ATI LEADERSHIP FUNDAMENTAL EXAM
1. A client is brought to the emergency department following a motor-vehicle crash. Drug use is suspected in
the crash,
... [Show More] and a voided urine specimen is ordered. The client repeatedly refuses to provide the specimen.
Which of the following is the appropriate action by the nurse?
a. Tell the client that a catheter will be inserted.
b. Document the client’s refusal in the chart.
c. Assess the client for urinary retention.
d. Obtain a provider’s prescription for a blood alcohol level.
2. A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to assign to a
licensed practical nurse?
a. Pick up the meal trays after lunch.
b. Administer a nasogastric tube feeding.
c. Plan break times for assistive personnel.
d. Determine adequacy of ventilator settings.
3. A nurse preceptor is evaluating a newly licensed nurse’s competency in assisting with a sterile procedure.
Which of the following actions indicates the newly licensed nurse is maintaining sterile technique? (SATA)
a. Places sterile items within a 1.25 cm (0.5 in) border around the edges of the sterile field
b. Opens the sterile pack by first unfolding the top flap away from her body
c. Prepares a container of sterile solution on the field after putting on sterile gloves
d. Removes the outside packaging of a sterile instrument before dropping it onto the sterile
field
e. Holds the sterile solution bottle with the label facing up
4. A nurse enters a client’s room and identifies that the client is receiving too much IV fluid because the IV
pump is not working properly. Which of the following actions should the nurse take first?
a. Auscultate the client’s lungs.
b. Notify the provider.
c. Place a faulty equipment tag on the pump.
d. Complete an incident report.
5. A nurse is planning care for a group of clients and can delegate care to a licensed practical nurse (LPN) and
an assistive personnel. Which of the following tasks should the nurse assign to the LPN?
a. Reinforcing teaching with a client who is learning to self-administer insulin
b. Ambulating a client who is scheduled for discharge later in the day
c. Administering morphine IV bolus to a client who is hr postoperative
d. Admitting a new client who has chronic back pain to the unit
6. A nurse is supervising a newly licensed nurse who is performing surgical asepsis. After donning a sterile
gown and gloves, which of the following actions by the newly licensed nurse demonstrates correct aseptic
technique?
a. The nurse applies goggles.
b. The nurse turns her back to the sterile field.
c. The nurse holds her hands above her waist.
d. The nurse puts on a face mask.
7. A nurse who is caring for a group of clients delegates collection of vital signs to an assistive personnel
(AP). Which of the following actions should the nurse take to evaluate the delegated task?
a. Review vital sign trends at the end of the shift.
b. Recheck vital signs that are outside the expected reference range.
c. Ask the AP to write a summary of the delegated tasks during the shift.
d. Compare the vital signs the AP obtained with those taken by another AP on a previous shift.
8. A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive personnel?
a. Obtaining a stool sample from a client who has renal failure
b. Monitoring a client who has a fluid restriction
c. Assessing a client who just returned from hemodialysis
d. Reviewing dietary instructions for a client who has kidney stones
9. A nurse is triaging a group of clients following a disaster. Which of the following clients should the nurse
recommend for treatment first?Grade_bender
a. A client who has a neck injury and is unable to breathe spontaneously
b. A client who has two open chest wounds with a left tracheal deviation
c. A client who has major burns over 75% of her body surface area
d. A client who has bipolar disorder and is exhibiting signs of hallucination (Class 3)
10. A nurse manager is reviewing guidelines for informed consent with the nursing staff. Which of the
following statements by a staff nurse indicates that the teaching was effective?
a. “A family member can interpret to obtain informed consent from a client who is deaf.”
b. “Consent can be given by a durable power of attorney.”
c. “Guardian consent is required for an emancipated minor.”
d. “The nurse can answer any questions the client has about the procedure.”
