as a new nurse on a pediatric unit you must work nights and you have minimal time to spend with your children your colleague observes that you speak a

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ATI Proctored Leadership Exam

1. As a new nurse on a pediatric unit, you must work nights and you have minimal time to spend with your children. Your colleague observes that you speak abruptly with parents and you become easily annoyed when the patients cry or when they are demanding. You realize you are becoming increasingly more distressed and that you have no time with your children and, as a result you: (Select all that apply.)

A. Express negative comments to colleagues about patients and parents who annoy you.
B. Ask the nurse manager to have a schedule with an equal number of day and night shifts so that you can be with your children.
C. Call off sick as frequently as you can without violating policies so that you have more time with your children.
D. Minimize your communication with patients and parents so you do not offend them.

Correct answer: B

Rationale: The correct answer is B. Asking the nurse manager for a schedule with an equal number of day and night shifts is a proactive and constructive approach to address the issue of having minimal time with your children. This solution aims to balance work and personal life effectively. Choices A, C, and D are incorrect. Expressing negative comments about patients and parents (Choice A) is unprofessional and can create a negative work environment. Calling off sick frequently (Choice C) is irresponsible and violates work policies, leading to potential disciplinary actions. Minimizing communication with patients and parents (Choice D) is not a suitable approach as effective communication is essential in healthcare to provide optimal care and support to patients and their families.

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. Which of the following is a common characteristic of a high reliability organization (HRO)?

A. Flexibility
B. Reluctance to simplify
C. Preoccupation with failure
D. Deference to expertise

Correct answer: C

Rationale: A common characteristic of a high reliability organization (HRO) is a preoccupation with failure. HROs focus on identifying and addressing potential failure points to prevent errors and maintain high levels of safety and reliability. This mindset helps them anticipate and mitigate risks proactively, leading to better outcomes and performance. Choices A, B, and D are incorrect. While flexibility, reluctance to simplify, and deference to expertise may be important in various contexts, they are not the primary defining characteristics of a high reliability organization. The core focus of HROs is on continuously monitoring for potential failures and working to prevent them.

4. A 28-year-old male patient with type 1 diabetes reports how he manages his exercise and glucose control. Which behavior indicates that the nurse should implement additional teaching?

A. The patient always carries hard candies when engaging in exercise.
B. The patient goes for a vigorous walk when his glucose is 200 mg/dL.
C. The patient has a peanut butter sandwich before going for a bicycle ride.
D. The patient increases daily exercise when ketones are present in the urine.

Correct answer: D

Rationale: The correct answer is D because increasing exercise when ketones are present in the urine is inappropriate and potentially dangerous for a patient with type 1 diabetes. This behavior can worsen the ketosis and lead to further complications. Choices A, B, and C demonstrate appropriate self-management strategies for a patient with type 1 diabetes. Carrying hard candies during exercise can help prevent hypoglycemia, going for a walk with a glucose level of 200 mg/dL can help lower blood sugar, and having a snack before physical activity can provide necessary energy.

5. Which of the following are essential components of strategic planning? (Select all that apply.)

A. Values
B. Vision & Mission statements
C. Reengineering
D. A & B

Correct answer: D

Rationale: Values and vision and mission statements are indeed essential components of strategic planning. Values help define the organization's core beliefs and principles, guiding its decisions and actions. Vision and mission statements articulate the organization's goals, purpose, and direction, serving as a roadmap for strategic planning and decision-making. Reengineering is not a core component of strategic planning; it involves the redesign of processes to improve performance, efficiency, and quality. Therefore, option C is incorrect. The correct answer is D because both values and vision and mission statements play crucial roles in shaping an organization's strategic planning process.