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. By using ___________ in the workplace, nurses increase their professional influence.

Correct answer: C

Rationale: By using expert power in the workplace, nurses increase their professional influence. Expert power is derived from an individual's knowledge, skills, or expertise in a particular area. This allows nurses to influence others based on their competence and credibility, rather than through political skills (choice A), reward power (choice B), or the combination of power and politics (choice D). While political skills and understanding power dynamics can be beneficial, expert power is particularly effective in enhancing a nurse's professional influence.

3. What is the primary focus of the Triple Aim in healthcare?

Correct answer: A

Rationale: The primary focus of the Triple Aim in healthcare is indeed improving patient experience. While reducing healthcare costs and improving population health are important components of the Triple Aim framework, the primary goal is to enhance the overall experience of patients. Ensuring regulatory compliance, although important in healthcare, is not one of the primary focuses of the Triple Aim.

4. A healthcare professional is preparing to delegate client care tasks to an assistive personnel (AP). Which of the following tasks should the healthcare professional delegate?

Correct answer: A

Rationale: The correct answer is option A: 'Confirming that a client's pain has decreased after receiving an analgesic.' This task involves assessing the effectiveness of the medication, which can be delegated to the assistive personnel. Options B, C, and D involve skills that should be performed by licensed healthcare professionals due to their complexity and potential risks if not done correctly. Ambulating a postoperative client requires monitoring for signs of distress or complications, inserting a urinary catheter involves an invasive procedure with infection risks, and demonstrating the use of medical devices like an incentive spirometer requires specialized knowledge to ensure correct usage.

5. Which of the following is an example of an outcome measure in healthcare?

Correct answer: A

Rationale: Patient satisfaction scores are considered an outcome measure in healthcare because they reflect the patient's experience and perception of the care received. Patient satisfaction scores focus on the quality of care provided and the patient's overall satisfaction with their healthcare experience. Choices B, C, and D are not examples of outcome measures. The length of hospital stay is a process measure, healthcare provider performance reviews are a provider-specific evaluation, and the number of diagnostic tests ordered is more related to resource utilization rather than a direct patient outcome.

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