ATI LPN
ATI Leadership Proctored Exam 2019
1. On what basis does the U.S. healthcare system operate?
- A. Healthcare is a basic right provided to all equally.
- B. Ability to pay determines access to care.
- C. Only the rich are entitled to healthcare.
- D. Health insurance is required to obtain care.
Correct answer: B
Rationale: The correct answer is B. In the U.S., the healthcare system operates on a model where access to healthcare services is largely determined by an individual's ability to pay for care. This means that those with more financial resources have greater access to a wider range of healthcare services, while those with limited financial means may face barriers to accessing necessary care. Choices A, C, and D are incorrect because healthcare in the U.S. is not universally provided as a basic right to all equally, it is not exclusively for the rich, and while health insurance is common, it is not the sole determinant of access to care.
2. In the past year, Barangay A had an average population of 1655. There were 46 babies born in that year, 2 of whom died less than 4 weeks after birth, and 4 stillbirths were recorded. What is the neonatal mortality rate?
- A. 27.8/1000
- B. 43.5/1000
- C. 86.9/1000
- D. 130.4/1000
Correct answer: B
Rationale: Neonatal mortality rate is calculated by dividing the number of babies who died before reaching the age of 28 days by the total number of live births, then multiplying by 1,000. In this case, 2 babies died within 28 days out of 46 total live births. Therefore, the neonatal mortality rate is (2/46) * 1000 = 43.5/1000.
3. A client with a history of diabetes mellitus presents with confusion, sweating, and palpitations. What should the nurse do first?
- A. Check the client's blood glucose level.
- B. Administer 10 units of insulin.
- C. Give the client a high-protein snack.
- D. Measure the client's blood pressure.
Correct answer: A
Rationale: The correct first action for a client presenting with confusion, sweating, and palpitations, suggestive of hypoglycemia, is to check the client's blood glucose level. This step helps to confirm if the symptoms are due to low blood sugar levels and guides appropriate interventions. Administering insulin without knowing the current blood glucose level can be dangerous and is not recommended as the initial step. Offering a high-protein snack may be necessary after confirming hypoglycemia, but checking the blood glucose level takes precedence. Measuring blood pressure is not the priority in this situation; addressing hypoglycemia is the immediate concern.
4. A client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin 0.4 mg sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure is still stable, what should the nurse do next?
- A. Administer another nitroglycerin tablet.
- B. Apply 1 to 3 L/minute of oxygen via nasal cannula.
- C. Call for a 12-lead electrocardiogram (ECG) to be performed.
- D. Wait an additional 5 minutes, then give a second nitroglycerin tablet.
Correct answer: A
Rationale: When a client with angina pectoris continues to experience chest pain despite initial nitroglycerin administration and stable blood pressure, the appropriate next step is to administer another nitroglycerin tablet. This helps to further dilate coronary arteries, improving blood flow to the heart muscle and relieving chest pain. Applying oxygen via nasal cannula (Choice B) may be necessary if the client displays signs of respiratory distress or hypoxemia, but in this case, the priority is addressing the unresolved chest pain. Calling for a 12-lead electrocardiogram (ECG) (Choice C) is important to assess for any changes in the client's cardiac status, but administering another nitroglycerin tablet takes precedence in managing the ongoing chest pain. Waiting an additional 5 minutes before giving a second nitroglycerin tablet (Choice D) may delay symptom relief and potentially worsen the client's condition if the chest pain persists.
5. What is the best nursing intervention for a patient with hyperkalemia?
- A. Administer potassium-wasting diuretics
- B. Encourage a low-potassium diet
- C. Administer potassium supplements
- D. Administer IV fluids
Correct answer: A
Rationale: The correct answer is to administer potassium-wasting diuretics. Hyperkalemia, which is high potassium levels, is managed by promoting the excretion of potassium from the body. Potassium-wasting diuretics help the kidneys eliminate excess potassium. Encouraging a low-potassium diet (choice B) is important for long-term management but not the immediate intervention for hyperkalemia. Administering potassium supplements (choice C) would worsen the condition by further increasing potassium levels. Administering IV fluids (choice D) may help with hydration but does not directly address the high potassium levels characteristic of hyperkalemia.
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