ATI RN
ATI Leadership Practice A
1. A few weeks after an 82-year-old with a new diagnosis of type 2 diabetes has been placed on metformin (Glucophage) therapy and taught about appropriate diet and exercise, the home health nurse makes a visit. Which finding by the nurse is most important to discuss with the healthcare provider?
- A. Hemoglobin A1C level is 7.9%.
- B. Last eye exam was 18 months ago.
- C. Glomerular filtration rate is decreased.
- D. Patient has questions about the prescribed diet.
Correct answer: C
Rationale: The most important finding to discuss with the healthcare provider is the decreased glomerular filtration rate. In patients on metformin therapy, monitoring kidney function is crucial as metformin is primarily excreted through the kidneys. A decreased glomerular filtration rate can lead to metformin accumulation in the body, increasing the risk of lactic acidosis, a serious adverse effect. The hemoglobin A1C level being 7.9% indicates poor diabetes control but can be addressed through medication adjustments and lifestyle modifications. The patient needing an eye exam after 18 months is important but not as urgent as discussing the decreased glomerular filtration rate. Patient questions about the prescribed diet can be addressed during the visit without the need for immediate healthcare provider intervention.
2. Which of the following is the preferable alternative to firing an employee?
- A. Voluntary resignation
- B. Training
- C. Confrontation
- D. Coaching
Correct answer: A
Rationale: The preferable alternative to firing an employee is voluntary resignation. When an employee voluntarily resigns, it allows them to leave on their terms, maintaining their dignity and possibly avoiding negative consequences associated with being fired. Training, confrontation, and coaching are not alternatives to firing but rather methods that can be used to address performance or behavior issues before resorting to termination.
3. Organizations are made up of intertwined links and diversified choices that generate unanticipated consequences. This defines which of the following theories?
- A. Contingency theory
- B. Closed system theory
- C. Open system theory
- D. Chaos theory
Correct answer: D
Rationale: The correct answer is D, Chaos theory. Chaos theory is characterized by organizations that are made up of intertwined links and diversified choices that generate unanticipated consequences. Contingency theory (choice A) is based on the idea that there is no one best way to organize and manage a corporation. Closed system theory (choice B) refers to systems that are closed off from the outside environment and do not interact with it. Open system theory (choice C) views organizations as open systems that interact with their external environment.
4. When matching a job with an experienced RN, what is the first step in the selection process?
- A. Job analysis
- B. Selection techniques
- C. Methods of recruiting
- D. Assurance of legal requirements
Correct answer: A
Rationale: The correct answer is A, job analysis. Job analysis is the first step in the selection process as it involves gathering information about the duties, responsibilities, necessary skills, outcomes, and work environment of a particular job. This information is crucial in creating an accurate job description and specification that will guide the recruitment and selection process. Choices B, C, and D are incorrect because while selection techniques, methods of recruiting, and legal requirements are important aspects of the selection process, they come after the job analysis has been completed.
5. When looking at the issue surrounding absenteeism, an innovative approach would be:
- A. Rewarding those who do not use days.
- B. Substituting personal days.
- C. Termination.
- D. Disciplinary actions.
Correct answer: B
Rationale: The correct answer is B. Substituting personal days for sick days can be considered an innovative approach to addressing absenteeism as it allows for proper planning by the nurse manager. This approach promotes a proactive and flexible solution that encourages employees to manage their time off more effectively. Choice A, rewarding those who do not use days, may not address the root causes of absenteeism and could create a culture of presenteeism. Choices C and D, termination and disciplinary actions, are punitive measures that do not focus on preventive strategies or address the underlying reasons for absenteeism.
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