Nursing Confidentiality and Client Care: Best Practices and Decision Making, Exams of Nursing

Download Nursing Confidentiality and Client Care: Best Practices and Decision Making and more Exams Nursing in PDF only on Docsity! ATI Leadership A Questions with Answers 100% Perfect 1. A nurse is caring for several clients. Which of the following actions should the nurse take to maintain client confidentiality? A. Tell a client’s partner that the results of his wife’s lab tests cannot be disclosed without her permission B. Ask the assistive personnel to refer to clients by room number in public areas C. Explain to a student nurse that verbal permission must be obtained before using a client’s name in school assignments D. Share info about a client with immediate family members after personal ID has been provided 2. A nurse is caring for a client who asks for info about advance directives. Which of the following is an appropriate response by the nurse? *** A. Your advance directives will take effect when you are unable to make health care decisions B. You will not be able to make changes to the advance directives once you sign it C. Your advance directives can specify which medical care you do not want but cannot specify which medical treatments you can have D. You must have advance directives on record within 24hr of a hospital admission 3. A nurse assumes care of a client following morning report and notes that the client’s morning lab results have not been received. Which of the following actions should the nurse take? A. Administer the client’s insulin as prescribed B. Give the NPH and hold the regular insulin until the lab results are back C. Obtain a capillary blood glucose reading D. Hold the client’s breakfast until the lab results are back 4. A nurse on a med-surg unit is caring for four clients. The nurse should recognize that which of the following clients is the highest priority? A. A client scheduled for a tubal ligation in 2hr who is crying B. A client who has peripheral vascular disease and has an absent pulse in the right foot C. A client who has type 1 DM and needs the first dressing change for a stage II decubitus ulcer D. A client who has MRSA and has an axillary temp of 38C (100.4F) 5. A nurse has four client assignments on a maternal newborn unit. Which of the following tasks can be delegated to an AP? A. Verifying the mother’s fundal height B. Assisting the mother with cord care C. Showing the mother how to position the newborn for sleep D. Measuring output of the mother’s first voiding 6. An AP tells the charge nurse that it is unfair that she has to take care of all the clients who are incontinent. Which of the following responses by the charge nurse is appropriate? A. I delegate tasks to personnel based on their job descriptions B. Everyone working here has to care for clients who are incontinent 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 incontinent? 7. A client is considering having a tubal ligation, and she tells the nurse that she is uncertain if it is the right thing to do. Which of the following is an appropriate response by the nurse? A. Provide information on alternate birth control methods B. Ask the client if she has her partner’s approval C. Emphasize the benefits of having the procedure D. Discuss with the client her feelings about the procedure 8. A nurse manager is reviewing the stages of conflict resolution with the nursing staff. The nurse manager should instruct the staff to expect the stages of the conflict to occur in what order? A. Conflict aftermath 5 B. Felt conflict 3 C. Manifest conflict 4 D. Latent conflict 1 E. Perceived conflict 2 9. A nurse is conducting an orientation class for new clients and their families at a long-term care facility. Which of the following client rights should the nurse address at the orientation? Select all that apply A. The right to be treated with respect and dignity B. Redirect the conversation when negative comments about the changes are made C. Encourage staff members who support the changes to discuss the issue with resistant staff D. Suggest that resistant staff members transfer to a different unit E. Reprimand staff members who are resistant to the changes 19. A charge nurse is planning client care assignments for the unit. Which of the following clients should the nurse assign to an LPN? A. A client who has anemia and is scheduled for a blood transfusion B. A client who has Crohn’s disease and requires an enteral feeding C. A client who has a new diagnosis of diabetes and requires teaching for self-administration of insulin D. A client who has a pulmonary embolism and is receiving an IV infusion of heparin 20. A nurse is caring for a client who has acute diverticulitis and is scheduled for surgery within the next 2 hr. The client tells the nurse that she has called a taxicab and is leaving the hospital. After notifying the surgeon, which of the following actions should the nurse take next? A. Have the client sign the “Against Medical Advice” form B. Inform the client about the risks she may encounter by leaving the facility C. Document the client’s statements in the medical record D. Notify the risk manager 21. A nurse is observing a newly