ATI Leadership 2019 A questions verified with 100% correct answers, Exams of Leadership and Team Management

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ATI Leadership 2019 A

1. An AP tells a charge nurse that it is unfair that they have to take care of all the clients who are in continent. Which of the following responses should the charge nurse make? A. I delegate tasks to personnel based on their job descriptions B. Everyone working here has to care for clients who are in continent C. Let's talk about organizing the workflow so you care for fewer of these clients D. Why do you not want to care for clients who are in continent.? ANS A. I delegate tasks to personnel based on their job descriptions
2. A nurse on a MedSurg unit is caring for four clients. The nurse should recognize that which of the following clients is the priority? A. A client who is scheduled for a tubal ligation in two hours and is crying B. A client who has PVD and absent pulse in right foot C. A client who has T1DMN needs first dressing change for ulcer

D. A client who has MR essay and axillary temp of 38°C ANS B. A client who has peripheral vascular disease and absent pulse in right foot

3. Which of the following instructions provided by a nurse reflects effective communication regarding delegation of a task to an AP? A. Take vital signs every two hours for the client you had a choleycystectomy in room 6122 B. Check the UO at 11 o'clock for John Doe and report it to me immediately C. Report to me if the chest tube drainage is excessive for Jane doe in room 2438 D. Please notify me of any clients who is vital signs or blood glucose levels are significant ANS B. Check the UO at 11 o'clock for John Doe and report it to me immediately This instruction follows the five rights of delegation by including the requirements for right direction/communication the data to collect, client-specific information, a timeline for coat collection, and the expectation for communicating the findings back to the nurse

4. A client on a general surgical unit tells the nurse that staff members are not answering the call light promptly. The client request to be transferred to another unit. Which of the following actions should the nurse take first? A. Notify charge nurse of clients request to transfer B. Assured client that their concern has been shared with the staff C. Tell client that future calls will be answered in timely manner

D. Ask client to verbalize their expectations ANS D. Ask client to verbalize their expectations

5. A nurse is caring for a client who is recovering from a stroke. The provider recommends extracranial intracranial bypass, but the client tells the nurse that he will not have the surgery. Which of the following action should the nurse take? A. Informed the client of consequences of decreased cerebral circulation B. Initiate mental health consult to determine why client refuses surgery C. Discussed clients concerns about having the surgery D. Provide client with information on additional treatment options ANS C. Discuss clients concerns about having the surgery
6. A charge nurse is supervising the care of several clients. Which of the following actions requires intervention by the charge nurse? A. A nurse photocopying their assigned clients diagnostic test results B. AP documents a client VS on clients paper-based graph

record C. Unit secretary faxing clients lab results to the provider D. RN stays with client who is reading the medical records that were request- ed ANS A. Nurse photocopying their assigned clients diagnostic test results

7. A nurse is receiving report from the AP assigned to the nurses group of clients. Which of the following statements from the EAP indicates the client the nurse should assess first A nurse is receiving report from the AP assigned to the nurses group of clients. Which of the following statements from the AP indicates the client the nurse should assess first? A. Client who had ABD surgery three days ago and reporting feeling consti- pated B. Client who had hip surgery reports pain 4/ C. Client indwelling urinary catheter removed eight hours ago reports inabil- ity to void D. Client who is scheduled for discharge today states they are ready to sign their paper ANS C. Client who had indwelling urinary catheter removed eight hours ago reports inability to void

8. A nurse manager is planning an in-service for a group of nurses about caring for clients following stem cell transplant. Which of the following instructions should the nurse manager include in the teaching? A. Assigned to clients who have had a stem cell transplant to the same room B. Obtain rectal temp Q4 hours C. Where an N 95 respirator mask while caring for these clients

D. Place clients in positive pressure airflow rooms ANS D. Place clients and positive pressure airflow rooms. The patient requires protective equipment precautions following a stem cell trans- plant in a private, positive pressure airflow room. The room air is filtered through a HEPA filter and the air flow rate is set at more than 12 error exchanges per hour

9. A nurse is developing a plan of care for a school age child whose family is homeless. Which of the following findings should the nurse identify as a priority? A. Child has red fissures at the corners of their mouth B. Child has several small bruises on both legs C. Child sleeps for 13 H hour each night D. Child is not regularly attending school ANS A. Child has red fissures at the corners of the mouth. use Maslow's hierarchy of needs, This can indicate a vitamin B deficiency which is a physiological need
10. A charge nurse recognizes a trend of poor attendance at monthly staff meetings. To address this issue, which of the following actions should the nurse charge nurse take first?

