

Question 5 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.

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