ATI RN
ATI Leadership Proctored Exam
1. A patient with type 2 diabetes is scheduled for a follow-up visit in the clinic several months from now. Which test will the nurse schedule to evaluate the effectiveness of treatment for the patient?
- A. Urine dipstick for glucose
- B. Oral glucose tolerance test
- C. Fasting blood glucose level
- D. Glycosylated hemoglobin level
Correct answer: D
Rationale: The correct answer is D: Glycosylated hemoglobin level. Glycosylated hemoglobin, also known as hemoglobin A1c, provides a long-term indicator of blood glucose control over the past 2-3 months. It is a valuable tool in assessing the effectiveness of diabetes treatment because it reflects average blood sugar levels during this period. Choices A, B, and C are not as effective for evaluating long-term glucose control. Urine dipstick for glucose only provides a snapshot of glucose levels at the time of testing, oral glucose tolerance test evaluates how the body processes glucose after drinking a sugary solution, and fasting blood glucose level gives a point-in-time measurement of glucose levels after fasting, but they do not reflect the overall glucose control over several months.
2. The nurse has been teaching a patient with type 2 diabetes about managing blood glucose levels and taking glipizide (Glucotrol). Which patient statement indicates a need for additional teaching?
- A. �If I overeat at a meal, I will still take the usual dose of medication.�
- B. �Other medications besides the Glucotrol may affect my blood sugar.�
- C. �When I am ill, I may have to take insulin to control my blood sugar.�
- D. �My diabetes won�t cause complications because I don�t need insulin.�
Correct answer: D
Rationale:
3. Which finding indicates a need to contact the health care provider before the nurse administers metformin (Glucophage)?
- A. The patient�s blood glucose level is 174 mg/dL.
- B. The patient has gained 2 lb (0.9 kg) since yesterday.
- C. The patient is scheduled for a chest x-ray in an hour
- D. The patient�s blood urea nitrogen (BUN) level is 52 mg/dL.
Correct answer: D
Rationale:
4. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?
- A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
- B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
- C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
- D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.
Correct answer: C
Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.
5. A healthcare professional is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the healthcare professional identify as an indication that the treatment was successful?
- A. Increase in hematocrit
- B. Increase in respiratory rate
- C. Decrease in heart rate
- D. Decrease in capillary refill time
Correct answer: D
Rationale: The correct answer is D: Decrease in capillary refill time. In a client with fluid volume deficit, improving capillary refill time indicates that the perfusion status is improving due to the increase in fluid volume. Choices A, B, and C are incorrect. An increase in hematocrit may indicate hemoconcentration due to fluid loss, an increase in respiratory rate may suggest respiratory distress, and a decrease in heart rate may not be directly related to fluid volume status.
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