A. Write a memorandum emphasizing the importance of attending staff meet- ings B. Appoint a task force to promote attendance at the meetings C. Explore the reasons that staff are not attending the meetings D. Reduce the number of meetings the staff are required to attend ANS C. Explore the reasons the staff are not attending the meetings

11. A nurse walks into the nurses station and see several staff members looking at the EMR record of a celebrity client on another unit. Which of the following actions should the nurse take first? A. Remind the staff members that this is a breach of confidentiality B. Discuss the issue with the nurse manager C. Request that administrative restriction be placed on the clients record access D. Prepare a memo for facility ethics committee ANS A. Remind the staff members that this is a breach of confidentiality
12. A nurse is providing preop teaching for a client who is scheduled for a TKA and speaks a different language than the

nurse. Which of the following

inter-professional team members should the nurse include in the discus- sion? ANS Interpreter

13. A nurse is reviewing a clients clinical pathway upon discharge following hip arthroplasty. Which of the following information can assist the nurse in evaluating the cost effectiveness of the care? A. The age of client B. Availability of community support groups C. Length of clients stay D. Type of insurance the client carries ANS C. Length of clients stay
14. A nurse is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following actions should the nurse plan to take? A. Assess clients incision Q8 hours for first 48 hours B. Inform AP of clients weight bearing status C. Instruct client to cross legs at ankles when sitting D. Teach clients partner to assist the client to flex the hip at least 120° each hour ANS B. Inform the AP of the clients weight bearing status
15. A case manager is planning interprofessional conference

for a client who is three days postop following ORIF of right hip. Which of the following concerns is the priority for discussion at the conference? A. Client does not have transportation for DC home B. Client refuses to attend PT sessions C. Clients home health nurse has not completed the home assessment D. Client describes feelings of depression after family visits ANS B. Client refuses to attend PT sessions. The greatest risk to this client is postoperative complications due to immobility, such as atelectasis or pneumonia

16. A nurse is caring for a client who has osteoarthritis and reports difficulty buttoning their clothes. The nurse should recommend a referral for the client to which of the following members of the inter-professional team? A. Podiatrist B. Social worker C. Para medical technologist D. Occupational therapist ANS D. Occupational therapist The nurse should recommend a referral to an occupational therapist for a client who has osteoarthritis and reports difficulty with ADLs, such as buttoning clothing. Occupational therapy can assist the client with exercises to help the client complete

these tasks. A podiatrist specializes in the care of clients who have conditions involving the feet and ankles. A social worker specializes in counseling and care of clients who have concerns related to psychosocial needs, such as financial or domestic issues. A paramedical technologist specializes in the performance of medical procedures such as phlebotomy or ECG monitoring.

17. A charge nurse is observing a newly licensed nurses use of time man- agement skills. Which of the following actions by the newly licensed nurse indicates effective use of the skill? A. Documents client tasks at end of shift B. Gather supplies as needed while completing activity C. Groups tasks that are in same location D. Skips breaks throughout the day to complete work on time ANS C. Groups tasks that are in same location The newly licensed nurse should group tasks that are in the same location to effectively use time. This prevents the nurse from going back and forth from one area to another. This action promotes effective time-management skills.
18. A nurse is caring for a client who requests pain medication. The nurse fulfills a promise to return with the

med within 15 minutes. The nurse is demonstrating which of the following ethical principles? beneficen ce utility justice Fidelity ANS Fidelity; actions are taken to display loyalty and keep a promise made to the client. Beneficence; actions are taken to "do good" and promote goodness and kindness. Utility; actions are taken to bring the most to the greatest number of people, where the good of many will outweigh the needs of an individual client. Justice; actions are taken to seek fairness, where all clients are treated equally regardless of sex, sexual orientation, religion, ethnicity, disease, or social standing.

