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
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 3 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 4 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 5 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 6 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 7 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 8 of 9
A patient with long-standing type 1 diabetes presents to the emergency department with a loss of consciousness and seizure activity. The patient has a history of renal insufficiency, gastroparesis, and peripheral diabetic neuropathy. Emergency personnel reported a blood glucose of 32 mg/dL on scene. When providing discharge teaching for this patient and family, the nurse instructs on the need to do which of the following? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B: Administer 15 grams of carbohydrate orally for severe episodes of hypoglycemia. In this scenario, the patient is experiencing severe hypoglycemia (blood glucose of 32 mg/dL) leading to loss of consciousness and seizure activity. Administering 15 grams of carbohydrate orally is crucial to rapidly raise the blood glucose levels and address the hypoglycemia. This immediate intervention can help reverse the symptoms and prevent further complications. The incorrect choices: A: Administering glucagon intramuscularly is typically reserved for severe hypoglycemia when the patient cannot take anything by mouth. In this case, oral intake is preferred for faster absorption. C: Discontinuing the insulin pump is not necessary in this situation since the primary concern is treating the acute hypoglycemia. Removing the infusion set can lead to hyperglycemia if not managed properly. D: Increasing home blood glucose monitoring and reporting patterns of hyp
Question 9 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