ATI RN
ATI Leadership Proctored Exam 2023
1. After change-of-shift report, which patient should the nurse assess first?
- A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
- B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
- C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
- D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain
Correct answer: C
Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.
2. A healthcare provider is planning the discharge of a newborn who requires apnea monitoring at home. To which of the following community agencies should the healthcare provider anticipate referring the guardian of the newborn?
- A. Child Protective Services
- B. Public Health
- C. Home Health
- D. Women, Infants, and Children (WIC)
Correct answer: C
Rationale: Home health agencies specialize in providing at-home care and monitoring services, making them the appropriate referral for a newborn requiring apnea monitoring. These agencies can offer skilled nursing care, education, and support to ensure the well-being of the newborn in a home setting. Child Protective Services (Choice A) is not relevant in this scenario as it deals with child welfare and protection from abuse or neglect. Public Health (Choice B) focuses on community health initiatives but may not provide the specialized care needed for apnea monitoring. Women, Infants, and Children (WIC) program (Choice D) offers nutritional support and education for low-income pregnant women, new mothers, and young children, which is not directly related to providing monitoring services for a newborn with apnea.
3. Which of the following should be included in a discussion of advance directives with new nurse graduates?
- A. According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
- B. The advance directive designates an individual who will make financial decisions for the client if he or she is unable to do so.
- C. A living will designates who will make health-care decisions for an individual in the event the individual is unable or incompetent to make his or her own decisions.
- D. The advance directive designates a health-care surrogate who will make known the client’s wishes regarding medical treatment if the client is unable to do so.
Correct answer: A
Rationale: According to the Patient Self-Determination Act, nurses are required to inform clients of their right to create an advance directive.
4. Which action demonstrates a coparticipative manner in the nursing model of care?
- A. Working with the patient and family to achieve the best outcome.
- B. Encouraging the shy student to participate in class discussions, demonstrating transpersonal caring.
- C. Finding a way for a patient to see a dog, understanding the patient's needs.
- D. Accepting individuals for who they are, maintaining a nonjudgmental attitude.
Correct answer: A
Rationale: A coparticipative manner in the nursing model of care involves collaborating with the patient and family to achieve the best outcome. This approach emphasizes working together as a team to address healthcare needs and make decisions. While encouraging a shy student, understanding a patient's needs, and maintaining a nonjudgmental attitude are all important aspects of nursing care, the coparticipative manner specifically focuses on partnership and shared decision-making in the care process.
5. Who were the first public health nurses who provided care for the sick and the poor?
- A. The Presbyterian Church
- B. Salerno
- C. Jewish scholars
- D. Convent deaconesses
Correct answer: D
Rationale: The correct answer is D, Convent deaconesses. Deaconesses from local convents were the first public health nurses who provided care for the sick and the poor. They exemplified care guided by the Christian belief in compassion and helping others. The other choices (A, B, C) are incorrect because the Presbyterian Church, Salerno, and Jewish scholars were not specifically mentioned as the pioneers of public health nursing. The extract highlights the significant role of convent deaconesses in laying the foundation for modern public health nursing.
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