ATI RN
ATI Leadership Practice B
1. The nurse is interviewing a new patient with diabetes who receives rosiglitazone (Avandia) through a restricted access medication program. What is most important for the nurse to report immediately to the health care provider?
- A. The patient's blood pressure is 154/92.
- B. The patient has a history of emphysema
- C. The patient's blood glucose is 86 mg/dL.
- D. The patient has chest pressure when walking
Correct answer: D
Rationale: Chest pressure while walking may indicate heart-related issues such as angina or a heart attack. Rosiglitazone (Avandia) has been associated with increased risks of cardiovascular events like heart failure. Given these risks, chest pressure is an urgent symptom that must be reported immediately to prevent potentially life-threatening complications.
2. Which of the following types of HMOs (Health Maintenance Organizations) contracts with two or more IPAs (Independent Practice Associations)?
- A. Staff model
- B. Point of service model
- C. Network model
- D. Group model
Correct answer: C
Rationale: The correct answer is C, the Network model. This type of HMO contracts with two or more IPAs. In a Network model, multiple IPAs work together to provide healthcare services to the members. Choice A, the Staff model, involves physicians who are employees of the HMO. Choice B, the Point of Service model, allows members to seek care outside the network at a higher cost. Choice D, the Group model, does not specifically contract with IPAs.
3. A client who is nonambulatory notifies the nurse that their trash can is on fire. After the nurse confirms the presence of the fire, which of the following actions should the nurse take next?
- A. Activate the emergency fire alarm.
- B. Extinguish the fire.
- C. Evacuate the client.
- D. Confine the fire.
Correct answer: D
Rationale: In this situation, the nurse's priority should be to confine the fire. By confining the fire, the nurse can prevent it from spreading further and causing more harm. Activating the emergency fire alarm (choice A) is important but should come after confining the fire. Extinguishing the fire (choice B) might not be safe for the nurse to do without proper equipment and training. Evacuating the client (choice C) can be considered once the fire is confined to ensure the client's safety.
4. What is the main purpose of a utilization review?
- A. Evaluate patient outcomes
- B. Ensure compliance with regulations
- C. Reduce hospital readmissions
- D. Assess financial impact
Correct answer: A
Rationale: The main purpose of a utilization review is to evaluate patient outcomes and ensure that patients receive appropriate care based on medical necessity and quality standards. While ensuring compliance with regulations, reducing hospital readmissions, and assessing financial impact are important aspects of healthcare management, the primary goal of utilization review is to focus on the quality and effectiveness of patient care.
5. An unresponsive patient with type 2 diabetes is brought to the emergency department and diagnosed with hyperosmolar hyperglycemic syndrome (HHS). The nurse will anticipate the need to
- A. give a bolus of 50% dextrose.
- B. insert a large-bore IV catheter.
- C. initiate oxygen via nasal cannula.
- D. administer glargine (Lantus) insulin.
Correct answer: B
Rationale: In a patient with hyperosmolar hyperglycemic syndrome (HHS), severe dehydration and electrolyte imbalances are common. To address these issues, the priority intervention is to insert a large-bore IV catheter for fluid resuscitation and electrolyte replacement. Giving a bolus of 50% dextrose would worsen the hyperglycemia. Initiating oxygen via nasal cannula may be beneficial for respiratory support but is not the priority in this scenario. Administering glargine (Lantus) insulin is not the initial treatment for HHS as it does not address the underlying severe dehydration and electrolyte imbalances.
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