11. A nurse is caring for four clients. For which of the following clients should the nurse collaborate with the
facility ethics committee?
a. A middle adult client who leaves the facility against medical advice
b. An older adult client who has advanced directives on file
c. A young adult client who is participating in a medical research study
d. An adolescent client whose parents refuse a blood transfusion for religious reasons
12. A nurse in an ambulatory care setting is orient a newly licensed nurse who is preparing to return a call to a
client. The nurse should explain that which of the following is an objective of telehealth?
a. Assessing client needs
b. Developing client treatment protocols
c. Providing medication reconciliation
d. Establishing communication between providers (Community Health pg. 75)
13. A nurse is providing discharge teaching to a client who has a new diagnosis of diabetes. The client
expresses concern about the cost of blood-glucose monitoring supplies. Which of the following actions
should the nurse take?
a. Refer the client to the social services department.
b. Provide the client with a week’s worth of supplies from the hospital (still needs help paying after)
c. Ask the provider about the possibility of less frequent monitoring (pt needs to monitor often)
d. Recommend the client reuse the testing lancets (breaks the safety & infection protocol)
14. A charge nurse is receiving change-of-shift report. Which of the following situations should the charge
nurse address first?
a. A nurse on the previous shift wrote an incident report about a medication error.
b. Two staff members have called to say they will be absent.
c. Transport assistance is unavailable to take a client to occupational therapy.
d. The emergency department nurse is waiting to give report on a new admission.
15. A nurse who is precepting a newly licensed nurse is discussing the client assignment for the shift. Which of
the following actions should the nurse preceptor take first to demonstrate appropriate time management?
a. Complete required tasks.
b. Review the client’s new laboratory values.
c. Determine client care goals (set/plan goals)
d. Document assessment data.
16. A charge nurse is reviewing information about HIPAA with a group of staff nurses. Which of the following
statements by a staff nurse indicates understanding?
a. “Clients who participate in research studies forfeit their HIPAA right to privacy.”
b. “HIPAA allows facility-specific coding of client health care information to ensure privacy.”
c. “HIPAA prohibits the uploading of photographs of client’s providers to social media sites.”
d. “HIPAA allows clients to request a review of their own medical records.”
17. A nurse is caring for a client who has a tumor. The provider recommends surgery. The client refuses, but
the client’s partner wants the surgery performed. Which of the following is the deciding factor in
determining if the surgery will be done?
a. Whether the client understands the risk of refusing the procedure
b. Whether the facility ethics committee reached a consensus on the case
c. Whether the partner is the client’s durable power of attorney for health care
d. Whether the client’s refusal is based on religious beliefGrade_bender
18. A charge nurse is planning the care of four newborns. An assistive personnel and licensed practical nurse
are available for staffing. Which of the following tasks should the nurse assign to a licensed practical
nurse?
a. Conduct the newborn hearing screening. (RN assessment)
b. Administer a hepatitis B vaccine.
c. Perform a New Ballard screening. (RN assessment)
d. Obtain vital signs. (CNA)
19. During a staff meeting a unit manager reviews the results for documenting client education and finds that
they are below the benchmark. Which of the following strategies should the nurse manager implement
first?
a. Train LPNs to reinforce teaching with clients using a standardized teaching plan.
b. Determine factors that interfere with the documentation of client education.
c. Include documentation of client education as part of unit nurses’ annual performance evaluation.
d. Offer incentives for the staff once the unit’s results are back in adherence with the benchmark.
