ATI Nur 130 exam 3 Fall

The correct answers are:

A. Give the client printed information describing diabetes mellitus.

B. Engage in a question-and-answer session with the client.

E. Give the client a fill-in-the-blank quiz.

F. Ask the client to describe the manifestations of hypoglycemia and hyperglycemia.

Explanation:

The cognitive domain of learning focuses on acquiring and understanding knowledge. It involves mental processes such as remembering, understanding, applying, analyzing, evaluating, and creating. Teaching methods that fall under this domain focus on increasing a client’s knowledge about their condition and its management.

Why the correct answers are based on the cognitive domain:

A. Give the client printed information describing diabetes mellitus.

Providing printed materials is a cognitive learning method because it gives the client factual knowledge about diabetes that they can read and understand.

B. Engage in a question-and-answer session with the client.

This method promotes cognitive learning by encouraging the client to recall, comprehend, and apply information about diabetes through active discussion.

E. Give the client a fill-in-the-blank quiz.

Quizzes test the client’s ability to recall and apply knowledge, which falls under the cognitive domain. It assesses whether the client understands key concepts about their condition.

F. Ask the client to describe the manifestations of hypoglycemia and hyperglycemia.

This requires the client to recall and explain information, demonstrating their knowledge and understanding of symptoms related to blood glucose imbalances.

Why the other options are incorrect:

C. Ask the client how they feel about checking their blood glucose.

This falls under the affective domain of learning, which involves emotions, attitudes, and feelings. Asking about feelings assesses emotional readiness and personal attitudes toward self-care, rather than knowledge.

D. Ask the client to demonstrate checking their blood glucose level.

This falls under the psychomotor domain of learning, which involves developing physical skills. Demonstrating a technique, such as using a blood glucose monitor, is a hands-on skill rather than an intellectual or knowledge-based activity.

Summary:

The cognitive domain of learning involves knowledge acquisition, comprehension, and recall. Teaching strategies that support this domain include providing printed materials, engaging in discussions, using quizzes, and asking clients to recall information. The other domains—affective (emotions and attitudes) and psychomotor (physical skills)—are separate from cognitive learning.

The correct answer is B: The primary goals of MNT are to achieve and maintain optimal blood glucose levels, achieve a lipid profile that reduces the risk of cardiovascular disease, and prevent/slow chronic complications of the disease. Addressing individual nutrition needs is essential for personalized care.

Explanation:

Why this answer is correct:

Medical Nutrition Therapy (MNT) is a cornerstone of diabetes management and focuses on the following key goals:

Achieving and maintaining optimal blood glucose levels: By managing carbohydrate intake and ensuring balanced meals, MNT helps regulate blood sugar levels, which is critical in controlling diabetes.

Achieving a lipid profile that reduces the risk of cardiovascular disease:

People with diabetes have a higher risk of cardiovascular complications. Therefore, MNT aims to improve lipid profiles (cholesterol and triglyceride levels) through diet, which reduces cardiovascular risk.

Preventing or slowing the progression of chronic complications of diabetes:

Proper nutrition can help prevent or manage complications such as nephropathy, retinopathy, and neuropathy, which are common in individuals with poorly controlled diabetes.

Addressing individual nutrition needs:

Each person's nutritional needs, preferences, lifestyle, and comorbidities are unique. Tailoring the MNT plan to individual needs allows for more effective diabetes management and improves patient adherence.

Why the other choices are incorrect:

A. The primary goals of MNT are to achieve and maintain optimal blood pressure levels and reduce the risk of cardiovascular disease. Addressing individual nutrition needs is not necessary in diabetes management. This statement is partially correct in that managing blood pressure and cardiovascular risk is important for people with diabetes. However, it neglects the most important goal of MNT, which is achieving and maintaining optimal blood glucose levels. Additionally, addressing individual nutrition needs is crucial for personalized care and effective diabetes management.

C. The primary goals of MNT are to achieve and maintain normal blood pressure and maintain the pleasure of eating. Addressing individual nutrition needs is important only for those with severe diabetes complications. While maintaining normal blood pressure is important in diabetes management, this statement does not address the core focus of MNT—blood glucose control. While it is important to consider the patient's enjoyment of food, it should not overshadow the primary goal of controlling glucose levels and preventing complications. Also, nutrition needs should be addressed for all individuals with diabetes, not just those with severe complications.

D. The primary goals of MNT are to reduce cholesterol levels and increase physical activity. Addressing individual nutrition needs is not relevant in diabetes management. While reducing cholesterol and promoting physical activity are beneficial for overall health and diabetes management, this statement fails to emphasize the primary goal of MNT, which is blood glucose control. Additionally, addressing individual nutrition needs is a fundamental part of diabetes care, as it helps to tailor interventions and achieve optimal outcomes for each patient.\

Summary:

The primary goals of MNT in diabetes care are to control blood glucose, improve lipid profiles, and prevent or delay complications. It is essential to address individual nutrition needs to provide personalized care that optimizes outcomes and improves the quality of life for individuals with diabetes. Option B accurately reflects the comprehensive approach of MNT in managing diabetes.

