ATI Fundamentals for Nursing Edition 11.0 questions and answers solved. A nurse is disc, E, Exams of Nursing

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ATI Fundamentals for Nursing Edition 11.

1. A nurse is discussing the purpose of regulatory agencies during a staff meeting. Which of the following tasks should the nurse identify as the respon- sibility of state licensing boards? A. Monitoring evidence - based practice for clients who have a specific diag- nosis B. Ensuring that health care providers comply with regulations C. Setting quality standards for accreditation of health care facilities D. Determining whether medications are safe for administration to clients ANSWER 1. A. Utilization review committees have the responsibility of monitoring for appropriate diagnosis and treatment according to evidence-based practice for diagnosis and treatment of hospitalized clients. B. CORRECT ANSWER State licensing boards are responsible for ensuring that health care providers and agencies comply with state regulations.

C. The Joint Commission has the responsibility of setting quality standards for accreditation of health care facilities. D. The U.S. Food and Drug Administration has the responsibility of determining whether medications are safe for administration to clients.

2. 2. A nurse is explaining the various types of health care coverage clients might have to a group of nurses. Which of the following health care financing mechanisms should the nurse include as federally funded? (Select all that apply.) A. Preferred provider organization (PPO) B. Medicare C. Long-term care insurance D. Exclusive provider organization (EPO) E.. Medicaid ANSWER 2. A. PPOs, long-term care insurance, and EPOs are privately funded. B. CORRECT ANSWER Medicare and Medicaid are federally funded health insurance pro- grams. C. PPOs, long-term care insurance, and EPOs are privately funded. D. PPOs, long-term care insurance, and EPOs are privately funded. E. CORRECT

ANSWER Medicare and Medicaid are federally funded health insurance pro- grams.

3. 3. A nurse manager is developing strategies to care for the increasing number of clients who have obesity. Which of the following actions should the nurse include as a primary health care strategy?

A. Collaborating with providers to perform obesity screenings during routine office visits B. Ensuring the availability of specialized beds in rehabilitation centers for clients who have obesity C. Providing specialized intraoperative training in surgical treatments for obesity D. Educating acute care ANSWER 3. A. CORRECT ANSWER Obesity screenings at office visits is an example of primary health care. Primary health care emphasizes health promotion and disease control, is often delivered during office visits, and includes screenings. B. Care that is provided in a rehabilitation center as an example of restorative health care. C. Specialized and highly technical care is an example of tertiary health care. D. Education about postoperative complications for acute care nurses is an example of secondary health care.

4. 4. A nurse is explaining the various levels of health care services to a group of newly licensed nurses. Which of the following examples of care or care settings should the nurse classify as tertiary care? (Select all that apply.) A. Intensive care unit

B. Oncology treatment center C. Burn center D. Cardiac rehabilitation E. Home health care ANSWER 4. A. CORRECT ANSWER Tertiary health care involves the provision of specialized and highly technical care (the care nurses deliver in intensive care units). B. CORRECT ANSWER Tertiary health care involves the provision of specialized and highly technical care, such as the care nurses deliver in intensive care units, an oncology treatment center, and a burn center. C. CORRECT ANSWER Tertiary health care involves the provision of specialized and highly technical care, such as the care nurses deliver in intensive care units, an oncology treatment center, and a burn center. D. Cardiac rehabilitation and home health care are examples of restorative care. E. Cardiac rehabilitation and home health care are examples of restorative care.

5. 5. A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? (Select all that apply) A. Home health care

B. Rehabilitation facilities C. Diagnostic centers D. Skilled nursing facilities E. Oncology centers ANSWER 5. A. CORRECT ANSWER Restorative health care involves intermedi- ate follow-up care for restoring health and promoting self. care. Home health care, rehabilitation faollities, and skilled nursing facilities are types of restorative health care. B. CORRECT ANSWER Restorative health care involves intermediate follow-up care for restoring health and promoting self, care. Home health care, rehabilitation facilities, and skilled nursing facilises are types of restorative health care. C. Secondary health care includes the diagnosis and treatment of acute injury or liness. Diagnostic centers are a type of secondary health care. D. CORRECT ANSWER Restorative healóh care involves intermediate follow-up care for restoring health and promoting sell. care. Home health care, rehabilitation facilities, and skilled

nursing facilities are types of restorative health care. E. Tertiary health care is specialized and highly technical care.

6. 1. A goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional care team? A. Social worker B. Certified nursing assistant C. Registered dietitian D. Occupational therapist ANSWER 1. A. A social worker can coordinate community ser- vices to help the client, but not specifically with self-feeding devices. B. A certified nursing assistant can help the client with feeding, but does not typically procure adaptive devices for the client. C. A registered dietitian can help with educating the client about meeting nutritional needs, but cannot help with the client's physical limitations. D. CORRECT ANSWER The nurse should identify that an occupational therapist can assist clients who have physical challenges to use adaptive devices and strategies to help with self-care

activities. A certified nursing assistant can help the client with feeding but does not typically procure adaptive devices for the client.