20. A nurse is explaining ethics and values to a newly licensed nurse. The nurse should explain that preventing
client injury by removing a fall hazard demonstrates which of the following ethical principles?
a. Utility
b. Autonomy
c. Nonmaleficence
d. Veracity
21. A nurse is caring for a group of clients. Which of the following clients should the nurse plan to assess first?
a. A client who has congestive heart failure and has lost 0.9 kg (2 lb) in the past 24 hr (improvement)
b. A client who has diabetes mellitus and reports paresthesia in his fingers and toes (ABC--
circulation)
c. A client who has a nasogastric tube and has crackles in the lungs (ABC--airway)
d. A client who has a new diagnosis of Graves’ disease and a TSH level of 0.2 microunits/mL
22. A charge nurse is planning to evacuate clients on the unit because there is a fire on another floor. Which of
the following clients should the nurse evacuate first?
a. A client who is in Buck’s traction for a left hip fracture (can’t necessarily move too much)
b. A client who is 1 day postoperative following thoracic surgery and has a chest tube (possible
physical instability)
c. A client who is confused and restrained for safety (still needs continual nursing care/assessment)
d. A client who is receiving IV chemotherapy and is ambulatory
23. A nurse enters the room of a client who is unconscious and finds that the client’s son is reading her
electronic medical records from a monitor located at the bedside. Which of the following actions should the
nurse take first?
a. Recommend the son meet with the provider to get information about his mother’s condition.
b. Report the possible violation of client confidentiality to the nurse manager.
c. Complete an incident report regarding the breach of the client’s confidentiality.
d. Log out the computer so that the client’s son is unable to view his mother’s information.
24. A nurse is preparing a client for cardiac catheterization. Just before the procedure, the client asks the nurse
about the risks of the procedure. Which of the following actions should the nurse take?
a. Explain the risks of the procedure to the client.
b. Convey the client’s request to the nurse who witnessed the consent.
c. Check to see if the medial record indicates the provider explained the procedure to the client.
d. Notify the provider about the client’s concerns.
25. A nurse is prioritizing care after receiving change-of-shift report on four clients. Which of the following
clients should the nurse assess first?
a. A client who reports a headache with sensitivity to light
b. A client who reports an urge to void but has not urinated during the prior shift
c. A client who reports indigestion and pain in her jaw
d. A client who reports feeling lightheaded when he stands up from a lying position
26. A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the
following actions should the nurse take first?
a. Discuss time management strategies with the nurses.
b. Determine the reasons the nurses are not taking scheduled breaks. Assess firstGrade_bender
c. Provide coverage for the nurses’ breaks.
d. Review facility policies for taking scheduled breaks.
27. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage bone
cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse
make before delegating care?
a. Has the AP checked the client’s pain level prior to turning her? (RN only - do not delegate what
you can EAT = evaluate, assess, teach)
b. Is the client’s family present so the AP can show them how to turn the client? (this is not
necessary)
c. Has data been collected about specific client needs related to turning? (Assessment of holistic
care r/t pt needs and what the experienced AP can do)
d. Does the AP have the time to change the client’s central IV line dressing after turning her? (AP
cannot change dressings)
28. A nurse is preparing to transfer a client from the emergency department to a medical-surgical unit using the
SBAR communication tool. Which of the following information should the nurse include in the background
portion of the report?
a. A prescribed consultation -under situation
b. The client’s vital signs
c. The client’s name -under situation
d. The client’s code status -under situation
29. A nurse is planning discharge for a client who has rheumatoid arthritis. Which of the following statements
by the client should the nurse identify as an indication that a referral to an occupation therapist is
necessary?
a. “I need some help planning my meals to maintain my weight.”
b. “I am tired of having pain in my joints all the time.”
c. “I’m having difficulty climbing the stairs at my house.”
d. “I will need assistance with bathing.”
30. A nurse in the emergency department is caring for a 16-year-old client who reports abdominal pain and is
accompanied by an adult neighbor. The provider diagnoses a ruptured appendix and states that the client
requires an emergency appendectomy. Which of the following actions should the nurse?
a. Ask the adult neighbor to sign the consent form.
b. Obtain consent from the hospital administrator.
c. Witness the client signing the consent form.
d. Attempt to notify the client’s guardian to obtain consent.
