what is the main purpose of a utilization review
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Nursing Elites

ATI RN

ATI Leadership Practice B

1. What is the main purpose of a utilization review?

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.

2. What is the primary goal of a clinical nurse leader (CNL)?

Correct answer: C

Rationale: The primary goal of a clinical nurse leader (CNL) is to improve patient outcomes by overseeing patient care delivery, coordinating with healthcare team members, and ensuring quality care. While managing nursing staff (choice A) and implementing evidence-based practices (choice D) are important aspects of a CNL's role, the ultimate focus is on enhancing patient outcomes. Coordinating patient care (choice B) is part of the CNL's responsibilities but not the primary goal.

3. 12. A patient receives aspart (NovoLog) insulin at 8:00 AM. At which time will it be most important for the nurse to monitor for symptoms of hypoglycemia?

Correct answer: A

Rationale: After receiving aspart (NovoLog) insulin, which has a rapid onset, it is crucial to monitor the patient for symptoms of hypoglycemia during the peak action time. Typically, the peak action of aspart insulin occurs around 2 hours after administration. Therefore, the nurse should be most vigilant for hypoglycemia symptoms at 10:00 AM. Choice B (12:00 PM) is incorrect as it falls after the expected peak action time. Choices C (2:00 PM) and D (4:00 PM) are also incorrect because the peak action time of aspart insulin typically occurs earlier, around 2 hours post-administration.

4. For a 55-year-old female patient with type 2 diabetes and a nursing diagnosis of imbalanced nutrition: more than body requirements, which goal is most important?

Correct answer: A

Rationale: The most important goal for a 55-year-old female patient with type 2 diabetes and imbalanced nutrition due to more than body requirements is to reach a glycosylated hemoglobin level of less than 7%. This goal directly addresses the management of diabetes and is crucial in preventing complications associated with high blood sugar levels. Choice B focuses on weight loss, which may be beneficial but is not as critical as controlling blood sugar levels. Choice C, distributing calories throughout the day, is important for glycemic control but not as immediate as reaching a target HbA1c level. Choice D, stating the reasons for eliminating simple sugars, is a good educational goal but not as urgent as achieving glycemic control.

5. What is the primary role of a nurse manager in a healthcare setting?

Correct answer: D

Rationale: The primary role of a nurse manager in a healthcare setting is to ensure the efficient operation of the unit. While enforcing hospital policies and overseeing patient care are important aspects of their role, the main responsibility lies in ensuring the smooth and effective functioning of the unit. Managing the financial aspects of the unit is also crucial, but it is not the primary role of a nurse manager, as their focus is more on operational efficiency and quality of care.

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