ATILeadershipManagementProctored
Exam
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Question text
A nurse is preparing a client who speaks limited
... [Show More] English for surgery. Which of the following
is the most appropriate nursing action in obtaining informed consent from this client?
Select one:
a. The nurse should explain the procedures using pictures and hand gestures.
b. Do nothing as this is the provider’s primary concern.
d. Have the nurse respond to the client’s concerns so the provider can prepare for surgery.
c. “My Dilantin dose will be increased several days before the procedure.”
Because the therapeutic action of ECT is to induce seizures, any medications that affect the
client’s seizure threshold must be decreased or discontinued several days before the
procedure.
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The correct answer is: “My Dilantin dose will be increased several days before the
procedure.”
Question 3
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Question text
A nurse is performing initial teaching with a client who will be receiving electroconvulsive
therapy (ECT). Which statement by the client indicates a need for further teaching?
Select one:
a. “I will stop taking my lithium for 2 weeks prior to my procedure.”
b. “Before the procedure, I will have an EKG to assess for heart irregularities.”
d. “I will need to continue taking my regular blood pressure medication.”
Question text
A daughter of a client with a terminal illness pulls a nurse to the side and says, “Although my
mother’s living will states she is not to be resuscitated, the family wants everything done to
save her if she has a cardiac arrest.” How should the nurse respond?
Select one:
a. “I will contact the provider to make him aware of your request.”
b. “Since the living will is a legal document a lawyer will have to make the changes.”
Question 2
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d. “The living will documents your mother’s wishes and must be followed.”
A living will is a document that expresses the client’s wishes regarding medical treatment in
the event the client becomes incapacitated and is facing end-of-life issues. The client’s
wishes should be followed by the health care provider.
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The correct answer is: “The living will documents your mother’s wishes and must be
followed.”
Question 4
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c. Consult the hospital’s ethics committee.
If the nurse believes the provider’s actions are directly against the client’s wishes, the
nurse should contact the hospital’s ethics committee. These committees are typically
multidisciplinary and are organized to consciously and reflectively consider significant
and often difficult issues related to client care. Any nurse can consult the hospital’s
ethics committee when deemed necessary.
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The correct answer is: Consult the hospital’s ethics committee.
Question 5
c. “If your mother has a cardiac arrest, we will begin resuscitation if you wish.”
Question text
A provider informs the wife of a comatose client with terminal cancer that she will need to
sign the consent for insertion of a gastrostomy feeding tube. The nurse knows this is against
the client’s wishes. What is the appropriate action by the nurse?
Select one:
a. Prepare the consent for the wife to sign.
b. Inform the wife she cannot sign the consent
d. Ask the provider for an order for a NG tube instead.
a. “I have excellent job skills; I just need to find a new employer.”
Cognitive reframing is a simple and effective technique for reducing stress by looking at
things in a more positive light in order to experience them as less stressful. Cognitive
reframing for this client would involve building confidence in job skills and searching for a
new job.
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The correct answer is: “I have excellent job skills; I just need to find a new employer.”
Question 6
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Question text
A client is seeking treatment for stress related to unexpected loss of employment and is
engaging in the stress management technique of cognitive reframing. Which of the
following statements would indicate to the nurse that the client understands this stress
management technique?
Select one:
b. “Once I decided what was most important to me, things got easier.”
c. “I can visualize the perfect interview and being offered a new job.”
d. “When I do my daily yoga exercises, I feel so much better.”
Question text
A nurse is preparing a client with terminal illness for discharge to a nursing home when he
states: “I don’t want to go to a nursing home to die. I would rather die at home.” What
would be the most appropriate action by the nurse?
Select one:
a. Continue to make the discharge arrangements.
b. Inform the provider of the client's decision.
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d. Contact the client's case manager.
Contact the client’s case manager would be the most appropriate action by the nurse. The
case manger would be able to determine if the client’s wishes could be carried out.
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The correct answer is: Contact the client's case manager.
Question 7
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c. Assist the client to deep breathe, splinting with a pillow.
The client is experiencing respiratory acidosis from hypoventilation caused by painful
respirations due to fractured ribs. Splinting the chest wall with a pillow will decrease pain
associated with deep breathing. Deeper breaths will allow for better gas exchange, which
will correct the acidosis.
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The correct answer is: Assist the client to deep breathe, splinting with a pillow.
Question 8
Correct
c. Assess the client's reasons for feeling this way.
Question text
A client is hospitalized for multiple rib fractures following a motor vehicle accident (MVA).
The results of an arterial blood gas (ABG's) are; pH 7.30, pCO2 48, HCO3 26 and pO2 91
on 2 L/min of oxygen per nasal cannula. Which of the following interventions has
the highest priority?
Select one:
a. Increase the client's O2 delivery to 4 L/min.
b. Administer an anti-anxiety agent to calm the client.
d. Notify the health care provider of the abnormal ABG's. [Show Less]