A.T.I Leadership Final: Graded Questions with Answers for a Guaranteed A+, Exams of Nursing

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ATI Leadership Final: Graded Questions with

Answers for a Guaranteed A+

A nurse manager is participating in a root cause analysis following a sentinel event on the unit. Which of the following statements defines the purpose of a root cause analysis? A. A root cause analysis assists in preparing a legal defense for the event. B. A root cause analysis estimates the costs involved in the event. C. A root cause analysis investigates deviations from standards of care surrounding the event. D. A root cause analysis determines if employees involved in the event should be terminated. - correct- - C. A root cause analysis investigates deviations from standards of care surrounding the event. A root cause analysis is a function of quality improvement seeking to determine what factors led to a deviation from established standards of care that resulted in errors in client care. Incorrect Answers: A. A root cause analysis does not involve preparing a legal defense regarding a sentinel event. B. A root cause analysis is a function of quality improvement in client care. It does not examine the costs involved in a sentinel event. D. As part of the quality-improvement process, a root cause analysis does not focus on individual performance but on organizational processes that led to an event. The results of a root cause analysis may indicate that employees need counseling in an effort to improve the quality of client care. /

A nurse is teaching a group of unit nurses about the Health Insurance Portability and Accountability Act (HIPAA). Which of the following pieces of information should the nurse include in the teaching? A. The Privacy Rule limits the client's rights to personal health information. B. The electronic transfer of information allows each provider to use his/her own electronic format for claim transactions. C. Standardized numbers can have a varied format for identifying health plans. D. The Security Rule provides a uniform level of security to protect client records. - - correct- - D. The Security Rule provides a uniform level of security to protect client records. The security rule provides a uniform level of protection of clients' records, which includes maintaining the confidentiality, integrity, and availability of the client's records. Incorrect Answers:A. The privacy rule gives the client the right to access personal health information and medical records. B. Providers use a standardized transfer process when transferring electronic information among health care organizations. C. A standard format is used for standardized numbers, which identify the client's health plans, providers, and employers (e.g. an employer's tax identification number). / A nurse is admitting a client who has measles. This client should be placed in which of the following types of isolation? A. Airborne

B. Producing remission C. Hastening death D. Providing comfort measures - - correct- - D. Providing comfort measures Palliative care is an approach to care that promotes comfort for a client who has a terminal diagnosis and is not receiving aggressive therapy. Palliative care focuses on managing manifestations of the disease, not on curing the disease. Incorrect Answers:A. Curing the disease is only possible when specific treatment is available. Palliative care is only an option when there is no possibility of a cure or when a client with a terminal disease has refused treatment. B. If a remission is possible with treatment, this should be offered to the client before palliative care. Palliative care is only an option when there is no possibility of a remission or when a client who has a terminal disease has refused treatment. C. Palliative care is not intended to prolong or hasten death. Instead, it seeks to provide comfort for a client who is terminally ill. / A home health care nurse is conducting a home hazard assessment. For which of the following findings should the nurse intervene? A. The client's hot water heater temperature is set to 46.1°C (115°F). B. There are 8 steps to enter the client's home. C. The client's household lamps have 40-watt light bulbs installed.

D. The bathroom has a handheld shower attachment for bathing. - - correct- - C. The client's household lamps have 40-watt light bulbs installed. The nurse needs to intervene for low-wattage light bulbs. Inadequate lighting increases the risk of falls and presents a safety hazard for the client. Incorrect Answers:A. The nurse does not need to intervene, as hot-water heater temperatures should be set to a maximum of 49°C (120°F). B. The nurse does not need to intervene for the steps leading into the client's home. The nurse should, however, assess any broken or loose steps and note the security of handrails on both sides of the stairway. D. The nurse does not need to intervene for a handheld shower attachment, as this will assist the client in bathing. The nurse should inspect the tub for a nonstick surface. /// A nurse is writing a goal for a client's reaction following the administration of a medication. This action should take place during which of the following phases of the nursing process? A. Planning B. Evaluation C. Analyzing D. Assessment - - correct- - A. Planning

Collect the staff members' input about planning and implementing the change. The nurse manager should apply the nursing process priority-setting framework to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with an assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, he/she must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with the knowledge to make an appropriate decision. Therefore, the nurse manager should first assess the situation by collecting the staff members' input and collaborating about implementing the change smoothly and efficiently. Incorrect Answers: A. The nurse manager should discuss the importance of the charge nurses' role in implementing the change; however, there is another action the nurse manager should take first. B. Educating staff members about the change will promote understanding and implementation of the new system; however, there is another action the nurse manager should take first. C. The nurse manager should enlist informal leaders in promoting the change; however, there is another action the nurse manager should take first. // A nurse is teaching a group of newly licensed nurses about violations of client rights. Which of the following examples of a violation of client rights should the nurse include in the teaching? A. A client who is confused and recovering from abdominal trauma has mitten restraints placed to prevent disruption of an abdominal wound. B. A client who has schizophrenia is placed in the seclusion room of the psychiatric unit for making frequent outbursts of obscenities directed at nurses of the opposite sex. C. A health care proxy releases the medical records of a client to a long-term care facility for a placement evaluation.