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50. A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be
assigned to an RN who has floated from a medical-surgical unit?
a. A client who has gestational diabetes and is receiving biweekly nonstress tests
b. A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA
pump
c. A multigravida client who has preeclampsia and is receiving mistoprostol (Cytotec) for induction of
labor
d. A client who is at 32 weeks of gestation and has a premature rupture of membranes
51. A nurse working on a medical-surgical unit is managing care of four clients. The nurse should schedule an
interdisciplinary conference for which of the following clients?
a. A client who is at risk for pressure ulcers and has an albumin level of 4.2 g/dLGrade_bender
b. A client who has Type 1 diabetes and uses an insulin pump
c. A client who has orthostatic hypotension and is receiving IV fluids
d. A client who is receiving heparin and has an aPTT of 34 seconds (On heparin: 45-80 sec)
Rationale: https://quizlet.com/35490529/ati-normal-range-lab-values-flash-cards/
52. A charge nurse is assessing staff knowledge about safety procedures regarding needle stick injuries. Which of
the following statements by a nurse indicates appropriate understanding of these safety procedures? REPEAT
a. “prophylactic treatment should be initiated after a needlestick during preparation of an injection.”
b. “I should stop the bleeding as soon as possible following a needlestick injury.”
c. “an incident report should be completed if a client receives a stick from her own used needle.”
d. “the needle should be recapped to prevent injury during transport to the biohazard container.”
53. A nurse on a medical-surgical unit is caring for a group of clients with the assistance of a licensed practical
nurse (LPN) and an assistive personnel. Which of the following tasks should the nurse assign to the LPN?
a. Obtaining a urine specimen from an older adult client (AP/CNA)
b. Providing postmortem care for a client who has just died (AP/CNA)
c. Accompanying a client who just had a wound debridement to physical therapy (AP/CNA)
d. Reinforcing dietary teaching with a client who has heart disease
54. A nurse enters the room of a client who is unconscious and finds that the client’s son is reading her electronic
medical records from a monitor located at the bedside. Which of the following actions should the nurse take first?
REPEAT
a. Recommend the son meet with the provider to get information about his mother’s condition
b. Complete an incident report regarding the breach of the client’s confidentiality
c. Log out the computer so that the client’s son is unable to view his mother’s information
d. Report the possible violation of client confidentiality to the nurse manager
55. A home health nurse is assessing the home environment of a client who is on continuous oxygen therapy. Which
of the following findings requires the nurse to intervene?
a. The oxygen machine has a grounded plug
b. The family keeps a spare oxygen tank in the room
c. The windows of the client’s room are open
d. The client is covered with a woolen blanket
56. A nurse is teaching a client how to use a finger-stick glucometer at home. Which of the following instructions
should the nurse include? REPEAT
a. Elevate the arm for 1 min before taking the blood sample
b. Cap the lancet prior to putting it in the trash
c. Obtain the blood sample from the finger pads
d. Warm the hands prior to piercing the skin
57. A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is
disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take? REPEAT
a. Contact the client’s next of kin to obtain consent for treatment
b. Proceed with treatment without obtaining written consent
c. Have the client sign a consent for treatment
d. Notify risk management before initiating treatment
58. A client has a new permanent pacemaker inserted. Which of the following home care instructions should the
nurse include? REPEAT
a. The client should avoid using a microwave oven to heat food
b. Regular programming evaluations can be conducted by telephone
c. the client should avoid using remote control devices to prevent dysrhythmias
d. Swimming could cause the unit to have an electrical short
59. While auditing the medical records of clients currently on an oncology unit, the nurse manager finds that six of
the 15 records lack documentation regarding advance directives. Which of the following is the priority action for the
nurse to take? REPEAT
a. Reinforce the potential consequences of not having this information on record to the nursing staff
b. Ask nurses who are caring for clients without this information in the medical record to obtain it.
c. Meet with the nursing staff to review the policy regarding advance directives
d. Remind nurses to obtain this information during the admission process
60. A client is admitted with COPD. Which of the following findings should the nurse report to the provider?
REPEATGrade_bender
a. Oxygen saturation 89% on room air
b. White blood cell count 9,000/mm^3
c. Report of dyspnea on exertion
d. Bilateral crackles on auscultation of lungs
61. A charge nurse notices that two staff nurses are not taking meal breaks during their regular 8-hr shifts. Which of
the following actions should the nurse take first?
