ATI RN
clinical skills questions Questions
Question 1 of 9
Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used to
Correct Answer: A
Rationale: Rationale: Slow continuous ultrafiltration is a method used to remove excess plasma water in cases of volume overload, making choice A the correct answer. This process does not involve adding dialysate (choice C) or combining ultrafiltration, convection, and dialysis (choice D). While ultrafiltration does involve the removal of fluids and solutes, it is primarily achieved through ultrafiltration rather than convection (choice B).
Question 2 of 9
The removal of plasma water and some low–molecular weight particles by using a pressure or osmotic gradient is known as
Correct Answer: D
Rationale: The correct answer is D: ultrafiltration. Ultrafiltration involves the removal of plasma water and low-molecular weight particles using a pressure or osmotic gradient. This process allows small molecules to pass through a semipermeable membrane while retaining larger molecules. Dialysis (A) involves the removal of waste products and excess fluids from the blood, while diffusion (B) is the movement of molecules from an area of high concentration to low concentration. Clearance (C) refers to the rate at which a substance is removed from the blood by a specific organ or process. Ultrafiltration specifically targets the removal of plasma water and low-molecular weight particles through a pressure or osmotic gradient, making it the correct choice in this context.
Question 3 of 9
The patient undergoes a cardiac catheterization that requires the use of contrast dyes during the procedure. To detect signs of contrast-induced kidney injury, the nurse should
Correct Answer: B
Rationale: Correct Answer: B Rationale: 1. Contrast dyes can cause kidney injury due to their nephrotoxic effects. 2. Serum creatinine levels are a reliable indicator of kidney function. 3. Evaluating serum creatinine for up to 72 hours after the procedure allows detection of any contrast-induced kidney injury. 4. Monitoring serum creatinine helps in early identification and intervention for renal complications. Summary: A: Incorrect. Urine output alone is not a definitive indicator of kidney injury. C: Incorrect. Renal ultrasound is not typically used for detecting contrast-induced kidney injury. D: Incorrect. Postvoid residual volume is not specific for contrast-induced kidney injury.
Question 4 of 9
The critical care nurse is responsible for monitoring the patient receiving continuous renal replacement therapy (CRRT). In doing so, the nurse should
Correct Answer: B
Rationale: Correct Answer: B Rationale: 1. Hemofilter clotting can affect CRRT efficiency. 2. Assessing every 6 hours allows early detection and intervention. 3. Clotting can lead to treatment interruptions or complications. 4. Regular assessment ensures optimal therapy delivery. Other Choices: A: Assessing tubing warmth is not a reliable indicator of CRRT function or complications. C: Covering dialysis lines to protect from light is not a standard practice in CRRT monitoring. D: Using clean technique is not sufficient for vascular access dressing changes; aseptic technique is required for infection prevention.
Question 5 of 9
Which of the following patients is at the highest risk for hyperosmolar hyperglycemic syndrome?
Correct Answer: D
Rationale: The correct answer is D because the 83-year-old long-term care resident with type 2 diabetes and advanced Alzheimer's disease who recently developed influenza is at the highest risk for hyperosmolar hyperglycemic syndrome (HHS). This patient has multiple risk factors for HHS, including age, type 2 diabetes, advanced Alzheimer's disease, and the added stress of influenza, which can exacerbate hyperglycemia. The combination of these factors can lead to severe hyperglycemia, dehydration, and electrolyte imbalances characteristic of HHS. Choice A is incorrect because although excessive exercise can lead to hypoglycemia in individuals with type 1 diabetes, it is not a risk factor for HHS. Choice B is incorrect as forgetting to take insulin can lead to diabetic ketoacidosis in type 1 diabetes, not HHS. Choice C is incorrect as starting insulin injections in a patient with type 2 diabetes and coronary artery disease does not automatically increase the risk
Question 6 of 9
Which of the following are appropriate nursing interventions for the patient in myxedema coma? (Select all that apply.)
Correct Answer: A
Rationale: Correct Answer: A Rationale: 1. Administering levothyroxine is crucial in treating myxedema coma as it helps replace the deficient thyroid hormone. 2. This intervention addresses the underlying cause of myxedema coma, which is severe hypothyroidism. 3. Levothyroxine administration can help reverse the symptoms of myxedema coma and improve the patient's condition. Summary of Incorrect Choices: - B: Encouraging high sodium intake is not appropriate as myxedema coma is associated with fluid retention and sodium may exacerbate this. - C: Passive rewarming interventions are not relevant for myxedema coma, as the condition is not typically related to hypothermia. - D: While monitoring airway and respiratory effort is important in general patient care, it is not a specific intervention for myxedema coma.
Question 7 of 9
The nurse is assigned to care for a patient who presented to the emergency department with diabetic ketoacidosis. A continuous insulin intravenous infusion is started, and hourly bedside glucose monitoring is ordered. The targeted blood glucose value after the first hour of therapy is
Correct Answer: C
Rationale: The correct answer is C: a decrease of 35 to 90 mg/dL compared with admitting values. In diabetic ketoacidosis, there is severe hyperglycemia which needs to be corrected gradually to prevent complications like cerebral edema. A rapid decrease in glucose levels can lead to osmotic shifts and neurological issues. The targeted decrease of 35 to 90 mg/dL is considered safe and effective in managing hyperglycemia in these patients. This range ensures a controlled reduction in blood glucose levels without causing harm. Choice A (70 to 120 mg/dL) is too broad and may lead to overly aggressive treatment. Choice B (a decrease of 25 to 50 mg/dL) is too conservative and may not adequately address the high glucose levels seen in diabetic ketoacidosis. Choice D (less than 200 mg/dL) does not provide a specific target range for glucose reduction, which is essential in managing diabetic ketoacidosis effectively.
Question 8 of 9
A patient presents to the emergency department with the following clinical signs: Pulse: 132 beats/min Blood pressure: 88/50 mm Hg Respiratory rate: 32 breaths/min Temperature: 8°F Chest x-ray: Findings consistent with congestive heart failure Cardiac rhythm: Atrial fibrillation with rapid ventricular response These signs are consistent with which disorder?
Correct Answer: D
Rationale: Rationale: The clinical signs indicate a hypermetabolic state with tachycardia, hypotension, tachypnea, and potential fever, typical of a thyroid storm. The presence of congestive heart failure and atrial fibrillation further support this diagnosis due to the hyperthyroid state exacerbating cardiovascular symptoms. Adrenal crisis (A) would present with hypotension and shock, but not with the hypermetabolic state seen here. Myxedema coma (B) would present with hypothermia, bradycardia, and altered mental status, which are not present in this case. SIADH (C) would typically present with hyponatremia and concentrated urine, which are not seen here.
Question 9 of 9
A normal glomerular filtration rate is
Correct Answer: B
Rationale: The correct answer is B (80 to 125 mL/min) because this range represents the normal glomerular filtration rate (GFR) for a healthy adult. GFR indicates the rate at which blood is filtered by the kidneys, with 125 mL/min being the average value. Values below 80 mL/min (Choice A) suggest impaired kidney function, while values above 189 mL/min (Choice D) may indicate hyperfiltration or underlying conditions. Choice C (125 to 180 mL/min) falls within the normal range, but the typical average is around 125 mL/min. Thus, choice B is the correct answer as it reflects the standard GFR range for adults.