Nursing Clinical Skills questions

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

Correct Answer: D

Rationale: Correct Answer: D Rationale: In diabetic emergencies, starting IV dextrose at 250 mg/dL prevents hypoglycemia while resolving ketoacidosis. Below 250 mg/dL, the body can use endogenous glucose, so IV dextrose is not necessary. Summary: A: Incorrect. Normal saline may be used for initial fluid resuscitation but does not address the need for glucose. B: Incorrect. Starting dextrose at 70 mg/dL may lead to unnecessary hyperglycemia and complications. C: Incorrect. Waiting until 150 mg/dL delays the provision of necessary glucose for metabolic functions.

Correct Answer: A

Rationale: The correct answer is A: fluid retention of 1.5 liters. The weight gain from 5 kg to 99 kg indicates an increase of 94 kg. Since 1 kg of weight gain is approximately equal to 1 liter of fluid retention, the patient has retained 94 liters of fluid. Therefore, the correct choice is fluid retention of 1.5 liters. Choice B is incorrect because the weight gain indicates fluid retention, not loss. Choice C is incorrect as it mentions equal intake and output, which does not match the weight gain observed. Choice D is incorrect as it suggests fluid loss, which contradicts the weight gain.

Correct Answer: D

Rationale: The correct answer is D: 1 to 2 L/day. Normal urine output typically ranges from 1 to 2 liters per day, which is considered adequate for maintaining proper hydration and eliminating waste products. A: 80 to 125 mL/min is too low for daily output. B: 180 L/day is excessively high and unrealistic. C: 80 mL/min is also too low for daily urine output. Therefore, D is the most appropriate choice based on standard guidelines for urine excretion.

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.