ATI LEADERSHIP QUESTIONS AND ANSWERS 2019 A
Client has a living will that declines the use of artificial enteral nutrition
review the clients request
... [Show More] with the family
school-age child whose family is homeless
child has red fissures at the corners of the mouth
increased rate of client med errors
inform staff of the penalties
committee that is revising the policy for client discharge
determine goals and objectives
dilemma is referred to the ethics committee
assist in weighing the options involved in the decision
fire on the unit
assist clients who are in immediate danger
who reports vomiting and diarrhea for the past 6hrs
serum potassium
client rights should the nurse address at the orientation
-respect and dignity
-refuse meds
-leave regardless
-fully informed of their health
admitting clients following an earthquake
sucking chest wound
nurse manager teaching about confidentiality requirements to the staff
change of shift report can be given at bedside
newly licensed nurse perform a sterile dressing change on client who has central venous catheter
pick up the first sterile glove
3 days post op following open heart surgery
clients level of consciousness
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in-service for group of nurses caring for clients following stem cell transplants
positive-pressure air flow
newly licensed nurse perform a routine abdominal assessment
place the client in a dorsal recumbent postioin
nurse is supervising the care of several clients
nurse is photocopying their assigned clients dx tests
discharge upon following hip arthroplasty
length of clients stay
terminal illness and voices concern about performing self care
case manager will coordinate the resources you willl need
AP tells charge nurse that is unfair that they have to take care of all the clients incontinent
I delegate tasks to personnel based on their job descriptions
client who is scheduled for outpatient surgery
ask the client to explain the procedure that is being performed
expressive aphasia
procedure that does not require written informed consent
staff nurse's behavior has changed over the past few weeks
frequent use of restroom
conflict is affecting the functioning of the unit
explore alternative solutions to address unit workflow
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tubal ligation and reports being uncertain
discuss the client's feelings about the procedure
implementing a plan to decrease the rate of pressure injuries in a long term care facility
compare data from client records regarding skin integrity
nurse is caring for four clients
a client who has a femur fracture
wheelchair with a group of assistive personnel
raise the footplates of the wheelchair before transferring
should the charge nurse identify as demonstrating sterile technique
the nurse places the sterile package with the top flap
time-management skills
group tasks that are in the same location
newborn who requires apnea monitoring at home
home health
cancer that has metastisized
gather info about palliative care
no orthopedic experience
client who had right above-the-knee amputation 24hr ago
client is seeking drugs and is not in distress
clients are the experts on their own pain
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client who requests pain medication
fidelity
client requests to be transferred to another unit
ask the client to verbalize their expectations
stroke and now has left sided weakness
advise the client to install grab bars
poor attendance at monthly staff meetings
explore the reasons that staff are not attending meetings
increase in UTI on the unit
perform a chart review to gather data about the clients
verify that the client has given informed consent prior to which of the procedures?
receiving moderate sedation
statements from the AP indicates the client the nurse should assess first?
the client who had an indwelling urinary catheter
following tasks should the nurse assign to the LPN?
provide an enteral feeding to a client who has Crohns disease
experiencing life-threatening injuries
identify stable clients for transfer to a surgical unit
mental health unit is teaching a newly licensed nurse about client rights
clients on a mental health unit can refuse their meds
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pulmonary tuberculosis
wear an N95
I want to skip this dose of meds
inform the client of the consequences of refusing the meds
med surge unit is caring for four clients. priority?
client who has peripheral vascular disease
accommodate new bariatric services
-role model a positive approach
-encourage staff
inter-professional conference for a client who is 3 days post op
client refuses to attend physical therapy
client who does not have advance directive
provide the client with info about advance directives
tasks should the nurse plan to delegate to an AP
intake and output
ventilator-associated pneumonia
notify the quality improvement team
looking at EM for a celebrity client on another unit
remind the staff members that this is a breach of confidentiality
extra cranial-intracranial bypass
discuss the clients concerns about having the surgery
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remove a clients indwelling urinary catheter
review the AP skill competency checklist
client following a total hip arthroplasty
inform the AP of the clients weight-bearing status
inserted central catheters in the ICU
state nurse practice act NPA
daily visits and receives lab results for four adult clients
platelets 100,000/mm3
arrived late to work multiple times over the past several weeks
-schedule meeting with the nurse
-written reprimand
-suspension
-termination
total knee arthroplasty and speaks a different language
interpreter
nurse reflects effective communication regarding delegation of a task to an AP
check urinary output at 1100 for John Doe
difficulty buttoning their clothes
occupational therapist
Terms in this set (60)
Original
manager confronts a nurse with smell of alcohol on her breath. which action to take?
