ATI Nur 130 exam 3 Fall

The correct answer is C: Focus on consuming complex carbohydrates and monitoring carbohydrate intake to manage blood glucose levels.

Explanation:

Why this answer is correct:

For individuals with diabetes, carbohydrate consumption plays a significant role in managing blood glucose levels. The general guideline is to focus on consuming complex carbohydrates, which are digested more slowly and have a lower glycemic index. Complex carbohydrates, found in foods like whole grains, vegetables, and legumes, are preferable to simple sugars because they help to avoid rapid spikes in blood glucose.

In addition, monitoring carbohydrate intake is critical for managing blood glucose levels. It's important for individuals with diabetes to be aware of the total amount of carbohydrates they are consuming in order to prevent hyperglycemia (high blood sugar). Portion control and balance with other macronutrients (protein and fats) are also part of the strategy for managing diabetes.

Why the other choices are incorrect:

A. Consume a diet high in simple sugars to provide quick energy.

This recommendation is not appropriate for individuals with diabetes. Simple sugars can cause rapid spikes in blood glucose, which can be harmful, especially for individuals with diabetes who have impaired insulin function. It is better to focus on foods that provide a more stable release of glucose into the bloodstream, such as complex carbohydrates.

B. Limit carbohydrate intake to less than 10% of daily calories.

While reducing carbohydrate intake can help manage blood glucose levels, limiting it to less than 10% of daily calories is an extreme and unrealistic recommendation. Carbohydrates are an essential macronutrient, and individuals with diabetes should not eliminate them entirely. Instead, focusing on the quality and amount of carbohydrates consumed, as well as portion control, is more effective.

D. Avoid all carbohydrate-rich foods to prevent blood glucose spikes.

Avoiding all carbohydrate-rich foods is not a practical or healthy approach for managing diabetes. Carbohydrates are necessary for energy and overall health. The key is not to avoid them completely but to choose the right types of carbohydrates (complex carbohydrates) and monitor their intake to manage blood glucose levels. Completely eliminating carbohydrates could lead to nutritional deficiencies and an imbalanced diet.

Summary:

The best approach for individuals with diabetes is to focus on consuming complex carbohydrates, such as those found in whole grains, vegetables, and legumes, while monitoring carbohydrate intake to prevent blood glucose spikes. This approach allows for balanced energy intake and better management of blood sugar levels. Option C provides the most accurate and practical guideline for carbohydrate consumption in diabetes management.

The correct answer is A: Hyperopia

Explanation:

Why this answer is correct:

Hyperopia, or farsightedness, is a refractive error in which a person can see distant objects clearly, but close objects appear blurry. This happens when light entering the eye is focused behind the retina. It commonly develops as people age, particularly when the eye loses some of its focusing ability for near objects, as Leslie Waterman has experienced.

Why the other choices are incorrect:

B) Myopia:

Myopia, or nearsightedness, is the opposite of hyperopia. It occurs when a person can see nearby objects clearly, but distant objects appear blurry. This is not the case with Leslie, as he sees distance clearly.

C) Astigmatism:

Astigmatism is a refractive error caused by an irregularly shaped cornea or lens, leading to blurred or distorted vision at all distances. While Leslie has trouble with nearby sights, this doesn't describe the specific condition he reports.

D) Presbyopia:

Presbyopia is age-related difficulty in focusing on nearby objects, typically starting around age 40. While this could be a concern for older adults, it is not the same as hyperopia, where distant objects are seen clearly, and presbyopia specifically refers to difficulty focusing on near objects, which Leslie mentions.

Summary:

The best description of Leslie Waterman's visual condition is hyperopia, where distant objects are seen clearly, but close objects are blurry. This condition typically arises as individuals age, and it differs from myopia, astigmatism, and presbyopia.

The correct answer is D: Offering false reassurance

Explanation:

Why this is correct:

The nurse's response, "Don't worry, no one will harm your family," represents offering false reassurance. This type of communication breakdown occurs when the nurse provides statements that minimize or deny the patient's feelings or concerns, even though these concerns may be real to the patient. In this case, the nurse is dismissing the patient's fear without exploring the underlying issue or validating the patient's feelings. False reassurance can make the patient feel misunderstood and may prevent further discussion about their concerns, which can hinder the therapeutic relationship and effective care.

Why the other choices are incorrect:

A. Offering sympathy

Offering sympathy typically involves expressing pity or sorrow for someone's situation, often with a more empathetic tone. The nurse’s response, however, is not sympathetic. Rather than expressing empathy or understanding, it shuts down the conversation with a reassured statement that may not align with the patient's experience.

B. Providing a passive response

A passive response would be one where the nurse does not engage with the patient’s feelings at all, perhaps by ignoring the concern or failing to respond. In this case, the nurse does engage, but with a statement that minimizes the concern, rather than passively ignoring it.