licensed nurse who is performing a sterile dressing change on a client who has a central venous catheter. Which of the following is an appropriate action by the newly licensed nurse? A. Opens the top flap of the sterile package toward herself B. Maintain a 1.25cm (1/2 inc) border around the edges of the sterile field C. Picks up first sterile glove by grasping the folded cuff edge D. Places the transparent dressing using clean gloves 22. A client presents to the ED with weakness, vomiting, and diarrhea for the past 3 days. Which of the following is the highest priority assessment for this client? A. Bowel sounds B. The client’s temperature C. Urine specific gravity D. Serum potassium level 23. A nurse is caring for a client who is refusing a blood transfusion due to religious beliefs. The provider discusses this treatment and likely outcomes with the client, who remains opposed to the transfusion. Which of the following is the appropriate intervention for the nurse? A. Have the provider reinforce the necessity of the transfusion B. Encourage the family to persuade the client to reconsider the transfusion C. Ask the chaplain to convince the client that the transfusion is acceptable D. Support the client’s decision to forego the transfusion 24. A client seen in the ED for back pain is provided a prescription for oxycodone. A staff nurse tells the charge nurse that she thinks the client is seeking drugs and is not actually in distress. Which of the following responses by the charge nurse is appropriate? A. Clients are the experts on their own pain B. Let’s withhold the oxycodone until we can consult with the provider C. Contact mental health services to arrange for a consultation D. It sounds like non-pharmacological interventions would be best for this client 25. A charge nurse is discussing issue with a staff nurse. When evaluating statements by the staff nurse, the charge nurse should recognize that which of the following reflects and intrapersonal conflict? A. I’m not sure whether I want to apply for the unit manager’s position or start a family this year B. I feel frustrated because I just readmitted a client who refuses to take his insulin C. The unit manager is more concerned with saving money than with clients getting quality care D. Every time I request an extra day off I’m denied, but other nurses’ requests are approved 26. An older adult client is brought to ED by family members. The client has stage IV pressure ulcers, and a close inspection of the wounds reveals the presence of maggots. Which of the following is the nurse’s legal responsibility regarding this situation? A. Confront the family members B. Call the local police department C. Notify Adult Protective Services D. Report the situation to facility administrators 27. A nurse working in a community health clinic is caring for four clients who each have a communicable disease. Which of the following conditions is considered a nationally notifiable infectious disease? A. Respiratory syncytial virus (RSV) B. MRSA C. C-diff D. Chlamydia trachomatis 28. A charge nurse is talking with a staff nurse following a workshop on advance directives. Which of the following statements by the staff nurse demonstrates understanding of advance directives? *** A. A client’s advance directives are not valid until the provider writes a prescription B. A health care proxy should make decisions for a client who has a terminal illness C. A family member of a client can have the living will overturned in some cases D. A client who has an acute illness may not have a DNR prescription 29. A nurse working in a long-term care facility is making a room assignment for a client who has dementia and is easily agitated. Which of the following rooms should the nurse select for the client? A. A semiprivate room near the unit’s activity room B. A newly renovated room near the entrance of the unit C. A corner room between the conference room and elevator D. A private room near the nurse’s station 30. A charge nurse is planning care for a group of clients. Which of the following tasks should be delegated to an AP? Select all that apply A. Flushing a client’s saline lock B. Ambulating a client who uses a walker C. Adding thickener to thin liquids on a client’s food tray D. Showing a client how to use an incentive spirometer E. Evaluating a client’s gag reflex before mealtime 31. A charge nurse is assigning tasks to an RN, an LPN, and an AP. Which of the following tasks should the charge nurse delegate to the RN? A. Completing an admission assessment for a client who has just transferred from the ED C. A client who has arm contusions and manifests asymmetrical thoracic movement D. A client who has abrasions to the face and is requesting medication for severe pain 41. A facility has identified an increase in health care-associated UTIs on the med-surg unit. A nurse is participating in a quality improvement process to address this problem. Which of the following should be the first step in the process? A. Determine the effectiveness of planned interventions B. Implement strategies to decrease the incidence of UTIs C. Develop a plan that outlines the process for data collection D. Establish best practice