ATI LEADERSHIP STUDY GUIDE (Natasha LeGendre)
1. A nurse is working on a quality improvement team that is assessing an increase in clients
falls at the
... [Show More] facility after problem identification which of the following actions should the
nurse plan to take first as part of a quality improvement process
a. Notify staff of increase fall rate
b. review current literature regarding clients fall
c. identify clients who are at risk for falls
d. implemented A fall prevention plan
2. A client who is febrile is admitted to the hospital for the treatment of pneumonia. In
accordance with the care pathway antibiotic therapy is prescribed which of the following
situations require the nurse to complete a variance report with regards to the care
pathway?
a. The route of antibiotic therapy on the care pathway was from IV to PO
b. A blood culture was obtained after antibiotic therapy had been initiated
c. An allergy to penicillin requires an alternative antibiotic to be prescribed
d. antibiotic therapy was initiated 2 hours after implementation of the care pathway
3. A nurse is caring for a client who has cancer the client and her partner are asking the
nurse about Hospice care which of the following statements by the nurse is appropriate
a. Hospital is no longer available for clients who are in Hospice care
b. Hospice care will prolong the life expectancy of the client who are terminally ill
c. Hospice care is a multi-disciplinary program for clients who are terminally ill
d. hospice care is helpful for clients are very stages of chronic
4. A nurse manager discovers there is conflict between nurses working the day shift and
the nurses working night shift. Which of the following actions should the nurse manager
take first?
a. Meet with a committee of nurses from each shift to discuss issues related to the
conflict
b. Gathering information regarding the situation
c. Acknowledge the conflict and encourage the nurses to focus on working as a
team
d. Encourage the nurses to resolve the conflict autonomously
5. A nurse working in the emergency Department is assessing several clients which of the
following clients is the highest priority
a. A client who reports right sided flank pain and diaphoretic
b. A client who has active bleeding from a puncture wound of the left groin area
c. A client who has raised skin rash on his arm neck and face
d. a client who reports shortness of breath and left neck and shoulder pain
6. A nurse is providing change your shift report to an oncoming nurse which of the
following information should the nurse include in the report?
a. The client is in the radiology department for a chest X Ray
b. The client is the president of the local bank
c. The client's partner came to visit him two hours ago
d. the client has routine vital signs prescribed
7. A nurse is planning discharge for a client who had a lung reception. The nurse initiates a
referral to a social worker which of the following assessment data supports his referral?
a. client is to have a range of motion exercises Ambulation (OT)
b. client is to have someone bring oxygen tanks and equipment to her home (CM)
c. client needs to have someone come in to Help her bathe at home (CM)
d. client needs to arrange financial resources to purchase equipment (CS)
8. A nurse is caring for client who request information about the prevalence of Tay-Sachs
disease, which of the following resources should the nurse use to obtain this information
a. The client’s health care provider
b. an evidence-based nursing Journal special one
c. A collaborate user- edited website
d. The facility's case manager
9. A nurse is orienting a newly licensed nurse about client confidentiality. Which of the
following statements by the newly licensed nurse indicates an understanding of the
teaching?
a. I can use another nurse’s password as long as I log off after using the computer
b. I should encrypt personal health information when sending emails
c. I should discard personal health information documents in the trash before
leaving the unit
d. I can post the clients vitals in the client's room
10. A nurse is providing instructions about chemotherapy for a client who has a new
diagnosis of breast cancer. The client has decided to try an alternative treatment rather
than starting chemotherapy which of the following actions should the nurse take
a. Tell client they cannot change their mind once consent is given
b. Inform the client about the risks of not starting chemotherapy immediately
c. notify its spiritual services to speak with the client about their decision
d. respect the client decision about not receiving chemotherapy
11. A charge nurse notices that two staff nurses are not taking meal breaks during their shift
which of the following actions should the nurse take first?
a. Discuss time management strategies with the nurses
b. provide coverage for the nurse’s breaks
c. review facility policies for taking schedule breaks
d. determine the reasons the nurses are not taking a scheduled break
12. A nurse is preparing discharge planning for a client who has a newly placed
tracheostomy tube, the nurse should access the clients need for which of the following
supplies to manage the tracheostomy at home (select all that apply)
a. Obturator
b. Cotton balls
c. oxygen tank
d. petroleum Jelly
e. pipe cleaners
13. 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 arrhythmias. Which of the
following actions should the nurse take?
a. Have the client sign a consent for treatment
b. notify risk management before initiating treatment
c. contact the clients next of kin to obtain consent for treatment
d. proceed with treatment without obtaining written consent
14. A nurse is planning to develop a standard for removal of indwelling urinary catheters
from clients following column reception. Which of the following resources should the
nurse use?
