A.T.I Leadership Focused Review: Multiple Questions with Correct Answers for Exam Success, Exams of Nursing

Download A.T.I Leadership Focused Review: Multiple Questions with Correct Answers for Exam Success and more Exams Nursing in PDF only on Docsity!

ATI Leadership Focused Review: Multiple Questions

with Correct Answers for Exam Success

A nurse is orienting a newly licensed nurse to the procedure involved in obtaining informed consent. The nurse knows informed consent is based on the ethical principle of - - correct- autonomy. By the middle of a shift, two of the three nurses working have gone home ill, leaving the nursing unit short staffed. Which of the following is the most appropriate action for the charge nurse? - correct- - Call the nursing supervisor and request additional staff. Which of the following observations made by a nurse should be reported to the nurse manager as a violation against HIPPA? - - correct- - Talking about clients with other nurses in the cafeteria An RN is part of a team that consists of a licensed practicval nurse (LPN) and an assistive personnel (AP). One of the clients the team is assigned to care for has a small bowel obstruction and is NPO with a nasogastric (NG) tube set to continuous drainage. Which of the following tasks must be retained by the RN? - - correct- - Assess for bowel sounds every 2 hr. A nurse manager calls a meeting of the unit's staff members to discuss cost containment issues. The nurse manager has asked for member input regarding strategies that might help reduce costs. The nurse understands that this is an example of which of the following types of leadership? - - correct- - Democratic A client receiving care from a home health nurse asks what is included in a living will. The nurse explains that a living will is a document that - - correct- - allows the client to express personal wishes regarding health care decisions A nurse is completing a variance (or incident) report after administering an incorrect dose of medication to a client, even though the client experienced no ill effects from the error. The nurse

should understand that the purpose of completing the variance report is to - - correct- - identify situations that contribute to the occurrence of mediation errors. An assistive personnel (AP) who appears to be under the influence of alcohol reports to duty on the night shift. Which of the following is an appropriate response by the charge nurse? - correct-

• Ask the nursing supervisor to observe the AP and validate the charge nurse's suspicions. A nurse is concerned that some of the behaviors of the night charge nurse seem to be unprofessional. The charge nurse repeatedly asks the nurse for assistance with client care and brushes up against the nurse during the completion of the tasks. One night, the charge nurse asks the nurse to go out on a date and indicates that a sexual relationship between them would mean a better schedule for the nurse. The first action that the nurse should take in this situation is to - - correct- - tell the charge nurse in clear terms that this conduct is causing feelings of discomfort and that the behaviors are to stop immediately. An adult client who has an injury that requires immediate surgical intervention is being transferred from a small, rural hospital to a Level I emergency department. The client has been medicated during transport with intravenous meperidine (Demerol). The receiving nurse understands that consent for the surgery - - correct- - should be obtained from a relative of the client A nurse manager believes that a nurse is taking breaks that are too frequent and too length. Which of the following is an assertive statement that the charge nurse should use to initiate discussion of the issue? - - correct- - "I understand that you are allowed to take scheduled breaks during each shift, but I have noticed that you are taking more than the number allocated. I would like to schedule a time when we could discuss this behavior." A client in a long term care facility falls out of bed, fracturing the left hip. The side rails on the bed were not raised at bedtime, although this client was identified to be at risk for falling. The nurse recognizes this incident as an example of - - correct- - negligence. A nurse obtains blood samples for type and cross match from two clients who are both scheduled for surgical procedures in the morning. Later in the shift, the nurse becomes concerned that the labels on the specimens may have been accidentally switched. Due to the nature of the procedures, the nurse believes that neither client I likely to require a transfusion.

A nurse who is preparing a client teaching session is interrupted to admit a new client. By the end of the shift, the nurse still has not completed the teaching and reports this to the night shift nurse. The day shift nurse expresses frustration at not meeting the client's needs due to workload. The night shift nurse recognizes this nurse is most likely experiencing which of the following? - - correct- - Intrapersonal conflict A nurse in an emergency department has admitted several clients for further observation and assessment. Which of the following clients requires the nurse to inform the proper agency, secondary to the nurse's role as a mandated reporter? - - correct- - A child who was left unsupervised for several hours at home and is being treated for a fractured leg Two nurses on the same shift request the same weekend off, and no other nurses are available to cover the request. The nurse manager decides the nurse who put in the request first will be granted time off, and the other nurse will need to work. Using this conflict resolution strategy, the nurse manager's actions should produce which of the following outcome results. - - correct- Win-lose A nurse is caring for a client who is in the bathroom. The nurse hears a loud thud and, after opening the bathroom door, sees the client on the floor. The nurse's first action should be to - correct- - determine unresponsiveness. A charge nurse is making assignments for the oncoming shift. Which of the following clients is appropriate for the charge nurse to assign to a licensed practical nurse (LPN)? - - correct- - A client who is disoriented and awaiting transfer to a long-term care facility. A client who received a sedative-hypnotic medication at bedtime becomes confused during the night. The client gets out of bed and falls, sustaining a laceration that requires suturing. Which of the following statements should be included as part of the nurse's documentation in the client's chart? - - correct- - "Client found sitting on the floor with 3 cm laceration above left eyebrow. Oriented to name only. Primary care provider notified." A mayor has been admitted to an oncology unit. A local newspaper report phones the unit seeking information and states, "It is the public's right to know the health status of elected