7. 2. A nurse is caring for a group of clients on a medical-surgical unit. For which of the following client care needs should the nurse initiate a referral for

a social worker? (Select all that apply.) A. A client who has terminal cancer requests hospice care in the home. B. A client asks about community resources available for older adults. C. A client states, "I would like to have my child baptized before surgery." D. A client requests an electric wheelchair for use after discharge. E. A client ANSWER 2. A. CORRECT ANSWER The nurse should initiate a referral for a social worker to provide information and assistance in coordinating hospice care for a client. B. CORRECT ANSWER The nurse should initiate a referral for a social worker to provide information and assistance in coordinating care for community resources available for clients. C. The nurse should initiate a referral for spiritual support staff it a client requests specific religious sacraments or prayers. D. CORRECT ANSWER The nurse should initiate a referral for a social worker to assist the client in obtaining medical equipment for use after discharge. E. The nurse should provide client teaching for concerns regarding the use of a nebulizer. If

additional information is needed, initiate a referral for a respiratory therapist.

8. 3. A client who is postoperative following knee arthroplasty is concerned about the adverse effects of the medication prescribed for pain management. Which of the following members of the interprofessional care team can assist the client in understanding the medication's effects? (Select all that apply.) A. Provider B. Certified nursing assistant C. Pharmacist D. Registered nurse E. Respiratory therapist ANSWER 3. A. CORRECT ANSWER The provider must be knowledgeable about any medication prescribed for the client, including its actions, effects, and interactions. B. It is not within the scope of a certified nursing assistant's duties to counsel a client about medications. C. CORRECT ANSWER A pharmacist must be knowledgeable about any medication dis- pensed for the client, including its actions, effects, and interactions.

D. CORRECT

ANSWER A registered nurse must be knowledgeable about any medication administered, including its actions, effects, and interactions. E. Although some analgesics can cause respiratory depression, requiring assis- tance from a respiratory therapist, it is not within this therapist's scope of practice to counsel the client about medications prescribed by the provider.

9. 4. A client who had a cerebrovascular accident has persistent problems with dysphagia. The nurse caring for the client should initiate a referral with which

of the following members of the interprofessional care team? (Select all that apply.) A. Social worker B. Certified nursing assistant C. Occupational therapist D. Speech-language pathologist E. Physical therapist ANSWER 4. C, D. CORRECT ANSWER The nurse should identify that a speech. language pathologist and an occupational therapist can initiate specific therapy for clients who have difficulty with feeding due to swallowing difficulties. A. A social worker can coordinate community services to help the client, but not specifically with dysphagia. B. A certified nursing assistant can help the client with feeding but cannot assess and treat dysphagia. E. A physical therapist can assist clients who have motor challenges to improve abilities with self-care and work but cannot assess and treat dysphagia.

10. 5. A nurse is acquainting a group of newly licensed nurses with the roles of the various members of the health care team they will encounter on a medical-surgical

unit. When providing examples of the types of tasks certified nursing assistants (CNAs) can perform, which of the following client activities should the nurse include? (Select all that apply.) A. Bathing B. Ambulating C. Toileting D. Determining pain level E. Measuring vital signs ANSWER 5. A, B, C, E. CORRECT ANSWER The nurse should identify that it is within the range of function for a CNA to provide basic care to clients, such as bathing, assisting with ambulation, assisting with toileting, and measuring and recording vital signs. D. Determining pain level is a task that requires the assessment skills of licensed personnel (nurses). It is outside the range of function for a CNA.

11. 1. A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries.The nurse understands that this client's choice is an example of which of the following ethical principles?

A. Fidelity B. Autonomy C. Justice D. Nonmaleficence ANSWER 1. A. Fidelity is the fulfillment of promises. The nurse has not made any promises; this is the client's decision. B. CORRECT ANSWER The nurse identifies that in this situation, the client is exercising

their right to make their own personal decision about surgery, regardless of others' opinions of what is "best" for them. This is an example of autonomy. C. Justice is fairness in care delivery and in the use of resources. Because the client has chosen not to use them, this principle does not apply. D. Nonmaleficence is a commitment to do no harm. In this situation, harm can occur whether or not the client has surgery. However, because they choose not to, this principle does not apply.

12. 2. A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Beneficence ANSWER 2. A. Fidelity is the fulfillment of promises. Unless the nurse has specifically promised the client a pain-free recovery, which is unlikely, this principle does not apply to this action. B. Autonomy is the right to make personal decisions, even when they are not necessarily in

the person's best interest. In this situation, the nurse is delivering responsible client care. This principle does not apply. C. Justice is fairness in care delivery and in the use of resources. Pain management is available for all clients who are postoperative, so this principle does not apply. D. CORRECT ANSWER The nurse should identify that beneficence is action that promotes good for others, without any self-interest. By administering pain medication before the client attempts a potentially painful exercise like ambulation, the nurse is taking a specific and positive action to help the client.