a. Providing coverage for the nurses’ breaks
b. Determining the reasons the nurses are not taking scheduled breaks
c. Discussing time management strategies with the nurses
d. Review facility policies for taking scheduled breaks
62. A nurse is caring for a client who has anorexia nervosa. Which of the following interdisciplinary team members
should be consulted in regard to this client’s care? (select all that apply.) REPEAT
a. Occupational therapist
b. Nutritional therapist
c. Physical therapist
d. Mental health counselor
e. Case manager
63. A nurse manager is reviewing guidelines for informed consent with the nursing staff. Which of the following
statements by a staff nurse indicates that the teaching was effective? REPEAT
a. “Guardian consent is required for an emancipated minor.”
b. “Consent can be given by a durable power of attorney.”
c. “A family member can interpret to obtain informed consent from a client who is deaf.”
d. “The nurse can answer any questions the client has about the procedure”
64. A nurse on a medical-surgical unit is caring for four clients. The nurse should recognize that which of the
following clients is the highest priority? REPEAT
a. A client who is newly diagnosed with pancreatic cancer and scheduled to begin IV chemotherapy
b. A client who has peripheral vascular disease and has an absent pedal pulse in the right foot
c. A client who is postoperative following a laminectomy 12 hours ago and is unable to void
d. A client who has methicillin-resistant Staphylococcus aureus (MRSA) and has an axillary temperature
of 38 C (101 F)
65. A client is scheduled for a tubal ligation procedure starts to cry as she is wheeled into the surgical units. Which
of the following nursing statements is an appropriate nursing response?
a. “It’s not too late to cancel the surgery if you want to.” REPEAT
b. “This won’t take long and it will be over before you know it.”
c. “Why did you make the decision to have this procedure?”
d. “You shouldn’t be worried because the procedure is very safe”
66. A nurse working in the emergency department is assessing several clients. Which of the following clients is the
highest priority?
a. A client who has a raised red skin rash on his arms, neck, and face
b. A client who reports right-sided flank pain and is diaphoretic
c. A client who reports shortness of breath and left neck and shoulder pain
d. A client who has active bleeding from a puncture wound of the left groin area
67. A nurse is working on a quality improvement team that is assessing an increase in client falls at the facility.
After problem identification, which of the following actions should the nurse plan to take first as part of the quality
improvement process? REPEAT
a. Review current literature regarding client falls
b. Implement a fall prevention plan
c. Notify staff of the increased fall rate
d. Identify clients who are at risk for falls
68. A nurse is evaluating a newly licensed nurse who is administering a vitamin K. (Aquamephyton) injection to a
newborn. Which of the following actions by the newly licensed nurse indicates understanding of the teaching?
(Select all that apply.) REPEAT
a. Selects the dorsogluteal site to administer the injections
b. Cleans the injection site with alcohol
c. Applies gentle pressure at the site after injection
d. Aspirates the syringe for blood return after needle insertionGrade_bender
e) Inserts the needle at a 45 degree angle (90 degree)
69. A nurse enters a client’s room and observes a fire in the trash can. Identify the sequence of actions the nurse
should take. (Move all the actions into the box on the right, placing them in the selected order of performance.)
REPEAT
Activate the fire alarm system 2
Confine the fire by closing doors and windows 3
Extinguish the fire if possible 4
Remove the client from the area 1
70. Which of the following actions taken by a nurse constitutes battery?
a. Failing to put up side rails on a confused client’s bed
b. Telling a client who refused his oral medication that he will be given an injection
c. Inserting a feeding tube against the wishes of a client who refuses to eat (REPEAT)
d. Threatening to apply wrist restraints to control a client who is agitated [Show Less]