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ATI Leadership Proctored
1. When a client who is in pain refuses to be repositioned, what should the nurse consider first in making a decision about what to do?
- A. Why a decision is needed.
- B. Who actually gets to make the decision?
- C. What are the alternatives?
- D. When a decision is needed.
Correct answer: A
Rationale: In this scenario, the nurse should first consider why a decision is needed. Understanding the underlying reason for the decision helps in selecting the best action to meet the desired goal. Who actually makes the decision is important but not the primary consideration. Exploring alternatives comes after determining the reason for the decision, who makes it, and when it is needed.
2. Which of the following strategies is most effective for improving staff morale?
- A. Increasing workload
- B. Increasing salaries
- C. Providing feedback
- D. Offering incentives
Correct answer: C
Rationale: Providing feedback is the most effective strategy for improving staff morale. Feedback helps employees understand their performance, areas of improvement, and areas of strength, fostering a sense of recognition and growth. Increasing workload (choice A) can lead to burnout and decreased morale. While increasing salaries (choice B) and offering incentives (choice D) can be motivating, they may not address underlying issues or provide the same level of personal development and recognition that feedback offers.
3. A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses?
- A. Moral suffering
- B. Moral distress
- C. Ethical dilemma
- D. Veracity
Correct answer: A
Rationale: Moral suffering occurs when a situation results in a feeling of uneasiness or concern because of behaviors or circumstances that challenge one�s own morals and beliefs.
4. A 26-year-old female with type 1 diabetes develops a sore throat and runny nose after caring for her sick toddler. The patient calls the clinic for advice about her symptoms and a blood glucose level of 210 mg/dL despite taking her usual glargine (Lantus) and lispro (Humalog) insulin. The nurse advises the patient to
- A. use only the lispro insulin until the symptoms are resolved
- B. limit calorie intake until the glucose is less than 120 mg/dL
- C. monitor blood glucose every 4 hours and notify the clinic if it continues to rise
- D. decrease carbohydrate intake until glycosylated hemoglobin is less than 7%
Correct answer: C
Rationale: In this scenario, the nurse should advise the patient to monitor her blood glucose every 4 hours and notify the clinic if it continues to rise. This is important because the patient is experiencing symptoms of an illness (sore throat and runny nose) that can lead to fluctuations in blood glucose levels. By monitoring frequently, any significant rise in blood glucose can be detected early, enabling prompt intervention. Choice A is incorrect because abruptly stopping glargine (Lantus) insulin can lead to uncontrolled blood glucose levels. Choice B is incorrect as limiting calorie intake is not the appropriate immediate action for managing high blood glucose levels. Choice D is also incorrect as adjusting carbohydrate intake based on glycosylated hemoglobin levels is not the immediate action needed in this acute situation.
5. Which of the following can cause negative effects on decision making among groups?
- A. Rationalization
- B. Groupthink
- C. Risky shift
- D. Dialectical inquiry
Correct answer: B
Rationale: The correct answer is B: Groupthink. Groupthink is a negative phenomenon occurring in highly cohesive, isolated groups where members tend to think alike, which hinders critical thinking and can lead to poor decision-making. Rationalization refers to justifying or explaining behaviors or decisions in a logical manner. Risky shift is a phenomenon in groups where decisions become riskier or more extreme than individual members would make on their own. Dialectical inquiry is a technique used to counteract groupthink by encouraging debate and presenting opposing viewpoints to arrive at more thoughtful decisions.
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