officials." Which of the following is an appropriate response by the nurse in relation to this statement from the news media? - - correct- - Refer all inquiries to the nursing supervisor. A nurse is working with an assistive personnel (AP) in a long term care facility. According to the five rights of delegation, which of the following determinations should the nurse make prior to assignment of tasks? - - correct- - The degree of supervision that the AP will require to complete the task Because of recommendations following a regulatory agency visit, the nurse manager mandates a policy change. One of the nurses on the unit is very resistant to the change, and the nurse manager notes that the nurse does not deliver care according to the new policy. Which of the following actions is appropriate to take with the nurse who is resisting the change? - - correct- Encourage the nurse to verbalize reasons for resisting the change. A nurse wants to support a health related bill that is due to be addressed by the state legislature. Which of the following statements by the nurse is appropriate to include in a letter to the state legislator? - - correct- - "I would like to request your support of State Bill 132 regarding appropriations for rural health clinic funding." A nurse is reviewing client assignments and wishes to delegate several tasks to an assistive personnel (AP). The nurse is unsure if a certain task is within the scope of practice for the AP. Which of the following sources of information should the nurse consult to determine if the task can be delegated? - - correct- - Hospital policy manual A member of the interdisciplinary health care team approaches a nurse and begins to shout loudly about a radiology test that had been delayed. Which of the following responses is appropriate? - - correct- - Ask the team member to lower his voice and restate his concern. An adolescent client in a rehabilitation setting has a computer, radio, DVD player, and video game unit all turned on at the same time for most of the day. The nurse notes that there are not enough electrical outlets and that extension cords with multiple outlets are in use to accommodate this equipment. Which of the following is an appropriate nursing action? - correct- - Explain to the client that extension cords cannot be used for safety reasons and that she may call the staff if she wants something plugged in that is not currently connected.

A nurse is caring for four clients who are scheduled for diagnostic tests. The nurse will need to obtain written consent from the client who is to receive which of the following tests? - - correct- Cerebral arteriogram Nurse is reviewing the process of medication reconciliation with a newly licensed nurse. The nurse should include? - - correct- - The purpose of medication reconciliation is to prevent adverse medication reactions. Caring for a client who falls in his room. Nurse assesses the client, notifies provider, and completes incident report, which action should the nurse take next? - - correct- - Submit the incident report to the risk manager. Following a tornado, a nurse is determining which of the clients assigned to her care can be discharged to free up beds for injured clients. Which client should be recommended for discharge? - - correct- - A young adult client who has Crohn's disease and is 1 day preoperative for an ileostomy. AP comes to work with a new set of artificial nails. The nurse takes the AP to a private location to discuss the issue. Which of the following is appropriate? - - correct- - There is a higher risk of infection for our clients associated with artificial nails. Nurse has several tasks to delegate to an assistive personnel. Which of the following tasks should the nurse ask the AP to perform first? - - correct- - Take an arterial blood gas specimen to the laboratory. Nurse manager is reviewing the admission history of four adults who were admitted to the med/surg unit during the shift. which situation is the nurse required to disclose information to an outside agency about the client & circumstances? - - correct- - A dependent adult admitted for the treatment of a spiral fracture. An AP tells the manager that she observed a nurse on the unit removing morphine from syringes prior to administering the medication to clients. Which action should the manager take first? - correct- - Gather data about the nurse's work performance and attendance history.

Client with severe head injury and is declared brain dead. Transplant coordinator has spoken to family about organ donation. Client's spouse is confused and doesn't know what to do. What is the appropriate response? - - correct- - What do you think your spouse would have wanted? Which lab finding requires follow up? BUN 15 mg/dL Platelet count 60,000/mm WBC 6,000/mm Hemoglobin 14 g/dL - - correct- - Platelet count 60,000/mm Older client with terminal illness and ventilator dependent. Client is A&O and wants to discontinue ventilator. Continued treatment against the client's wishes is a violation of? Veracity Autonomy Fidelity Justice - - correct- - Autonomy Nurse prepares a soap suds enema to a client with constipation. Nurse explains procedure and client states "Doctor didn't tell me I was supposed to receive an enema." Which of the following nursing actions is appropriate at this time? - - correct- - Check the client's medical record for the providers prescription. Manager is reviewing Good Samaritan laws with a group of newly licensed nurses. Which statement is appropriate? - - correct- - "If you render aid in an accident, do not leave the scene until another competent person can take over." Nurse overhears two APs from med/surg discussing a client in the cafeteria. Which of the following is the priority nursing action? - - correct- - Quietly tell the APs that this is not appropriate.

