Nursing Clinical Skills questions

Correct Answer: D

Rationale: In hyperosmolar hyperglycemic syndrome, patients have high blood glucose levels, leading to dehydration and increased serum osmolality. Unlike diabetic ketoacidosis, there is no significant ketosis in hyperosmolar hyperglycemic syndrome. Therefore, the correct answer is D: Higher serum glucose, higher osmolality, and no ketosis. A: Lower serum glucose, lower osmolality, and greater ketosis - This is incorrect because hyperosmolar hyperglycemic syndrome is characterized by high blood glucose levels and no significant ketosis. B: Lower serum glucose, lower osmolality, and milder ketosis - This is incorrect because hyperosmolar hyperglycemic syndrome presents with higher glucose levels and no ketosis. C: Higher serum glucose, higher osmolality, and greater ketosis - This is incorrect because hyperosmolar hyperglycemic syndrome does not typically involve significant ketosis.

Correct Answer: A

Rationale: The correct answer is A: Decreased reflexes. In myxedema coma, a severe form of hypothyroidism, patients often present with decreased mental status, hypothermia, and bradycardia. Decreased reflexes are a common neurological manifestation due to the slowing of metabolic processes and the central nervous system depression associated with this condition. Hyperthermia (B) is not typically seen in myxedema coma, as patients usually have low body temperature. Hyperventilation (C) is also unlikely, as respiratory depression is more common. Tachycardia (D) is incorrect because bradycardia is more characteristic of myxedema coma.

Correct Answer: D

Rationale: The correct answer is D: �Recovery is possible, but it may take several months.� This response is the best because acute kidney injury can be reversible with appropriate management, and recovery may take time. It is important to provide hope and encouragement to the patient. A: �Unfortunately, kidney injury is not reversible; it is permanent.� - This is incorrect as acute kidney injury can be reversible with timely intervention and proper treatment. B: �Kidney function usually returns within 2 weeks.� - This is incorrect because the recovery timeline varies for each individual and can take longer than 2 weeks. C: �You will know for sure if you start urinating a lot all at once.� - This is incorrect as increased urine output may not always indicate complete recovery from acute kidney injury.

Correct Answer: A

Rationale: The correct answer is A: He will go into adrenal crisis. Rationale: 1. Glucocorticoids suppress the body's natural production of cortisol. 2. Abruptly stopping high-dose glucocorticoid therapy can lead to adrenal insufficiency. 3. Adrenal crisis can result in symptoms like weakness, fatigue, hypotension, and potentially life-threatening consequences. 4. This patient, being on high-dose glucocorticoid therapy, is at risk for adrenal crisis if he abruptly stops the medication. Summary: B: Thyroid storm is not related to abruptly stopping glucocorticoid therapy. C: Autoimmune disease remission is unlikely to occur within 3 days of stopping medication. D: It is not appropriate to stop high-dose glucocorticoid therapy abruptly, as it can lead to adverse effects like adrenal crisis.

Correct Answer: A

Rationale: The correct answer is A: Hypotension. Hemodialysis can lead to hypotension due to rapid fluid removal, causing a drop in blood pressure. This occurs as the dialysis machine removes excess fluid, affecting plasma volume. Hypotension can result in complications like dizziness, nausea, and potential cardiac issues. Dysrhythmias (B) are less common during hemodialysis for acute kidney injury. Muscle cramps (C) may occur due to electrolyte imbalances but are not as common as hypotension. Hemolysis (D) is not a common complication of hemodialysis but can occur if there are issues with the dialysis machine or blood tubing.