Nursing Clinical Skills questions

Questions 28

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Nursing Clinical Skills questions Questions

Question 1 of 5

The patient is getting hemodialysis for the second time when he complains of a headache and nausea and, a little later, of becoming confused. The nurse realizes these are symptoms of

Correct Answer: C

Rationale: The correct answer is C: dialysis disequilibrium syndrome. This syndrome occurs when there is a rapid shift in electrolytes, especially in the brain, due to the removal of waste products during hemodialysis. The symptoms of headache, nausea, and confusion align with this syndrome as the brain struggles to adjust to the changes. Dialyzer membrane incompatibility (A) is unlikely as it typically presents with allergic reactions, not neurological symptoms. A shift in potassium levels (B) may cause symptoms like muscle weakness or irregular heartbeat, not headache and confusion. Hypothermia (D) would present with low body temperature, shivering, and confusion, but in this case, the symptoms are more indicative of dialysis disequilibrium syndrome.

Question 2 of 5

Which of the following laboratory values would be more common in patients with diabetic ketoacidosis?

Correct Answer: A

Rationale: The correct answer is A (Blood glucose >1000 mg/dL) because diabetic ketoacidosis is characterized by severe hyperglycemia. High blood glucose levels (>1000 mg/dL) are common due to insulin deficiency leading to increased glucose production. B: Negative ketones in the urine would be incorrect as DKA results in ketone production, leading to ketonuria. C: Normal anion gap would be incorrect as DKA typically presents with an elevated anion gap metabolic acidosis due to ketone accumulation. D: pH 7.24 would be incorrect as DKA would present with a lower pH due to metabolic acidosis.

Question 3 of 5

A normal urine output is considered to be

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.

Question 4 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 5 of 5

In hyperosmolar hyperglycemic syndrome, the laboratory results are similar to those of diabetic ketoacidosis, with three major exceptions. What differences would you expect to see in patients with hyperosmolar hyperglycemic syndrome?

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.

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