a. Provide prescription
b. Maslow hierarchy of needs
c. Surgical record
d. critical pathway
15. A nurse who is precepting a newly licensed nurse is discussing the client assignments for
the shift. Which of the following action should the nurse preceptor take first to
demonstrate appropriate time management?
a. Document assignment data
b. determine clients care goals
c. review the client new laboratory values
d. complete required tasks
16. A nurse is planning preoperative teaching for a client who is scheduled for a
cholecystectomy the client does not speak the same language as the nurse, she is
accompanied by her adolescent daughter which of the following action should the nurse
take?
a. Use it bilingual dictionary to translate
b. access the language line to interpret what is being said
c. ask the client's daughter to interpret the conversation
d. talk loudly while facing the client
17. A charge nurse is making room for new admissions following a community disaster
which of the following clients should the nurse recommend for discharge?
a. A client who has an angina and a troponin level of 3ng/ml
b. a client who has a deep vein thrombosis an in INR of 2.0
c. a client who is receiving chemotherapy and has a tumor lysis syndrome
d. a client who has a new onset of left sided weakness
18. A nurse is planning to discharge a client who has a terminal cancer and suggest that the
family might benefit from respite services when the clients partner ask how this service
can help, which of the following responses by the nurse is appropriate?
a. This service offers psychological interventions during and after your wife's illness
b. this service delivers meals and supplies to reduce your errands away from home
c. It makes it possible for you to have some time away from caring for your wife
d. the clinician help reduce the severity of your wife's physical problems
19. A home health nurse is performing a safety assessment for a client home which of the
following findings should the nurse identify as a safety hazard?
a. The client has used tacks to secure the carpet on the stairs
b. the client is stores cleaning supplies in a lock cabinet above his head
c. the client bedside lamp is plugged in using an extension cord with two prongs
d. the client's electrical cord is taped to the floor
20. A nurse from the labor and delivery unit is assigned to float to a medical surgical unit
which of the following actions should the nurse take first?
a. Clarify competencies with the medical surgical charge nurse
b. inform the nursing supervisor of the lack of experience on the medical surgical
unit
c. Request orientation to the medical surgical unit
d. refer to the assigned resource nurse regarding client assignments
21. A nurse is speaking with a visitor who asks a question about the status of a relative who
is a client on the unit, which the following responses by the nurse is appropriate?
a. please ask your relatives about this because I cannot share information about
her
b. I am not talking care of your relative today, so I don't have the latest information
c. let me check your relatives’ medical records to see how she's doing
d. I will have your relatives nurse come in talk to you about her care
22. A nurse is supervising an assisting personal (AP) who is feeding a client who has
dysphagia which of the following actions by the assistant personal (AP) should the nurse
identify as correct techniques?
a. Withholding fluids until the end of the meal
b. instructing the client to place her chin towards her chest when swallowing
c. elevating the head of the client’s bed to 30 degree during mealtime
d. providing a 10-minute rest period prior to meals
23. A newly licensed nurse realizes that she administered Metoprolol 25 MG PO to the
wrong client. Where should they follow in action should the nurse preform first?
a. Call the provider
b. inform the nurse manager
c. complete an incident report
d. measure the client’s vital signs
24. A nurse manager is reviewing isolation guidelines with a newly licensed nurse which of
the following statements by the newly licensed nurse indicates understanding of
isolation guidelines?
a. I will instruct visitors to wear a mask when visiting the client who is on contact
precaution
b. I will have a client who is on an airborne precaution wear a mask when out of
the room
c. I will place a client who has compromise immunity in a negative pressure airflow
room
d. I will wear an N 95 respirator mask when caring for a client who is on droplet
precautions
25. A nurse on a medical surgical unit is caring for a group of clients with the assistance of a
licensed practical nurse a an assistant personal which of the following tasks should the
nurse assign to the LPN?
a. Reinforcing dietary teaching with a client who has heart disease
b. Accompanying a client who just had a wound debridement to physical therapy
c. providing postmortem care for a client who had just died
d. obtaining a urine specimen from an older adult client
26. A nurse in the emergency Department is assessing clients who have been triage using
the triage tag system following a hurricane disaster which of the following client should
the nurse assess first?
a. A client who has a yellow tag
b. a client who has a green tag
c. a client who has a red tag
d. A client who has a black tag
27. A nurse enters a client room and notices a small fire in the bathroom trash can, the
nurse removes the client from the room why should they follow in actions should the
nurse take next?
