which patient action indicates a good understanding of the nurses teaching about the use of an insulin pump

ATI RN

ATI Leadership Proctored Exam 2019

1. Which patient action indicates a good understanding of the nurse�s teaching about the use of an insulin pump?

A. The patient programs the pump for an insulin bolus after eating
B. The patient changes the location of the insertion site every week
C. The patient takes the pump off at bedtime and starts it again each morning.
D. The patient plans for a diet that is less flexible when using the insulin pump.

Correct answer: A

Rationale:

2. A nurse is assessing a client who received an IV fluid bolus for dehydration. Which of the following findings should the nurse identify as an indication of fluid volume excess?

A. Hypotension
B. Distended neck veins
C. Slow capillary refill
D. Weak, thready pulse

Correct answer: B

Rationale: The correct answer is B: 'Distended neck veins.' Distended neck veins are a sign of fluid volume excess, indicating an overload of fluids in the body. This can be caused by excessive fluid administration. Hypotension (choice A) is more commonly associated with fluid volume deficit. Slow capillary refill (choice C) and a weak, thready pulse (choice D) are also signs of decreased fluid volume, not fluid volume excess.

3. What is the primary purpose of a nurse staffing committee?

A. To oversee patient safety initiatives
B. To develop staffing policies and procedures
C. To coordinate patient care
D. To manage nurse recruitment

Correct answer: B

Rationale: The primary purpose of a nurse staffing committee is to develop staffing policies and procedures to ensure adequate nurse-to-patient ratios. By establishing these guidelines, the committee aims to optimize patient care by ensuring appropriate staffing levels, which in turn can enhance patient safety and coordination of care. While overseeing patient safety initiatives and managing nurse recruitment are important aspects of healthcare management, the core function of a nurse staffing committee is to create and implement policies that govern the allocation and distribution of nursing staff to meet patient care needs effectively. Therefore, choices A, C, and D, though relevant to healthcare, do not align with the primary purpose of a nurse staffing committee as outlined in the question.

4. When a patient with type 2 diabetes is admitted for a cholecystectomy, which nursing action can the nurse delegate to a licensed practical/vocational nurse (LPN/LVN)?

A. Communicate the blood glucose level and insulin dose to the circulating nurse in surgery.
B. Discuss the reason for the use of insulin therapy during the immediate postoperative period.
C. Administer the prescribed lispro (Humalog) insulin before transporting the patient to surgery.
D. Plan strategies to minimize the risk for hypoglycemia or hyperglycemia during the postoperative period.

Correct answer: C

Rationale: The correct answer is C because the administration of prescribed lispro (Humalog) insulin before transporting the patient to surgery is a task that can be safely delegated to a licensed practical/vocational nurse (LPN/LVN). This action is within the scope of practice of an LPN/LVN and does not require independent nursing judgment. Choices A and B involve communicating and discussing important medical information, which are higher-level nursing actions typically performed by registered nurses. Choice D involves planning strategies to manage blood glucose levels postoperatively, which requires critical thinking and assessment skills usually performed by a registered nurse.

5. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to

A. use only the lispro insulin until the symptoms are resolved
B. limit calorie intake until the glucose is less than 120 mg/dL
C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%

Correct answer: C

Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.