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Module Report
Tutorial: Real Life RN Maternal Newborn 3.0
Module:
Gestational Diabetes
Individual Name:
Institution:
Program Type:
BSN
Standard Use Time and Score
Gestational Diabetes
Date/Time
Time Use
Score
7/29/2022 11:45:20 PM
31 min
Strong
Reasoning Scenario Details
Gestational Diabetes – Use on 7/29/2022 11:14:25 PM
Reasoning Scenario Performance Related to Outcomes:
*See Score Explanation and Interpretation below for additional details.
Body Function
Strong
Ingestion, Digestion, Absorption & Elimination
100%
Regulation and Metabolism
100%
Reproduction
100%
NCLEX RN
Strong
RN Management of Care
100%
RN Safety and Infection Control
100%
RN Health Promotion and Maintenance
100%
RN Pharmacological and Parenteral Therapies
100%
RN Reduction of Risk Potential
100%
100%
QSEN
Strong
Satisfactory
Needs
Improvement
Satisfactory
Needs
Improvement
Satisfactory
Needs
Improvement
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Safety
100%
Patient-Centered Care
100%
Evidence Based Practice
100%
Decision Log:
Optimal Decision
Scenario
Nurse Ellen is calculating Ms. AndersonÂ¶s estimated date of delivery.
Question
Nurse Ellen is calculating Ms. AndersonÂ¶s estimated date of delivery. Which of
the following is an appropriate response by Ellen?
Selected Option
“Your estimated date of delivery is April 20th.”
Rationale
Using Naegele’s rule, the nurse should calculate the estimated date of delivery
by determining the first day of the clientÂ¶s last menstrual cycle, adding 7 days,
and then counting forward 9 months.
Optimal Decision
Scenario
Nurse Ellen is converting Ms. AndersonÂ¶s weight to pounds.
Question
Nurse Ellen is converting Ms. AndersonÂ¶s weight to pounds. If Ms. Anderson
weighs 113 kg, how many pounds does she weigh? (Round to the nearest
tenth.)
Selected Option
248.6
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Rationale
Follow these steps for the Ratio and Proportion method of calculation:
Step 1: What is the unit of measurement the nurse should calculate? lb
Step 2: Set up an equation and solve for X.
1 kgClient’s weight in kg 2.2 lbX lb1 kg113 NJ 2.2 lbX lb
X lb = 248.6 lb
Step 3: Round if necessary.
Step 4: Determine whether the weight conversion makes sense. If the client
weighs 113 kg, it makes sense that the client weighs 248.6 lb.
Follow these steps for the Desired Over Have method of calculation:
Step 1: What is the unit of measurement the nurse should calculate? lb
Step 2: Set up an equation and solve for X.
Client’s weight in kg Ã® 2.2 lbX OE 1 kg113 kg Ã® 2.2 lbX OE 1 kg
X lb = 248.6 lb
Step 3: Round if necessary.
Step 4: Determine whether the weight conversion makes sense. If the client
weighs 113 kg, it makes sense that the client weighs 248.6 lb.
Follow these steps for the Dimensional Analysis method of calculation:
Step 1: What is the unit of measurement the nurse should calculate? (Place the
unit of measure being calculated on the left side of the equation.)
X lb =
Step 2: Determine the ratio that contains the same unit as the unit being
calculated. (Place the ratio on the right side of the equation, ensuring that the
unit in the numerator matches the unit being calculated.)
2.2 lbX OE #1601 kg
Step 3: Place any remaining ratios that are relevant to the item on the right side
of the equation, along with any needed conversion factors, to cancel out
unwanted units of measurement.
2.2 lb113 kgX OE #160 Ã® #1601 kg1
Step 4: Solve for X.
X kg = 248.6 lb
Step 5: Round if necessary.
Step 6: Determine whether the weight conversion makes sense. If the client
weighs 113 kg, it makes sense that the client weighs 248.6 lb.
Optimal Decision
Scenario
Nurse Ellen is the explaining risk factors of gestational diabetes to Ms.
Anderson.
Question
Nurse Ellen is explaining the risk factors for developing gestational diabetes to
Ms. Anderson. Which of the following should Ellen include? (Select all that
apply.)