19. A nurse is planning DC care for a client who had a stroke and now has left side weakness. Which of the following interventions should the nurse include in the plan of care? A. Request purchase from DME B. Advise patient to install grab bars in bathroom at home C. Encourage client to allow HHA to perform ADLs discourages indepen- dence D. Contact Hospice to provide F/you care ANS B. Advise patient to install grab bars in bathroom at home
20. A charge nurse is leading a committee that is revising the policy for client discharge. After developing the initial plan, which of the following actions should the nurse take next? A. Set target dates for completion B. Identify areas of support C. Determine goals and objectives D. Implement recommended strategies ANS C. Determine goals and objectives
21. A nursing unit is undergoing changes to accommodate new bariatric ser- vices that will be available on the unit. Some staff members have verbalized displeasure with these changes. Which of the following action should the charge nurse take? Select all that apply -role model a positive approach to changes -redirect the conversation with staff make negative comments

about the changes -encourage staff members who support the changes to discuss the issue with resistant staff -suggest that resistant staff members transfer to different unit -reprimand staff members who are resistant to the changes ANS Role model a positive approach to changes. encourage staff members who support the changes to discuss the issue with resistant staff 22.A nurse on a mental health unit is teaching a newly licensed nurse about client rights. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? ANS D. Clients on a mental health unit can refuse their medication 23.A nurse on a MedSurg unit has arrive late to work multiple times over the past several weeks. Identify the sequence the nurse manager should follow when disciplining the employee ANS Schedule a meeting with the nurse

provide a written reprimand temporarily remove the nurse from scheduled shifts terminate the nurses employment

24. A nurse is planning to do you see of a newborn who requires apnea monitoring at home. To which of the following community agencies should the nurse anticipate referring the guardian of the newborn? Child protective services Public health Home health Women, Infants, and Children ANS Home health 25.A client who has back pain presented to the ER and is provided a prescription for oxycodone. A staff nurse tells the charge nurse that they think the client is seeking drugs and is not actually in distress. Which of the following responses should the charge nurse make? ANS Clients are the experts on their own pain
25. A nurse asks a newly hired a P to remove a clients indwelling urinary catheter. Which of the following actions should the nurse take to ensure the AP is qualified to perform this task

Show the AP how to remove an indwelling urinary catheter. Review the AP's skill competency checklist. Ask the AP if they know how to remove an indwelling urinary catheter. Pair the newly hired AP with an experienced AP. ANS Review the AP skill compe- tency checklist

27. A nurse manager is teaching about confidentiality requirements to the staff. Which of the following staff comments indicates an understanding of the teaching? "Change-of-shift report can be given at the client's bedside." "I can provide client information over the phone if the caller identifies them- selves as family." "A client cannot see their medical record because it is considered to be property of the facility."

"Access to client information is limited to direct care providers." ANS Change of shift report can be given at the clients bedside

28. Two nurses on a unit H contend that the other is not doing fair share of work. The conflict is affecting the functioning of the unit. A charge nurse should approach this conflict in which of the following ways? Schedule the nurses to work on alternating shifts. Organize a task force to evaluate the situation. Tell the nurses that it is their responsibility to cooperate with coworkers. Explore alternative solutions to address unit workflow with the nurses. ANS Ex- plore alternative solutions to address unit workflow with the nurses 29.A nurse is assigning care for for clients. Which of the following task for the Nurse plan to tailgate to AP? ANS Determine the client intake and output 30.A nurse is caring for a client who was hospitalized and has expressive aphasia. The clients family reports that the nurse failed to obtain written informed consent before inserting a indwelling urinary catheter. Which of the following responses should the nurse make ANS This is a procedure that does not require written informed consent

31. Facility has been notified of a train do you rail meant resulting in multiple clients experiencing life-threatening injuries. The external disaster plan has been activated. Which of the following action should the charge nurse on the PACU take? Take extra wheelchairs to the emergency department. Send PACU assistive personnel to assist with triage. Identify stable clients for transfer to a surgical unit. Report to the command center for further instructions. ANS Identify stable clients for transfer to a surgical unit
32. A charge nurse is preparing to observe a newly licensed nurse perform a routine abdominal assessment. Which of the following action should the charge nurse expect the newly licensed nurse to take? Place the client in a dorsal recumbent position for the examination. Auscultate for vascular bruits with the diaphragm of the stethoscope. Begin the assessment by using light palpation over the abdomen. Ensure that the client has a full bladder before beginning the procedure. ANS - Place the client in a dorsal recumbent position for the exam or supine position and ensure that the client relaxes her abdominal muscles