guidelines for reducing the incidence of UTIs 42. A charge nurse is delegating tasks on a nursing unit that is short staffed. A client has a prescription for a wound irrigation twice a day. Which of the following is an appropriate action for the charge nurse to take? *** A. Perform the dressing change himself on rounds B. Delegate the procedure to an AP C. Assign the procedure to an LPN D. Reschedule the procedure to be performed once per day 43. A charge nurse is evaluating a newly licensed nurse at the end of orientation. Which of the following behaviors indicates the nurse is using effective time management skills? A. Performs total care for her assigned clients B. Waits to complete charting until the end of the shift C. Uses a set list of priorities throughout the shift D. Makes a list of non-essential tasks to perform later 44. A hospital has been notified of a train derailment resulting in multiple clients experiencing life-threatening injuries. The external disaster plan has been activated. Which of the following is an appropriate action of the charge nurse on the PACU? *** A. Take extra wheelchairs to the ED B. Send PACU AP to assist with triage C. Identify stable clients for transfer to a surgical unit D. Report to the command center for further instructions 45. A nurse is caring for a client who is 3 days postop following open heart surgery and is to transfer to the medical- surgical unit. Which of the following should the nurse plan to include in the verbal report? A. The client’s dressing change schedule B. The client’s LOC C. The client’s vital signs from the previous shift D. The client’s occupation 46. A case manager is initiating the plan of care for a client receiving warfarin who had a stroke. Which of the following is most important for the case manager to include in the client’s plan of care? A. Scheduling follow-up tests for prothrombin time and INR B. Making a referral to speech therapy C. Arranging physical therapy home visits D. Providing client education related to dietary restrictions 47. A nurse manager needs to address an increased rate of client med errors. Which of the following strategies represents an authoritarian approach to managing this issue? A. Inform the staff of the penalties that can result from med errors B. Encourage the staff to have 2 nurses verify medication orders to prevent errors C. Provide a suggestion box for the staff to submit ideas for error prevention D. Ask 3 experienced nurses to help investigate common causes of the errors 48. A charge nurse is responsible for a caseload of clients on a surgical unit. Which of the following occurrences during the shift requires the completion of an incident report? A. A client’s advance directives are not in the med record B. A nurse administers a routine medication 30 min after the scheduled time when the client returns from physical therapy C. A client’s IV solution infused over 6 hr instead of the prescribed 8 hr D. A nurse documents a client’s vital signs on the graphic record at the end of the shift 49. A nurse manager is coordinating staff assignments for RNs and LPNs following a local disaster. Which of the following is an appropriate assignment by the nurse manager to provide safe and effective client care? *** A. RNs transport class IV (black tag) clients B. LPNs provide care to class III (green tag) clients C. LPNs initiate care to class I (red tag) clients D. LPNs facilitate care to class II (yellow tag) clients 50. An RN delegates the task of obtaining the BP of a client who is 2hr postop following a cholecystectomy to an LPN. The LPN reports a BP that is significantly higher than the client’s previous reading. Which of the following actions should the RN take first? A. Recheck the client’s BP B. Treat the client’s BP with a prescribed antihypertensive C. Ask the LPN to review the technique for obtaining BP D. Review the client’s medical record for other episodes of elevated BP 51. A charge nurse is performing chart reviews on infection control precautions implemented by nursing personnel during the admission of clients to the unit. Which of the following is an appropriate infection control precaution? A. Droplet precautions for a client who has meningococcal pneumonia B. Airborne precautions for a client who has shigella C. Droplet precautions for a client who has MRSA D. Airborne precautions for a client who has RSV 52. A staff nurse at a long-term care facility is evaluating an AP caring for a group of clients who require restraints. Which of the following is an appropriate action by the AP? A. Securing mitten restraints around the forearm B. Using a square knot when securing the restraint strap C. Applying the belt restraint beneath the client’s clothing D. Placing the restraint tie on a moveable part of the bed frame 53. A nurse case manager is planning a teaching session on use of critical pathways with a group of newly licensed nurses. The nurse should include which of the following in the teaching about critical pathways? A. Critical pathways promote individualized care B. Critical pathways decrease administrative work time C. Critical pathways prevent unnecessary expense D. Critical pathways incorporate provider preferences