after change of shift report which patient should the nurse assess first after change of shift report which patient should the nurse assess first
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Nursing Elites

ATI RN

ATI Leadership Proctored Exam 2019

1. After receiving change-of-shift report, which patient should the nurse assess first?

Correct answer: B

Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.

2. What is a chronic lung disease that includes chronic bronchitis and emphysema?

Correct answer: A

Rationale: The correct answer is Chronic Obstructive Pulmonary Disease (COPD). COPD is a chronic lung condition that encompasses chronic bronchitis and emphysema, causing airflow obstruction from the lungs. Pneumonia (choice B) is an infection in the lungs, while asthma (choice C) is characterized by airway inflammation and constriction. Tuberculosis (choice D) is a bacterial infection that primarily affects the lungs but is distinct from COPD.

3. A nurse is assessing a client with suspected post-traumatic stress disorder (PTSD). Which of the following findings shouldn't the nurse expect?

Correct answer: D

Rationale: Findings in a client with PTSD include flashbacks, avoidance of reminders of the trauma, increased arousal and hypervigilance, and negative changes in thoughts and mood. Manic episodes are not typically associated with PTSD.

4. When a client is prescribed hydrochlorothiazide, what adverse effect should they monitor for as instructed by the nurse?

Correct answer: A

Rationale: Hyponatremia is a critical adverse effect associated with hydrochlorothiazide use. This medication is a diuretic that can lead to excessive loss of sodium and water from the body, potentially causing low sodium levels and resulting in hyponatremia. Monitoring for signs and symptoms of hyponatremia, such as confusion, headache, weakness, and muscle cramps, is essential to prevent serious complications. Ototoxicity (choice B) is not a common adverse effect of hydrochlorothiazide. Hypoglycemia (choice C) and hyperkalemia (choice D) are also not typically associated with hydrochlorothiazide use.

5. A nurse is caring for a client who has a new prescription for metformin. Which of the following findings in the client's medical history should the nurse report to the provider?

Correct answer: D

Rationale: The correct answer is D, history of kidney disease. Metformin should be used with caution in clients with kidney disease due to the risk of lactic acidosis, a serious complication. Reporting this finding to the provider is crucial for assessing the appropriateness of continuing metformin therapy. Choices A, B, and C do not contraindicate the use of metformin, so they are not the priority for reporting.

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