clinical skills questions

Correct Answer: C

Rationale: The correct answer is C: �The fistula will be usable in about 4 to 6 weeks.� This is because arteriovenous fistulas typically require a maturation period of 4 to 6 weeks before they can be used for dialysis. During this time, the fistula will develop into a strong, durable access point for hemodialysis. Choice A is incorrect because the fistula needs time to mature before it can be used, and immediate use may damage it. Choice B is incorrect as it underestimates the maturation period required. Choice D is incorrect as the maturation time does not depend on the manufacturer but on the patient's physiology and healing process.

Correct Answer: D

Rationale: Rationale: The clinical signs indicate a hypermetabolic state with tachycardia, hypotension, tachypnea, and potential fever, typical of a thyroid storm. The presence of congestive heart failure and atrial fibrillation further support this diagnosis due to the hyperthyroid state exacerbating cardiovascular symptoms. Adrenal crisis (A) would present with hypotension and shock, but not with the hypermetabolic state seen here. Myxedema coma (B) would present with hypothermia, bradycardia, and altered mental status, which are not present in this case. SIADH (C) would typically present with hyponatremia and concentrated urine, which are not seen here.

Correct Answer: D

Rationale: The correct answer is D: syndrome of inappropriate secretion of antidiuretic hormone (SIADH). In this scenario, the patient's symptoms of decreased urine output, shortness of breath, edema, and mental status changes are indicative of fluid overload due to SIADH. SIADH causes excessive release of antidiuretic hormone (ADH), leading to water retention and dilutional hyponatremia. This results in edema, decreased urine output, and neurological symptoms. A: Adrenal crisis presents with hypotension, shock, and electrolyte abnormalities, not consistent with the patient's symptoms. B: Diabetes insipidus would present with excessive urine output and thirst, opposite of the patient's symptoms. C: Myxedema coma results from severe hypothyroidism and presents with hypothermia, bradycardia, and altered mental status, not consistent with the patient's symptoms. In summary, the patient's clinical presentation aligns

Correct Answer: C

Rationale: The correct answer is C: �The fistula will be usable in about 4 to 6 weeks.� This is because arteriovenous fistulas typically require a maturation period of 4 to 6 weeks before they can be used for dialysis. During this time, the fistula will develop into a strong, durable access point for hemodialysis. Choice A is incorrect because the fistula needs time to mature before it can be used, and immediate use may damage it. Choice B is incorrect as it underestimates the maturation period required. Choice D is incorrect as the maturation time does not depend on the manufacturer but on the patient's physiology and healing process.

Correct Answer: C

Rationale: The correct answer is C (80 mL/hour) as it is considered a minimally acceptable urine output for a patient weighing 75 kg. Adequate urine output is crucial for kidney function and fluid balance. The general rule is to maintain a urine output of at least 0.5 mL/kg/hour, which in this case would be 37.5 mL/hour for a 75 kg patient. Option C (80 mL/hour) exceeds this minimum requirement, ensuring proper kidney perfusion and waste elimination. Options A (Less than 30 mL/hour) and D (150 mL/hour) are incorrect as they fall below or exceed the recommended urine output range, potentially indicating renal impairment or fluid overload, respectively. Option B (37 mL/hour) is close to the minimum requirement but does not provide a sufficient margin for variations in fluid status or kidney function.