an rns current patient and family have presented her with an ethical dilemma what is the first step the rn should take to find a workable solution to
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Nursing Elites

ATI RN

ATI Leadership Proctored Exam 2019

1. An RN’s current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem?

Correct answer: B

Rationale: The first step the RN should take to find a workable solution to the problem is assessment.

2. The healthcare provider suspects the Somogyi effect in a 50-year-old patient whose 6:00 AM blood glucose is 230 mg/dL. Which action will the nurse teach the patient to take?

Correct answer: C

Rationale: The Somogyi effect, also known as rebound hyperglycemia, occurs due to an excessive insulin dose at night, leading to hypoglycemia in the early morning hours. To address this, the nurse should instruct the patient to check their blood glucose during the night to determine if hypoglycemia is present, which triggers the rebound hyperglycemia. By monitoring blood glucose levels during the night, the patient can identify if adjustments are needed to prevent this phenomenon and maintain stable glucose levels. Choices A, B, and D are incorrect. Avoiding snacking at bedtime, increasing rapid-acting insulin dose, or administering a larger dose of long-acting insulin are not appropriate actions to manage the Somogyi effect. Checking blood glucose during the night is crucial to identify and prevent the rebound hyperglycemia characteristic of this phenomenon.

3. Which of the following laws govern nursing practice?

Correct answer: A

Rationale: The correct answer is A: Statutory laws. Statutory laws are those created by various legislative bodies, such as state legislatures. In the context of nursing practice, laws that govern it are statutory laws specifically tailored to regulate the profession. Choice B, Common laws, are not specific to regulating nursing practice but rather are based on judicial decisions. Choice C, Administrative laws, deal with regulations set by administrative agencies and may not directly govern nursing practice. Choice D, Constitutional laws, pertain to the fundamental principles outlined in a country's constitution and are not the primary laws that regulate nursing practice.

4. Which information will the nurse include when teaching a 50-year-old patient who has type 2 diabetes about glyburide (Micronase, DiaBeta, Glynase)?

Correct answer: B

Rationale: The correct answer is B: Glyburide stimulates insulin production and release from the pancreas. Glyburide belongs to the sulfonylurea class of antidiabetic medications, which work by stimulating the pancreas to produce and release more insulin. This helps to lower blood glucose levels. Choice A is incorrect because glyburide does not decrease glucagon secretion; instead, it acts on insulin. Choice C is incorrect because taking glyburide when blood glucose is low can lead to hypoglycemia. Choice D is incorrect as there is no specific interaction between glyburide and IV contrast media that requires avoiding its use for 48 hours.

5. An RN is writing reminders for good documentation for the nurses on her staff. The purpose is to ensure nursing documentation is legally credible. Which of the following is a recommendation she should include in the reminders?

Correct answer: B

Rationale: The correct recommendation that should be included in the reminders for ensuring legally credible nursing documentation is to 'Only use approved abbreviations.' Using shortcuts in documentation (Choice A) may lead to incomplete or vague information, compromising the credibility of documentation. Documentation should not be subjective (Choice C) but rather objective and based on factual information. While it is important to document after care is provided (Choice D), the immediate documentation following care provision is critical for accuracy and legal credibility.

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