ATI RN
ATI Leadership Practice B
1. The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?
- A. Give the patient 4 to 6 oz more orange juice.
- B. Administer the PRN glucagon (Glucagon) 1 mg IM.
- C. Have the patient eat some peanut butter with crackers.
- D. Notify the healthcare provider about the hypoglycemia.
Correct answer: A
Rationale: The correct action for the nurse to take next is to give the patient 4 to 6 oz more orange juice. The patient's blood glucose has increased from 62 mg/dL to 67 mg/dL after consuming the initial 4 oz of orange juice, indicating that the treatment is effective. Providing additional orange juice will help further raise the blood glucose levels. Administering glucagon (Choice B) is not necessary as the patient's blood glucose is already rising. Having the patient eat peanut butter with crackers (Choice C) is a slower-acting option compared to orange juice. Notifying the healthcare provider about the hypoglycemia (Choice D) is not needed at this point since the patient's blood glucose is improving.
2. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?
- A. The patient's blood pressure is 154/92.
- B. The patient has a history of emphysema
- C. The patient's blood glucose is 86 mg/dL.
- D. The patient has chest pressure when walking
Correct answer: D
Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.
3. An RN enters a patient�s room to place an indwelling urinary catheter, as ordered by the health-care professional. The client is alert and oriented and tells the RN he wants to leave the hospital now and not receive further treatment. Which of the following actions by the RN would be considered false imprisonment?
- A. The RN tells the client he is not allowed to leave until the physician has released him.
- B. The RN asks the client why he wishes to leave.
- C. The RN asks the client to explain what he understands about his medical diagnosis.
- D. The RN asks the client to sign an against medical advice discharge form.
Correct answer: A
Rationale: Verbal or physical detainment of a client who desires to leave the institution is false imprisonment.
4. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to
- A. give a bolus of 50% dextrose.
- B. insert a large-bore IV catheter.
- C. initiate oxygen via nasal cannula.
- D. administer glargine (Lantus) insulin.
Correct answer: B
Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.
5. A nurse is evaluating teaching for a client who has heart failure. Which of the following statements by the client indicates an understanding of the teaching?
- A. I am limiting my sodium intake to 2 grams daily.
- B. I have been weighing myself every other morning.
- C. I am trying to decrease my intake of foods with potassium.
- D. I am eating fewer potato chips and more fruit for snacks.
Correct answer: A
Rationale: The correct answer is A. Limiting sodium intake is crucial for clients with heart failure to manage their condition effectively. Excessive sodium can lead to fluid retention and worsen heart failure symptoms. Weighing oneself is important for monitoring fluid retention but does not directly show an understanding of dietary restrictions. Decreasing potassium intake is not typically recommended for heart failure clients unless specifically advised by a healthcare provider. While choosing healthier snacks is beneficial, the focus on sodium intake is more critical for heart failure management.
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