ATI RN
Nursing Clinical Skills questions Questions
Question 1 of 5
The nurse is caring for a patient who suffered a head trauma following a fall. The patient�s heart rate is 112 beats/min and blood pressure is 88/50 mm Hg. The patient has poor skin turgor and dry mucous membranes. The patient is confused and restless. The following laboratory values are reported: serum sodium is 115 mEq/L; blood urea nitrogen (BUN) 50 mg/dL; and creatinine 8 mg/dL. The findings are consistent with which disorder?
Correct Answer: A
Rationale: The correct answer is A: Cerebral salt wasting. This is indicated by the low serum sodium level (115 mEq/L), which can occur in patients with head trauma and lead to excessive sodium loss through the kidneys. This results in hypovolemia, leading to low blood pressure and tachycardia. The elevated BUN (50 mg/dL) and creatinine (8 mg/dL) levels suggest dehydration and renal impairment due to volume depletion. The patient's poor skin turgor, dry mucous membranes, confusion, and restlessness further support the diagnosis of cerebral salt wasting. Summary: B: Diabetes insipidus is characterized by excessive urination and thirst due to insufficient production of antidiuretic hormone (ADH). This patient's symptoms are not consistent with diabetes insipidus. C: Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is characterized by excessive release of ADH, leading to water retention and
Question 2 of 5
The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of
Correct Answer: A
Rationale: The correct answer is A: a percutaneous catheter at the bedside. In this urgent situation, a percutaneous catheter can be quickly inserted at the bedside to provide immediate vascular access for hemodialysis. This option allows for rapid initiation of treatment without the need for surgical placement or waiting for a more permanent access like an arteriovenous fistula or graft. Incorrect Choices: B: A percutaneous tunneled catheter may require more time for insertion due to tunneling and may not be suitable for immediate use. C: An arteriovenous fistula is a more permanent access created surgically and requires time to mature before being used for hemodialysis. D: An arteriovenous graft is also a surgical option that requires time to heal and mature before being used for hemodialysis.
Question 3 of 5
The patient is in a progressive care unit following arteriovenous fistula implantation in his left upper arm, and is due to have blood drawn with his next set of vital signs and assessment. When the nurse assesses the patient, the nurse should
Correct Answer: D
Rationale: The correct answer is D. Auscultating the left arm for a bruit and palpating for a thrill post arteriovenous fistula implantation is crucial to assess the patency and functionality of the fistula. A bruit indicates turbulent blood flow, while a thrill signifies the presence of a strong pulse through the fistula. These assessments help identify any complications like stenosis or thrombosis. Drawing blood or taking blood pressures from the arm with the fistula can lead to inaccurate results or damage the fistula. Starting a new IV line in the left lower arm is unnecessary and not relevant to monitoring the arteriovenous fistula.
Question 4 of 5
The patient�s potassium level is 0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?
Correct Answer: A
Rationale: The correct answer is A: Sodium polystyrene sulfonate. It works by exchanging sodium ions for potassium ions in the colon, leading to potassium excretion. A is the safest option without the risk of causing hypernatremia or intestinal necrosis like B. Regular insulin (C) may cause hypoglycemia and is not as effective as A in reducing potassium levels. Calcium gluconate (D) does not directly reduce potassium levels and is used for treating hyperkalemia-related cardiac toxicity.
Question 5 of 5
A patient presents to the emergency department with suspected thyroid storm. The nurse should be alert to which of the following cardiac rhythms while providing care to this patient?
Correct Answer: A
Rationale: The correct answer is A: Atrial fibrillation. In thyroid storm, excess thyroid hormone levels can lead to increased sympathetic activity, causing tachycardia and arrhythmias like atrial fibrillation. Atrial fibrillation is common in thyroid storm due to the hypermetabolic state and increased risk of atrial arrhythmias. Other choices are incorrect: B (Idioventricular rhythm) is not typically associated with thyroid storm, C (Junctional rhythm) is less likely since atrial arrhythmias are more common, and D (Sinus bradycardia) is unlikely due to the hypermetabolic state causing tachycardia.
Similar Questions
Join Our Community Today!
Join Over 10,000+ nursing students using Nurselytic. Access Comprehensive study Guides curriculum for ATI-RN and 3000+ practice questions to help you pass your ATI-RN exam.
Subscribe for Unlimited Access