set up formal meeting within 24 hr
client requests pain med. nurse fulfills a promise to return with med in 15 min. nurse demonstrates which ethical principle
fidelity
adverse effects after a new med. which communication tool for complication
SBAR
urgent care nurse pain assessment not to policy. take which action
report this issue to the nurse manager
potassium 3.2, been paging provider for 1hr to report. which intervention next
notify nursing supervisor
assign AP which task
suction a clients trach
informed consent prior to
receiving moderate sedation
pt has dnr. AP understands when states...
"i will call for the clients nurse to come to the room if i cannot detect a pulse"
charge nurse orienting new nurse. understands when..
"after i finish with the printout of my assignment i will put it in the shredder
nurse planning DC for stroke. which intervention
advise client to install grab bars in her bathroom at home
frayed cord of infusion pump. take which action
Report the pump...
long term facility transferring to acute care facility. include what info in paper work
list of current medications
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charge nurse supervising several clients which require intervention
studentnurse photocopying...
nurse caring for four clients. which priority
client with PVD and absent pulse
staff not answering call light promplty
ask the client to verbalize his expectations
planning care for client who has dementia
placing client in a room near the nurses station
UTI quality improvement
establish best practice guidelines for reducing the incidence of UTIs
AP qualified
review the APs skill competency checklist
change of shift 4 clients
miss graves needs pain reassed
tubal ligation, uncertain
discuss the clients feelings about the procedure
committee for discharge
determine goals and objectives
mental health mechanical restraints
i should request the provider to examine the client within 1 hour of applying mechanical restraints
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arguing about restock
i would like for you to approach the ap to resolve the problem
time management skills
groups tasks that are in the same location
no ortho experience
client who had a right above knee amp 24 hr ago
safe use of wheelchair
raise footplates before transferring
external disaster plan activated
identify stable patients for transfer to surg unit
smoke from wastebasket
transported client to hallway
charge managing conflict...
you always complete your work on time and do a great job.....
caring following stem cell
place clients in positive pressure airflow rooms
decrease rate of pressure ulcers
compare data from clients records regarding skin integrity
sterile dressing change
the nurse places the sterile package with the top flap opening away from her
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reflects intrapersonal conflict
im not sure whether i want to apply for unit manager or start a family
delegating unit short staffed. wound irrigation
assign procedure to LPN
outpatient surgery gave consent
ask the client to explain the procedure that is being performed
joint repacement surgery
advocacy
planning daily work priority
assign client care to staff
discharged with post op infection, PICC
ensure that home infusion therapy has been arranged
nurse receiving report on four clients
Potassium 6.5
difficulty buttoning her clothes
occupational therapy
morning lab results, exhibit
obtain a cap blood glucose reading
nurse has arrived late
issue informal verbal
give nurse formal
suspend without pay
terminate employement
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clinical pathway following hip arthroplasty
length of clients stay
abdominal pain admitted
completing the clients initial admin assessment
18 yr old rhabdomyosarcoma
the nurse states i can gather info about palliative care
client rights understanding of teacing
clients on mental health unit can refuse meds
ER perfomring triage after MVC
arm contusions and asym thoracic movement
delegate to ap
measuring I&O
staff looking atEMR for celeb
remind staff this is a breach of confidentiality
COPD receiving oxygen
an office chair
oxygen tank on floor
throw rug over vinyl
restraints to combative
quick release tie to secure restraint
2 hr postop following chole
recheck the clients BP
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right direction of communication
tell me what time the client in 205 voids for the first time after cath removal
four clients who's priority
adult client femur fracture SOB
poor attendence
explore reasons staff are not attending
breast cancer otions
lets talk about benefits of each
VAP
notify quality improvement team
cancer and vomits blood
mop the floors with a bleach solution
advance directives
this means i have outlines my wishes for med treatments
community health clinic communicable diseases. nationally infection disease
chlamydia
An RN has to teach the client initially but can delegate ________to an LPN.