A volunteer assigned to the peds unit reports to the charge nurse for an assignment. Which assignment is unsafe for the volunteer? - - correct- - Transporting a school age client who is in traction to another department. Charge nurse has access to the facility's electronic client records. It is appropriate for the charge nurse to share her personal password with whom? - - correct- - No one. Nurse prepares to bathe a client. Which action should the nurse take? - - correct- - Pull the curtain around the client's bed. Nurse is caring for a client who is scheduled to have surgery. In preparing the client for surgery, which of the following actions is considered outside the nurse's responsibilities? - - correct- Explaining the operative procedure, risks, and benefits. Nurse in a long term care facility has assigned a task to an AP. AP refuses to perform the task. Which of the following is an appropriate statement for the nurse to make? - - correct- - I need to talk to you about the unit policies regarding client assignments. Nurse has been reassigned from her regular area of work to a unit that is short staffed. Which action should the nurse take first? - - correct- - Ask what she will be assigned to do. Nurse is participating in a disaster simulation in which a toxic substance is released into a crowded stadium. Multiple clients are transported to the facility. Which of the following activities would be lowest priority for the nurse? *Preventing cross contamination of clients *Performing concise client assessment *Transferring client to discharge location *Maintaining a client tracking system - - correct- - Transferring client to discharge location.

Place the steps in order for fire emergency. *Pull the fire alarm *Confine the fire *Extinguish the fire *Rescue the clients - - correct- - Rescue the clients. Pull the fire alarm. Confine the fire. Extinguish the fire. Which situation would the nurse complete an incident report? +Nurse ID's broken piece of equipment +Staff member doesn't show up for their shift. +Client discovers that his dentures are missing. +Nurse has a disagreement with supervisor about inadequate staffing. - - correct- - Client discovers that his dentures are missing. Charge nurse notes a staff nurse delegates an unfair share of tasks to the AP and the nurses on the next shift report the staff nurse frequently leaves tasks uncompleted. Which statement should the charge nurse make to resolve this conflict? - - correct- - I need to talk to you about unit expectations regarding delegating and completing tasks. Nurse is working with an AP to care for a group of clients on the pediatric unit. Which of the following tasks should the nurse have the AP perform first? - - correct- - Check to see if the elbow restraint is in place for an infant who is postoperative from a surgical correction of a cleft palate.

(Incorrect answers are Providing discharge instructions to a confused client's spouse & Initiating a plan of care for a client who is postop from appy.) Client has been taking warfarin at home and lab value shows INR of 3.5. She wants to check herself out and refuses to wait until her provider can discuss the situation. What action does the nurse take? - - correct- - Explain the risk the client faces if she leaves the facility. Client 6 hr postop from total hysterectomy. What part of the SBAR includes oxygen saturation and apical heart rate? - - correct- - Assessment Caring for preop patient. Nurse signs as a witness on the client's consent form. Nurse signature on the consent form indicates which of the following? - - correct- - Confirms the client appears competent to provide consent. Health Care Proxy -- which statement needs clarification? - - correct- - I have to choose a family member as my health proxy. When planning delegation of tasks to AP, a nurse considers the 5 rights of delegation. Which of the following should the nurse consider when using one of the 5 rights? +AP ability to prioritize +AP has knowledge & skill to perform task +AP rapport with clients +AP ability to complete task without assistance - - correct- - AP has knowledge & skill to perform task Nurse should delegate collection of which of the following specimens to the AP? +Wound drainage for culture +Urine from the indwelling catheter +Blood of PaCO

+random stool specimen - - correct- - Random stool specimen Nurse on med/surg has accepted a transfer to ICU. Prior to transfer, nurse completes an online critical care & emergency nursing course. The nurse demonstrating which of the following principles? Veracity Autonomy Fidelity Nonmaleficence - - correct- - Nonmaleficence Nurse is caring for a client in research study for experimental chemo. After three treatments, the medication is discontinued due to evidence of rapidly advancing kidney failure. Nurse should understand discontinuing the medication follows which ethical principle? Veracity Autonomy Fidelity Nonmaleficence - - correct- - Nonmaleficence Nurse in acute care setting is serving on a committee whose charge is to use the auditing process to client care. Which of the following aspects of client care is measured by a process audit? - correct- - Quality of nursing care provided. Nurse is caring for a client dying of metastatic breast cancer. Nurse is concerned that administering a dose of pain medication might hasten the client's death. Which ethical principle should the nurse use to support the decision not to administer the medication? - - correct- Nonmaleficence Nurse experiences a needle stick injury. First action by nurse? - - correct- - Wash the site of injury with soap and water.