D. The parents of a 16-year-old who has gunshot wounds decide to limit their child's visitors to family members only. - - correct- - B. A client who has schizophrenia is placed in the seclusion room of the psychiatric unit for making frequent outbursts of obscenities directed at nurses of the opposite sex. Seclusion is a restraint that should be used when a client is demonstrating violent or selfdestructive behavior that jeopardizes the safety of self or others. This client does not meet the criteria for seclusion. Incorrect Answers: A. This client is at risk of causing self-injury by disrupting the abdominal wound. The nurse should apply mitten restraints, which are less restrictive than wrist restraints. C. The client's health care proxy has the authority to consent to the release of medical records. D. A 16-year-old client is a minor; therefore, the client's parents have the right to make this decision for the client. // Due to staffing shortages, a nurse manager floats a medical-surgical nurse to the pediatric unit. This nurse has limited experience with children. Which of the following actions should the nurse manager take? A. Provide constant supervision for the medical-surgical nurse. B. Have the medical-surgical nurse provide relief for unit nurses during break and lunch times. C. Assign a unit nurse to act as a resource for the medical-surgical nurse. D. Delegate assistive personnel tasks to the medical-surgical nurse. - - correct- - C. Assign a unit nurse to act as a resource for the medical-surgical nurse.

B. A toddler admitted the day before with dehydration is not considered stable; therefore, the toddler should remain hospitalized. D. An adolescent who has acute glomerulonephritis and a urine output of 20 mL/hr is not stable; therefore, the adolescent should remain hospitalized. // A nurse is preparing to give a change-of-shift report to the oncoming nurse. Which of the following pieces of information should the nurse include? A. Routine care procedures for the client B. Biographical information C. Assumptions regarding relationships among the client's family members D. Objective measurements about the client's condition - - correct- - D. Objective measurements about the client's condition The nurse should include objective observations and measurements about the client's condition in the report. Incorrect Answers: A. The nurse should not include routine care procedures for the client in the report. B. The nurse should not include biographical information for the client in the report since this information is already available. C. The nurse should not include assumptions regarding relationships among the client's family members in the report. /

A nurse is teaching a newly licensed nurse about advanced directives. Which of the following statements by the newly licensed nurse indicates an understanding of this teaching? A. "Clients are required to complete an advance directive prior to discharge." B. "If the client has a health care proxy, he/she is no longer consulted for health care decisions." C. "I will assess the client's understanding of life-sustaining measures." D. "I will ask the next of kin if I should honor the client's advance directive." - - correct- - C. "I will assess the client's understanding of life-sustaining measures." The nurse needs to assess whether the client has an accurate understanding of life-sustaining measures in order to make informed decisions in advance directives. Incorrect Answers: A. The Patient Self-Determination Act requires all health care facilities receiving Medicare and Medicaid reimbursement to ask clients if they have advance directives, but it does not require a client to complete them during hospitalization. B. The health care proxy designates someone else to make health care treatment decisions when the client is unable to do so, based on the client's wishes. If the client is alert and oriented, the nurse should consult the client for health care decisions. D. The Patient Self-Determination Act requires health care facilities receiving Medicare and Medicaid reimbursement to recognize advance directives. These directives allow clients to specify aspects of care they wish to receive if they become unable to communicate these preferences. /

A. Verify the client's list of allergies in the medical record B. Assist with placing the client onto the stretcher for transport to the surgical suite C. Complete the preoperative checklist for the client D. Call to inform the provider about the client's preoperative elevated blood glucose level - correct- - B. Assist with placing the client onto the stretcher for transport to the surgical suite Helping the client onto the stretcher for transport to the surgical suite is a skill that is within the scope of practice for the AP. Incorrect Answers: A. Verifying the client's allergies is a part of the preoperative assessment data. This is not within the scope of practice for the AP. C. A preoperative checklist is a tool for ensuring client safety and completion of nursing interventions. This documentation should be completed by the nurse, as it is not within the scope of practice for the AP. D. The nurse should call to inform the provider about the client's elevated blood glucose level. Although the AP may have obtained the high blood glucose reading, it is not within the scope of practice of an AP to call the provider. The provider might give a prescription for medication over the phone, which a nurse should transcribe into the client's medical record. / A nurse is caring for a client who is undergoing a repair of an abdominal aortic aneurysm. After the surgery and immediate postoperative recovery, the nurse should expect which of the following team members to coordinate the client's ongoing and specific needs for care?