reinforcing the teaching
An LPN can perform ______care.
tracheostomy care
Can an RN delegate to an LPN to perform suctioning?
yes
Can an RN delegate to an LPN to put in a urinary catheter?
yes
Can an RN delegate to an AP to feed a client not on swallow precautions?
yes
Is an RN allowed to delegate to an AP to collect a urine sample?
yes
A nurse delegates to an AP to assist in obtaining vital signs from a postop patient who required naloxone (narcan) for depressed respirations. Is this an appropriate task for the AP?
no
An older adult client who is on fall precautions is found lying on the floor of his hospital room. Which of the following actions is most appropriate for the nurse to take first?
A. Call the client's provider
B. Ask a staff member for assistance getting the client back in bed
C. Inspect the client for injuries
D. Ask the client why he got out of bed w/out assistance
C. Inspect the client for injuries
An RN on a med-surg unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the LPN?
A. Obtain vitals for a client who is 2 hr postop following a cardiac cath
B. Administering a unit of PRBCs
C. Instructing a client in the performance of wound care
D. Developing a plan of care for a newly admitted client
A
A nurse is caring for an older adult client who has left the unit for a radiology procedure. The client's son asks the nurse what med is being given to the client. Which of the following is an appropriate response by the nurse?
A. "I am sorry, but that is information you will need to ask your mother or her doctor."
B. "Your mother is taking famotidine (Pepcid) for the ulcer & lorazepam (Ativan) for anxiety."
C. "You will need to ask the charge nurse for that info."
D. "Don't worry. We will give your mother all pertinent info before discharge."
A.
A nurse works in a mental health facility that uses a case management nursing model to provide care. The nurse should recognize that which of the following describes a case management approach to care?
A. A nurse provides total care for several clients
B. Collaboration between disciplines creates a multidisciplinary care plan for each client.
C. The focus of care is on detecting disorders at an early stage.
D. The team leader assigns care for a group of clients
B
A nurse overhears a client talking with an attorney, reporting physical abuse, use of restraints & denial of meals. What action should the nurse take?
A. Report the conversation to the nurse manager to allow for follow-up investigation.
B. Question the client about the allegations to identify staff who were allegedly involved.
C. Ignore the conversation unless the client brings it to the attention of the nurse.
D. Recognize this as a privileged communication that cannot be discussed w/anyone.
A
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A nurse manager is planning a department meeting to discuss client advocacy. Which of the following situations should be included in the discussion? Select all that apply.
A. Discussing treatment options w/a client who was pancreatic cancer
B. Notifying the surgeon when a client signing a surgical consent form has questions about the procedure
C. Helping a client make a list of questions she would like to ask the provider
D. Clarifying the dosage of a med prescribed for an older adult client who has impaired liver function
E. Carrying out end-of-life wishes outlined in the living will of an older adult
B, C, D, E
A nurse is assessing a client's negligible progress in following a weight loss program. Which of the following is a likely reason the client was unable to achieve a short-term goal established during the planning phase of the nursing process?
A. The goals were realistic & formulated w/client input.
B. The underlying problem behind past weight gain was misidentified.
C. The implementation of the plan used flexibility in following the nursing actions
D. The nurse obtained objective & subjective data during the assessment.
B
A nurse has prepared an IM injection for a client who is preoperative, when another client suddenly calls for assistance. The nurse asks an LPN to give the injection since an AP is waiting to take the client to surgery. Which of the following is an appropriate action by the LPN?
A. Prepare a new syringe for the client who is preop
B. Give the prepared med to the client who is preop
C. Help the client requesting assistance so the nurse can give the prepared injection
D. Report this request to the charge nurse
C
A new charge nurse on a busy surgical unit notes a high degree of tension among the nursing staff. Which of the following should be the initial method used for resolving this issue?
