ATI RN
clinical skills exam questions Questions
Question 1 of 5
Which of the following is a high-priority nursing diagnosis for both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome?
Correct Answer: B
Rationale: The correct answer is B: Fluid volume deficient. Both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome can lead to severe dehydration and electrolyte imbalances. Addressing fluid volume deficiency is crucial to stabilize the patient's condition. Choice A is not the priority as the main concern is the fluid imbalance, not activity intolerance. Hyperthermia (choice C) may be present but is not the primary concern compared to fluid volume deficit. Impaired nutrition (choice D) is not the immediate priority in these emergency situations. In summary, maintaining fluid balance is essential to manage both conditions effectively.
Question 2 of 5
Continuous renal replacement therapy (CRRT) differs from conventional intermittent hemodialysis in that
Correct Answer: D
Rationale: Step-by-step rationale: 1. CRRT removes solutes and water slowly to avoid hemodynamic instability. 2. Slow removal better tolerates fluid and electrolyte shifts in critically ill patients. 3. Unlike intermittent hemodialysis, CRRT provides continuous, gentle therapy. 4. Choice A is incorrect as both CRRT and intermittent hemodialysis use a hemofilter. 5. Choice B is incorrect as CRRT does not provide faster solute and water removal. 6. Choice C is incorrect as CRRT allows for diffusion to occur, albeit at a slower rate. Summary: Continuous renal replacement therapy (CRRT) removes solutes and water slowly to prevent hemodynamic instability, making it a gentler and more continuous process compared to intermittent hemodialysis. The other choices are incorrect as CRRT does use a hemofilter, does not provide faster removal, and still allows for diffusion to occur.
Question 3 of 5
A college student was admitted to the emergency department after being found unconscious by a roommate. The roommate informs emergency medical personnel that the student has diabetes and has been experiencing flulike symptoms, including vomiting, since yesterday. The patient had been up all night studying for exams. The patient used the last diabetes testing supplies 3 days ago and has not had time to go to the pharmacy to refill prescription supplies. Based upon the history, which laboratory findings would be anticipated in this client? (Select all that apply.)
Correct Answer: B
Rationale: The correct answer is B: Blood glucose: 524 mg/dL. The patient likely has diabetic ketoacidosis (DKA) due to missed insulin doses, stress, and illness leading to high blood glucose levels. DKA is characterized by hyperglycemia, ketosis, and metabolic acidosis. A low blood glucose level (Choice A) is not consistent with DKA. HCO3- of 10 mEq/L (Choice C) indicates metabolic acidosis, but it's not specific to DKA. A PaCO2 of 37 mm Hg (Choice D) is within the normal range and not directly related to DKA.
Question 4 of 5
A patient is admitted to the critical care unit with a diagnosis of diabetic ketoacidosis. Following aggressive fluid resuscitation and intravenous (IV) insulin administration, the blood glucose begins to normalize. In addition to glucose monitoring, which of the following electrolytes requires close monitoring?
Correct Answer: C
Rationale: The correct answer is C: Potassium. During treatment of diabetic ketoacidosis, as blood glucose levels decrease, potassium levels can quickly drop due to insulin therapy driving potassium into cells. Monitoring potassium levels closely is crucial to prevent hypokalemia, which can lead to life-threatening cardiac arrhythmias. Choice A: Calcium - Calcium levels are not typically affected by diabetic ketoacidosis treatment and do not require immediate monitoring in this context. Choice B: Chloride - Chloride levels are usually not significantly impacted by diabetic ketoacidosis treatment and do not need close monitoring in this case. Choice D: Sodium - While sodium levels can be affected by dehydration in diabetic ketoacidosis, they are not as critical to monitor as potassium levels during treatment.
Question 5 of 5
The patient is diagnosed with acute kidney injury and has been getting dialysis 3 days per week. The patient complains of general malaise and is tachypneic. An arterial blood gas shows that the patient’s pH is 19, with a PCO of 30 mm Hg and a bicarbonate level of 13 mEq/L. The nurse prepares to
Correct Answer: B
Rationale: The correct answer is B: prepare for intubation and mechanical ventilation. The patient's arterial blood gas results indicate metabolic acidosis (low pH, low bicarbonate) with respiratory compensation (low PCO). In this scenario, the patient is likely experiencing respiratory fatigue due to tachypnea from metabolic acidosis. Intubation and mechanical ventilation are needed to support the patient's respiratory effort and correct the acid-base imbalance. Administering morphine (choice A) can further depress the respiratory drive. Administering intravenous sodium bicarbonate (choice C) can temporarily correct the pH but does not address the underlying respiratory distress. Canceling dialysis (choice D) is not indicated as it does not address the acute respiratory compromise.
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