ATI RN
ATI Leadership Practice B
1. A client with limited mobility in their lower extremities is at risk for skin breakdown. Which of the following actions should the nurse take to prevent skin breakdown?
- A. Place the client in high-Fowler's position.
- B. Increase the client's intake of carbohydrates.
- C. Massage areas of skin that are darker than the surrounding skin tissue with unscented lotion.
- D. Have the client use a trapeze bar when changing position
Correct answer: B
Rationale: The correct answer is B: Increase the client's intake of carbohydrates. Adequate nutrition, including carbohydrates, is essential for tissue repair and preventing skin breakdown. Placing the client in high-Fowler's position (choice A) may help with respiratory function but does not directly prevent skin breakdown. Massaging areas of darker skin (choice C) can cause further damage to the skin. Using a trapeze bar (choice D) may assist with changing positions but does not directly address skin breakdown prevention.
2. 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.
3. Although technology has seen many advances, which two ethical principles may be in conflict because of technology?
- A. Beneficence and justice
- B. Beneficence and nonmaleficence
- C. Beneficence and veracity
- D. Beneficence and confidentiality
Correct answer: B
Rationale: The correct answer is B: Beneficence and nonmaleficence. Beneficence is the ethical principle of doing good to benefit others, while nonmaleficence is the principle of doing no harm to others. With technological advances, there can be a conflict between these two principles, as the benefits of technology may inadvertently cause harm, leading to an ethical dilemma. Choices A, C, and D are incorrect because while beneficence is involved in all options, the conflicting principle of nonmaleficence specifically addresses the avoidance of harm, making it the most relevant in the context of technology's impact on ethical principles.
4. There are many ways to ensure that your appraisal system is nondiscriminatory. Which of the following is one way to ensure this?
- A. Giving the appraisal once per year
- B. Having no appeal process
- C. Withholding information from the employee
- D. Not allowing any input from the employee
Correct answer: A
Rationale: To ensure that an appraisal system is nondiscriminatory, one important step is to provide the appraisal once per year. This allows for ongoing evaluation and helps prevent bias. Choice B is incorrect because having no appeal process can lead to unfair treatment without a chance for review. Choice C is incorrect as withholding information from the employee can hinder transparency and objectivity. Choice D is incorrect as not allowing any input from the employee can overlook valuable insights and perspectives that could contribute to a fair evaluation process.
5. 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.
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