A. Work w/the nurses to identify stressors
B. Hire additional staff to decrease the work load
C. Make relaxation tapes available to staff to help decrease stress
D. Reassess the situation after the nurses have become accustomed to the new charge nurse
A
A nurse on a long-term care unit finds that a client receiving dialysis was administered captopril (capoten), which was not prescribed for the client. In which order should the nurse take the actions listed?
___Complete an incident report.
___Contact the risk manager.
___Instruct the client to call for assistance when getting out of bed.
___Measure the client's vital signs
___Notify the provider
1. Measure the client's vitals
2. Instruct the client to call for assistance when getting out of bed
3. Notify provider
4. Complete an incident report
5. Contact the risk manager
A nurse is caring for a group of clients on a med surg unit. Which of the following tasks should the nurse delegate to the assistive personnel (AP)? Select all that apply.
A. Collecting a stool specimen
B. Providing instructions about using a spirometer
C. Measuring oral intake
D. Providing postmortem care
E. Changing a dressing
A, C, D
A nurse on a med surg unit is planning care of assigned clients. Which of the following clients should the nurse assess first?
A. A client who is newly admitted & is to have an indwelling urinary catheter inserted
B. A client who has kidney stones & reports flank pain 6 out of 10
C. A client diagnosed w/early-stage chronic kidney disease w/a serum creatinine level of 2.0 mg/dL
D. A client who has a cast newly applied on his forearm and reports tingling of his fingers
D
An RN working w/an LPN is planning client care assignments. Which of the following tasks should the nurse delegate to the LPN?
A. Performing tracheostomy suctioning for a stable client
B. Performing an admission assessment of a client who is preop
C. Initiating the referral of a client to hospice
D. Interpreting a client's digoxin level
A
A client is prescribed morphine sulfate IM. Which of the following should the nurse recognize as a requirement for governing controlled substances?
A. Delegate med admin to a RN
B. Ask another nurse to observe disposal of unused med
C. Request another nurse to validate admin of the med
D. Observe the LPN admin the med
B
An older adult client who has early Alzheimer's disease is living w/an adult child who is employed part-time but is committed to keeping her parent at home. Which of the following options is appropriate for the nurse to discuss w/the client & family at this time?
A. Hospice care
B. Adult day care
C. An assisted-living facility
D. Long-term care facility
B
A nurse is overheard telling other nurses that the unit manager gives preferential treatment to nurses on the night shift. Which of the following approaches by the unit manager reflects an assertive response to resolution of this conflict?
A. Understand that the vocal nurse is misinformed & take no action.
B. Assign the vocal staff nurse to work the night shift to allow direct experience w/the night shift.
C. Meet one-on-one w/the vocal staff nurse to discuss the concerns raised
D. Confront the staff nurse during the next unit meeting regarding her statement
C
A nurse is caring for a group of clients on a medical unit. Which of the following is the priority finding the nurse should report to the provider?
A. A client receiving metoclopramide (Reglan) reports diarrhea
B. A client receiving tamsulosin (Flomax) reports feeling dizzy
C. A client receiving cephalexin (Keflex) reports dyspnea
D. A client receiving erythromycin (E-Mycin) reports epigastric pain
C
A nurse is caring for a client who has recently been prescribed lithium carbonate (Eskalith). Which of the following is the priority assessment finding for this client?
A. Fine hand tremors
B. Weight gain of 2.7 kg (6 lb)
C. Report of nausea
D. Poor motor coordination
D
A nurse manager is reviewing the function of "Code of Ethics for Nurses with Interpretive Statements" during a staff meeting. The nurse manager recognizes that this document is:
A. legally binding
B. mandatory for the practice of nursing
C. a description of requirements for licensure
D. a guide for professional actions
D.
A nurse manager finds an increased incidence of health-care associated infections (HAIs) on a long term care unit. Which of the following is the priority action the nurse manager should take to address the problem?
