The patient is complaining of severe flank pain when he tries to urinate. His urinalysis shows sediment and crystals along with a few bacteria. Using this information along with the clinical picture, the nurse realizes that the patient’s condition is

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Question 1 of 5

The patient is complaining of severe flank pain when he tries to urinate. His urinalysis shows sediment and crystals along with a few bacteria. Using this information along with the clinical picture, the nurse realizes that the patient’s condition is

Correct Answer: C

Rationale: The correct answer is C: intrarenal. The presence of sediment, crystals, and bacteria in the urinalysis indicates an issue originating within the kidney itself. This suggests a problem like a urinary tract infection or kidney stone causing the severe flank pain. Prerenal and postrenal conditions usually involve issues outside the kidney such as dehydration or urinary tract obstruction, which are not supported by the urinalysis findings. Choice D, not renal related, is incorrect as the symptoms and urinalysis results clearly point towards a renal issue.

Question 2 of 5

The nurse is assessing a patient with a new arteriovenous fistula, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable. The nurse should

Correct Answer: C

Rationale: The correct answer is C: notify the provider immediately. The absence of bruit, thrill, and palpable distal pulses in a new arteriovenous fistula suggests potential complications like thrombosis or stenosis, requiring urgent intervention. Notifying the provider promptly allows for timely assessment and appropriate management to prevent further complications. Summary: A: Reassessing the patient in an hour may delay necessary intervention for a potentially serious issue. B: Raising the arm above the level of the patient’s heart does not address the underlying problem and may not improve the situation. D: Applying warm packs to the fistula site is not the appropriate intervention for the absence of bruit and thrill and may not address the underlying cause.

Question 3 of 5

Continuous venovenous hemodialysis is used to

Correct Answer: D

Rationale: The correct answer is D because continuous venovenous hemodialysis combines ultrafiltration, convection, and dialysis techniques. Ultrafiltration removes excess fluid, convection helps in removing solutes, and dialysis involves the diffusion of solutes across a semipermeable membrane. This comprehensive approach ensures effective removal of both fluid and solutes in critically ill patients. Incorrect Answer Analysis: A: Removing fluids and solutes through convection alone is not the complete process in continuous venovenous hemodialysis. B: While volume overload is addressed, continuous venovenous hemodialysis involves more than just removing plasma water. C: Adding dialysate is not the primary method in continuous venovenous hemodialysis; it involves ultrafiltration, convection, and dialysis techniques.

Question 4 of 5

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 low blood pressure, tachycardia, and lack of urine output indicate hypovolemia. Fluid replacement with saline will help restore circulating volume, improve blood pressure, and support renal perfusion. A: Blood transfusion is not indicated as the primary issue is hypovolemia, not anemia. C: Inotropic agents are used to increase cardiac contractility but are not the initial treatment for hypovolemia. D: Antiemetics may help with symptoms but do not address the underlying issue of fluid loss and hypovolemia.

Question 5 of 5

The patient is in the critical care unit and will receive dialysis this morning. The nurse will (Select all that apply.)

Correct Answer: A

Rationale: The correct answer is A because evaluating morning lab results is crucial to monitor the patient's condition before dialysis. Abnormal results may impact the dialysis treatment plan. Option B is incorrect as administering antihypertensive medications is not directly related to dialysis. Option C is incorrect as assessing the dialysis access site is the responsibility of the dialysis team. Option D is incorrect as weighing the patient is not typically done immediately before dialysis.

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