ATI RN
ATI Leadership Practice B Questions
Question 1 of 5
The nurse has administered 4 oz of orange juice to an alert patient whose blood glucose was 62 mg/dL. Fifteen minutes later, the blood glucose is 67 mg/dL. Which action should the nurse take next?
Correct Answer: A
Rationale: Rationale: The correct answer is A because the patient's blood glucose level has increased slightly, indicating the orange juice is working. Giving more orange juice is appropriate to continue raising the blood glucose level. Administering glucagon (B) is not necessary as the patient's glucose is improving. Eating peanut butter with crackers (C) may be too slow to raise the glucose level. Notifying the healthcare provider (D) is not needed at this point as the patient is responding to the initial intervention.
Question 2 of 5
When using an open irrigation technique to irrigate a client's indwelling urinary catheter, which of the following actions should the nurse take?
Correct Answer: B
Rationale: The correct answer is B: Perform the irrigation using a 20-mL syringe. This is the correct action because using a 20-mL syringe allows for precise and controlled instillation of the irrigation fluid into the catheter. Using a smaller syringe helps prevent excessive pressure within the catheter, reducing the risk of trauma or damage to the client's urinary system. A: Positioning the client in a side-lying position is not essential for open irrigation technique, as long as the client is comfortable and the procedure can be safely performed. C: Instilling 15 mL of irrigation fluid with each flush may not be appropriate as the volume needed may vary based on the client's condition. D: Although measuring and recording the amount of irrigant used is important for documentation purposes, it is not the immediate action to ensure the safe and effective irrigation of the catheter.
Question 3 of 5
A client with limited mobility in their lower extremities is at risk for skin breakdown. Which of the following actions should the nurse take to prevent skin breakdown?
Correct Answer: B
Rationale: The correct answer is B: Increase the client's intake of carbohydrates. Adequate nutrition, including carbohydrates, is essential for skin health and wound healing. Carbohydrates provide energy for the body's healing processes. Skin breakdown can be prevented by ensuring the client has a well-balanced diet. A: Placing the client in high-Fowler's position is not directly related to preventing skin breakdown in this scenario. C: Massaging areas of skin that are darker than the surrounding skin tissue with lotion may cause more harm than good, as it can increase the risk of skin breakdown. D: Having the client use a trapeze bar when changing position is important for mobility but does not directly address the prevention of skin breakdown.
Question 4 of 5
A nurse enters a client's room and finds them on the floor. The client's roommate reports that the client was trying to get out of bed and fell over the side rail onto the floor. Which of the following statements should the nurse document about this incident?
Correct Answer: C
Rationale: Rationale: The correct answer is C because it accurately describes the situation based on the information provided. Documenting that the client was trying to get out of bed aligns with the roommate's report of the incident. This statement is factual and relevant to the client's condition. Summary: A: Incident report completed - Not relevant to documenting the client's actions during the fall. B: Client climbed over the side rails - Assumes an action not reported by the roommate. D: Client found lying on floor - Describes the outcome, but does not explain the cause of the fall.
Question 5 of 5
A nurse is evaluating teaching for a client who has heart failure. Which of the following statements by the client indicates an understanding of the teaching?
Correct Answer: A
Rationale: The correct answer is A because limiting sodium intake to 2 grams daily is crucial for managing heart failure by reducing fluid retention and strain on the heart. This statement shows understanding of dietary restrictions to manage the condition effectively. Choice B is incorrect because while monitoring weight is important for heart failure, it does not specifically demonstrate understanding of the teaching provided. Choice C is incorrect because decreasing potassium intake is not recommended for heart failure management unless specifically advised by a healthcare provider. Choice D is incorrect as it mentions a positive dietary change, but does not address the key issue of sodium intake, which is essential for managing heart failure.