C. Showing disapproval

Showing disapproval involves making a judgmental or critical comment about the patient’s actions, beliefs, or behavior. In this case, the nurse does not criticize or express disapproval of the patient’s concern but instead dismisses it with reassurance. Therefore, this is not an example of showing disapproval.

Summary:

The nurse's response exemplifies offering false reassurance, which is a communication breakdown. By invalidating the patient’s concerns with an overly simplistic and dismissive statement, the nurse is not allowing space for the patient’s fears to be heard or addressed. Effective communication would involve validating the patient's feelings and exploring the concern further to provide support and possibly connect the patient to appropriate resources.

The correct answer is D: Charge nurse

Explanation:

When a nurse suspects that a coworker is chemically impaired, the first step is to report the concern to the immediate supervisor, which in this case is the charge nurse. The charge nurse has the authority to assess the situation, monitor the impaired nurse’s behavior, and take immediate action if necessary, such as removing the impaired nurse from patient care responsibilities.

Why the other choices are incorrect:

A. Chief nursing officer (CNO) – Incorrect.

The CNO is responsible for the overall nursing operations of the hospital but is not the first person to be notified in cases of suspected impairment. Issues like this should be addressed at the unit level first before escalating further if necessary.

B. Unit director – Incorrect.

While the unit director (or nurse manager) oversees the department, the charge nurse is typically the first point of contact in an immediate situation. The unit director may become involved later for further investigation and disciplinary actions.

C. Hospital supervisor – Incorrect.

The hospital supervisor oversees administrative and operational aspects of the entire hospital and is usually not the first point of contact for concerns about a chemically impaired coworker.

Summary:

The charge nurse should be notified first because they are the immediate supervisor responsible for handling unit-level issues, ensuring patient safety, and initiating the proper protocol for addressing suspected impairment.

The correct answer is D: Glucagon is a counterregulatory hormone released in response to cellular deficiency of glucose.

Explanation:

Why this answer is correct:

Glucagon is a counterregulatory hormone that plays a vital role in increasing blood glucose levels when they are too low. It is secreted by the alpha cells in the pancreas, not the beta cells. When the body senses low blood glucose (hypoglycemia), glucagon is released to promote the release of glucose from the liver into the bloodstream. This process helps to restore normal glucose levels and provides energy for cells. Glucagon works in opposition to insulin, which decreases blood glucose by promoting glucose uptake into cells. Thus, glucagon's primary role is to prevent hypoglycemia by stimulating glucose production and release.

Why the other choices are incorrect:

A) Glucagon is secreted by beta cells in the pancreas.

This statement is incorrect because glucagon is secreted by the alpha cells, not the beta cells. Beta cells are responsible for secreting insulin, which lowers blood glucose levels.

B) Glucagon promotes the uptake of glucose into cells.

This statement is incorrect. Glucagon does not promote glucose uptake into cells. Instead, it increases blood glucose levels by stimulating the liver to release stored glucose (glycogen). Insulin, not glucagon, promotes the uptake of glucose into cells.

C) Glucagon is a hormone that lowers blood glucose levels.

This statement is incorrect. Glucagon raises blood glucose levels, not lowers them. It acts to counterbalance insulin's effect, which lowers blood glucose by promoting glucose uptake into cells.

Summary:

Glucagon is a counterregulatory hormone that increases blood glucose levels by stimulating the liver to release glucose. It is secreted by the alpha cells in the pancreas in response to low blood glucose levels. This process is essential for maintaining glucose homeostasis, especially during fasting or periods of increased energy demand.

The correct answer is A: The client's systolic blood pressure decreases from 110 mm Hg to 105 mm Hg.

Explanation:

Postural (orthostatic) hypotension occurs when a person's blood pressure drops significantly upon standing, leading to symptoms such as dizziness, lightheadedness, or even fainting. A successful intervention would be indicated by minimal or no significant drop in blood pressure when transitioning from lying to standing.

A systolic drop of less than 20 mm Hg (or a diastolic drop of less than 10 mm Hg) is considered normal and suggests that the body's compensatory mechanisms, such as vasoconstriction and increased heart rate, are effectively maintaining blood pressure. In this case, the client’s systolic blood pressure only decreases by 5 mm Hg (from 110 to 105 mm Hg), indicating that the intervention (gradual position change) was effective in preventing a significant blood pressure drop.

Why the other choices are incorrect:

B. The client reports nausea. – Incorrect.

Nausea is not a sign of effective intervention. It could indicate persistent orthostatic intolerance, hypoperfusion, or another underlying issue.

C. The client’s heart rate increases from 100/min to 108/min. – Incorrect.

A mild increase in heart rate can be a compensatory response, but a continued rise suggests that the body is struggling to maintain blood pressure. A significant increase (more than 20 beats per minute) is a sign of persistent orthostatic hypotension.

D. The client reports dizziness. – Incorrect.

Dizziness is a classic symptom of postural hypotension and suggests that the intervention was not effective. The goal of assisting the client gradually is to prevent dizziness and maintain adequate perfusion.

