after change of shift report which patient will the nurse assess first

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. Which of the following best describes the concept of evidence-based management?

A. Using personal experience to make managerial decisions
B. Combining managerial expertise with the latest research evidence
C. Using intuition and experience to guide management decisions
D. Relying on peer-reviewed literature to inform management practices

Correct answer: B

Rationale: The concept of evidence-based management involves combining managerial expertise with the latest research evidence to make informed decisions. Choice A is incorrect because relying solely on personal experience may not align with the best available evidence. Choice C is incorrect as it emphasizes intuition over research evidence. Choice D is incorrect because evidence-based management involves not only peer-reviewed literature but also incorporating managerial expertise.

3. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

A. Hypotension
B. Distended neck veins
C. Slow capillary refill
D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

4. A nurse recognizes which of the following as a primary goal of nursing?

A. Assist patients to achieve a peaceful death.
B. Improve personal knowledge and skills to enhance patient outcomes.
C. Advocate for quality of life over the quantity of life.
D. Work to control costs to enhance patients' quality of life.

Correct answer: A

Rationale: The correct answer is A: 'Assist patients to achieve a peaceful death.' One of the primary goals of nursing is to help patients experience a comfortable and peaceful passing when faced with terminal illness or at the end of life. This involves providing holistic care, managing symptoms, and ensuring that patients are as comfortable and pain-free as possible. Choices B, C, and D are incorrect because while improving knowledge and skills, advocating for quality of life, and controlling costs are important aspects of nursing care, they are not the primary goal related to end-of-life care.

5. Selye's stress theory explains that a person stressed for long periods of time will:

A. Face exhaustion and be more susceptible to illnesses.
B. Become fatigued and become stronger.
C. Become more assertive.
D. Safety needs.

Correct answer: A

Rationale: Selye's stress theory posits that individuals experiencing prolonged stress are likely to face exhaustion and become more susceptible to illnesses. This is because the body's response to chronic stress can lead to physical and psychological depletion, increasing the risk of health problems. Choice B is incorrect as becoming stronger is not a typical outcome of prolonged stress according to Selye's theory. Choice C, becoming more assertive, is not directly related to the physical implications of chronic stress. Choice D, safety needs, is unrelated to Selye's stress theory and does not reflect the expected outcomes of prolonged stress.