ATI RN
ATI Leadership Proctored Exam 2019
1. 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.
2. Which of the following best describes the concept of patient autonomy?
- A. The right of patients to make their own healthcare decisions
- B. The duty to do no harm
- C. The obligation to tell the truth
- D. The responsibility to provide equitable care
Correct answer: A
Rationale: Patient autonomy refers to the right of patients to make their own healthcare decisions based on their values and preferences. It emphasizes the importance of respecting patients' rights to choose their treatment options, even if their decisions may not align with healthcare providers' recommendations. Choice B, the duty to do no harm, refers to the ethical principle of nonmaleficence, which is separate from patient autonomy. Choice C, the obligation to tell the truth, is related to the principle of veracity and does not directly encompass patient autonomy. Choice D, the responsibility to provide equitable care, pertains to the concept of justice in healthcare and is not synonymous with patient autonomy.
3. The nurse overhears a physician yelling at a newly hired graduate nurse in the hall. What is the nurse's best caring response?
- A. Yell at the physician for yelling at a new graduate and report the incident to the supervisor.
- B. Wait until the situation ends and comfort the graduate privately.
- C. Suggest that the physician take a quieter and more private approach to the problem.
- D. Ignore the situation to avoid embarrassing the graduate further.
Correct answer: C
Rationale: Suggesting a quieter and more private approach to the problem is the best caring response as it addresses the issue respectfully. This response shows empathy towards the graduate nurse and also aims to improve the situation without escalating it further. Choice A is not ideal as responding to yelling with yelling can exacerbate the situation and create more tension. Choice B, while offering comfort, does not directly address the inappropriate behavior of the physician. Choice D is not recommended as ignoring the situation may not help the graduate nurse and can lead to the continuation of inappropriate behavior without intervention.
4. A healthcare professional is preparing to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the healthcare professional delegate?
- A. Confirming that a client's pain has decreased after receiving an analgesic
- B. Ambulating a client who is postoperative
- C. Inserting an indwelling urinary catheter for a client
- D. Demonstrating the use of an incentive spirometer to a client
Correct answer: A
Rationale: The correct answer is option A: 'Confirming that a client's pain has decreased after receiving an analgesic.' This task involves assessing the effectiveness of the medication, which can be delegated to the assistive personnel. Options B, C, and D involve skills that should be performed by licensed healthcare professionals due to their complexity and potential risks if not done correctly. Ambulating a postoperative client requires monitoring for signs of distress or complications, inserting a urinary catheter involves an invasive procedure with infection risks, and demonstrating the use of medical devices like an incentive spirometer requires specialized knowledge to ensure correct usage.
5. After her evaluation, a staff nurse exclaims: 'I'm not sure if my manager knows much about my performance, really. He only had three specific examples to give me, two good performance examples and one to work on, and they all happened in the last month. I don't feel like he can see the whole picture.' What kind of performance appraisal rating does this statement exemplify?
- A. Recency error
- B. Leniency error
- C. Halo error
- D. Absolute judgment
Correct answer: A
Rationale: The statement exemplifies a recency error. Recency error occurs when a manager assesses an employee's performance primarily based on recent events, rather than considering the entire evaluation period. In this case, the staff nurse feels that her manager focused only on recent examples, leading to an incomplete assessment of her overall performance. Choice B, Leniency error, refers to a rater consistently giving high ratings to all employees regardless of performance, which is not evident in this scenario. Choice C, Halo error, involves allowing one positive attribute of an individual to overshadow other characteristics during appraisal, which is not the case here. Absolute judgment, Choice D, is when a rater evaluates an employee without reference to any specific criteria, which is not reflected in the staff nurse's feedback.
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