ATI RN
ATI Leadership Practice A
1. Which of the following best describes the concept of shared decision-making in healthcare?
- A. The process by which patients make healthcare decisions on their own
- B. A collaborative process that allows patients and providers to make healthcare decisions together
- C. A method for providers to dictate treatment plans to patients
- D. The use of evidence-based guidelines to make healthcare decisions
Correct answer: B
Rationale: The correct answer is B. Shared decision-making in healthcare involves a collaborative process between patients and providers to make healthcare decisions together. This approach considers the patient's preferences, values, and the best available evidence to reach a decision that aligns with the patient's goals. Choice A is incorrect because shared decision-making does not involve patients making decisions on their own. Choice C is incorrect as it describes a paternalistic approach where providers dictate treatment plans to patients without involving them in the decision-making process. Choice D is incorrect as it refers to the use of evidence-based guidelines, which is important but not the sole focus of shared decision-making.
2. A nurse is caring for a client who has an indwelling urinary catheter. Which of the following findings indicates that the catheter requires irrigation?
- A. Urine is positive for ketones
- B. Urine has an unusual odor
- C. Urine specific gravity is 1.035 (normal range: 1.010 to 1.025)
- D. Bladder scan shows 525 mL of urine
Correct answer: A
Rationale: The correct answer is A. Ketones in the urine may indicate infection or blockage in the urinary catheter, necessitating irrigation to ensure proper drainage. Choice B, an unusual odor in the urine, may suggest infection but does not directly indicate the need for catheter irrigation. Choice C, a high urine specific gravity, is indicative of concentrated urine but does not specifically point to the need for catheter irrigation. Choice D, a bladder scan showing 525 mL of urine, indicates urine retention, which may require catheterization or further assessment but not necessarily irrigation.
3. When lifting a bedside cabinet to move it closer to a client, what action should the nurse take to prevent self-injury?
- A. Keep the feet close together.
- B. Use the back muscles for lifting.
- C. Stand close to the cabinet when lifting it.
- D. Bend at the waist.
Correct answer: A
Rationale: The correct answer is A: 'Keep the feet close together.' When lifting a heavy object such as a bedside cabinet, it is essential to maintain a wide base of support by keeping the feet close together. This provides better stability and reduces the risk of injury. Choice B is incorrect because using the back muscles for lifting can lead to back strain and injury; it is recommended to use the legs instead. Choice C is incorrect as standing close to the cabinet may cause the nurse to lose balance and strain the back. Choice D is incorrect because bending at the waist increases the risk of back injury. Therefore, the safest and most appropriate action is to keep the feet close together to ensure stability and prevent self-injury.
4. The changes brought forth by the state boards of nursing are an example of which type of change agent?
- A. Resistance
- B. Empirical–rational
- C. Normative–reeducative
- D. Power–coercive
Correct answer: D
Rationale: The changes implemented by state boards of nursing typically fall under the category of Power–coercive change agents. State boards of nursing have the authority to enforce changes through regulations and policies, making use of their legitimate power. Resistance (choice A) is not the correct answer as it refers to opposition to change rather than the entity driving change. Empirical–rational (choice B) focuses on convincing individuals through empirical evidence and rational arguments, which is not reflective of the state boards' authority. Normative–reeducative (choice C) involves persuading individuals to change based on shared values and beliefs, which is not the primary approach of state boards of nursing.
5. A client is refusing a blood transfusion for religious reasons. The client's partner wants the client to have the blood transfusion. Which of the following actions should be taken?
- A. Ask the client to consider a direct donation
- B. Withhold the blood transfusion
- C. Ask the client to consider a direct donation
- D. Request a consultation with the ethics committee
Correct answer: A
Rationale: In this situation, the nurse should ask the client to consider a direct donation. This option respects the client's autonomy by exploring alternative options that align with the client's beliefs. Withholding the blood transfusion (choice B) goes against the client's wishes and autonomy. Requesting a consultation with the ethics committee (choice D) should be considered if there is a disagreement that cannot be resolved at the bedside, but it is not the initial step. Choice C is a duplicate of choice A and does not provide a different or additional action to address the situation.
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