a 28 year old male patient with type 1 diabetes reports how he manages his exercise and glucose control which behavior indicates that the nurse should

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ATI Leadership

1. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

A. The patient always carries hard candies when engaging in exercise.
B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
C. The patient has a peanut butter sandwich before going for a bicycle ride.
D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

2. Which of the following best describes the concept of shared governance?

A. Top-down management
B. Nurse-led committees
C. Shared decision making
D. Hierarchical structure

Correct answer: C

Rationale: The correct answer is C: 'Shared decision making.' Shared governance in healthcare involves empowering nurses to participate in decision-making processes that affect their practice. This model fosters collaboration, transparency, and accountability among healthcare providers. Choice A, 'Top-down management,' is incorrect because shared governance promotes a bottom-up approach. Choice B, 'Nurse-led committees,' is partially correct as it is a component of shared governance, but the core concept is broader and encompasses shared decision making beyond committee leadership. Choice D, 'Hierarchical structure,' is incorrect as shared governance aims to flatten hierarchies and distribute decision-making authority among healthcare team members.

3. A manager has been given a deadline to complete an assignment by the end of the day. It will take every minute left of the afternoon to complete. Which interventions illustrate assertiveness to minimize interruptions in order to meet the deadline? (Select all that apply.)

A. Allowing voicemail to answer all incoming calls or turning off email notification
B. Delegating a discharge planning issue for a patient to one of the staff nurses
C. Placing a 'Do Not Disturb for the Afternoon' sign on the office door
D. All of the above

Correct answer: D

Rationale: All the interventions listed are appropriate ways to minimize interruptions. By allowing voicemail to answer calls or turning off email notifications, the manager can focus solely on the assignment. Delegating tasks to staff nurses frees up the manager's time. Placing a 'Do Not Disturb for the Afternoon' sign on the office door sends a clear message to minimize interruptions and focus on the deadline. Therefore, all of the above interventions illustrate assertiveness to meet the deadline by minimizing interruptions.

4. In order to assist an older diabetic patient to engage in moderate daily exercise, which action is most important for the nurse to take?

A. Determine what type of activities the patient enjoys.
B. Remind the patient that exercise will improve self-esteem.
C. Teach the patient about the effects of exercise on glucose levels.
D. Give the patient a list of activities that are moderate in intensity.

Correct answer: A

Rationale: The correct answer is to determine what type of activities the patient enjoys. This approach is crucial as it helps in personalizing the exercise plan to the patient's preferences, making it more likely for them to adhere to it. Choice B is incorrect because focusing on self-esteem may not directly motivate the patient to engage in exercise. Choice C, although important, may not be the initial step as understanding the patient's preferences comes first. Choice D limits the patient's autonomy by not involving them in the decision-making process.

5. What is the main purpose of conducting a SWOT analysis in healthcare?

A. Identify strengths and weaknesses
B. Develop strategic goals
C. Assess external opportunities
D. Streamline healthcare processes

Correct answer: C

Rationale: The main purpose of conducting a SWOT analysis in healthcare is to assess external opportunities along with identifying strengths, weaknesses, and threats. While identifying strengths and weaknesses is a part of the analysis, the primary goal is to evaluate external opportunities and threats to develop strategic goals. Option A is incorrect as the analysis encompasses more than just strengths and weaknesses. Option B is incorrect as developing strategic goals is a result of the analysis, not the main purpose. Option D is incorrect as streamlining healthcare processes is not the primary focus of a SWOT analysis.