The correct answer is C: Comparing the patient's current status with expected outcomes.

Explanation:

The evaluation phase of the nursing process focuses on determining whether the patient’s condition has improved, remained the same, or worsened in response to the nursing interventions. The nurse assesses the patient’s current status and compares it to the expected outcomes outlined in the care plan. If the expected outcomes have been met, the care plan may be continued or discontinued. If they have not been met, modifications may be necessary.

Why the other options are incorrect:

A. Revising the nursing diagnosis based on patient feedback.

Revising the nursing diagnosis is part of the planning phase, not the evaluation phase. While patient feedback is important, the primary focus of evaluation is comparing actual outcomes to expected ones to determine the effectiveness of interventions.

B. Monitoring the patient's vital signs for any changes.

Monitoring vital signs is an ongoing assessment activity that occurs throughout the nursing process. While vital signs are an important component of evaluation, the evaluation phase is broader and involves comparing the patient's overall progress against the goals set in the care plan.

D. Documenting the patient's progress without making any changes to the care plan.

Documentation is important, but evaluation is an active process that requires assessing progress and determining whether changes to the care plan are necessary. If the care plan is ineffective, adjustments should be made rather than just documenting progress.

Summary:

During the evaluation phase, the nurse compares the patient's actual status with expected outcomes to determine if interventions were successful or if modifications to the care plan are needed.

The correct answer is C: Emphasizing healthy lifestyle behaviors

Explanation:

Why this answer is correct:

The most effective primary prevention strategy for reducing the risk of developing type 2 diabetes is emphasizing healthy lifestyle behaviors, particularly those that focus on diet, physical activity, and weight management. Research has shown that maintaining a healthy weight, engaging in regular physical activity (such as at least 30 minutes of moderate exercise most days of the week), and adopting a balanced diet (low in processed foods, high in fiber, and rich in fruits and vegetables) can significantly reduce the risk of developing type 2 diabetes, even in individuals with risk factors such as obesity or a family history of the disease. Preventative measures like these address the root causes of insulin resistance, which is central to the development of type 2 diabetes.

Why the other choices are incorrect:

A. Regular dental check-ups

While dental check-ups are important for overall health, there is no direct evidence linking regular dental visits with the prevention of type 2 diabetes. However, individuals with diabetes are at higher risk for dental issues, making dental care essential for managing the condition once it occurs.

B. Routine vision screening

Vision screening can detect diabetic retinopathy, which is a complication of diabetes, but it is not a preventive measure for type 2 diabetes itself. Routine vision screening is important for those already diagnosed with diabetes, but it does not prevent the onset of the disease.

D. Annual cholesterol testing

Although cholesterol testing is important for monitoring heart health, especially in individuals with diabetes or those at risk, it is not a primary prevention strategy for diabetes. Cholesterol levels are more related to cardiovascular disease risk than to the prevention of diabetes. However, managing cholesterol is a part of managing overall health once diabetes is diagnosed.

Summary:

The most effective strategy for preventing type 2 diabetes is emphasizing healthy lifestyle behaviors, which include maintaining a healthy weight, being physically active, and eating a balanced diet. These behaviors directly address the key risk factors for the development of type 2 diabetes and can help prevent or delay the onset of the disease. The other options, while important for overall health, do not directly prevent the development of diabetes.

Correct Answer B: Raise the head of the bed to improve the patient's breathing.

Explanation:

Why Answer B is Correct:

The first priority in caring for a patient with respiratory distress is to optimize their breathing. Raising the head of the bed improves lung expansion and facilitates easier breathing, which is essential for a patient with respiratory alterations. This action will likely improve the patient’s oxygenation and comfort, especially before the diagnostic test.

Why the Other Choices Are Incorrect:

A) Administer supplemental oxygen to increase oxygen saturation levels.

While administering supplemental oxygen may be needed for patients with low oxygen saturation, the immediate priority is improving their breathing by positioning them appropriately. Oxygen administration can follow once the patient’s position is adjusted.

C) Provide pain medication for any discomfort related to the procedure.

While pain management is important, the immediate concern for a patient with respiratory issues is to ensure proper ventilation and breathing. Pain medication can be provided after addressing their breathing needs.

D) Explain the procedure and ensure the patient understands the steps.

Communication is important, but breathing support is the priority when the patient is struggling with shortness of breath. Explaining the procedure can follow once the patient is more comfortable and their breathing is stabilized.