a. activate the fire alarm
b. remove all clients from the unit
c. close the fire doors and the doors to the client’s rooms
d. extinguish the fire
28. A nurse is assessing pressure ulcers on four clients to evaluate the effectiveness of a
change in wound care procedure, which of the following findings indicates wound
healing?
a. deep red color on the center of a client's wound
b. Erythema on the skin surrounding a client wound
c. inflammation noted on the tissue edges of a client's wound
d. increase in sanguineous exudate from the clients wound
29. A nurse enters the room of a client who is unconscious and finds that the 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. Report the possible violation of client confidentiality to the nurse manager
b. complete an incident report regarding the breach of client’s confidentiality
c. recommend to his son to meet with the provider to get information about his
mother's condition
d. log out the computer so that the client's son is unable to view his mother's
information
30. A nurse is providing information to a client about advance directives the nurse should
explain that advance directives include which of the following?
a. Information regarding organ donation
b. a form with directions for contacting next of kind
c. instructions regarding treatments the client desires or does not desire
d. information regarding the disposition of the client's body upon death
31. A nurse witnesses a coworker not following facility procedure with discarding the
unused portion of control substances, which of the following actions should the nurse
take? (select all that apply)
a. File an anonymous report of the incident to the nurse manager
b. identify all witnesses to the incident
c. request that the co-worker complete an incident report
d. document a factual account of the incident
e. submit an incident report to the risk management
32. 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?
a. a client who is post-operative following it laminectomies 4 hours ago in unable to
void
b. A client who has peripheral vascular disease and has an absent Pedel pulse on
the right foot
c. A client who is newly diagnosed with pancreatic cancer and is scheduled to begin
IV chemotherapy
d. a client who has MRSA and has an axillary temperature of 38C (101 F)
33. 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 1-day post-operative following thoracic surgery and has a chest
tube
b. A client who is confused and restrained for safety
c. A client who is receiving IV chemotherapy and is ambulatory
d. A client who is in Bucks traction for a hip Fracture
34. A nurse is caring for a group of clients who are receiving physical therapy. Which of the
following information regarding a client should the nurse report to the physical
therapist?
a. A client has a Hemoglobin of 5g/DL
b. A client has a new diagnosis of colorectal cancer
c. A client has opioid-induced constipation
d. A client has a prescription for a clean-catch urine test
35. A charge nurse is evaluating the implementation of infection control measures by unit
nurses when caring for clients who are Clostridium difficile. The charge nurse should
intervene for which of the following actions by a unit nurse?
a. Places the client in contact precautions
b. Cleans contaminated equipment with bleached- based solution
c. Uses Alcohol-based hand sanitizer after removing gloves
d. Wears goggles when emptying the bedpan of liquid stools
36. A charge nurse is completing client care assignments. Which of the following
assignments is appropriate for a LPN?
a. A client who is 1-day post-operative and has a continuous bladder irrigation
b. A client who requires discharge instructions for type 1 diabetes mellitus
c. A client who is receiving IV chemotherapy
d. A client who requires a blood transfusion to be administered
37. A charge nurse is evaluating the implementation of infection control measures by unit
nurses when caring for clients who have c.difficile. The charge nurse should intervene for
which of the following actions by the unit nurse?
a. Places the client in contact precautions
b. Cleans contaminated equipment with bleach-based solution
c. Uses alcohol-based hand sanitizer after removing gloves
d. Wears goggles when emptying the bedpan of liquid stool
38. A charge nurse is completing client care assignments. Which of the following
assignments is appropriate for a licensed practical nurse?
a. A client who is 1 day postoperative and has a continuous bladder irrigation
b. A client who requires discharge instructions for type 1 DM
c. A client who is receiving IV chemotherapy
d. A client who requires a blood transfusion to be administered.
39. 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 is at 32 weeks of gestation and has premature rupture of membranes
b. A client who has gestational diabetes and is receiving biweekly nonstress tests
c. A multigravida client who has preeclampsia and is receiving misoprostol for induction od
labor
d. A primigravida client who is 1 day postoperative following a cesarean section and has a
PCA pump.
