ATI RN
ATI Leadership Proctored Exam 2023
1. In the grievance process, a nurse disagrees with statements made by a physician about performance and talks to the nurse manager. Which step in the process is this?
- A. First
- B. Second
- C. Third
- D. Fourth
Correct answer: A
Rationale: The correct answer is A: First. In the grievance process, the initial step involves the nurse talking to the nurse manager to address the issue informally. Subsequently, step two entails filing a written appeal to the director of nursing or designee. Step three involves a formal meeting with the employee, agent, grievance chairperson, nursing administrator, and director of human resources. The final step, step four, is arbitration, which is initiated when no mutually acceptable solutions can be reached by the involved parties. Therefore, the nurse talking to the nurse manager about the disagreement is the first step in the grievance process.
2. After change-of-shift report, which patient should the nurse assess first?
- A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
- B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
- C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
- D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain
Correct answer: C
Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.
3. In a unionized hospital, nurses receive compensatory pay for working holidays based on the hours worked with no extra compensation. Despite management refusing to consider changes to the compensatory pay system suggested by nurses during the annual employee satisfaction survey, a trend member listened to both parties and made non-legally binding recommendations. What is this type of settlement known as?
- A. Collective bargaining
- B. Mediation
- C. Grievance
- D. Binding arbitration
Correct answer: B
Rationale: Mediation involves a neutral third party who assists in resolving disputes by providing non-legally binding recommendations. In this scenario, the trend member acted as a mediator by listening to both nurses and management and offering suggestions without the authority to enforce them as a legally binding decision. Collective bargaining refers to negotiations between labor unions and employers to determine terms of employment. Grievance is a formal complaint by an employee against an employer. Binding arbitration involves a neutral third party making a final and legally binding decision to resolve a dispute.
4. To form a core support group of nurses, where should the nurse organizer conduct meetings to gather initial information?
- A. Away from the work site with a group of managers to learn both sides of the situation
- B. In homes or local businesses with staff nurses
- C. At the facility to discuss nursing concerns
- D. At the work site with staff nurses who are respected leaders
Correct answer: B
Rationale: The correct approach is to conduct meetings in homes or local businesses with staff nurses. This location ensures confidentiality, prevents management influence, and allows the focus to be on gathering support for forming a core support group. Choice A is incorrect as involving managers may compromise the independence and authenticity of the group. Choice C is incorrect as conducting meetings at the facility may not provide a secure and unbiased environment for open discussions. Choice D is incorrect because holding meetings at the work site with respected leaders may lead to biased opinions and hinder open communication.
5. A healthcare professional is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following procedural plans is the healthcare professional following?
- A. patient classification categories
- B. diagnostic related groups
- C. Care map / clinical practice guideline
- D. functional nursing
Correct answer: C
Rationale: A care map or clinical practice guideline is a standardized plan of care that outlines the recommended interventions and treatments for patients with a specific condition. In this scenario, following a total hip arthroplasty, healthcare professionals typically refer to a care map or clinical practice guideline to ensure the patient receives appropriate care based on evidence-based practices and standards. Choices A, B, and D are incorrect in this context. Patient classification categories refer to grouping patients based on care needs, diagnostic related groups are used for billing purposes, and functional nursing is a care delivery system that assigns specific tasks to nursing personnel.
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