ATI RN
Contemporary Issues in Nursing Questions
Question 1 of 5
A patient is admitted for a hysterectomy, and the RN develops and implements the plan of care but also delegates to the LPN/LVN the responsibility of administering oral medications. While off duty, this RN receives a call requesting a change in the plan of care because the patient has developed deep vein thrombosis. The nurse who originally planned the care is practicing which type of nursing care delivery?
Correct Answer: B
Rationale: The correct answer is B: Primary nursing care delivery. In primary nursing, one nurse assumes 24-hour responsibility for planning, implementing, and evaluating the care of a patient. In this scenario, the RN developed and implemented the plan of care and delegated specific tasks to the LPN/LVN. The RN remains responsible for the overall care even while off duty, as evidenced by receiving a call regarding a change in the plan of care. The other choices are incorrect because: A: Modular nursing involves a team of healthcare providers working together, sharing responsibilities, and providing care collectively. C: Team nursing involves a team of healthcare providers with different levels of expertise working collaboratively to deliver patient care. D: Functional nursing divides tasks among different team members based on their skill sets, which is not the case in the scenario provided.
Question 2 of 5
Which factors would be considered in the first steps in developing an effective patient classification system? (select all that apply)
Correct Answer: A
Rationale: In developing a patient classification system, planned procedures are crucial as they determine resource allocation, staffing needs, and patient acuity. Understanding the procedures aids in categorizing patients accurately based on care requirements. Ethnic diversity, clinical competency, and educational level are not primary factors in this initial step as they do not directly impact patient classification. Ethnicity does not determine care needs, staff competency should already be ensured, and nurse education level is not the sole determinant of patient classification. Hence, A is the correct choice for developing an effective patient classification system.
Question 3 of 5
A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to the physician, and the infant falls off the scale. When evaluating the incident, the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known, and the location of the scale so far from the delivery field. These nurses are performing a(n):
Correct Answer: B
Rationale: The correct answer is B: root cause analysis. Root cause analysis involves identifying the underlying causes of an incident to prevent its recurrence. In this scenario, the nurse and manager are examining factors contributing to the infant falling off the scale. They are looking beyond the immediate event to understand the systemic issues that led to the incident, such as the need for additional staff during multiple births and the placement of the scale far from the delivery field. By conducting a root cause analysis, they aim to address these underlying issues and prevent similar incidents in the future. A: Standardization of care refers to consistent application of best practices, which is not the focus of the nurse and manager's actions in this situation. C: Process variation involves analyzing inconsistencies in processes, which is not the primary concern in this incident. D: Analysis of a deployment flowchart examines the flow of resources in a process, which is not directly related to identifying the root causes of the incident.
Question 4 of 5
Patients with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged. To improve quality of care, a type of "road map" that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented. This road map is referred to as a(n):
Correct Answer: B
Rationale: The correct answer is B: critical pathway. Critical pathways are structured, multidisciplinary care plans that detail essential steps in the care of patients with specific conditions, such as heart failure. They standardize treatment by outlining the sequence and timing of interventions, tests, and medications, helping to improve efficiency and quality of care. Critical pathways guide daily care by providing a roadmap for healthcare providers to follow, ensuring that patients receive appropriate and timely interventions. Explanation of other choices: A: Benchmark - Benchmarks are standards or reference points used for comparison, not a structured care plan like a critical pathway. C: Algorithm - Algorithms are step-by-step procedures for solving problems, not necessarily a comprehensive care plan like a critical pathway. D: Case management - Case management involves coordinating care and services for individual patients, not a standardized care plan for a specific disease like a critical pathway.
Question 5 of 5
The number of IV site infections has more than doubled on a nursing unit. The staff determine common causes include the site is cleaned using inconsistent methods, dressing frequently becomes wet when patient showers, IV tubing is not changed every 48 hours per protocol, and inadequate hand washing of RN prior to insertion. A bar graph demonstrates the frequency in descending order, with 80% of infections being attributed to inadequate hand washing. The quality tool used is a:
Correct Answer: C
Rationale: The correct answer is C: Pareto chart. A Pareto chart is a quality tool used to prioritize issues by identifying the most significant factors contributing to a problem. In this case, the Pareto chart is appropriate because it helps visually show that inadequate hand washing is the primary cause of IV site infections, as it accounts for 80% of all infections. The chart allows the staff to focus their efforts on addressing this key issue first, which is crucial for effectively reducing the overall infection rate. Incorrect choices: A: Cause-and-effect diagram - This tool is used to identify and analyze potential causes of a problem, but it does not prioritize them in the same way a Pareto chart does. B: Run chart - A run chart is used to track data over time to identify trends and patterns, but it does not prioritize the causes of a problem like a Pareto chart. D: Flowchart - Flowcharts are used to map out a process or workflow, but they do not prioritize issues