ATI RN
clinical skills exam questions Questions
Question 1 of 5
A patient with pancreatic cancer has been admitted to the critical care unit with clinical signs consistent with syndrome of inappropriate secretion of antidiuretic hormone. The nurse anticipates that clinical management of this condition will include
Correct Answer: C
Rationale: Step 1: Syndrome of inappropriate antidiuretic hormone (SIADH) leads to excess water retention, diluting sodium levels in the blood. Step 2: Fluid restriction is the mainstay of treatment to prevent further dilution of sodium. Step 3: Administering 3% normal saline (choice A) can worsen the condition by further increasing sodium levels. Step 4: Exogenous vasopressin (choice B) would exacerbate the problem by increasing water retention. Step 5: Low sodium diet (choice D) may be beneficial in the long term but is not the immediate priority.
Question 2 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 3 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.
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
A patient with newly diagnosed type 1 diabetes is being transitioned from an infusion of intravenous (IV) regular insulin to an intensive insulin therapy regimen of insulin glargine and insulin aspart. How should the nurse manage this transition in insulin delivery?
Correct Answer: D
Rationale: The correct answer is D: Discontinue the IV infusion and administer the Lantus insulin at bedtime. This is the correct approach because insulin glargine (Lantus) is a long-acting basal insulin that provides a steady level of insulin throughout the day and night. By administering it at bedtime, it mimics the basal insulin secretion in a person without diabetes. This helps maintain stable blood sugar levels overnight. Choice A is incorrect because continuing the IV insulin infusion for 24 hours alongside insulin glargine is unnecessary and may lead to insulin overdose. Choice B is incorrect because discontinuing the IV infusion in several hours without administering the long-acting insulin can lead to inadequate insulin coverage. Choice C is incorrect because insulin aspart is a rapid-acting insulin that should be given with meals, not as a basal insulin replacement at bedtime.
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