A. Monitor the staff's hand hygiene techniques
B. Hold a mandatory in-service about hand hygiene & infection rates
C. Require nurses to take an online course on HAIs
D. Conduct a chart review to gather data about clients who developed HAIs
D
A nurse manager is about to write a 2 month performance appraisal for a newly graduated nurse. Which of the following factors should the nurse manager take into consideration when planning a performance appraisal interview for this nurse?
A. The written appraisal & interview should sound friendly & be informal
B. No one except the nurse manager should have input regarding the nurses's appraisal
C. A nursing administrator who does not know the nurse should conduct the interview to promote fairness
D. The nurse should have a copy of performance standards before the appraisal interview
D
A nurse working at a rehab facility attends an interdisciplinary team meeting for a client who has had a left hemispheric stroke. Which of the following members of the interdisciplinary team should the nurse expect to contribute to the plan of care? Select all that apply.
A. Nurse
B. Occupational therapist
C. Speech therapist
D. Physical therapist
E. Respiratory therapist
A, B, C, D
A nurse is writing a goal for a client's reaction following the admin of a med. Which of the following phases of the nursing process should the nurse modify?
A. Planning
B. Evaluation
C. Analyzing
D. Assessment
A
The actual writing of an expected outcome is done in the planning phase of the nursing care plan.
A charge nurse on a med surg unit is assigning client care to an RN and an LPN. Which of the following tasks should the nurse assign to the RN? Select all that apply.
A. Performing colostomy care
B. Administering blood to a client
C. Developing a plan of care for a client
D. Calculating a TPN flow rate
E. Checking nasogastric tube patency
B, C, D
A nurse manager is providing info about the audit process to members of the nursing team. Which of the following statements should the nurse manager include? Select all that apply.
A. A structure audit evaluates the setting & resources available to provide care
B. An outcome audit evaluates the results of the nursing care provided
C. A root cause analysis is indicated when a sentinel event occurs
D. Retrospective audits are conducted while the client is receiving care
E. After data collection is completed, it is compared to a benchmark
A, B, C, E
A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following will provide the most relevant info regarding the efficacy of the procedure?
A. Frequency w/which the procedure is performed
B. Client satisfaction w/performance of procedure
C. Incidence of complications r/t procedure
D. Accurate documentation of how the procedure was performed
C
A nurse manager has received a performance appraisal from the unit manager. Which of the following actions by the unit manager requires intervention?
A. The evaluation was conducted in the unit manager's office
B. Data that was collected for the previous 12 months was presented
C. Verbal concerns provided by a staff member were incorporated into the data
D. The nurse was asked to review the performance appraisal & complete a self-evaluation
C
A nurse is preparing to transfer an older adult client who is 72 hr postop from a surgical procedure to a long term care facility. Which of the following should the nurse include in the transfer report? Select all that apply.
A. Type of anesthesia used
B. The client's advance directives status
C. The client's vital signs on day of admission
D. The client's medical diagnosis
E. Need for special equipment
B, D, E
A nurse is participating in an interprofessional conference for a client who has a recent C6 spinal cord injury. The client worked as a construction worker prior to his injury. Which of the following members of the interprofessional team should also participate in planning care for this client? Select all that apply.
A. Physical therapist
B. Speech therapist
C. Occupational therapist
D. Psychologist
E. Vocational counselor
A, C, D, E
A nurse manager is working with a committee of nurses whose task is to update the policies for new employee orientation. The nurse manager directs the team to collect as much data as possible & recommend several options. Which of the following decision-making styles is being demonstrated by the nurse manager?
A. Decisive
B. Flexible
C. Hierarchical
D. Integrative
D.
A nurse who has just assumed the role of unit manager is examining her skills in interprofressional collaboration. Which of the following actions support interprofessional collaboration? Select all that apply.
A. Use aggressive communication when addressing the team
B. Recognize the knowledge & skills of each member of the team
C. Ensure that a nurse is assigned to serve as the group facilitator for all interdisciplinary meetings
D. Encourage the client & family to participate in the team meeting
E. Support team member requests for referral
B, D, E
A nurse is caring for a client who is being prepared for surgery. The client hands the nurse info about advance directives & states, "Here, I don't need this. I am too young to worry about life-sustaining measures & what I want done for me." Which of the following actions should the nurse take?
