ATI RN
clinical skills questions Questions
Question 1 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 2 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 3 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 4 of 9
Identify which substances in the glomerular filtrate would indicate a problem with renal function. (Select all that apply.)
Correct Answer: A
Rationale: The presence of protein in the glomerular filtrate indicates a problem with renal function as healthy kidneys should not allow large molecules like proteins to pass through the filtration barrier. This could be a sign of kidney damage or dysfunction. Sodium, creatinine, and red blood cells are normally present in the filtrate and are not specific indicators of renal function issues. Sodium is actively reabsorbed in the renal tubules, creatinine is a waste product filtered by the kidneys, and a small number of red blood cells may pass through the filtration barrier under normal circumstances.
Question 5 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 6 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 7 of 9
A patient is admitted to the oncology unit with a small-cell lung carcinoma. During the admission, the patient is noted to have a significant decrease in urine output accompanied by shortness of breath, edema, and mental status changes. The nurse is aware that this clinical presentation is consistent with
Correct Answer: D
Rationale: The correct answer is D: syndrome of inappropriate secretion of antidiuretic hormone (SIADH). In this scenario, the patient's symptoms of decreased urine output, shortness of breath, edema, and mental status changes are indicative of fluid overload due to SIADH. SIADH causes excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. This results in edema, decreased urine output, and neurological symptoms. A: Adrenal crisis presents with hypotension, shock, and electrolyte abnormalities, not consistent with the patient's symptoms. B: Diabetes insipidus would present with excessive urine output and thirst, opposite of the patient's symptoms. C: Myxedema coma results from severe hypothyroidism and presents with hypothermia, bradycardia, and altered mental status, not consistent with the patient's symptoms. In summary, the patient's clinical presentation aligns
Question 8 of 9
An individual with type 2 diabetes who takes glipizide has begun a formal exercise program at a local gym. While exercising on the treadmill, the individual becomes pale, diaphoretic, shaky, and has a headache. The individual feels as though she is going to pass out. What is the individual’s priority action?
Correct Answer: B
Rationale: The correct answer is B: Eat something with 15 g of simple carbohydrates. In this scenario, the individual is exhibiting signs of hypoglycemia due to the combination of glipizide (which can lower blood sugar) and exercise. The priority action is to raise blood sugar levels quickly to prevent further complications. Consuming simple carbohydrates, like glucose tablets or juice, will rapidly increase blood sugar levels. This is crucial to prevent the individual from passing out or experiencing more serious consequences. Choice A is incorrect because while hydration is important, it is not the immediate priority in this situation. Choice C is incorrect as going to the first-aid station may waste valuable time when immediate action is needed. Choice D is incorrect as taking another dose of the oral agent can further lower blood sugar levels and worsen the hypoglycemia.
Question 9 of 9
A 100-kg patient gets hemodialysis 3 days a week. In planning the care for this patient, the nurse recommends
Correct Answer: A
Rationale: The correct answer is A: a diet of 2500 to 3500 kcal per day. During hemodialysis, patients often experience increased energy expenditure due to the treatment process. Therefore, maintaining a higher caloric intake is crucial to prevent malnutrition and support the body's needs. Options B, C, and D are incorrect as limiting protein intake to less than 50 grams per day may lead to malnutrition in a patient undergoing hemodialysis, restricting potassium intake to 10 mEq per day may not be appropriate as individual needs vary, and restricting fluid intake to less than 500 mL per day can lead to dehydration and electrolyte imbalances in a patient undergoing hemodialysis.