Selected Ordering
Obesity Maternal age over 25Family history of diabetes mellitus
Rationale
Risk factors for the development of gestational diabetes include obesity, familial
history, and maternal age over 25.
Optimal Decision
Scenario
Nurse Ellen is discussing the 1-hr oral glucose tolerance test with Ms. Anderson.
Question
Nurse Ellen is preparing to administer a 1-hr oral glucose tolerance test for Ms.
Anderson. Which of the following actions should Ellen take?
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Selected Option
Obtain a blood specimen 1 hr after Ms. Anderson ingests the oral glucose
solution.
Rationale
The nurse should obtain a blood specimen from the client 1 hr after she ingests
the oral glucose solution.
Optimal Decision
Scenario
Nurse Jill is explaining the results of the 1-hr oral glucose tolerance test to Ms.
Anderson.
Question
Nurse Jill is explaining the results of the 1-hr oral glucose tolerance test to Ms.
Anderson. Which of the following is an appropriate response?
Selected Option
“You will need to have the 3-hour oral glucose tolerance test.”
Rationale
A blood glucose level of 142 mg/dL is above the expected reference range.
Therefore, the client should have a 3-hr oral glucose tolerance test.
Optimal Decision
Scenario
Nurse Jill is preparing to perform a 3-hr oral glucose tolerance test to confirm a
diagnosis of gestational diabetes.
Question
Nurse Jill is teaching Ms. Anderson about a 3-hr oral glucose tolerance test to
confirm a diagnosis of gestational diabetes. Which of the following should be
included in the teaching?
Selected Option
“The nurse will check your blood glucose level hourly during the test.”
Rationale
The 3-hr oral glucose tolerance test involves obtaining four blood samples. The
first is a fasting blood glucose level, followed by three blood samples at hourly
intervals.
Optimal Decision
Scenario
Nurse Jill is explaining the unexpected results of the 3-hr oral glucose tolerance
test to Ms. Anderson.
Question
Nurse Jill is explaining the unexpected results of the 3-hr oral glucose tolerance
test to Ms. Anderson. Which of the following is an appropriate statement by Jill?
Selected Option
“You will have a diagnosis of gestational diabetes if two blood glucose levels are
elevated.”
Rationale
The nurse should review the blood glucose levels at each interval of the 3-hr
oral glucose tolerance test. Two elevated blood glucose levels confirm a
diagnosis of gestational diabetes.
Optimal Decision
Scenario
Nurse Jill is teaching Ms. Anderson about dietary modifications for gestational
diabetes.
Question
Nurse Jill is teaching Ms. Anderson about dietary modifications for gestational
diabetes. Which of the following should Jill include in the teaching?
Selected Option
“You should consume 2,000 calories daily.”
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Rationale
A client who has gestational diabetes and is overweight should consume 25
kcal/kg/day to control blood glucose and maintain proper nutrition for the fetus.
Optimal Decision
Scenario
Nurse Jill is teaching Ms. Anderson the technique for self-blood glucose
monitoring.
Question
Nurse Jill is teaching Ms. Anderson the technique for self-blood glucose
monitoring. Identify the sequence of actions Ms. Anderson should take when
performing a self-blood glucose test. (Reorder the steps by dragging them into
the desired sequence.)
Selected Ordering
Choose a vascular puncture site. Wipe the finger with an antiseptic swab.Prick
the finger using a dart-like motion.Gently squeeze around the puncture site.Hold
the strip under the puncture site.Apply pressure to the puncture site.
Rationale
When obtaining a blood glucose level using a glucometer, the client should first
choose a vascular puncture site, such as the side of the finger. Next, the client
should cleanse the finger with an antiseptic wipe or soap and water. Then the
client should prick the finger using a darting motion, and gently massage the
puncture site to facilitate blood flow without touching the site. The client should
hold the monitor strip under the puncture site to obtain the blood sample, and
then apply pressure to the puncture site to assist with hemostasis.
Optimal Decision
Scenario
Nurse Jill is preparing to educate Ms. Anderson about insulin injections.
Question
Nurse Jill is preparing to educate Ms. Anderson regarding self-administering
Regular insulin (Humulin R). Which of the following should Jill include in the
teaching?
Selected Option
Rotate the administration of insulin within one site for a week.
