an unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome hhs the nur

ATI RN

ATI Leadership Practice B

1. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to

A. give a bolus of 50% dextrose.
B. insert a large-bore IV catheter.
C. initiate oxygen via nasal cannula.
D. administer glargine (Lantus) insulin.

Correct answer: B

Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.

2.

A. Autonomy
B. Nonmaleficence
C. Beneficence
D. Distributive justice

Correct answer: A

Rationale: This is an example of the ethical principle of autonomy.

3. A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?

A. Pad the client's wrists before applying the restraints.
B. Evaluate the client's circulation every 8 hours after application.
C. Secure the restraint ties to the bed's side rails.
D. Remove the restraints every 4 hours to evaluate the client's status.

Correct answer: C

Rationale: When applying wrist restraints, it is crucial to secure the restraint ties to the bed's side rails to ensure the client's safety and prevent injury. Padding the client's wrists (Choice A) is not a standard practice and may compromise the effectiveness of the restraints. Evaluating the client's circulation (Choice B) is important but should be done more frequently than every 8 hours to ensure prompt detection of any circulation issues. Removing the restraints every 4 hours (Choice D) is unnecessary and may increase the risk of injury or agitation in the client.

4. The manager of a medical-surgical unit is very task-motivated. Using Fiedler's Contingency Theory, under what circumstances would the manager be most effective?

A. Only during highly stressful situations.
B. When there is little to no stress.
C. Under highly structured situations.
D. When the situation is loosely structured.

Correct answer: C

Rationale: According to Fiedler's Contingency Theory, task-motivated managers are most effective under highly structured situations. This is because in such environments, where priorities are clear and tasks are well-defined, task-oriented managers can excel in organizing and accomplishing objectives efficiently. Choices A and B are incorrect because the effectiveness of a task-motivated manager is not solely linked to stress levels but rather to the structure of the situation. Choice D is also incorrect as a loosely structured situation would not provide the clarity and direction that a task-motivated manager thrives in.

5.

A. Fidelity
B. Confidentiality
C. Veracity
D. Accountability

Correct answer: B

Rationale: The principle of confidentiality requires nurses to hold healthcare information and anything patients tell them in the strictest confidence.