after change of shift report which patient should the nurse assess first

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 is a common characteristic of a Magnet-designated hospital?

A. High nurse turnover rates
B. Strong emphasis on interdisciplinary teamwork
C. Limited opportunities for professional development
D. Focus on advanced technology for patient care

Correct answer: B

Rationale: A common characteristic of a Magnet-designated hospital is a strong emphasis on interdisciplinary teamwork. This emphasis promotes collaboration among healthcare professionals from different disciplines to provide holistic and patient-centered care. Choice A is incorrect as Magnet hospitals typically have lower nurse turnover rates due to better work environments. Choice C is also incorrect as Magnet hospitals usually offer ample opportunities for professional growth and development. Choice D is not a defining characteristic of Magnet hospitals, although they may utilize advanced technology, the primary focus is on the quality of care provided through teamwork and excellence in nursing practice.

3. As a new nurse on a pediatric unit, you must work nights and you have minimal time to spend with your children. Your colleague observes that you speak abruptly with parents and you become easily annoyed when the patients cry or when they are demanding. You realize you are becoming increasingly more distressed and that you have no time with your children and, as a result you: (Select all that apply.)

A. Express negative comments to colleagues about patients and parents who annoy you.
B. Ask the nurse manager to have a schedule with an equal number of day and night shifts so that you can be with your children.
C. Call off sick as frequently as you can without violating policies so that you have more time with your children.
D. Minimize your communication with patients and parents so you do not offend them.

Correct answer: B

Rationale: The correct answer is B. Asking the nurse manager for a schedule with an equal number of day and night shifts is a proactive and constructive approach to address the issue of having minimal time with your children. This solution aims to balance work and personal life effectively. Choices A, C, and D are incorrect. Expressing negative comments about patients and parents (Choice A) is unprofessional and can create a negative work environment. Calling off sick frequently (Choice C) is irresponsible and violates work policies, leading to potential disciplinary actions. Minimizing communication with patients and parents (Choice D) is not a suitable approach as effective communication is essential in healthcare to provide optimal care and support to patients and their families.

4. What are the advantages of using internal pools of nurses for staffing purposes?

A. Familiarity with the hospital & Lower cost
B. Centralization
C. Staffing mix
D. Staff satisfaction

Correct answer: A

Rationale: The correct answer is A: Familiarity with the hospital & Lower cost. Internal float pools of nurses offer advantages such as being familiar with the hospital environment and staff, which can enhance communication and collaboration. Additionally, utilizing internal nurses is more cost-effective compared to hiring agency nurses, contributing to financial savings for the healthcare facility. Choice B, Centralization, is not a direct advantage of using internal pools of nurses. Choice C, Staffing mix, is a broader concept that does not specifically address the advantages of internal nurse pools. Choice D, Staff satisfaction, is important but not directly related to the specific advantages of utilizing internal nurse pools for staffing purposes.

5. Which of the following is an example of an outcome measure in healthcare?

A. Patient satisfaction scores
B. Length of hospital stay
C. Healthcare provider performance reviews
D. Number of diagnostic tests ordered

Correct answer: A

Rationale: Patient satisfaction scores are considered an outcome measure in healthcare because they reflect the patient's experience and perception of the care received. Patient satisfaction scores focus on the quality of care provided and the patient's overall satisfaction with their healthcare experience. Choices B, C, and D are not examples of outcome measures. The length of hospital stay is a process measure, healthcare provider performance reviews are a provider-specific evaluation, and the number of diagnostic tests ordered is more related to resource utilization rather than a direct patient outcome.