clinical skills exam questions

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.

Correct Answer: B

Rationale: The correct answer is B: deficiency of corticosteroids. Acute adrenal crisis is caused by a sudden and severe deficiency of cortisol and aldosterone, which are essential corticosteroids produced by the adrenal glands. Without these hormones, the body cannot regulate blood pressure, electrolyte balance, and respond to stress adequately. Acute renal failure (choice A) does not directly lead to adrenal crisis. High doses of corticosteroids (choice C) can suppress the adrenal glands but do not cause acute adrenal crisis. Overdose of testosterone (choice D) does not impact the production of cortisol and aldosterone, thus not causing acute adrenal crisis.

Correct Answer: A

Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. KUB x-ray is a noninvasive diagnostic procedure that provides information about the size, shape, and position of the kidneys, ureters, and bladder. It can help detect abnormalities such as kidney stones or structural issues. Rationale: 1. KUB x-ray is noninvasive, meaning it does not require any incisions or insertion of instruments into the body. 2. It is commonly used as an initial screening tool to assess kidney function. 3. Renal ultrasound (Choice B) is also noninvasive but primarily used for imaging the kidneys and not the entire urinary system. 4. MRI (Choice C) and IVP (Choice D) are more invasive procedures that involve injecting contrast agents and may not be routinely used for initial kidney function assessment. In summary, the KUB x-ray is the correct choice as it is a noninvasive procedure specifically designed to evaluate kidney

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.

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.