ATI RN
ATI Leadership Proctored Exam 2023
1. 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?
- A. Avoid snacking at bedtime.
- B. Increase the rapid-acting insulin dose.
- C. Check the blood glucose during the night.
- D. Administer a larger dose of long-acting insulin.
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.
2. A client is experiencing preterm contractions and dehydration. Which of the following statements should the nurse make?
- A. Dehydration is treated with calcium supplements.
- B. Dehydration can increase the risk of preterm labor.
- C. Dehydration is associated with gastroesophageal reflux.
- D. Dehydration is caused by decreased hemoglobin and hematocrit.
Correct answer: Dehydration can increase the risk of preterm labor.
Rationale: Dehydration can lead to an imbalance in electrolytes and cause uterine irritability, potentially leading to preterm contractions. It is essential for the nurse to educate the client on the importance of adequate hydration to reduce the risk of preterm labor. The statement 'Dehydration can increase the risk of preterm labor' directly addresses the client's condition and provides relevant information for their understanding and management of the situation.
3. Which parenting style is characterized by warmth, control, and communication?
- A. Authoritarian
- B. Permissive/indulgent
- C. Authoritative
- D. Neglectful/uninvolved
Correct answer: C
Rationale: The correct answer is C. The authoritative parenting style is characterized by a balance of warmth, control, and communication. This style promotes a nurturing environment where rules are established, but there is also room for open communication and understanding. Choice A, Authoritarian, is characterized by high control and low warmth, with strict rules and limited communication. Choice B, Permissive/indulgent, is characterized by high warmth and low control, with few rules and little discipline. Choice D, Neglectful/uninvolved, is characterized by low warmth, low control, and lack of communication or involvement in the child's life.
4. Which expectant mother has the greatest risk of a baby born with fetal alcohol syndrome?
- A. Chloe, a Caucasian American
- B. Latima, an African American
- C. Yvonne, a Native American
- D. Ming, an Asian American Answer: C Page Ref: 85 Skill Level: Apply known or suspected teratogens. Topic: Prenatal Environmental Influences Difficulty Level: Moderate
Correct answer: C
Rationale: According to research, Native American populations have the highest prevalence of fetal alcohol syndrome (FAS) in the United States. This increased risk is due to various social, cultural, and environmental factors within Native American communities.
5. What should the nurse do when continuous bubbling is seen in the chest tube water seal chamber?
- A. Tighten the connections of the chest tube system
- B. Clamp the chest tube
- C. Replace the chest tube
- D. Continue monitoring the chest tube
Correct answer: A
Rationale: When continuous bubbling is observed in the chest tube water seal chamber, the nurse should tighten the connections of the chest tube system. This action can often resolve an air leak causing the continuous bubbling. Clamping the chest tube or replacing it would not address the underlying issue of an air leak and may lead to complications. Continuing to monitor the chest tube without taking corrective action may result in the deterioration of the patient's condition.
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