ATI RN
ATI Leadership Proctored Exam 2019
1. What is the primary focus of the Institute for Healthcare Improvement (IHI)?
- A. Patient safety
- B. Cost reduction
- C. Healthcare innovation
- D. Research funding
Correct answer: A
Rationale: The primary focus of the Institute for Healthcare Improvement (IHI) is patient safety. IHI is renowned for its efforts in developing and implementing evidence-based practices to enhance patient safety and improve the quality of care in healthcare settings. While cost reduction, healthcare innovation, and research funding are important aspects of healthcare, the core mission of the IHI revolves around prioritizing patient safety. Patient safety involves reducing medical errors, improving care processes, and creating a safer environment for patients, which are all fundamental to the work of the IHI.
2. On what are most nursing paradigms based?
- A. The nurse's ability to perform procedures with skill
- B. Dr. Jean Watson's transpersonal caring theory
- C. Maslow's theory of hierarchy of needs
- D. Learning by studying nursing theories and clinical experiences
Correct answer: D
Rationale: Most nursing paradigms are founded on the understanding and application of nursing theories through studying them and gaining practical experiences in clinical settings. While the nurse's ability to perform procedures with skill is important, it is not the foundation of nursing paradigms. Dr. Jean Watson's transpersonal caring theory and Maslow's theory of hierarchy of needs are significant in nursing practice but do not serve as the basis for most nursing paradigms. Nursing paradigms are shaped by a combination of studying nursing theories and hands-on clinical experiences, which provide the foundational knowledge and practical skills needed for nursing practice.
3. After receiving change-of-shift report, which patient should the nurse assess first?
- A. 19-year-old with type 1 diabetes who has a hemoglobin A1C of 12%
- B. 23-year-old with type 1 diabetes who has a blood glucose of 40 mg/dL
- C. 40-year-old who is pregnant and has an oral glucose tolerance test result of 202 mg/dL
- D. 50-year-old who uses exenatide (Byetta) and is complaining of acute abdominal pain
Correct answer: B
Rationale: The correct answer is B because the patient with a blood glucose level of 40 mg/dL (hypoglycemia) needs immediate attention. Hypoglycemia is an emergency situation that requires prompt intervention to prevent adverse effects such as seizures or loss of consciousness. Assessing and managing this patient first is crucial to prevent further deterioration. Choices A, C, and D do not present immediate life-threatening situations requiring urgent intervention like severe hypoglycemia does. While a high hemoglobin A1C level (choice A), an abnormal oral glucose tolerance test result (choice C), and acute abdominal pain (choice D) are important issues, they do not pose an immediate threat to the patient's life compared to severe hypoglycemia.
4. While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that the hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example.
- A. Parallel
- B. Functional
- C. Service-integrated
- D. Matrix
Correct answer: B
Rationale: The correct answer is B: Functional. In functional structures, employees are grouped into departments based on specialty, allowing individuals with similar skills and tasks to work together efficiently. In this scenario, organizing the hospital into departments such as nursing, dietary, and pharmacy based on their specialties exemplifies a functional organizational structure. Choice A, Parallel structure, involves independent units working on similar tasks, which is not the case here. Choice C, Service-integrated structure, emphasizes cross-functional teamwork across various departments, which is not the main focus in the scenario. Choice D, Matrix structure, involves employees reporting to multiple managers for different projects or tasks, which is not described in the scenario.
5. According to Watson's theory, how should the nurse manager deal with a staff member who has a substance addiction and is arriving at work under the influence of the substance?
- A. Send the nurse home with instructions not to return until clear of the substance.
- B. Call the police and have the nurse arrested for working while impaired.
- C. Confront the nurse privately, order drug testing, and suggest a substance abuse program.
- D. Notify the board of nursing and fire the nurse immediately.
Correct answer: C
Rationale: According to Watson's theory, a caring approach is essential. Confronting the nurse privately, ordering drug testing, and suggesting a substance abuse program demonstrates empathy and supports the staff member in seeking help for their addiction. This approach aligns with the principles of human caring and compassion, focusing on the well-being and recovery of the individual rather than punitive measures. Choices A and D are too harsh and lack empathy, not considering the individual's well-being or offering support for rehabilitation. Choice B is inappropriate and punitive, not aligned with a caring and compassionate approach as advocated by Watson's theory.
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