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ATI Leadership
1. An RN is reviewing professional behavior expectations with a group of new nurses. Which of the following statements should be included in the teaching?
- A. It is not OK to discuss your days at work on social media.
- B. When you are passionate about a topic, speak up in professional platforms.
- C. Your behavior outside of the practice setting can impact your license.
- D. Nurses may lose their licenses for unprofessional actions.
Correct answer: D
Rationale: The correct statement to include in the teaching is that nurses may lose their licenses for unprofessional actions. This is an important reminder to new nurses about the serious consequences of unprofessional behavior in the healthcare field. Choice A is incorrect because discussing work on social media can breach patient confidentiality. Choice B is incorrect as speaking up in blogs and forums may not always align with professional conduct standards. Choice C is incorrect as behavior outside the practice setting, if unprofessional, can indeed impact a nurse's license.
2. A nurse is reviewing the laboratory results of a female client who has hypovolemia. Which of the following laboratory results would be a priority for the nurse to report to the provider?
- A. BUN 21 mg/dL (10 to 20 mg/dL)
- B. Potassium 5.8 mEq/L (3.5 to 5 mEq/L)
- C. Creatinine 1.4 mg/dL (0.5 to 1.1 mg/dL)
- D. Sodium 132 mEq/L (136 to 145 mEq/L)
Correct answer: B
Rationale: In a client with hypovolemia, the nurse should prioritize reporting the elevated potassium level of 5.8 mEq/L to the provider. Hypovolemia can lead to electrolyte imbalances, and hyperkalemia (potassium level above 5.0 mEq/L) is a serious condition that can result in cardiac arrhythmias and requires immediate attention. The other laboratory results, BUN, creatinine, and sodium, are also important in assessing renal function and fluid balance, but the priority in this case is the elevated potassium level due to its potential life-threatening complications.
3. Why is increasing the use of advanced practice nurses encouraged?
- A. A 2010 Institute of Medicine report recommended nurses practice to the full extent of their education.
- B. Advanced practice nurses act as an extension of physicians.
- C. The National League for Nursing advocates for the master of science in nursing (MSN) as the terminal degree for nurse practitioners.
- D. Advanced practice nurses lack the skills to diagnose.
Correct answer: A
Rationale: The correct answer is A because the 2010 Institute of Medicine report recommended that nurses practice to the full extent of their education, which includes utilizing advanced practice nurses. This supports the efficient delivery of healthcare services by leveraging the expertise and skills of advanced practice nurses. Choice B is incorrect as it describes the role of advanced practice nurses rather than providing a reason for increasing their use. Choice C is unrelated to the encouragement of increasing the use of advanced practice nurses as it focuses on the terminal degree for nurse practitioners. Choice D is incorrect as advanced practice nurses do possess the skills necessary to diagnose and provide advanced care, so the statement that they lack diagnostic skills is inaccurate.
4. The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as:
- A. Total patient care
- B. Qualified nurse case managers
- C. Established critical pathways
- D. Quality management system
Correct answer: A
Rationale: The correct answer is A: Total patient care. Total patient care is the original model of nursing care delivery, in which one RN has complete responsibility for all aspects of care for one or more patients. In this system, the nurse is accountable for the client's care and maintains continuous communication with the client, their family, physicians, and other healthcare team members. Choice B, Qualified nurse case managers, refers to nurses who coordinate care but do not provide direct hands-on patient care. Choice C, Established critical pathways, involves predefined care plans for specific conditions but does not imply direct accountability as in total patient care. Choice D, Quality management system, relates to processes to ensure and enhance the quality of care but is not specifically about the direct provision of patient care.
5. A client complains every morning that the night shift nursing staff does not answer his call light promptly to assist his elimination needs. His concerns are not shared with the Nurse Manager, and he falls while trying to walk to the bathroom. This fall could be attributed to which of the following?
- A. Breakdown in communication
- B. Lack of staff
- C. Lack of concern
- D. Breakdown in management
Correct answer: A
Rationale: The correct answer is A: Breakdown in communication. In this scenario, the client's complaints about the night shift nursing staff not responding promptly to his call light indicate a lack of effective communication. If the client's concerns were properly communicated to the Nurse Manager, steps could have been taken to address the issue and prevent the fall. Choice B, Lack of staff, is incorrect as the issue here is not related to staffing levels but rather to communication breakdown. Choice C, Lack of concern, is not the primary cause of the fall; the root cause lies in communication failure. Choice D, Breakdown in management, while related, is not as direct a cause as the breakdown in communication which led to the fall.
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