40. A charge nurse overhears a provider and a nurse talking about a client’s diagnosis in the
cafeteria. Which of the following actions should the nurse take first?
a. Discuss the need for client confidentiality at the next staff meeting
b. Remind them that client information is confidential
c. Complete an incident report about the situation
d. Report the incident to the nurse supervisor
41. A nurse is delegating tasks to an assistive personnel (AP). Which of the following tasks
should the nurse assign to the AP?
a. Determine whether an oxygen flow meter is accurately set at 2L/min via nasal cannula
b. Tag a malfunctioning piece of equipment as broken
c. Check on a client whose telemetry monitor is continuously beeping
d. Instruct a client about the use of an incentive spirometer
42. 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. Offer incentives for the staff once the unit’s result are back in adherence with the
benchmark
b. Include documentation of client education as part of unit nurses’ annual performance
evaluation
c. Train LPNs to reinforce teaching with clients using a standardized teaching plan
d. Determine factors that interfere with the documentation of client education
43. A nurse is caring for a client who has a new diagnosis of chlamydia. Which of the
following actions should the nurse take?
a. Apply an antiviral cream to lesions
b. Instruct the client to use condoms until the treatment is completed
c. Initiate contact precautions
d. Report the infection to local health department
44. A charge nurse is teaching a newly licensed nurse about hazardous and infectious
materials. Which of the following situations should the nurse include as a safe handling
technique?
a. A nurse places a mask on a client with tuberculosis before transport to the radiology
department.
b. A nurse removes her gown after leaving the client’s room
c. A nurse cleans up a blood spill with hydrogen peroxide
d. A nurse disconnects an indwelling urinary catheter from the drainage bag to collect a
specimen
45. A client who is unconscious and has extensive internal injuries arrives via ambulance to
the ED. The staff cannot reach the client’s family. Which of the following permits the
staff to proceed with the emergency surgery?
a. Implied consent
b. Good Samaritan Act
c. Living will
d. Nonmaleficence
46. A nurse is teaching a newly licensed nurse about the purpose of interdisciplinary
conferences. The nurse should identify that which of the following clients needs an
interdisciplinary conference?
a. A client who had a recent stroke and is showing manifestations of depression
b. A client whose provider is unhappy with the nursing care
c. A client whose partner requests that the client be moved to a private room
d. A client whose MRI results have not been made available after 2 days
47. A nurse is caring doe a client who is scheduled for a hysterectomy and has signed the
informed consent form. The client tells the nurse she is unsure about having the
procedure. Which of the following responses should the nurse make?
a. You should not have signed the consent form if you have reservations about the surgery
b. Let me provide you with resources you can read about the surgery
c. If you have any concerns about the procedure, the surgery can be cancelled
d. I will contact the provider and request medication to help you relax
48. A charge nurse in the ED is supervising a nurse who is floating from the medical-surgical
unit. Which of the following assignments is appropriate for the float nurse?
a. Administer IV nitroglycerin to a client who is experiencing chest pain
b. Set up a trauma room for an incoming client who was in a motor-vehicle crash
c. Complete a SAD PERSONS assessment scale for a client who has attempted suicide
d. Perform a urinary catherization for a client who has experienced a cerebrovascular
accident
49. A nurse in the medical-surgical unit is delegating client care. Which of the following tasks
should the nurse delegate to an assistive personnel?
a. Instructing a client on self-administration of tap water enema
b. Suctioning a client’s long-term tracheostomy
c. Using a pain rating scale to monitor a client’s pain level
d. Performing a dressing change on a client’s peripherally inserted central catheter
50. 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. Transport assistance is unavailable to take a client to occupational therapy
c. The emergency department nurse is waiting to give report on a new admission
d. Two staff members have called to say the will be absent
51. A nurse manager is reviewing the nurse code of ethics with the staff nurses. Which of
the following statements by a staff nurse indicate understanding of the teaching? SATA
a. “I have the assistive personnel double-check packed RBCs when other nurses are busy”
b. “I will attend continuing education classes for professional growth”
c. “The family of a newly admitted client recently treated me to lunch in the hospital
cafeteria”
d. “I administer pain medication to my clients even if they have a history of narcotic
addiction”
e. “I can delegate the removal of an IV catheter to an LPN on the unit”
52. 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. Is the client’s family present so the AP can show them how to turn the client?
b. Has the AP checked the client’s pain level prior to turning her?
c. Does the AP have time to change the client’s central IV line dressing after turning her?
d. Has data been collected about specific client needs related to turning?
53. A nurse is planning care for a client who is disoriented and has a history of wandering.
Which of the following actions should the nurse include in the plan?
a. Obtain a prescription for a sedative for the client
b. Raise all four side rails on the client’s bed
c. Remove the clock and calendar from the client’s room
d. Provide distractions for the client during the day
54. A nurse working on a medical-surgical unit is managing the 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 4.2g/dL
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
55. A nurse is caring for a client who is scheduled for coronary artery bypass surgery and
does not wish to have any blood transfusions. The nurse should recognize that
administering blood to this client is a violation of which of the following ethical
principles?
a. Veracity
b. Fidelity
c. Justice
d. Autonomy
56. A nurse on surgical unit is preparing to transfer a client to a rehabilitation facility. Which
of the following information should the nurse include in the change-of-shift report?