Rationale
The client should rotate injections within one site for a week to allow for optimal
insulin absorption.
Optimal Decision
Scenario
Nurse Jill is teaching Ms. Anderson about clinical manifestations of
hypoglycemia.
Question
Nurse Jill is teaching Ms. Anderson about clinical manifestations of
hypoglycemia. Jill tells Ms. Anderson to watch for diaphoresis, headache, and
shakiness. Which of the following additional manifestations should Jill include in
the teaching?
Selected Option
Dizziness
Rationale
Dizziness is a clinical manifestation of hypoglycemia.
Optimal Decision
Scenario
Nurse Jill is discussing the treatment of hypoglycemia with Ms. Anderson.
Question
Nurse Jill is discussing the treatment of hypoglycemia with Ms. Anderson. Which
of the following should Jill include in the teaching?
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Selected Option
Drink 4 oz regular non-caffeinated soft drink.
Rationale
The client should treat a mild hypoglycemia episode with 15 g of carbohydrates.
Therefore, 4 oz regular non-caffeinated soft drink is appropriate to use for the
treatment of hypoglycemia.
Optimal Decision
Scenario
Nurse Jill is preparing Ms. Anderson for a nonstress test.
Question
Nurse Jill is preparing Ms. Anderson for a nonstress test. Which of the following
actions should Jill take?
Selected Option
Instruct Ms. Anderson to press the handheld marker when she feels fetal
movement.
Rationale
The nurse should instruct the client to press the handheld marker when she
feels fetal movement during a nonstress test.
Optimal Decision
Scenario
Nurse Jill is discussing potential complications of gestational diabetes with Ms.
Anderson.
Question
Nurse Jill is discussing potential complications of gestational diabetes with Ms.
Anderson. Gestational diabetes places the newborn at risk for which of the
following?
Selected Option
Hypoglycemia
Rationale
Newborns of mothers who have gestational diabetes are at risk for
hypoglycemia. The nurse should monitor the newborn following birth.
Optimal Decision
Scenario
Nurse Jill is reviewing the biophysical profile for Ms. Anderson.
Question
Nurse Jill is reviewing the components of the biophysical profile for Ms.
Anderson. Nurse Jill should recognize which of the following components of a
biophysical profile? (Select all that apply.)
Selected Ordering
Fetal toneFetal breathing movementAmniotic fluid volumeGross body movement
Rationale
Components of a biophysical profile include fetal tone, fetal breathing
movement, the volume of amniotic fluid, and fetal gross body movements.
Doppler blood flow analysis is a noninvasive test that studies blood flow to the
fetus and placenta using ultrasound, but it is not part of a biophysical profile.
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Score Explanation and Interpretation
Individual Performance Profile
REASONING SCENARIO INFORMATION
Reasoning Scenario Information provides the date, time and amount of time use, along with the score earned for each
attempt. The percentage of students earning a Scenario Performance of Strong, Satisfactory, or Needs Improvement is
provided. In addition, the Scenario Performance for each student is provided, along with date, time, and time use for
each attempt. This information is also provided for the Optimal Decision Mode if it has been enabled.
If a detrimental decision is made during a Real Life scenario, the scenario will diverge from the optimal path and
potentially end prematurely, in which case an indicator will appear on the score report.
REASONING SCENARIO PERFORMANCE SCORES
Strong
Exhibits optimal reasoning that results in positive outcomes in the care of clients and resolution
of problems.
Satisfactory
Exhibits reasoning that results in mildly helpful or neutral outcomes in the care of clients and
resolution of problems.
Needs
Improvement
Exhibits reasoning that results in harmful or detrimental outcomes in the care of clients and
resolution of problems.
REASONING SCENARIO PERFORMANCE RELATED TO NURSING COMPETENCY OUTCOMES
A performance indicator is provided for each outcome listed within the nursing competency outcome categories.
Percentages are based on the number of questions answered correctly out of the total number of questions that were
assigned to the given outcome. Outcomes have varying numbers of questions assigned to them. Also, due to divergent
paths within the branching simulation, the outcomes encountered and the number of questions for each outcome can
vary. The above factors cause limitations related to comparing scores across students or groups of students.
