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 nurse is caring for an elderly patient who was admitted with renal insufficiency. An expected laboratory finding for this patient may be
Correct Answer: C
Rationale: Correct Answer: C - Increased ability to excrete drugs. Rationale: 1. Renal insufficiency impairs kidney function, leading to decreased excretion of drugs. 2. In elderly patients with renal insufficiency, there may be compensatory mechanisms to enhance drug excretion. 3. This increased ability to excrete drugs helps prevent drug accumulation and potential toxicity. Summary: A: Increased GFR is not expected in renal insufficiency; it typically decreases. B: Serum creatinine level would likely be elevated in renal insufficiency, not normal. D: Hypokalemia is not a typical lab finding in renal insufficiency; hyperkalemia is more common.
Question 3 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 4 of 9
The most significant clinical finding of acute adrenal crisis associated with fluid and electrolyte imbalance is
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C: hyperkalemia): 1. Adrenal crisis leads to adrenal insufficiency, causing decreased cortisol levels. 2. Cortisol plays a crucial role in regulating potassium levels. 3. With decreased cortisol, potassium levels can rise, leading to hyperkalemia. 4. Hyperkalemia can result in life-threatening cardiac arrhythmias. Summary: A: Fluid volume excess is not typical in adrenal crisis. B: Hyperglycemia can be present but is not the most significant finding. D: Hypernatremia is not a typical feature of adrenal crisis.
Question 5 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 6 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 7 of 9
The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)
Correct Answer: A
Rationale: Explanation: A: Acidosis is a common reason to initiate dialysis in acute kidney injury due to impaired acid-base balance. B: Hypokalemia is not a common reason for initiating dialysis in acute kidney injury. C: Volume overload may require dialysis but is not as common as acidosis. D: Hyperkalemia is a valid reason for dialysis but not as common as acidosis in acute kidney injury.
Question 8 of 9
The nurse is caring for a patient who has a temporary percutaneous dialysis catheter in place. In caring for this patient, the nurse should
Correct Answer: C
Rationale: The correct answer is C because assessing the catheter site for redness and/or swelling is essential in monitoring for signs of infection or complications. Redness and swelling can indicate infection, which requires prompt intervention. A: Applying a sterile gauze dressing is not necessary for a temporary percutaneous dialysis catheter unless specified by the healthcare provider. B: Transparent dressings are typically left in place for several days unless there is a specific reason to change them more frequently. D: Using the catheter for drawing blood samples is not recommended as it can increase the risk of infection and may interfere with the dialysis process.
Question 9 of 9
The nurse is caring for a patient receiving peritoneal dialysis. The patient suddenly complains of abdominal pain and chills. The patient’s temperature is elevated. The nurse should
Correct Answer: D
Rationale: The correct answer is D: inform the provider of probable visceral perforation. This is the most urgent action as sudden abdominal pain, chills, and elevated temperature in a patient receiving peritoneal dialysis could indicate a serious complication like visceral perforation, which requires immediate medical attention to prevent further complications. Assessing peritoneal dialysate return (A) may provide some information but does not address the urgent need to address a potential visceral perforation. Checking the patient's blood sugar (B) and evaluating the patient's neurological status (C) are not priorities in this situation and do not address the potential life-threatening complication of visceral perforation.