A. Return the papers to the admitting dept w/a note stating that the client doesn't wish to address the issue at this time.
B. Explain to the client that you never know what can happen during surgery & that he should fill the paper's out "just in case."
C. Contact a client representative to talk w/the client & offer additional info about the purpose of advance directives
D. Inform the client that the surgery cannot be conducted unless he completes his advance directives forms
C
A nurse is serving as a preceptor to a newly licensed nurse & is explaining the role of the nurse as advocate. Which of the following situations illustrates the advocacy role? Select all that apply.
A. Verifying that a client understands what is done during a cardiac catheterization
B. Discussing treatment options for a terminal diagnosis
C. Informing members of the health care team that a client has DNR status
D. Reporting that a health team member on the previous shift did not provide care as prescribed
E. Assisting a client to make a decision about his care based on the nurse's recommendations
A, C, D
A nurse manager is providing info to the nurses on the unit about ensuring client rights. Which of the following outlines the rights of individuals in health care settings?
A. American Nurses Association Code of Ethics
B. HIPAA
C. Patient Self-Determination Act
D. Patient Care Partnership
D
A nurse is reviewing a client's health care record & discovers that the client's DNR order has expired. The client's condition is not stable. Which of the following actions should the nurse take?
A. Assume that the client does not want be resuscitated, & take no action if she experiences cardiac arrest
B. Write a note on the front of the provider order sheet asking that the DNR order be reordered
C. Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest
D. Call the provider to determine whether the order should be immediately reinstated
D
A home health nurse is assessing the safety of a client's home. Which of the following factors may increase the client's risk for falls? Select all that apply.
A. History of a previous fall
B. Reduced vision
C. Impaired memory
D. Takes rosuvastatin (Crestor)
E. Wears house slippers
F. Kyphosis
A, B, C, E, F
A client is brought back to the unit after a total hip arthroplasty. The client is confused, is moving his leg into positions that could dislocate the new hip joint, & repeatedly attempts to get out of bed. Which of the following actions should the nurse take? Select all that apply.
A. Apply arm & leg restraints immediately
B. Get an order from the provider
C. Have a family member sign the consent for restraints
D. Use a square knot to secure the restraints to the bed frame
E. Ensure that only one finger can be inserted between the restraint and the client
A, B, C
A nurse is observing a newly licensed nurse & an AP pull a client up in bed using a drawsheet. Which of the following actions by the newly licensed nurse indicates a need for further education?
A. The nurse spreads his legs apart
B. The nurse uses his body weight to counter the client's weight
C. The nurse's feet are facing inward, toward the center of the bed
D. The nurse uses the muscles in his arms to lift the client off the bed using the drawsheet
C
An AP reports that a client's finger-stick blood glucose reading 30 min before lunch is 58 mg/dL. The client's morning finger-stick blood glucose was 285 mg/dL. The client is asymptomatic for hypoglycemia, & his next dose of insulin is scheduled to be administered at this time. Which of the following actions should the nurse take first?
A. Recalibrate the glucometer, & recheck the client's blood glucose
B. Have the lab draw a stat serum glucose
C. Inform the AP to give the client 120 mL of orange juice
D. Administer insulin as prescribed
A
A nurse discovers that a client was administered an antihypertensive med in error. Number the following actions in the appropriate sequence that the nurse should follow.
___A. Call the client's provider
___B. Monitor the client's vitals
___C. Notify the risk manager
___D. Complete an incident report
___E. Instruct the client to remain in bed until further notice
1. B
2. E
3. A
4. D
5. C
- Monitor the client's vitals.
- Instruct the client to remain in bed until further notice.
- Call the client's provider
- Complete an incident report
- Notify the risk manager
A nurse manager is explaining the use of incident reports to a group of nurses in an orientation program. Which of the following statements should the nurse manager include? Select all that apply.
A. A description of the incident should be documented in the client's health care record
B. Incident reports should not be shared w/the client
C. Incident reports include a description of the incident & actions taken
D. A copy of the incident report should be placed in the client's health care record
E. The risk management dept. investigates the incident
A, B, C, E [Show Less]