ATI RN
ATI Leadership Practice A
1. Which of the following best describes the role of a nurse advocate?
- A. Direct patient care provider
- B. Advocate for patient needs
- C. Manage nursing staff
- D. Ensure policy adherence
Correct answer: B
Rationale: The correct answer is B: 'Advocate for patient needs.' A nurse advocate's primary role is to stand up for the patient's rights and ensure their needs are met. Choice A, 'Direct patient care provider,' is incorrect as while nurses do provide direct patient care, the specific role of a nurse advocate goes beyond that. Choice C, 'Manage nursing staff,' is incorrect as this pertains to a nurse manager's role, not a nurse advocate. Choice D, 'Ensure policy adherence,' is also incorrect as this reflects more of a quality assurance or compliance role, rather than the advocacy role of a nurse advocate.
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. A nurse is initiating a protective environment for a client who has had an allogeneic stem cell transplant. Which of the following precautions should the nurse plan for this client?
- A. Wear an N95 respirator when giving direct care to the client.
- B. Place the client in a private room with negative-pressure airflow.
- C. Ensure the client's room has at least six air exchanges per hour.
- D. Ensure the client wears a mask when outside their room if there is construction in the area.
Correct answer: A
Rationale: In a protective environment for a client with an allogeneic stem cell transplant, the nurse needs to wear an N95 respirator when providing direct care to the client. This precaution is essential to protect the client, whose immune system is compromised after the transplant, from exposure to potential pathogens. Placing the client in a private room with negative-pressure airflow (choice B) is more appropriate for clients with airborne infections. Ensuring the client's room has sufficient air exchanges (choice C) is important for maintaining air quality but is not the primary precaution for protecting an immunocompromised client. Making the client wear a mask when outside the room due to construction (choice D) focuses on external factors and does not directly address the risk of infection during direct care.
4. As a new graduate employed in a high-volume maternity unit that uses differentiated practice as its staffing model, what can the nurse expect?
- A. Evidence-based practice guides risk management principles.
- B. Client teaching is the responsibility of the team leader.
- C. The initial level of practice responsibility will be limited.
- D. Seniority is the main determinant of client assignments.
Correct answer: C
Rationale: In a differentiated practice model, the scope of nursing practice and responsibility are tailored to different levels of experience. As a new graduate with limited experience, the nurse can expect that the initial level of practice responsibility will be limited to match their skill level and knowledge. This allows for a gradual increase in responsibilities as the nurse gains more experience and expertise. Choice A is incorrect because evidence-based practice is related to clinical decision-making, not the staffing model. Choice B is incorrect as client teaching is typically a shared responsibility among the healthcare team, not solely the team leader's. Choice D is incorrect as differentiated practice models focus on skill level and competence rather than seniority when determining client assignments.
5. Which action by a patient indicates that the home health nurse�s teaching about glargine and regular insulin has been successful?
- A. The patient administers the glargine 30 minutes before each meal
- B. The patient�s family prefills the syringes with the mix of insulins weekly.
- C. The patient draws up the regular insulin and then the glargine in the same syringe.
- D. The patient disposes of the open vials of glargine and regular insulin after 4 weeks
Correct answer: D
Rationale:
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