which of the following best describes the concept of shared decision making in healthcare

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 manager who tells the staff to 'come to me with any problem' but then keeps the office door closed is using what type of communication?

A. Intrasender conflict
B. Diagonal communication
C. Metacommunication
D. Upward communication

Correct answer: A

Rationale: The correct answer is A: Intrasender conflict. Intrasender conflict happens when there is a discrepancy between verbal and nonverbal communication. In this scenario, the nurse manager's verbal message encourages staff to communicate openly, but the closed office door sends a conflicting nonverbal message, creating intrasender conflict. Metacommunication involves nonverbal behaviors like gestures or facial expressions that support or contradict verbal communication. Upward communication refers to the flow of information from staff to management or lower to upper management. Diagonal communication involves communication between individuals or departments at different hierarchical levels.

3. The nurse determines a need for additional instruction when the patient with newly diagnosed type 1 diabetes says which of the following?

A. �I can have an occasional alcoholic drink if I include it in my meal plan.�
B. �I will need a bedtime snack because I take an evening dose of NPH insulin.�
C. �I can choose any foods, as long as I use enough insulin to cover the calories.�
D. �I will eat something at meal times to prevent hypoglycemia, even if I am not hungry.�

Correct answer: C

Rationale:

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. What innate tendency influences staff to act in a certain way?

A. Instinct
B. Appreciation
C. Control
D. Esteem

Correct answer: A

Rationale: The correct answer is A: Instinct. Instinct theory suggests that behaviors are influenced by inherited or innate tendencies, guiding individuals to act in specific ways without conscious reasoning. In the context of staff behavior, instinct can play a significant role in shaping their actions and responses. Choices B, C, and D are incorrect. Appreciation, control, and esteem are external factors that may influence staff behavior, but in this context, the question specifically asks for an innate tendency that influences staff to act in a certain way, which aligns more closely with instinctive tendencies rather than external factors like appreciation, control, or esteem.