Summary:

For a patient with respiratory alterations, raising the head of the bed is the first priority as it helps improve breathing and oxygenation. After addressing the respiratory needs, other interventions like administering oxygen, pain management, and patient education can follow.

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 B: Chronic, inflammatory, degenerative, autoimmune disease

Explanation:

Why this answer is correct:

Rheumatoid arthritis (RA) is a chronic disease, meaning it persists over time. It is an inflammatory condition, characterized by inflammation of the joints, particularly the synovium (the lining of the joints). RA is degenerative, as the ongoing inflammation can lead to joint damage and loss of function. Additionally, it is an autoimmune disease, meaning the immune system mistakenly attacks the body's own tissues, specifically the joints in the case of RA.

Why the other choices are incorrect:

A) Acute, infectious, and degenerative is incorrect because rheumatoid arthritis is not infectious. It is chronic and autoimmune, not acute.

C) Acute, non-inflammatory, and metabolic is incorrect because RA involves inflammation and is not classified as a metabolic disease.

D) Chronic, viral, and degenerative is incorrect because RA is not caused by a viral infection but rather by autoimmune mechanisms.

Summary:

The correct classification of rheumatoid arthritis is B) chronic, inflammatory, degenerative, autoimmune disease, as it fits the characteristics of being long-lasting, causing joint inflammation, leading to tissue degeneration, and being driven by an autoimmune response.

The correct answer is D: Polyuria

Explanation:

Why this answer is correct:

Polyuria refers to excessive urination, which is a classic symptom of diabetes mellitus, particularly when blood glucose levels are elevated. In diabetes, high blood glucose (hyperglycemia) causes the kidneys to filter excess glucose out of the bloodstream, leading to an increase in urine production. This increased urine output is the body's attempt to eliminate the excess glucose, resulting in frequent and excessive urination, a key symptom of the condition.

Why the other choices are incorrect:

A) Oliguria

Oliguria refers to reduced urine output, specifically the production of less than 400 milliliters of urine per day. This condition is not typically associated with diabetes. Instead, polyuria, or excessive urination, is the more common manifestation of diabetes due to high blood glucose levels.

B) Anuria

Anuria is the complete lack of urine production or the production of less than 50 milliliters of urine per day. This is a severe medical condition often caused by acute kidney failure or severe dehydration, but it is not associated with diabetes. The hallmark of diabetes-related urination is polyuria, not anuria.

C) Dysuria

Dysuria refers to painful urination, often associated with urinary tract infections or bladder issues. It is not a typical symptom of diabetes mellitus. Although diabetes can increase the risk of infections, including urinary tract infections, dysuria itself is not a direct result of diabetes.

Summary:

Polyuria (excessive urination) is a common symptom of diabetes mellitus and occurs due to the kidneys' efforts to eliminate excess glucose from the blood. This condition is characterized by frequent, large amounts of urine output and is a key sign of hyperglycemia in individuals with diabetes.

Correct Answer C: Always take the medication with meals.

Explanation:

Why Answer C is Correct:

Amylin mimetics, such as Pramlintide, are prescribed to help control postprandial blood glucose levels in individuals with Type 1 diabetes. The medication works by slowing gastric emptying, promoting satiety, and inhibiting glucagon secretion, which helps prevent spikes in blood glucose after meals. Pramlintide should always be administered with meals because it specifically helps to manage blood glucose after eating by acting on the digestive process during meal times. Administering it around meals ensures optimal effectiveness in controlling postprandial glucose levels.

Why the Other Choices Are Incorrect:

A) Take the medication on an empty stomach.

Pramlintide should not be taken on an empty stomach. It is most effective when taken with meals to manage post-meal glucose levels. Taking it on an empty stomach would not provide the intended benefit in managing blood sugar related to food intake.

B) Administer the medication only if fasting blood glucose is high.

Pramlintide should not be administered only when fasting blood glucose is high. It is used to control postprandial glucose levels, so it is specifically administered with meals, regardless of fasting blood glucose readings. Using the medication only when fasting glucose is high would not address the post-meal glucose spikes it is designed to control.

D) Avoid carbohydrate-rich meals when using this medication.

There is no need to avoid carbohydrate-rich meals when using Pramlintide. The medication is designed to help control blood glucose spikes after meals, even those that are carbohydrate-rich. However, the client may need to adjust insulin doses or carbohydrate intake based on individual response, but avoiding carbs entirely is unnecessary and could lead to inadequate nutrition.

Summary:

The correct answer is C) Always take the medication with meals because Pramlintide is most effective in controlling post-meal glucose spikes when taken with food. The other options are incorrect because they either misinterpret the timing of the medication or suggest inappropriate dietary changes.