Nursing Clinical Skills questions

Correct Answer: A

Rationale: The correct answer is A. Bladder catheterization helps relieve urinary obstruction, a common postrenal cause of acute kidney injury. It allows urine to drain freely from the bladder. - B: Increasing fluid volume intake may worsen the condition by increasing the pressure on the obstructed kidneys. - C: Ureteral stenting is used for intrarenal causes, not postrenal causes. - D: Placement of nephrostomy tubes bypasses the obstruction but is usually reserved for more severe cases.

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: ADH deficiency. Diabetes insipidus is caused by a deficiency of antidiuretic hormone (ADH), leading to excessive urine production and thirst. ADH is responsible for regulating water reabsorption in the kidneys. When ADH levels are low or absent, the kidneys cannot concentrate urine effectively, resulting in excessive urine output. Explanation for why other choices are incorrect: B: ADH excess would not lead to diabetes insipidus, as it would result in increased water reabsorption and concentrated urine. C: ADH insensitivity refers to a condition where the body does not respond to ADH, but it does not cause diabetes insipidus. D: ADH replacement therapy is actually a treatment for diabetes insipidus, not a mechanism for its development.

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: 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.