ATI RN
clinical skills exam questions Questions
Question 1 of 9
The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient’s urinalysis results. The nurse should become concerned when
Correct Answer: D
Rationale: The correct answer is D because the presence of red blood cells and albumin in the urine indicates kidney damage, as these are not normally found in urine. A: Creatinine levels should be similar in blood and urine for proper kidney function. B: Sodium and chloride are normal components of urine. C: Uric acid levels can vary in urine and serum. Therefore, D is the correct answer as it signals potential kidney injury.
Question 2 of 9
The patient has been admitted to the hospital with nausea and vomiting that started 5 days earlier. Blood pressure is 80/44 mm Hg and heart rate is 122 beats/min; the patient has not voided in 8 hours, and the bladder is not distended. The nurse anticipates a prescription for “stat” administration of
Correct Answer: B
Rationale: The correct answer is B: fluid replacement with 0.45% saline. The patient's symptoms suggest dehydration and hypovolemia, indicated by low blood pressure, elevated heart rate, and lack of urine output. Fluid replacement with isotonic saline would help restore intravascular volume and improve blood pressure. Blood transfusion (A) is not indicated without evidence of significant blood loss. Inotropic agents (C) are used to improve cardiac function, which is not the primary issue in this case. Antiemetics (D) may help with nausea and vomiting but do not address the underlying cause of hypovolemia.
Question 3 of 9
A college student was admitted to the emergency department after being found unconscious by a roommate. The roommate informs emergency medical personnel that the student has diabetes and has been experiencing flulike symptoms, including vomiting, since yesterday. The patient had been up all night studying for exams. The patient used the last diabetes testing supplies 3 days ago and has not had time to go to the pharmacy to refill prescription supplies. Based upon the history, which laboratory findings would be anticipated in this client? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B: Blood glucose: 524 mg/dL. The patient likely has diabetic ketoacidosis (DKA) due to missed insulin doses, stress, and illness leading to high blood glucose levels. DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis. A low blood glucose level (Choice A) is not consistent with DKA. HCO3- of 10 mEq/L (Choice C) indicates metabolic acidosis, but it's not specific to DKA. A PaCO2 of 37 mm Hg (Choice D) is within the normal range and not directly related to DKA.
Question 4 of 9
Which of the following is a high-priority nursing diagnosis for both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome?
Correct Answer: B
Rationale: The correct answer is B: Fluid volume deficient. Both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome can lead to severe dehydration and electrolyte imbalances. Addressing fluid volume deficiency is crucial to stabilize the patient's condition. Choice A is not the priority as the main concern is the fluid imbalance, not activity intolerance. Hyperthermia (choice C) may be present but is not the primary concern compared to fluid volume deficit. Impaired nutrition (choice D) is not the immediate priority in these emergency situations. In summary, maintaining fluid balance is essential to manage both conditions effectively.
Question 5 of 9
The nurse has been assigned the following patients. Which patients require assessment of blood glucose control as a nursing priority? (Select all that apply.)
Correct Answer: C
Rationale: The correct answer is C because the patient with acute pancreatitis receiving TPN is at risk for hyperglycemia due to the high glucose content in TPN. Monitoring blood glucose levels is crucial to prevent complications. Explanation for why other choices are incorrect: A: The 18-year-old male post-surgery for a fractured femur does not have a direct correlation to blood glucose control assessment. B: The 29-year-old female undergoing evaluation for pheochromocytoma is not directly related to blood glucose control assessment. D: The 62-year-old morbidly obese female post-hysterectomy for ovarian cancer does not specifically require immediate blood glucose control assessment.
Question 6 of 9
Continuous renal replacement therapy (CRRT) differs from conventional intermittent hemodialysis in that
Correct Answer: D
Rationale: Step-by-step rationale: 1. CRRT removes solutes and water slowly to avoid hemodynamic instability. 2. Slow removal better tolerates fluid and electrolyte shifts in critically ill patients. 3. Unlike intermittent hemodialysis, CRRT provides continuous, gentle therapy. 4. Choice A is incorrect as both CRRT and intermittent hemodialysis use a hemofilter. 5. Choice B is incorrect as CRRT does not provide faster solute and water removal. 6. Choice C is incorrect as CRRT allows for diffusion to occur, albeit at a slower rate. Summary: Continuous renal replacement therapy (CRRT) removes solutes and water slowly to prevent hemodynamic instability, making it a gentler and more continuous process compared to intermittent hemodialysis. The other choices are incorrect as CRRT does use a hemofilter, does not provide faster removal, and still allows for diffusion to occur.
Question 7 of 9
A patient is admitted to the critical care unit with a diagnosis of diabetic ketoacidosis. Following aggressive fluid resuscitation and intravenous (IV) insulin administration, the blood glucose begins to normalize. In addition to glucose monitoring, which of the following electrolytes requires close monitoring?
Correct Answer: C
Rationale: The correct answer is C: Potassium. During treatment of diabetic ketoacidosis, as blood glucose levels decrease, potassium levels can quickly drop due to insulin therapy driving potassium into cells. Monitoring potassium levels closely is crucial to prevent hypokalemia, which can lead to life-threatening cardiac arrhythmias. Choice A: Calcium - Calcium levels are not typically affected by diabetic ketoacidosis treatment and do not require immediate monitoring in this context. Choice B: Chloride - Chloride levels are usually not significantly impacted by diabetic ketoacidosis treatment and do not need close monitoring in this case. Choice D: Sodium - While sodium levels can be affected by dehydration in diabetic ketoacidosis, they are not as critical to monitor as potassium levels during treatment.
Question 8 of 9
The patient is admitted to the unit with the diagnosis of rhabdomyolysis. The patient is started on intravenous (IV) fluids and IV mannitol. What action by the nurse is best?
Correct Answer: B
Rationale: The correct answer is B: Assess the patient's lungs. In rhabdomyolysis, muscle breakdown releases myoglobin which can cause kidney damage. Mannitol is given to prevent kidney damage by promoting diuresis. However, mannitol can also cause fluid overload and pulmonary edema. Therefore, assessing the patient's lungs is crucial to monitor for signs of fluid overload and prevent complications. A: Assessing the patient's hearing is not directly related to the management of rhabdomyolysis and mannitol administration. C: Decreasing IV fluids after administering a diuretic like mannitol can lead to inadequate fluid resuscitation and worsening kidney injury. D: Giving extra doses before radiological contrast agents is not necessary in the context of rhabdomyolysis and mannitol administration.
Question 9 of 9
Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)
Correct Answer: A
Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. KUB x-ray is a noninvasive diagnostic procedure that provides information about the size, shape, and position of the kidneys, ureters, and bladder. It can help detect abnormalities such as kidney stones or structural issues. Rationale: 1. KUB x-ray is noninvasive, meaning it does not require any incisions or insertion of instruments into the body. 2. It is commonly used as an initial screening tool to assess kidney function. 3. Renal ultrasound (Choice B) is also noninvasive but primarily used for imaging the kidneys and not the entire urinary system. 4. MRI (Choice C) and IVP (Choice D) are more invasive procedures that involve injecting contrast agents and may not be routinely used for initial kidney function assessment. In summary, the KUB x-ray is the correct choice as it is a noninvasive procedure specifically designed to evaluate kidney