ATI RN
Contemporary Issues in Nursing Questions
Question 1 of 9
Organizations measure the effectiveness of their budgets by examining actual revenues and expenditures versus:
Correct Answer: A
Rationale: The correct answer is A: planned variances. Organizations compare actual revenues and expenditures to planned variances to measure budget effectiveness. Planned variances show the differences between the budgeted amounts and the actual results, highlighting areas of over or underperformance. This analysis helps organizations identify reasons for deviations and adjust future budgets accordingly. Explanation for other choices: B: Incremental budgets focus on adjusting previous budgets by a fixed amount, not on comparing actual versus planned amounts. C: Productivity metrics measure the efficiency of resources used, not specifically related to budget effectiveness. D: Expected performance is a vague term that does not directly address comparing actual versus planned financial data.
Question 2 of 9
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
Question 3 of 9
In the preparedness phase for disasters, the community plans for a possible terrorist attack using anthrax as the weapon of destruction. What treatments and/or preparations would be needed?
Correct Answer: A
Rationale: The correct answer is A: Vaccines and Level B Personal Protection Equipment (PPE). In the preparedness phase for a terrorist attack using anthrax, vaccines are crucial for prevention. Level B PPE provides respiratory protection and skin protection against anthrax spores. This is essential for healthcare workers and first responders. Choice B is incorrect as it mentions treatment for burns, which is not relevant to anthrax exposure. Decontamination and Level A PPE are not specifically needed for anthrax. Choice C is incorrect as it mentions radioactive fallout, which is not relevant to anthrax. Social distancing is also not effective in preventing anthrax exposure. Choice D is incorrect as it mentions incendiary devices and treatment for burns, which are not related to anthrax exposure. Identifying and detecting propellants is also not relevant to anthrax preparedness.
Question 4 of 9
A nurse is very interested in learning more about health care economics and how she can use that knowledge to become a better patient advocate. She comments, "Nurses should not only deliver care one day at a time in one facility but should coordinate patient care as they move from acute care to rehabilitation to home care." This nurse would be a candidate for which nursing role?
Correct Answer: C
Rationale: Rationale: 1. The nurse's interest in coordinating patient care across different settings aligns with the role of a case manager. 2. Case managers focus on ensuring continuity of care and coordinating services for patients transitioning between different healthcare settings. 3. This role involves advocating for patients' needs and optimizing their health outcomes through seamless care transitions. Summary: A: DMP focuses on managing chronic illnesses, not coordinating care across settings. B: Utilization management nurses focus on determining appropriate reimbursement levels, not on care coordination. D: Reviewers for Managed Care Organizations focus on assessing medical necessity and cost-effectiveness, not on care coordination.
Question 5 of 9
The Affordable Care Act of 2011:
Correct Answer: B
Rationale: The correct answer is B because the Affordable Care Act of 2011 aimed to provide health care benefits to millions who were previously uninsurable or unable to afford insurance. This is in line with the main goal of the act, which was to increase access to affordable health care for Americans. Choice A is incorrect as the act does not mandate educational requirements for nurses. Choice C is incorrect as the act does not specifically cap the amount that hospitals and physicians can charge for procedures. Choice D is incorrect as the act focuses on expanding access to health insurance rather than directly subsidizing private insurance companies to reduce costs for individuals with chronic illnesses.
Question 6 of 9
A novice nurse is unsure of his ability to insert a nasogastric tube for one of the assigned patients who is vomiting coffee ground emesis. The novice nurse waits, hoping that someone with more experience will volunteer to do the job, or he just waits until the end of the shift. This nurse is practicing:
Correct Answer: C
Rationale: The correct answer is C: procrastination. Procrastination is the act of delaying or avoiding a task that needs to be accomplished. In this scenario, the novice nurse is avoiding the task of inserting a nasogastric tube for a patient who needs it due to uncertainty and fear. Waiting for someone else to volunteer or delaying the task until the end of the shift are clear examples of procrastination. Energy management (A) involves efficiently allocating time and resources, which is not demonstrated here. Priority setting (B) would involve recognizing the urgency of the situation and taking appropriate action. Introspection (D) refers to self-reflection and analyzing one's thoughts and feelings, which is not the primary issue at hand in this scenario.
Question 7 of 9
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 8 of 9
An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision?
Correct Answer: C
Rationale: The correct answer is C: Continual supervision is being provided until the RN determines competency. Rationale: 1. Continual supervision is necessary for the LPN/LVN on the first day to assess their competency. 2. The RN checks frequently throughout the shift to provide support and evaluate the LPN/LVN's performance. 3. Competency must be determined before reducing supervision levels. 4. This level of supervision ensures patient safety and quality care. Incorrect choices: A: There is no supervision - Incorrect because supervision is provided by the RN. B: Periodic inspection - Incorrect as continual supervision is needed for competency assessment. D: Initial supervision - Incorrect as supervision should continue until competency is established. In summary, choice C is correct as continual supervision is crucial for the LPN/LVN on their first day to ensure patient safety and quality care.
Question 9 of 9
A nurse who has practiced on an orthopedic unit for 10 years unexpectedly becomes pregnant. At delivery the physician informs the mother, "Your baby has Alport syndrome, but then I don't have to explain what that means with your medical background." The mother is unfamiliar with this disease and withdraws as a coping mechanism. Which nursing theory would provide a framework to guide nursing care for this mother?
Correct Answer: A
Rationale: The correct answer is A: Mishel's uncertainty of illness. This theory focuses on how individuals cope with uncertainty related to illness or health events. In this scenario, the mother is facing unexpected news about her baby's condition, causing her to withdraw as a coping mechanism due to the uncertainty she is experiencing. By utilizing Mishel's theory, nurses can provide support and guidance to help the mother navigate her feelings of uncertainty and develop coping strategies. Choice B (Orem's self-care deficit model) is not the best fit as it primarily focuses on the individual's ability to perform self-care activities, which may not directly address the mother's emotional response to uncertainty. Choice C (Nightingale's canons of nursing) is more focused on the environmental factors impacting health and may not address the mother's coping needs. Choice D (Levine's conservation model) emphasizes maintaining stability and balance in the body systems, which may not directly address the mother's emotional needs in coping with uncertainty.