ATI RN
Nursing Clinical Skills questions Questions
Question 1 of 9
Mechanisms for development of diabetes insipidus include which of the following? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: ADH deficiency. Diabetes insipidus is caused by a deficiency of antidiuretic hormone (ADH), leading to excessive urine production and thirst. ADH is responsible for regulating water reabsorption in the kidneys. When ADH levels are low or absent, the kidneys cannot concentrate urine effectively, resulting in excessive urine output. Explanation for why other choices are incorrect: B: ADH excess would not lead to diabetes insipidus, as it would result in increased water reabsorption and concentrated urine. C: ADH insensitivity refers to a condition where the body does not respond to ADH, but it does not cause diabetes insipidus. D: ADH replacement therapy is actually a treatment for diabetes insipidus, not a mechanism for its development.
Question 2 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 3 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 4 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 5 of 9
Mechanisms for development of diabetes insipidus include which of the following? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: ADH deficiency. Diabetes insipidus is caused by a deficiency of antidiuretic hormone (ADH), leading to excessive urine production and thirst. ADH is responsible for regulating water reabsorption in the kidneys. When ADH levels are low or absent, the kidneys cannot concentrate urine effectively, resulting in excessive urine output. Explanation for why other choices are incorrect: B: ADH excess would not lead to diabetes insipidus, as it would result in increased water reabsorption and concentrated urine. C: ADH insensitivity refers to a condition where the body does not respond to ADH, but it does not cause diabetes insipidus. D: ADH replacement therapy is actually a treatment for diabetes insipidus, not a mechanism for its development.
Question 6 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 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 would be seen in a patient with myxedema coma?
Correct Answer: A
Rationale: The correct answer is A: Decreased reflexes. In myxedema coma, a severe form of hypothyroidism, patients often present with decreased mental status, hypothermia, and bradycardia. Decreased reflexes are a common neurological manifestation due to the slowing of metabolic processes and the central nervous system depression associated with this condition. Hyperthermia (B) is not typically seen in myxedema coma, as patients usually have low body temperature. Hyperventilation (C) is also unlikely, as respiratory depression is more common. Tachycardia (D) is incorrect because bradycardia is more characteristic of myxedema coma.
Question 9 of 9
A patient has been on daily, high-dose glucocorticoid therapy for the treatment of rheumatoid arthritis. His prescription runs out before his next appointment with his physician. Because he is asymptomatic, he thinks it is all right to withhold the medication for 3 days. What is likely to happen to this patient?
Correct Answer: A
Rationale: The correct answer is A: He will go into adrenal crisis. Rationale: 1. Glucocorticoids suppress the body's natural production of cortisol. 2. Abruptly stopping high-dose glucocorticoid therapy can lead to adrenal insufficiency. 3. Adrenal crisis can result in symptoms like weakness, fatigue, hypotension, and potentially life-threatening consequences. 4. This patient, being on high-dose glucocorticoid therapy, is at risk for adrenal crisis if he abruptly stops the medication. Summary: B: Thyroid storm is not related to abruptly stopping glucocorticoid therapy. C: Autoimmune disease remission is unlikely to occur within 3 days of stopping medication. D: It is not appropriate to stop high-dose glucocorticoid therapy abruptly, as it can lead to adverse effects like adrenal crisis.