ATI RN
clinical skills questions Questions
Question 1 of 9
The nurse is providing insulin education for an elderly patient with long-standing diabetes. A prescription has been written for the patient to take 20 units of insulin glargine at 10 PM nightly. The nurse should instruct the patient that the peak of the insulin action for this agent is
Correct Answer: D
Rationale: The correct answer is D: peakless. Insulin glargine is a long-acting insulin with a smooth, consistent release of insulin over 24 hours, providing a steady level of insulin without a pronounced peak. This characteristic helps in maintaining stable blood glucose levels. Options A, B, and C are incorrect as they refer to peak values that do not apply to insulin glargine.
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 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 9
The nurse is caring for a patient who has undergone major abdominal surgery. The nurse notices that the patient’s urine output has been less than 20 mL/hour for the past 2 hours. The patient’s blood pressure is 100/60 mm Hg, and the pulse is 110 beats/min. Previously, the pulse was 90 beats/min with a blood pressure of 120/80 mm Hg. The nurse should
Correct Answer: A
Rationale: Rationale: 1. Urine output < 20 mL/hour indicates potential hypoperfusion. 2. Decreased urine output with hypotension and tachycardia suggests inadequate fluid resuscitation. 3. Administering a normal saline bolus can help improve perfusion and stabilize blood pressure. 4. Contacting the provider promptly for orders is crucial in managing this acute situation. Summary of Incorrect Choices: B. Delaying reporting to the provider risks worsening the patient's condition. C. Continuing to evaluate urine output without intervention can lead to further deterioration. D. Ignoring the urine output due to potential postrenal causes overlooks the urgent need for fluid resuscitation.
Question 5 of 9
What psychosocial factors may potentially contribute to the development of diabetic ketoacidosis? (Select all that apply.)
Correct Answer: A
Rationale: Rationale for correct answer A: Altered sleep/rest patterns can disrupt insulin regulation, leading to glucose imbalance and predisposing to diabetic ketoacidosis. Lack of sleep affects hormones that regulate blood sugar levels, increasing the risk of DKA. Summary of why other choices are incorrect: B: Eating disorder can affect blood sugar control but is not a direct cause of DKA. C: Exposure to influenza may trigger stress on the body but is not a psychosocial factor contributing to DKA. D: High levels of stress can impact blood sugar levels but are not specific psychosocial factors leading to DKA.
Question 6 of 9
A patient is receiving hydrocortisone sodium succinate for adrenal crisis. What other medication does the nurse prepare to administer?
Correct Answer: B
Rationale: The correct answer is B: A proton pump inhibitor. When a patient is receiving hydrocortisone for adrenal crisis, it can lead to increased gastric acid secretion. A proton pump inhibitor helps reduce acid production and prevents gastric ulcers. Regular insulin (A) is not typically indicated in this scenario. Canagliflozin (C) is a medication used for diabetes management and is not relevant here. Propranolol (D) is a beta-blocker and may mask signs of hypoglycemia when used with insulin, which is not suitable in this case.
Question 7 of 9
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.
Question 8 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 9 of 9
The nurse is providing insulin education for an elderly patient with long-standing diabetes. A prescription has been written for the patient to take 20 units of insulin glargine at 10 PM nightly. The nurse should instruct the patient that the peak of the insulin action for this agent is
Correct Answer: D
Rationale: The correct answer is D: peakless. Insulin glargine is a long-acting insulin with a smooth, consistent release of insulin over 24 hours, providing a steady level of insulin without a pronounced peak. This characteristic helps in maintaining stable blood glucose levels. Options A, B, and C are incorrect as they refer to peak values that do not apply to insulin glargine.