which statement by the patient indicates a need for additional instruction in administering insulin

ATI RN

ATI Leadership Practice B

1. Which statement by the patient indicates a need for additional instruction in administering insulin?

A. 'I need to rotate injection sites among my arms, legs, and abdomen each day.'
B. 'I can buy the 0.5 mL syringes because the line markings will be easier to see.'
C. 'I should draw up the regular insulin first after injecting air into the NPH bottle.'
D. 'I do not need to aspirate the plunger to check for blood before injecting insulin.'

Correct answer: A

Rationale: This statement indicates a need for additional instruction because while site rotation is essential, it's important to rotate sites within the same anatomical region (such as staying within the abdomen for several injections before moving to a different region). Rotating too frequently between different regions can cause inconsistent insulin absorption, which can affect blood sugar control.

2. Which of the following is an example of a sentinel event?

A. A patient fall with no injury
B. A medication error that results in no harm
C. A patient suicide while in a healthcare facility
D. A near miss incident

Correct answer: C

Rationale: The correct answer is C, a patient suicide while in a healthcare facility. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. Choices A, B, and D do not meet the criteria for sentinel events as described by The Joint Commission, as they do not involve death or serious harm to the patient.

3. A nurse has just inserted a nasogastric (NG) tube for a client. Which of the following findings should the nurse expect to confirm correct tube placement?

A. The client reports relief of nausea.
B. The tube aspirate has a pH less than 5.
C. Bowel sounds are present on auscultation.
D. An x-ray shows the end of the tube above the pylorus.

Correct answer: A

Rationale: The correct answer is A: The client reports relief of nausea. When the NG tube is correctly placed in the stomach, it can help alleviate feelings of nausea and discomfort. Choice B, a tube aspirate pH less than 5, is incorrect as it indicates gastric placement, not necessarily correct placement. Choice C, bowel sounds on auscultation, and Choice D, visualization of the tube on an x-ray above the pylorus, do not confirm correct NG tube placement; therefore, they are incorrect.

4. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?

A. The patient's blood pressure is 154/92.
B. The patient has a history of emphysema
C. The patient's blood glucose is 86 mg/dL.
D. The patient has chest pressure when walking

Correct answer: D

Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.

5. Which of the following is an example of total time lost?

A. Number of days off that an employee asks for
B. Number of scheduled days missed
C. Number of days missed
D. Number of days perceived to be absent

Correct answer: B

Rationale: The correct answer is B. Total time lost refers to the number of scheduled days that an employee misses. This includes days that were planned to be worked but were not. Choice A, 'Number of days off that an employee asks for,' is not necessarily time lost as these are approved absences. Choice C, 'Number of days missed,' is vague and does not specify if they are scheduled or unscheduled. Choice D, 'Number of days perceived to be absent,' is subjective and does not clearly relate to scheduled time lost.