13. 3. A nurse is instructing a group of newly licensed nurses about the responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Nonmaleficence

ANSWER 3. A. Fidelity is the fulfillment of promises. Because donor organs are a scarce resource compared with the numbers of potential recipients who need them, no one can promise anyone an organ. Thus, this principle does not apply. B. Autonomy is the right to make personal decisions, even when they are not necessarily in the person's best interest. No personal decision is involved with the

qualifications for organ recipients. C. CORRECT ANSWER The nurse should identify that justice is fairness in care delivery and in the use of resources. By applying the same qualifications to all potential kidney transplant recipients, organ procurement organizations demonstrate this ethical principle in determining the allocation of these scarce resources. D. Nonmaleficence is a commitment to do no harm. In this situation, harm can occur to organ donors and to recipients. The requirements of the organ procurement organizations are standard procedures and do not ad- dress avoidance of harm or injury.

14. 4. A nurse questions a medication prescription as too extreme in light of the client's advanced age and unstable status.The nurse understands that this action is an example of which of the following ethical principles? A. Fidelity B. Autonomy C. Justice D. Nonmaleficence

ANSWER 4. A. Fidelity is the fulfillment of promises. The nurse is not addressing a specific promise when they determine the appropriateness of a pre- scription for the client. Thus, this principle does not apply. B. Autonomy is the right to make personal decisions, even when they are not necessarily in the person's best interest. No personal decision is involved when the nurse questions the client's prescription. C. Justice is fairness in care delivery and in the use of resources. In this situation, the nurse is delivering responsible client care and is not assessing available resources. This principle does not apply. D. CORRECT ANSWER The nurse should identify that nonmaleficence is a commitment to do no harm. In this situation, administering the medication could harm the client. By questioning it, the nurse is demonstrating this ethical principle.

15. 5. A nurse is instructing a group of newly licensed nurses about how to know and what to expect when ethical dilemmas arise. Which of the following situations should the newly licensed nurses identify as an ethical dilemma? A. A nurse on a medical-surgical unit demonstrates signs of chemical impair- ment.

B. A nurse overhears another nurse telling an older adult client that if he doesn't stay in bed, she will have to apply restraints. C. A family has conflicting feelings about the initiation of en ANSWER 5. A Delivering client care while showing signs of a substance use disorder is a legal issue, not an ethical dilemma.

B. A nurse who threatens to restrain a client has committed assault. This is a legal issue, not an ethical dilemma. C. CORRECT ANSWER The nurse should identify that making the decision about initiating enteral tube feedings is an example of an ethical dilemma. A review of scientific data cannot resolve the issue, and it is not easy to resolve. The decision will have a profound effect on the situation and on the client. D. The selection of a person to make health care decisions on a client's behalf is a legal decision, not an ethical dilemma.

16. 1. A nurse observes an assistive personnel (AP) reprimanding a client for not using the urinal properly. The AP tells the client that diapers will be used next time the urinal is used improperly. Which of the following torts is the AP committing? A. Assault B. Battery C. False imprisonment D. Invasion of privacy ANSWER 1. A. CORRECT

ANSWER When recognizing cues, the nurse should identity that the AP is threatening the client; therefore, the AP is committing assault. The AP's threats could make the client become fearful and apprehensive. B. Battery is actual physical contact without the client's consent. Because the AP has only verbally threatened the client, battery has not occurred. C. Unless the AP restrains the client, there is no false imprisonment involved. D. Invasion of privacy involves disclosing information about a client to an unautho- rized individual.

17. 2. A nurse notes that an oncoming nurse smells of alcohol and seems unsteady. Which of the following actions should the nurse take? A. Report the oncoming nurse to the board of nursing. B. Confront the oncoming nurse. C. Notify the oncoming supervisor. D. Ask an assistive personnel (AP) if they smelled alcohol on the oncoming nurse's breath. ANSWER 2. A. The nurse should report the observation to the oncoming supervisor whose duty is to ensure that a thorough investigation occurs, and if the facts indicate the nurse reported to work after drinking alcohol, reporting the nurse to the state board of

nursing. B. The nurse should avoid confronting the oncoming nurse who might become hostile. C. CORRECT ANSWER The nurse's duty is to protect client safety. The nurse should report the observation to the oncoming supervisor whose duty is to ensure that a thorough investigation occurs, and if the facts indicate the nurse

reported to work after drinking alcohol, report the nurse to the state board of nursing. D. The nurse should also avoid involving another person on the shift such as the AP.

18. 3. A nurse is providing preoperative teaching for a client who is scheduled for surgery the next week. The client tells the nurse, "I plan to prepare my advance directives before I come to the hospital." Which of the following statements made by the client indicates an understand- ing of advance directives? A. "I'd rather have my brother make my decisions for me, but I know it must be my spouse.' B. "I know they won't go ahead with the surgery unless I fill out the form." C. "I plan to tell them I ANSWER 3. A. When analyzing cures, the nurse should recognize that the client can designate any competent adult to be their health care proxy. It does not have to be their spouse. B. The hospital staff cannot refuse care based on the lack of advance directives. The client has the right to decide and specify which medical procedures they want when a life- threatening situation arises.