Summary:

A minimal decrease in blood pressure (e.g., 110 mm Hg to 105 mm Hg) suggests that the intervention was successful in preventing postural hypotension.

Correct Answer C: It is the leading cause of blindness among people aged 20 to 74.

Explanation:

Why Answer C is Correct:

Diabetic retinopathy is a major cause of vision loss and is the leading cause of blindness among adults aged 20 to 74. It results from damage to the blood vessels in the retina due to prolonged high blood sugar levels. The condition can progress without symptoms, which is why early detection and regular eye exams are essential for people with diabetes.

Why the Other Choices Are Incorrect:

A) It primarily affects the large blood vessels in the retina

Diabetic retinopathy primarily affects the small blood vessels in the retina, not the large ones. High blood sugar levels can cause these small blood vessels to weaken, leak, or become blocked, leading to vision problems. The damage to large vessels is more associated with conditions like hypertensive retinopathy.

B) Diabetic retinopathy is typically a painful condition

Diabetic retinopathy is usually painless, especially in its early stages. People may not experience any symptoms until significant damage has occurred. By the time vision problems appear, the disease may be quite advanced, but it does not typically cause pain.

D) Management of diabetic retinopathy focuses solely on treatment once symptoms are present

Management of diabetic retinopathy focuses on prevention and early detection rather than waiting for symptoms to appear. Regular eye exams to check for early signs of the condition can help prevent severe vision loss. Treatment options like laser therapy or injections are available, but the focus is on managing the condition early, not just treating symptoms after they appear.

Summary:

The correct answer is C) It is the leading cause of blindness among people aged 20 to 74 because diabetic retinopathy is a significant cause of vision loss in this age group. The other options are incorrect because diabetic retinopathy affects small blood vessels in the retina, is typically painless, and should be managed through early detection and prevention, not just after symptoms arise.

CORRECT ANSWER D: All of the Above

EXPLANATION:

Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and sleep disturbances. Although the exact cause is unknown, several factors increase the risk of developing fibromyalgia, including:

Anxiety and Depression (A): Psychological stress and mood disorders are common in fibromyalgia patients. They can either trigger or worsen symptoms by affecting pain perception and stress responses.

Sleep Disorder (B): Poor sleep quality is both a symptom and a contributing factor in fibromyalgia. Sleep disturbances can increase pain sensitivity and fatigue, worsening the condition.

Viral Infection (C): Some patients report fibromyalgia symptoms after a viral illness, suggesting that infections may trigger or exacerbate the condition by affecting the immune system and central nervous system.

WHY THE OTHER OPTIONS ARE WRONG:

A)Anxiety and Depression.

While anxiety and depression are strongly associated with fibromyalgia, they are not the only predisposing factors. Sleep disturbances and viral infections also play a role.

B) Sleep Disorder.

Sleep disorders are common in fibromyalgia and contribute to symptom severity, but other factors, such as mood disorders and infections, also increase the risk.

C)Viral Infection.

Viral infections can trigger fibromyalgia symptoms, but they do not fully explain the development of the disorder in all patients. Psychological and sleep-related factors are also involved.

SUMMARY:

The correct answer is D) All of the Above because anxiety/depression, sleep disorders, and viral infections are all known predisposing factors for fibromyalgia. The condition is multifactorial, meaning that a combination of psychological, neurological, and environmental factors contributes to its onset and progression.

The correct answer is C: Tell me what happened to make you feel that way.

Explanation:

This statement reflects professional communication because it:

Acknowledges the client's feelings without dismissing them.

Encourages an open, nonjudgmental conversation where the client can share their perspective.

Promotes a solution-focused approach by seeking to understand the specific issue that led to the dissatisfaction.

This approach fosters a therapeutic relationship by demonstrating empathy, active listening, and respect for the client's concerns, which is essential in managing conflict and improving patient care.

Why the other choices are incorrect:

A. The nurses are doing the best that they can.

This response attempts to justify the behavior of the nurses without fully acknowledging the client's experience. It may sound dismissive of the client’s feelings and does not invite further discussion or exploration of the issue. It could shut down open communication rather than facilitate it.

B. This hospital does have some pretty bad nurses.

This statement is unprofessional and may escalate the situation. It blames others and could make the client feel like they are being heard for the wrong reasons. Additionally, this response is not constructive and does not address the client's concern in a therapeutic way.

D. The provider can discharge you if you are not happy with your care.

This response dismisses the client's concerns by implying they can leave if they're unhappy. It fails to acknowledge the client's feelings and does not attempt to resolve the issue. It also reflects an avoidance of addressing the real problem and might leave the client feeling unsupported.

Summary:

The best response, "Tell me what happened to make you feel that way," shows empathy and opens the door for the client to explain their experience. It encourages dialogue, promotes a problem-solving approach, and builds rapport with the client, all of which are critical in nursing practice to improve patient satisfaction and resolve conflicts effectively.