ATI RN LEADERSHIP NGN LATEST VERSIONS 2024
ACTUAL EXAM 2 LATEST VERSIONS 140
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED
... [Show More] ANSWERS)
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1. A nurse manager is preparing to institute a new system for
scheduling staff. Several nurses have verbalized their concern over
the possible changes that will occur. Which of the following is an
appropriate method to facilitate the adoption of the new scheduling
system?
A. Identify nurses who accept the change to help influence other staff
nurses
B. Provide a brief overview of the new scheduling system
immediately before
it implementation
C. Introduce the new scheduling system by describing how it will
save the institution money
D. Offer to reassign staff who do not support the change to another
unit - ...ANSWER...B. Provide a brief overview of the new
scheduling system immediately before
it implementation OR A. Identify nurses who accept the change to
help influence other staff nurses
2. A client who is febrile is admitted to the hospital for treatment of
pneumonia. In accordance with the care pathway, antibiotic therapy is
prescribed. Which of the following situations requires the nurse to
complete a variance report with regard to the care pathway?
A. Antibiotic therapy was initiated 2hr after implementation of the
care pathway
B. A blood culture was obtained after antibiotic therapy has been
initiated
C. The route of antibiotic therapy on the care pathway was changed
from IV to PO
D. An allergy to penicillin required an alternative antibiotic to be
prescribed - ...ANSWER...A. Antibiotic therapy was initiated 2hr
after implementation of the care pathway
3. A nurse should recognize that an incident report is required when
A. A client refuses to attend physical therapy
B. A visitor pinches his finger in the client‟s bed frame
C. A client throws a box of tissues at a nurse
D. A nurse gives a med 30 min late - ...ANSWER...A. A client refuses
to attend physical therapy
5. Client satisfactory surveys from a med-surg unit indicate the pain is
not being adequately relieved during the first 12 hr post-opt. The unit
manager decides to identify post-opt pain as a quality indicator.
Which of the following data sources will be helpful in determining the
reason why clients are not receiving adequate pain management after
surgery?
A. Prospective chart audit
B. Retrospective chart audit
C. Post-operative care policy
D. Pain assessment policy - ...ANSWER...D. Pain assessment policy
6. A nurse precepting a newly licenced nurse who is caring for a
client who is confused and has an IV infusion. The newly licensed
nurse has placed the client in wrist restraints to prevent dislodging the
IV catheter. Which of the following questions should the precepting
nurse ask?
A. "Did you secure the restraints to the side rails of the bed?"
B. "Are you able to insert two fingers between the restraint and the
client's skin?"
C. "Did you tie the restraints using double knot?"
D. "Are you removing the client‟s restraints every 4 hr?" -
...ANSWER...B. "Are you able to insert two fingers between the
restraint and the client's skin?"
7. A nurse is caring for an older adult client who has stage III pressure
ulcer. The nurse request a consultation with the wound care specialist.
Which of the following actions by the nurse is appropriate when
working with a consultant?
A. Arrange the consultation for time when the nurse is caring for the
client is able to be present for consultation
B. Provide the consultant with subjective opinions and beliefs about
the client's wound care.
C. Request the consultation after several wound care treatment tried
D. Arrange for the wound care nurse specialist to see the client daily
to provide
the recommended treatment - ...ANSWER...A. Arrange the
consultation for time when the nurse is caring for the client is able to
be present for consultation
8. A client is admitted with TB and placed in a negative pressure
room. Which of the following actions is appropriate?
A. Notify the local health department of the admission
B. Place a sign on the client's door with the diagnosis
C. Ensure that admitting staff undergo PPD skin tests
D. Determine who had contact with the client in the last 48 hr -
...ANSWER...D. Determine who had contact with the client in the last
48 hr
POSSIBLY: A. Notify the local health department of the admission
9. A nurse is caring for a client who is unconscious and whose partner
is healthcare proxy. The partner has spoken with the provider and
wishes to discontinue the client‟s feeding tube. The provider states
the nurse, "I will not discontinue the client‟s treatment. His partner
has no right to make decisions regarding the client‟s care. "Which of
the following responses by the nurse is appropriate?
A. You should consider speaking with the facility's ethics committee
before making your decision
B. You have the right to make a decision, even if the partner is the
client‟s health care proxy
C. The client has designated his partner as a health care proxy in his
advance
directives.
D. We‟ll need to have the nursing supervisor review the client‟s
advance directives - ...ANSWER...C. The client has designated his
partner as a health care proxy in his advance
directives.
10. A nurse is caring for a client who has increased intracranial
pressure and is receiving IV corticosteroids. Which of the following
info is most important for the nurse to report at shift change?
