ATI RN
Nursing Clinical Skills questions Questions
Question 1 of 9
Continuous venovenous hemofiltration is used to
Correct Answer: A
Rationale: The correct answer is A because continuous venovenous hemofiltration primarily removes fluids and solutes through convection. Convection involves the movement of solutes across a semi-permeable membrane by the force of the fluid flow. This process helps to achieve fluid balance and manage electrolyte levels in patients with renal failure. Choice B is incorrect because hemofiltration does not specifically target plasma water; it aims to remove both fluids and solutes. Choice C is incorrect as hemofiltration does not involve adding dialysate; it relies on the patient's blood passing through a filter to remove waste products. Choice D is incorrect because while hemofiltration may involve aspects of ultrafiltration and dialysis, the primary mechanism is convection for removing fluids and solutes.
Question 2 of 9
Acute kidney injury from postrenal etiology is caused by
Correct Answer: A
Rationale: The correct answer is A because acute kidney injury from postrenal etiology is caused by obstruction of the flow of urine, leading to back pressure and damage to the kidneys. Choices B and C relate to prerenal causes, affecting renal perfusion and volume status. Choice D refers to intrinsic renal causes, directly affecting kidney tissue function, not postrenal obstruction. Therefore, A is correct due to the nature of postrenal etiology.
Question 3 of 9
The patient is on intake and output (I&O), as well as daily weights. The nurse notes that output is considerably less than intake over the last shift, and daily weight is 1 kg more than yesterday. The nurse should
Correct Answer: C
Rationale: The correct answer is C: assess the patient's lungs. The discrepancy between intake, output, and weight gain indicates a potential fluid imbalance. By assessing the patient's lungs, the nurse can identify signs of fluid overload, such as crackles or difficulty breathing, which could explain the weight gain and imbalance. This step is crucial in determining the underlying cause and guiding further interventions. Drawing a trough level (A) or inserting an indwelling catheter (D) are not necessary at this point and may not address the immediate issue. Placing the patient on fluid restriction (B) should only be considered after a thorough assessment to determine the cause of the imbalance.
Question 4 of 9
Peritoneal dialysis is different from hemodialysis in that peritoneal dialysis
Correct Answer: B
Rationale: The correct answer is B because peritoneal dialysis uses the patient's own semipermeable membrane, the peritoneal membrane, to filter waste and excess fluid from the blood. This membrane allows for the exchange of fluids and solutes, making it an effective method for dialysis. A is incorrect because peritoneal dialysis can be used for acute kidney injury. C is incorrect as peritoneal dialysis can address drug overdose and electrolyte imbalance by removing toxins and balancing electrolytes. D is incorrect as peritoneal dialysis can be used in cases of water intoxication by helping to remove excess fluid from the body.
Question 5 of 9
The nurse is caring for a patient with acute kidney injury who is being treated with hemodialysis. The patient asks if he will need dialysis for the rest of his life. Which of the following would be the best response?
Correct Answer: D
Rationale: The correct answer is D: “Recovery is possible, but it may take several months.” This response is the best because acute kidney injury can be reversible with appropriate management, and recovery may take time. It is important to provide hope and encouragement to the patient. A: “Unfortunately, kidney injury is not reversible; it is permanent.” - This is incorrect as acute kidney injury can be reversible with timely intervention and proper treatment. B: “Kidney function usually returns within 2 weeks.” - This is incorrect because the recovery timeline varies for each individual and can take longer than 2 weeks. C: “You will know for sure if you start urinating a lot all at once.” - This is incorrect as increased urine output may not always indicate complete recovery from acute kidney injury.
Question 6 of 9
The patient is admitted with acute kidney injury from a postrenal cause. Acceptable treatments for that diagnosis include: (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A. Bladder catheterization helps relieve urinary obstruction, a common postrenal cause of acute kidney injury. It allows urine to drain freely from the bladder. - B: Increasing fluid volume intake may worsen the condition by increasing the pressure on the obstructed kidneys. - C: Ureteral stenting is used for intrarenal causes, not postrenal causes. - D: Placement of nephrostomy tubes bypasses the obstruction but is usually reserved for more severe cases.
Question 7 of 9
The patient is in a progressive care unit following arteriovenous fistula implantation in his left upper arm, and is due to have blood drawn with his next set of vital signs and assessment. When the nurse assesses the patient, the nurse should
Correct Answer: D
Rationale: The correct answer is D. Auscultating the left arm for a bruit and palpating for a thrill post arteriovenous fistula implantation is crucial to assess the patency and functionality of the fistula. A bruit indicates turbulent blood flow, while a thrill signifies the presence of a strong pulse through the fistula. These assessments help identify any complications like stenosis or thrombosis. Drawing blood or taking blood pressures from the arm with the fistula can lead to inaccurate results or damage the fistula. Starting a new IV line in the left lower arm is unnecessary and not relevant to monitoring the arteriovenous fistula.
Question 8 of 9
The critical care nurse knows that in critically ill patients, renal dysfunction
Correct Answer: B
Rationale: The correct answer is B because renal dysfunction is a common issue in critically ill patients due to factors like sepsis or hypoperfusion. This affects nearly two thirds of patients, leading to potential complications. Choice A is incorrect as renal dysfunction is common, not rare. Choice C is incorrect as mortality rates can still be high even with renal replacement therapy. Choice D is incorrect as renal dysfunction can significantly impact morbidity, mortality, and quality of life in critically ill patients.
Question 9 of 9
The nurse is caring for a patient who suffered a head trauma following a fall. The patient’s heart rate is 112 beats/min and blood pressure is 88/50 mm Hg. The patient has poor skin turgor and dry mucous membranes. The patient is confused and restless. The following laboratory values are reported: serum sodium is 115 mEq/L; blood urea nitrogen (BUN) 50 mg/dL; and creatinine 8 mg/dL. The findings are consistent with which disorder?
Correct Answer: A
Rationale: The correct answer is A: Cerebral salt wasting. This is indicated by the low serum sodium level (115 mEq/L), which can occur in patients with head trauma and lead to excessive sodium loss through the kidneys. This results in hypovolemia, leading to low blood pressure and tachycardia. The elevated BUN (50 mg/dL) and creatinine (8 mg/dL) levels suggest dehydration and renal impairment due to volume depletion. The patient's poor skin turgor, dry mucous membranes, confusion, and restlessness further support the diagnosis of cerebral salt wasting. Summary: B: Diabetes insipidus is characterized by excessive urination and thirst due to insufficient production of antidiuretic hormone (ADH). This patient's symptoms are not consistent with diabetes insipidus. C: Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is characterized by excessive release of ADH, leading to water retention and