A. Charge nurse B. Case manager C. Vascular surgeon D. Home health care nurse - - correct- - B. Case manager The case manager's role is to plan and coordinate resources and services to help meet the client's needs over the continuum of care. Incorrect Answers: A. The charge nurse's responsibilities include focusing on the day-to-day operations of the nursing unit, not on the specific needs of individual clients. C. The surgeon's responsibilities focus on intraoperative care as well as immediate postoperative needs, postoperative care, and management of complications. D. The home health care nursing staff's responsibilities include meeting the client's care needs, not coordinating them. // A nurse is caring for a client who has breast cancer and is scheduled for a mastectomy. The client tells the nurse she is concerned about how her partner will react to the procedure. Which of the following responses should the nurse make? A. "I will inform your surgeon that you are having second thoughts." B. "I think you should postpone the surgery until you are certain you want to have it done."

A.

This is a nontherapeutic response by the nurse. It changes the subject and demonstrates a lack of empathy with the client's concerns. B. This is a nontherapeutic response by the nurse and offers a personal opinion rather than professional advice to the client. D. This nontherapeutic response by the nurse makes a stereotypical remark about women undergoing a mastectomy and is insensitive to the client's concerns. // A group of providers is participating in a cardiopulmonary resuscitation effort for a client who is in cardiac arrest. Which of the following types of leadership is required for this group to function efficiently? A. Transformational B. Participative C. Autocratic D. Laissez-faire - - correct- - C. Autocratic Autocratic leadership is most effective in an emergency situation. An autocratic leader will direct and issues commands that are necessary for successful cardiopulmonary resuscitation. Incorrect Answers: A. Transformational leadership is not appropriate for an emergency situation. A transformational leader gives group members responsibilities that will enhance their professional development. In

B.

cardiopulmonary resuscitation, one person must organize the group's actions and guide the resuscitation efforts. Participative leadership, also called democratic leadership, is not appropriate for an emergency situation. A participative leader serves as a resource person and facilitator and is non-directive. In cardiopulmonary resuscitation, one person must organize the group's actions. D. Laissez-faire leadership is not appropriate for an emergency situation. A laissez-faire leader demonstrates a non-directive approach. In cardiopulmonary resuscitation, one person must organize the group's actions and guide the resuscitation efforts. /// After a disaster plan is enacted, a nurse in a pediatric unit is asked to prepare a list of clients who can be discharged home due to a local incident involving many children. Which of the following clients should the nurse place on the potential discharge list? (Select all that apply.) A. A preschooler with asthma who has scattered wheezes that resolve with PRN albuterol B. A school-age child with a femur fracture in an external fixation device whose pain is controlled with PRN oral codeine C. An adolescent client who is developmentally delayed, has a PICC line, and needs 6 more weeks of antibiotics D. A toddler with a ventricular septal defect and bronchiolitis who is on 28% oxygen by oxyhood E. An adolescent client who is 1 day postoperative following scoliosis repair and is on a PCA pump - - correct- - A. A preschooler with asthma who has scattered wheezes that resolve with PRN albuterol

D.

B. Inform the charge nurse of the client's feelings about the side rails. C. Leave the side rails down and document this decision as per the client's request.

D. Arrange for the client to discuss these feelings with another client who uses side rails. - correct- - C. Leave the side rails down and document this decision as per the client's request. Raising all four side rails can be considered a form of restraint if they restrict the client's ability to get in and out of bed. This client is on bed rest and does not require that level of mobility; however, if the client expresses a wish for the rails to be down, the client's level of consciousness is not impaired, and there is no other specific safety hazard posed by lowering the side rails, the client's request should be respected. Incorrect Answers: A. Although there is no harm in informing the provider about this request, the nurse is able to act independently and lower the client's side rails after determining the client is safe and not at risk of falling out of bed. A prescription from the provider is not required for this action. B. The nurse is able to act independently and lower the client's side rails after determining the client is safe and not at risk of falling out of bed. The charge nurse does not need to be notified. It is the responsibility of the nurse caring for the client to address the client's feelings. D. Discussing this decision with another client does not address the problem and could be considered an invasion of both clients' privacy. // A nurse in an acute care facility is implementing the facility's disaster plan following a flood in the community. Which of the following actions should the nurse take? A. Turn on clients' televisions so they can learn about the disaster. B. Identify stable clients in the ICU to transfer to the medical-surgical unit. C. Ask family members to come to the hospital to provide support to clients.