clinical skills exam questions

Correct Answer: B

Rationale: The correct answer is B: Fluid volume deficient. Both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome can lead to severe dehydration and electrolyte imbalances. Addressing fluid volume deficiency is crucial to stabilize the patient's condition. Choice A is not the priority as the main concern is the fluid imbalance, not activity intolerance. Hyperthermia (choice C) may be present but is not the primary concern compared to fluid volume deficit. Impaired nutrition (choice D) is not the immediate priority in these emergency situations. In summary, maintaining fluid balance is essential to manage both conditions effectively.

Correct Answer: B

Rationale: The correct answer is B: a decreased risk of peritonitis exists. Peritoneal dialysis involves using the peritoneum as a membrane for fluid exchange, reducing the risk of infections like peritonitis compared to hemodialysis. Option A is incorrect as peritoneal dialysis can be done at home and is less time-consuming than hemodialysis. Option C is incorrect as biochemical disturbances are corrected more gradually with peritoneal dialysis. Option D is incorrect as there is a risk of bleeding complications with peritoneal dialysis.

Correct Answer: A

Rationale: The correct answer is A because renin activates the renin-angiotensin-aldosterone cascade. Renin is released by the kidneys in response to low blood pressure or low sodium levels. It acts on angiotensinogen to form angiotensin I, which is then converted to angiotensin II by angiotensin-converting enzyme. Angiotensin II causes vasoconstriction, leading to increased blood pressure, and stimulates aldosterone release, promoting sodium and water retention. Choice B is incorrect because renin does not suppress angiotensin production; it actually initiates the process. Choice C is incorrect because renin's action leads to increased sodium reabsorption by stimulating aldosterone release. Choice D is incorrect because renin does not inhibit aldosterone release; it promotes it as part of the renin-angiotensin-aldosterone cascade.

Correct Answer: B

Rationale: The correct answer is B: Fluid volume deficient. Both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome can lead to severe dehydration and electrolyte imbalances. Addressing fluid volume deficiency is crucial to stabilize the patient's condition. Choice A is not the priority as the main concern is the fluid imbalance, not activity intolerance. Hyperthermia (choice C) may be present but is not the primary concern compared to fluid volume deficit. Impaired nutrition (choice D) is not the immediate priority in these emergency situations. In summary, maintaining fluid balance is essential to manage both conditions effectively.

Correct Answer: B

Rationale: The correct answer is B: Assess the patient's lungs. In rhabdomyolysis, muscle breakdown releases myoglobin which can cause kidney damage. Mannitol is given to prevent kidney damage by promoting diuresis. However, mannitol can also cause fluid overload and pulmonary edema. Therefore, assessing the patient's lungs is crucial to monitor for signs of fluid overload and prevent complications. A: Assessing the patient's hearing is not directly related to the management of rhabdomyolysis and mannitol administration. C: Decreasing IV fluids after administering a diuretic like mannitol can lead to inadequate fluid resuscitation and worsening kidney injury. D: Giving extra doses before radiological contrast agents is not necessary in the context of rhabdomyolysis and mannitol administration.