ATI RN
clinical skills questions Questions
Question 1 of 5
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 2 of 5
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 3 of 5
The patient has elevated blood urea nitrogen (BUN) and serum creatinine levels with a normal BUN/creatinine ratio. These levels most likely indicate
Correct Answer: B
Rationale: The elevated BUN and serum creatinine levels with a normal BUN/creatinine ratio suggest kidney dysfunction. This pattern is commonly seen in acute kidney injury, like acute tubular necrosis (ATN), where the kidneys are unable to properly filter waste products. Other choices (A) increased nitrogen intake and (C) hypovolemia would not cause the specific pattern of elevated BUN and creatinine levels with a normal ratio. (D) Fluid resuscitation would actually aim to correct hypovolemia and would not directly affect the BUN and creatinine levels.
Question 4 of 5
In calculating the glomerular filtration rate (GFR) results for women, the creatinine clearance is usually:
Correct Answer: A
Rationale: The correct answer is A: the same as for men. GFR is calculated based on factors like age, weight, and serum creatinine levels, which are not directly influenced by gender. Therefore, the creatinine clearance for women is the same as for men. Choices B, C, and D are incorrect because there is no inherent biological difference between men and women that would cause a difference in creatinine clearance for GFR calculation.
Question 5 of 5
What is a minimally acceptable urine output for a patient weighing 75 kg?
Correct Answer: C
Rationale: The correct answer is C (80 mL/hour) as it is considered a minimally acceptable urine output for a patient weighing 75 kg. Adequate urine output is crucial for kidney function and fluid balance. The general rule is to maintain a urine output of at least 0.5 mL/kg/hour, which in this case would be 37.5 mL/hour for a 75 kg patient. Option C (80 mL/hour) exceeds this minimum requirement, ensuring proper kidney perfusion and waste elimination. Options A (Less than 30 mL/hour) and D (150 mL/hour) are incorrect as they fall below or exceed the recommended urine output range, potentially indicating renal impairment or fluid overload, respectively. Option B (37 mL/hour) is close to the minimum requirement but does not provide a sufficient margin for variations in fluid status or kidney function.