A. Glasglow Coma scale score
B. Most recent blood glucose reading C. Lab test scheduled for next
shift
D. Reddened area on the coccyx - ...ANSWER...A. Glasglow Coma
scale score
11. A nurse is assigned the following four clients for the current shift.
Which of the following should the nurse assess first?
A. A client who has a hip fracture and is in Buck‟s traction
B. A client who has aspiration pneumonia and a respiratory rate of
28/min
C. A client who has diabetes mellitus stage 2 pressure ulcer on his
foot
D. A client who has a C diff infection and needs a stool specimen
collected - ...ANSWER...D. A client who has a C diff infection and
needs a stool specimen
collected
12. A nurse is caring for a client who fell and is reporting pain in the
left hip with external rotation of the left leg. The nurse has been
unable to reach the provider despite several attempts over the past 30
min. Which of the following actions should the nurse take?
A. Notify the nursing supervisor about the issues
B. Contact the client's physical therapist
C. Apply a warm compress to the hip
D. Reposition the client for comfort - ...ANSWER...A. Notify the
nursing supervisor about the issues
13. The mother of a client with breast cancer states, it's been hard for
her, especially after losing her hair. And it has been difficult to pay
for all the treatments. Which of the following actions is appropriate
for client advocacy?
A. The nurse investigates potential resources to help the client
purchase wig
B. The nurse explains to the mother that most clients with cancer lose
their hair
C. The nurse informs the next shift nurse regarding the mother‟s
concerns.
D. The nurse suggests counseling for the client‟s body image issues -
...ANSWER...A. The nurse investigates potential resources to help the
client purchase wig
14. Which of the following items must be discarded in a biohazard
waste receptacle?
A. A urinary catheter drainage bag from a client who is post-opt
B. A bed sheet from a client with bacterial pneumonia
C. A perineal pad from a client who is 24-hr post-vaginal delivery
D. An empty IV bag removed from a client who has HIV -
...ANSWER...D. An empty IV bag removed from a client who has
HIV
15. A nurse tells the unit manager, "I am tired of all the changes on
the unit. If things don‟tget
better, I‟m going to quit. "Which of the following responses
appropriate?
A. "So you are upset about all the changes on the Unit"
B. "I think you have a right to be upset, I am tired of the changes too"
C. "Just stick with it a little longer. Things will get better soon
D. " You should file complaints with hospital administrator -
...ANSWER...A. "So you are upset about all the changes on the Unit"
16. According to the HIPAA regulations, which of the following is a
violation of client confidentiality?
A. Telephone the pharmacy with a prescription for the spouse to pick
up
B. Providing a copy of the record to the transporting paramedic
C. Reporting a client‟s disposition to the referring provider
D. Informing housekeeping staff that the client is in dialysis unit -
...ANSWER...D. Informing housekeeping staff that the client is in
dialysis unit
17. A Nurse preceptor is evaluating a newly licensed nurse‟s
competency in assisting with a sterile procedure. Which of the
following actions indicates the nurse is maintaining sterile technique?
(Select all that apply.)
A. Open the sterile pack by first unfolding the flap farthest from her
body
B. Rests the cap of a solution container upside down on the sterile
field
C. Removes the outside packaging of a sterile instrument before
dropping into the sterile
field
D. Holds a bottle of a sterile solution 15 cm (6 inches) above the
sterile field
E. Places sterile items within 1.25 cm (0.5 inch) border around the
edge of the sterile field - ...ANSWER...A. Open the sterile pack by
first unfolding the flap farthest from her body
C. Removes the outside packaging of a sterile instrument before
dropping into the sterile
field
D. Holds a bottle of a sterile solution 15 cm (6 inches) above the
sterile field
E. Places sterile items within 1.25 cm NOTE: OTHER SOURCES
LIST ONLY A & C as the correct answers.
18. A nurse is providing care for 4 post-opt clients. The nurse should
first assess the client
A. Whose pulse has been steadily increasing during the past shift
B. Who is reporting a pain level of 8 on a scale of 0 to 10.
C. Whose urine output averaged 32 ml/hr for the past 24 hr
D. Who is reporting nausea after the prescribed antiemetic was
administered - ...ANSWER...B. Who is reporting a pain level of 8 on
a scale of 0 to 10.
19. A nurse is preparing to transcribe a client‟s med prescription in
the medical record. Which of the following should the nurse
recognize as containing the essential components of a medication
order?
A. NPH insulin 10 Units before and at bedtime
B. Haloperidol (Hadol) 1mg per mouth
C. Multivit every morning by mouth
D. Aspirin 650 mg by mouth every 4hr - ...ANSWER...D. Aspirin 650
mg by mouth every 4hr
20. A nurse is assisting with orientation of a newly licensed nurse.
The newly licensed nurse is having trouble focusing and has difficult [Show Less]