ATI RN
Nursing Clinical Skills questions Questions
Question 1 of 9
Factors associated with the development of nephrogenic diabetes insipidus include which of the following? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Heredity. Nephrogenic diabetes insipidus can be inherited as a genetic condition. The mutation in genes responsible for regulating water balance in the kidneys can lead to this disorder. Other choices are incorrect: B: Medications like lithium can cause acquired nephrogenic diabetes insipidus, not its development. C: Meningitis is an inflammatory condition that does not directly relate to nephrogenic diabetes insipidus. D: Pituitary tumors are associated with central diabetes insipidus, not nephrogenic.
Question 2 of 9
The patient is admitted with complaints of general malaise and fatigue, along with a decreased urinary output. The patient’s urinalysis shows coarse, muddy brown granular casts and hematuria. The nurse determines that the patient has:
Correct Answer: C
Rationale: The correct answer is C: intrarenal disease, probably acute tubular necrosis. The presence of coarse, muddy brown granular casts and hematuria in the urinalysis indicates damage to the renal tubules, which is characteristic of acute tubular necrosis. This condition is a type of intrarenal disease where there is direct damage to the kidney tubules, leading to decreased urinary output and symptoms like malaise and fatigue. Prerenal and postrenal conditions do not typically present with granular casts and hematuria, making choices A and B incorrect. Urinary tract infection is also unlikely to cause the specific findings seen in this case, ruling out choice D. Therefore, choice C is the most appropriate based on the urinalysis results and clinical presentation.
Question 3 of 9
A patient presents to the emergency department with suspected thyroid storm. The nurse should be alert to which of the following cardiac rhythms while providing care to this patient?
Correct Answer: A
Rationale: The correct answer is A: Atrial fibrillation. In thyroid storm, excess thyroid hormone levels can lead to increased sympathetic activity, causing tachycardia and arrhythmias like atrial fibrillation. Atrial fibrillation is common in thyroid storm due to the hypermetabolic state and increased risk of atrial arrhythmias. Other choices are incorrect: B (Idioventricular rhythm) is not typically associated with thyroid storm, C (Junctional rhythm) is less likely since atrial arrhythmias are more common, and D (Sinus bradycardia) is unlikely due to the hypermetabolic state causing tachycardia.
Question 4 of 9
The term used to describe an increase in blood urea nitrogen (BUN) and serum creatinine is
Correct Answer: B
Rationale: The correct answer is B: azotemia. Azotemia refers to elevated levels of nitrogenous waste products like BUN and creatinine in the blood. This occurs when the kidneys are not functioning properly, leading to decreased filtration and excretion of waste products. Oliguria (A) is reduced urine output, not specific to elevated BUN and creatinine levels. Acute kidney injury (C) is a broader term for sudden loss of kidney function. Prerenal disease (D) typically refers to conditions affecting blood flow to the kidneys, leading to decreased kidney function, but it does not specifically describe the increase in BUN and creatinine levels.
Question 5 of 9
The patient’s serum creatinine level is 7 mg/dL. The expected BUN level should be
Correct Answer: C
Rationale: The correct answer is C (10 to 20 mg/dL). In conditions where the serum creatinine level is elevated (7 mg/dL in this case), the BUN level is expected to also be elevated due to impaired kidney function. BUN levels are typically around 10-20 mg/dL, so this range is the most appropriate given the elevated creatinine level. Choice A (1 to 2 mg/dL) is too low and would not be expected with a creatinine level of 7 mg/dL. Choice B (7 to 14 mg/dL) is a bit low for such a high creatinine level. Choice D (20 to 30 mg/dL) is too high as it exceeds the typical range for BUN levels. Therefore, choice C is the most appropriate range based on the given information.
Question 6 of 9
The patient’s potassium level is 0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?
Correct Answer: A
Rationale: The correct answer is A: Sodium polystyrene sulfonate. It works by exchanging sodium ions for potassium ions in the colon, leading to potassium excretion. A is the safest option without the risk of causing hypernatremia or intestinal necrosis like B. Regular insulin (C) may cause hypoglycemia and is not as effective as A in reducing potassium levels. Calcium gluconate (D) does not directly reduce potassium levels and is used for treating hyperkalemia-related cardiac toxicity.
Question 7 of 9
The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of
Correct Answer: A
Rationale: The correct answer is A: a percutaneous catheter at the bedside. In this urgent situation, a percutaneous catheter can be quickly inserted at the bedside to provide immediate vascular access for hemodialysis. This option allows for rapid initiation of treatment without the need for surgical placement or waiting for a more permanent access like an arteriovenous fistula or graft. Incorrect Choices: B: A percutaneous tunneled catheter may require more time for insertion due to tunneling and may not be suitable for immediate use. C: An arteriovenous fistula is a more permanent access created surgically and requires time to mature before being used for hemodialysis. D: An arteriovenous graft is also a surgical option that requires time to heal and mature before being used for hemodialysis.
Question 8 of 9
Which of the following laboratory values would be more common in patients with diabetic ketoacidosis?
Correct Answer: A
Rationale: The correct answer is A (Blood glucose >1000 mg/dL) because diabetic ketoacidosis is characterized by severe hyperglycemia. High blood glucose levels (>1000 mg/dL) are common due to insulin deficiency leading to increased glucose production. B: Negative ketones in the urine would be incorrect as DKA results in ketone production, leading to ketonuria. C: Normal anion gap would be incorrect as DKA typically presents with an elevated anion gap metabolic acidosis due to ketone accumulation. D: pH 7.24 would be incorrect as DKA would present with a lower pH due to metabolic acidosis.
Question 9 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.