clinical skills questions

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Question 1 of 5

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 2 of 5

The nurse is caring for a patient receiving peritoneal dialysis. The patient suddenly complains of abdominal pain and chills. The patient�s temperature is elevated. The nurse should

Correct Answer: D

Rationale: The correct answer is D: inform the provider of probable visceral perforation. This is the most urgent action as sudden abdominal pain, chills, and elevated temperature in a patient receiving peritoneal dialysis could indicate a serious complication like visceral perforation, which requires immediate medical attention to prevent further complications. Assessing peritoneal dialysate return (A) may provide some information but does not address the urgent need to address a potential visceral perforation. Checking the patient's blood sugar (B) and evaluating the patient's neurological status (C) are not priorities in this situation and do not address the potential life-threatening complication of visceral perforation.

Question 3 of 5

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 4 of 5

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 5 of 5

The patient undergoes a cardiac catheterization that requires the use of contrast dyes during the procedure. To detect signs of contrast-induced kidney injury, the nurse should

Correct Answer: B

Rationale: Correct Answer: B Rationale: 1. Contrast dyes can cause kidney injury due to their nephrotoxic effects. 2. Serum creatinine levels are a reliable indicator of kidney function. 3. Evaluating serum creatinine for up to 72 hours after the procedure allows detection of any contrast-induced kidney injury. 4. Monitoring serum creatinine helps in early identification and intervention for renal complications. Summary: A: Incorrect. Urine output alone is not a definitive indicator of kidney injury. C: Incorrect. Renal ultrasound is not typically used for detecting contrast-induced kidney injury. D: Incorrect. Postvoid residual volume is not specific for contrast-induced kidney injury.

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