33. A nurse is caring for a client who is scheduled for outpatient surgery. Which of the following actions should the nurse take to verify the client gave informed consent? Verify that the client understands the risks of the surgery. Ask the client to explain the procedure that is being performed. Answer the client's questions about the outcomes of the surgery. Determine if the client understands the benefits of the procedure. ANS Ask the client to explain the procedure that is being performed
34. A nurse is caring for a client who has a terminal illness and voice his concern about performing self-care after discharge. Which of the following statement should the nurse me "A social worker will address your concerns after discharge." "You should plan to go to a skilled nursing facility after discharge." "Your case manager will coordinate the resources you will need." "You will need hospice care until you feel stronger." ANS Your case manager will coordinate the resources you will need
35. A charge nurse is observing a newly licensed nurse who is caring for a client who has pulmonary tuberculosis. The charge

nurse should expect the newly licensed nurse to take which of the following actions? Place the client on droplet precautions. Place the client in a room with positive-pressure airflow. Wear a surgical mask when taking the client out of the room. Wear an N95 respirator mask when in the client's room. ANS where an N 95 respirator mask when in the clients room

36. A nurse is serving on a committee that is considering the creation of a policy that will allow nurses to insert peripherally inserted central catheter's in the intensive care unit. Which of the following resources should the nurse consult in planning for this policy? National League for Nursing (NLN) American Academy of Nursing (AAN) Agency for Healthcare Research and Quality (AHRQ) State Nurse Practice Act (NPA) ANS State nurse practice act

• The nurse should consult the NPA in this situation because the NPA defines the scope and boundaries of professional nursing practice. The NPA provides

guidelines for developing standardized procedures within specific facilities where expanded nursing functions have been approved in collaboration with nurses, providers, and administration. The NLN is a national organization for faculty nurses and leaders in nurse ed- ucation. It offers faculty development, networking opportunities, testing services, nursing research grants, and public policy initiatives. The AAN is a professional organization that generates, synthesizes, and dissemi- nates nursing knowledge to contribute to health policy and practice for the benefit of the public and the nursing profession in general. The AHRQ is part of the United States Department of Health and Human Services, which supports research and is designed to improve the outcomes and quality of health care.

37. A nurse manager needs to address increased rate of client med errors. Which of the following strategies represents an authoritarian approach to managing the issue? Inform the staff of the penalties that can result from medication errors. Encourage the staff to have two nurses verify medication orders to prevent errors. Provide a suggestion box for the staff to submit ideas for

error prevention. Ask three experienced nurses to help investigate common causes of the errors. ANS Inform the staff of the penalties that can result from medication errors

• The nurse manager is using penalties to promote behavior change; this is characteristic of authoritarian leadership. 38.A nurse received notification of a fire on the unit which of the following actions should the nurse take first question ANS Assist clients who are in immedi- ate danger to a safe location

39. I charge nurse is observing a nurse perform a sterile dressing change. Which of the following actions should the charge nurse identify as demon- strating sterile technique The nurse places the sterile package with the top flap opening away from the body. The nurse pinches the flap on the inside of the package first to open it. The nurse reaches over the package to open the left flap.

The nurse pulls the last flap of the package away from the body. ANS The nurse place is the sterile package with the top flap opening away from the body 40.A nurse is reviewing safe use of wheelchair with a group of aAPWhich of the following instruction should the nurse include ANS Raise the foot plates of the wheelchair before transferring the patient

41. I charge nurse is planning client care assignments for the unit. Which of the following tasks should the nurse assigned to LPN? Determine the swallowing ability of a client who has had a stroke. Provide an enteral feeding to a client who has Crohn's disease. Develop a teaching plan for a client who has a new diagnosis of type 2 diabetes mellitus. Weigh a client who is 3 days postoperative following coronary artery bypass grafting. ANS Provide entry feeding to a client who has Crohn's disease
42. A client is considering having a tubal ligation and reports being uncertain about if it is the right thing to do. Which of the following actions should the nurse take? Provide information about alternate birth control

methods. Ask if the client has discussed the decision with their partner. Emphasize the benefits of having the procedure. Discuss the client's feelings about the procedure. ANS Discuss the clients feelings about the procedure

43. A nurse manager is auditing client charts and identifies an increase in ventilator associated pneumonia. Which of the following actions should the nurse manager take? Report the findings to the hospital ethics committee. Alert central supply. Fill out an incident report. Notify the quality improvement team. ANS Notify the quality improvement team 44.A nurse is caring for a client who is terminally ill and receiving nutritional support. The clients adult children disagree about continuing nutritional sup- port. The dilemma is referred to the ethics committee. Which of the following actions should the nurse expect the committee to take? ANS Assist in weighing the options involved in the decision. Ethics committees are members of the interprofessional team who assist with