ATI RN
ATI Leadership Proctored Exam 2019
1. Staff refuse to report unsafe conditions, with unattended entrances throughout the health care facility noted. Unidentified individuals are wandering the unit at night, and you:
- A. Establish expectations.
- B. Demand that they leave immediately.
- C. Ask them to leave.
- D. Observe their behaviors.
Correct answer: A
Rationale: In this scenario, the correct course of action is to establish expectations. By setting clear guidelines and expectations, you can address the issue of unidentified individuals wandering the unit at night in a proactive manner. This approach helps communicate what behaviors are acceptable, ensuring the safety of both staff and patients. Demanding that they leave immediately may not address the root cause of the problem and could escalate the situation. Simply observing their behaviors may not effectively resolve the issue or prevent future incidents. Asking them to leave without first establishing expectations may not prevent similar occurrences in the future.
2. Which of the following is an essential element of a quality improvement (QI) program?
- A. Blame and punishment
- B. Employee satisfaction
- C. Continual monitoring
- D. Strict adherence to policies
Correct answer: C
Rationale: The essential element of a quality improvement (QI) program is continual monitoring. Continual monitoring allows for the ongoing assessment of processes, identification of areas for improvement, and tracking of progress. Option A, 'Blame and punishment,' is incorrect as QI programs focus on systemic issues rather than individual blame. Option B, 'Employee satisfaction,' while important for organizational culture, is not an essential element of QI programs. Option D, 'Strict adherence to policies,' is valuable but not the core essential element, which is continual monitoring to drive improvement.
3. Which of the following best describes the concept of shared governance?
- A. Top-down management
- B. Nurse-led committees
- C. Shared decision making
- D. Hierarchical structure
Correct answer: C
Rationale: The correct answer is C: 'Shared decision making.' Shared governance in healthcare involves empowering nurses to participate in decision-making processes that affect their practice. This model fosters collaboration, transparency, and accountability among healthcare providers. Choice A, 'Top-down management,' is incorrect because shared governance promotes a bottom-up approach. Choice B, 'Nurse-led committees,' is partially correct as it is a component of shared governance, but the core concept is broader and encompasses shared decision making beyond committee leadership. Choice D, 'Hierarchical structure,' is incorrect as shared governance aims to flatten hierarchies and distribute decision-making authority among healthcare team members.
4. A client with limited mobility in their lower extremities is at risk for skin breakdown. Which of the following actions should the nurse take to prevent skin breakdown?
- A. Place the client in high-Fowler's position.
- B. Increase the client's intake of carbohydrates.
- C. Massage areas of skin that are darker than the surrounding skin tissue with unscented lotion.
- D. Have the client use a trapeze bar when changing position
Correct answer: B
Rationale: The correct answer is B: Increase the client's intake of carbohydrates. Adequate nutrition, including carbohydrates, is essential for tissue repair and preventing skin breakdown. Placing the client in high-Fowler's position (choice A) may help with respiratory function but does not directly prevent skin breakdown. Massaging areas of darker skin (choice C) can cause further damage to the skin. Using a trapeze bar (choice D) may assist with changing positions but does not directly address skin breakdown prevention.
5. A middle adult client tells the nurse, 'I feel so useless now that my children do not need me anymore.' Which of the following responses should the nurse make?
- A. Validate the client's feelings by saying, 'People in middle adulthood often find satisfaction in nurturing and guiding young people.'
- B. Encourage the client to explore the reasons behind feeling useless.
- C. Reassure the client by saying, 'You should be proud that your children are becoming independent.'
- D. Provide information by saying, 'Most people are happy when their children grow up and leave home.'
Correct answer: A
Rationale: The correct response is to validate the client's feelings by acknowledging that individuals in middle adulthood often derive satisfaction from nurturing and guiding young people. This response shows empathy and understanding towards the client's emotions. Choice B is incorrect because it may come across as dismissive of the client's feelings. Choice C is incorrect as it does not address the client's emotional state and could be perceived as minimizing their concerns. Choice D is incorrect as it generalizes feelings and may not be applicable to the client's specific situation.
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