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ATI Leadership
1. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?
- A. The patient always carries hard candies when engaging in exercise.
- B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
- C. The patient has a peanut butter sandwich before going for a bicycle ride.
- D. The patient increases daily exercise when ketones are present in the urine.
Correct answer: D
Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.
2. During the admission assessment of a client with advanced ovarian cancer, the nurse recognizes which symptom as typical of the disease?
- A. Diarrhea
- B. Hypermenorrhea
- C. Abnormal bleeding
- D. Abdominal distention
Correct answer: D
Rationale: Abdominal distention is a common symptom in advanced ovarian cancer due to several factors, including the accumulation of ascites (fluid in the abdominal cavity) and the presence of tumors that can increase abdominal girth. As the disease progresses, the pressure from growing masses or fluid buildup can lead to noticeable swelling and discomfort in the abdomen. This symptom often prompts further evaluation and can significantly impact the patient’s quality of life.
3. A nurse is talking with the partner of a client who has dementia. The client's partner expresses frustration about finding time to manage household responsibilities while caring for their partner. The nurse should identify that the partner is experiencing which of the following types of role-performance stress?
- A. Role ambiguity
- B. Role overload
- C. Role conflict
- D. Sick role
Correct answer: C
Rationale: In this scenario, the partner is struggling to balance caring for their loved one with dementia and managing household responsibilities. This situation represents role conflict, where conflicting demands from different roles (caregiver and homemaker) create stress. Role ambiguity (choice A) refers to uncertainty about what is expected in a role, not conflicting demands. Role overload (choice B) occurs when there are too many responsibilities within a single role, not conflicting roles. The sick role (choice D) is a sociological concept related to the rights and responsibilities of individuals who are ill.
4. A nurse is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?
- A. BUN 8 mg/dL
- B. Hgb 15 g/dL
- C. Creatinine 0.8 mg/dL
- D. Sodium 140 mEq/L
Correct answer: A
Rationale: A BUN level of 8 mg/dL is indicative of fluid volume excess, which is common in clients with heart failure.
5. How should a healthcare professional assess a patient for dehydration?
- A. Check for skin turgor
- B. Monitor blood pressure
- C. Check for dry mucous membranes
- D. Monitor urine output
Correct answer: A
Rationale: Checking for skin turgor is a reliable method to assess dehydration in patients. Skin turgor refers to the skin's elasticity and hydration status. When a healthcare professional gently pinches the skin on the back of the patient's hand or forearm, dehydration is indicated by the skin not snapping back immediately. Monitoring blood pressure (choice B) is important but is more indicative of cardiovascular status rather than dehydration specifically. Checking for dry mucous membranes (choice C) can be a sign of dehydration, but skin turgor is a more direct assessment. Monitoring urine output (choice D) is also essential but may not provide immediate feedback on hydration status as skin turgor does.
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