a. The steps to follow when providing would care
b. The belief that the client has a difficult relationship with his son
c. The client preferred time for bathing
d. The time the client received his last dose of pain medication
57. A nurse is assessing a client who had a stroke 2 days ago. Which of the following findings
should the nurse identify as a need for a referral to speech-language pathology?
a. Impaired voluntary cough
b. Unilateral ptosis
c. Altered level of consciousness
d. Diminished hand-to-mouth coordination
58. A nurse in the emergency department is assessing a preschool-age child who has bruises
on both arms and a spiral fracture of the left ulna. The child’s parents tells the nurse that
the child tripped over some toys and fell down. Which of the following actions should
the nurse take?
a. Report the child’s injuries to child protective services
b. Take pictures of the child’s injuries once the parent leaves the room
c. Have a facility security officer interview the parent
d. Complete an incident report concerning the child’s injuries
59. A charge nurse observes a client fall while ambulating with an assistive personnel and
notes that the client’s gait belt was not in place. When reviewing the incident report, the
charge nurse finds that the report does not mention the gait belt. Which of the following
ethical principles should the charge nurse follow?
a. Veracity
b. Fidelity
c. Nonmaleficence
d. Beneficence
60. A charge nurse is teaching a group of nurses about the purpose of a living will. Which of
the following information about living wills should the charge nurse include in the
teaching?
a. Addresses resuscitation measures
b. Provides protection against malpractice
c. Documents that the client gave informed consent
d. Designates a health care surrogate to make health care decisions
61. A nurse is caring for a client who has cancer. The client’s adult child asks the nurse for
information about the client’s treatment plan. Which of the following responses should
the nurse make?
a. “I cannot provide this information to you without your mother’s consent”
b. “You will have to speak directly to your mother about her treatment”
c. “I will ask your mother’s primary care provider to speak with you”
d. “What would you like to know about your mother’s treatment”
62. 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 diagnosis a
ruptured appendix and states that the client requires an emergency appendectomy.
Which of the following actions should the nurse take?
a. Ask the adult neighbor to sign the consent form
b. Attempt to notify the client’s guardian to obtain consent
c. Witness the client signing the consent form
d. Obtain consent from the hospital administrator
63. A nurse is participating in an interdisciplinary conference for a client who has heart
failure, report limited resources and lives alone. Which of the following action is the
nurse’s responsibility?
a. Order durable medical equipment for the client’s home
b. Perform a dietary assessment
c. Help the client obtain financial assistance
d. Coordinate the team and the plan of care
64. A nurse is caring for a client who has increased intracranial pressure and is receiving IV
corticosteroids. Which of the following information is most important for the nurse to
report at shift change?
a. Reddened area on the coccyx
b. Laboratory tests scheduled for next shift
c. Most recent blood glucose reading
d. Glasgow Coma Scale score
65. A nurse is preparing to transfer a client from the emergency department to a medicalsurgical unit using the SBAR communication tool. Which of the following should the
nurse include in the background portion of the report?
a. The client’s name
b. The client’s code status
c. A prescribed consultation
d. The client’s vital signs
66. Missing
67. A nurse is providing discharging teaching to the parent of a toddler who has a new
diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed
for her child. Which of the following referrals should the nurse recommend?
a. Pharmacist
b. Respiratory therapist
c. Child protective services
d. Social worker
68. A charge nurse is supervising the actions taken by a staff nurse following a client fall. The
charge nurse should identify that which of the following actions by the staff nurse
indicates an understanding of the procedure?
a. Lists names of witnesses to the fall in nurses’ notes
b. Documents in the client’s record that an incident report was filed
c. Sends the incident reports to the ethics committee
d. Includes the client’s account of the fall in the incident report
69. A nurse is caring for a client who has been admitted and diagnosed with type 1 diabetes
mellitus. The client tells the nurse she has decided to go home. Which of the following
actions should the nurse take?
a. Have the client sign the AMA form
b. Assign a security officer to the client’s room until the provider can speak with the client
c. Ask the client if she would like a sedative to help her relax
d. Inform the client that she cannot leave without a discharge prescription from the
provider
70. A nurse has just completed assessment charting on the electronic record for an assigned
client. Assistive personnel (AP) who just measured the client’s vital signs asks to chart
them while the nurse is still logged into the record. Which of the following actions
should the nurse take?
a. Allow the AP to document the vital signs prior to logging out
b. Log out so the AP can log in to document the vital signs
c. Offer to chart the vital signs for the AP
d. Recommend the AP come back later when the record is available [Show Less]