ATI RN
clinical skills questions Questions
Question 1 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 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 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 4 of 9
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 5 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 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
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 8 of 9
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 9 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.