NCLEXÂ® CLIENT NEED CATEGORIES
Management of Care Providing integrated, cost-effective care to clients by coordinating, supervising, and/or
collaborating with members of the multi-disciplinary health care team.
Safety and Infection
Control
Incorporating preventative safety measures in the provision of client care that provides
for the health and well-being of clients, significant others, and members of the health
care team.
Health Promotion
and Maintenance
Providing and directing nursing care that encourages prevention and early detection of
illness, as well as the promotion of health.
Psychosocial
Integrity
Promoting mental, emotional, and social well-being of clients and significant others
through the provision of nursing care.
Basic Care and
Comfort
Promoting comfort while helping clients perform activities of daily living.
Pharmacological and
Parenteral Therapies
Providing and directing administration of medication, including parenteral therapy.
Reduction of Risk
Potential
Providing nursing care that decreases the risk of clients developing health-related
complications.
Physiological
Providing and directing nursing care for clients experiencing physical illness.
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Score Explanation and Interpretation
Individual Performance Profile
QUALITY AND SAFETY EDUCATION FOR NURSES (QSEN)
Safety
The minimization of risk factors that could cause injury or harm while promoting quality
care and maintaining a secure environment for clients, self, and others.
Patient-Centered
Care
The provision of caring and compassionate, culturally sensitive care that is based on
a clientâ€™s physiological, psychological, sociological, spiritual, and cultural needs,
preferences, and values.
Evidence Based
Practice
The use of current knowledge from research and other credible sources, upon which
clinical judgment and client care are based.
Informatics
The use of information technology as a communication and information gathering tool
that supports clinical decision making and scientifically based nursing practice.
Quality Improvement Care related and organizational processes that involve the development and
implementation of a plan to improve health care services and better meet the needs of
clients.
Teamwork and
Collaboration
The delivery of client care in partnership with multidisciplinary members of the health
care team, to achieve continuity of care and positive client outcomes.
BODY FUNCTION
Cardiac Output and
Tissue Perfusion
The anatomical structures (heart, blood vessels, and blood) and body functions that
support adequate cardiac output and perfusion of body tissues.
Cognition and
Sensation
The anatomical structures (brain, central and peripheral nervous systems, eyes and ears)
and body functions that support perception, interpretation, and response to internal
and external stimuli.
Excretion
The anatomical structures (kidney, ureters, and bladder) and body functions that support
filtration and excretion of liquid wastes, regulate fluid and electrolyte and acid-base
balance.
Immunity
The anatomic structures (spleen, thymus, bone marrow, and lymphatic system) and body
functions related to inflammation, immunity, and cell growth.
Ingestion, Digestion,
Absorption, and
Elimination
The anatomical structures (mouth, esophagus, stomach, gall bladder, liver, small and
large bowel, and rectum) and body functions that support ingestion, digestion, and
absorption of food and elimination of solid wastes from the body.
Integument
The anatomical structures (skin, hair, and nails) and body functions related to protecting
the inner organs from the external environment and injury.
Mobility
The anatomical structures (bones, joints, and muscles) and body functions that support
the body and provide its movement.
Oxygenation
The anatomical structures (nose, pharynx, larynx, trachea, and lungs) and body functions
that support adequate oxygenation of tissues and removal of carbon dioxide.
Regulation and
Metabolism
The anatomical structures (pituitary, thyroid, parathyroid, pancreas, and adrenal glands)
and body functions that regulate the bodyâ€™s internal environment.
Reproduction
The anatomical structures (breasts, ovaries, fallopian tubes, uterus, vagina, vulva, testicles,
prostate, scrotum, and penis) and body functions that support reproductive functions.
DECISION LOG
Information related to each question answered in a scenario attempt is listed in the report. A brief description of the
scenario, question, selected option and rationale for that option are provided for each question answered. The words
â€œOptimal Decisionâ€ appear next to the question when the most optimal option was selected.
The rationale for each selected option may be used to guide remediation. A variety of learning resources may be used
in the review process, including related ATI Review Modules.
If a detrimental decision that could result in grave harm to the client is made during a Real Life scenario, the scenario
ends immediately and an indicator that a detrimental decision has been made appears in the score report.
A detrimental decision indicates the need to remediate the related topic area to prevent detrimental outcomes in the
future.
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