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1. Which of the following is an example of a sentinel event?
- A. A patient fall with no injury
- B. A medication error that results in no harm
- C. A patient suicide while in a healthcare facility
- D. A near miss incident
Correct answer: C
Rationale: The correct answer is C, a patient suicide while in a healthcare facility. A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. Choices A, B, and D do not meet the criteria for sentinel events as described by The Joint Commission, as they do not involve death or serious harm to the patient.
2. Upon noticing a visitor who is loud and active and carrying a gun on the unit where you are in charge, what should you do immediately?
- A. Ask the visitor to leave.
- B. Talk quietly to calm the visitor.
- C. Ask the visitor for the gun.
- D. Notify security with the details of the situation.
Correct answer: D
Rationale: In a situation where a visitor arrives on the unit with a gun, it is essential to prioritize the safety of patients and staff. Immediately notifying security with all the relevant details is the correct course of action. Asking the visitor to leave or engaging them could escalate the situation and put everyone at risk. Similarly, requesting the gun from the visitor directly is not advisable as it could lead to a dangerous confrontation. By alerting security promptly, you enable trained professionals to handle the situation safely and effectively, minimizing risks and ensuring the safety of all individuals involved.
3. What is the main focus of a clinical governance framework?
- A. Financial performance
- B. Regulatory compliance
- C. Patient care quality
- D. Staff satisfaction
Correct answer: C
Rationale: The main focus of a clinical governance framework is patient care quality. This framework is designed to ensure that patient care is safe, effective, and patient-centered. Choice A, financial performance, is not the main focus of a clinical governance framework, although financial aspects may be considered. Choice B, regulatory compliance, is important but not the primary focus of a clinical governance framework. Choice D, staff satisfaction, is also important but is not the main focus of a clinical governance framework, which primarily centers around patient care quality.
4. A 38-year-old patient who has type 1 diabetes plans to swim laps daily at 1:00 PM. The clinic nurse will plan to teach the patient to
- A. check glucose levels before, during, and after swimming.
- B. delay eating the noon meal until after swimming.
- C. increase the morning dose of neutral protamine Hagedorn (NPH) insulin.
- D. time the morning insulin injection so that the peak occurs while swimming.
Correct answer: A
Rationale: The correct answer is to teach the patient to check glucose levels before, during, and after swimming. This is important to monitor blood sugar levels and make adjustments as needed to prevent hypoglycemia or hyperglycemia. Delaying eating the noon meal until after swimming (Choice B) is not advisable as the patient needs proper nutrition both before and after exercise. Increasing the morning dose of NPH insulin (Choice C) should not be done without proper medical advice as it can lead to hypoglycemia. Timing the morning insulin injection to coincide with swimming (Choice D) is risky as the peak effect of insulin may lead to hypoglycemia during swimming.
5. 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?
- A. 10:00 AM
- B. 12:00 PM
- C. 2:00 PM
- D. 4:00 PM
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.
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