Which statement b the nurse giving report indicates to the oncoming nurse that she should assume total care for the client, rather than assigning tasks to AP? - - correct- - The client's BP and pulse have been fluctuating throughout the day. Nurse manager preparing for inservice program for the nurses on the unit about the new infusion pump. Which teaching strategies is most effective? - - correct- - Demonstrate using the device and observe the staff returning the demonstration. Home health nurse is planning care for a client with Alzheimer's. The partner is primary caregiver and reports no having enough time to complete his errands. Which referral should be made? +Hospice Care +Restorative Care +Mental Health Care +Respite Care - - correct- - Respite Care A nurse is triaging clients following a mass casualty event. Which client is emergent? +punctured femoral artery +multiple fractures +red rash over abdomen +severe flank pain radiating to the groin - - correct- - punctured femoral artery Manager received client request not to have a specific staff nurse care for her while at the facility. Which is the appropriate action? - - correct- - Address the concern with the specific staff nurse. Charge nurse is providing inservice for staff nurses on the use of new IV pumps. Which is the best way to evaluate staff competency with the new equipment? - - correct- - Allow time during the workday when each nurse can demonstrate proficiency. The nurse should delegate meal assistance of which of the following clients to the AP?

+lumbosacral spinal tumor +Guillain Barre Syndrome +ALS (amyotrophic lateral sclerosis) +Systemic sclerosis - - correct- - Client with lumbosacral spinal tumor (client not at risk for dysphagia) Nurse checks with AP on the unit throughout the shift to determine if they are completing tasks. This is which rights of delegation? - - correct- - Right Supervision Charge nurse hears provider speaking to a staff nurse in anger concerning incorrect supplies that are available to perform a procedure. Which statement is appropriate? - - correct- - It must be very frustrating when you don't have what you need to perform the procedure. Manager is preparing inservice program about managing conflict for the nurses on the unit. Which is an example of interpersonal conflict? - - correct- - An experienced nurse is uncivil to a newly licensed nurse. (Interpersonal conflict arises from differing goals and value systems. Ex. incivility and bullying) Triaging clients following a mass casualty event. Which should be assessed first? - - correct- - A client who has severe respiratory stridor and deviated trachea. Preparing to witness informed consent for a client who is preoperative. Client asks "Are there other options besides surgery?" Which response is appropriate? - - correct- - Have you discussed other treatments with your provider? Manager is providing an inservice program about delegation to AP with staff nurses on the unit. Which indicates understanding? - - correct- - The nurse should consider APs level of experience when making delegation decisions.

Nurse is teaching group of newly hired nurses about the requirements for disaster planning. Which of the following statements by one of the newly hired nurses indicates an understanding of the teaching? - - correct- - Disaster drills should be held on a regular basis. A nurse notes a provider frequently arrives to the unit with bloodshot eyes and smells like alcohol after lunch. Which of the following actions should the nurse take? - - correct- - Notify the nursing supervisor of the concerns. A nurse on a quality control committee is evaluating the results of recently implemented measures designed to reduce client medication errors. Which of the following methods should the nurse use to evaluate the success of the changes? a. Establish a benchmark to identify a standard of performance. b. Compare the number of medication errors before and after the action was implemented. c. Provide the staff with a questionnaire to quantify staff satisfaction with the changes. d. Conduct a study about the time and money costs of implementing the change. - - correct- - b. Compare the number of medication errors before and after the action was implemented. A nurse is caring for an older client who is disoriented and has a history of falls. Which action should the nurse take? +Raise all side rails on the client's bed +Obtain a prescription to restrain the client PRN +Check on the client hourly. +Instruct the client in the use of the call light +Apply an ambulation alarm to the client's leg - - correct- - +Check on the client hourly.

+Instruct the client in the use of the call light +Apply an ambulation alarm to the client's leg RN from maternal newborn is being floated to med/surg. Which of the following clients should the charge nurse on med/surg unit plan to assign to the RN? +terminal end stage renal disease +acute pancreatitis +one day post op following total abdominal hysterectomy +stroke and is to be admitted - - correct- - one day post op following total abdominal hysterectomy Nurse getting health history from a client who has a new prescription for glyburide to treat T2D. Which indicates a contraindication for taking the medication? - - correct- - I plan to continue nursing my baby until he is at least a year old. Teaching a newly licensed nurse about methods to reduce costs of client care. Which statement indicates understanding of the teaching? - - correct- - "I should encourage clients to receive an annual flu immunization." (Prevent the need for treatment and hospitalization necessary with flu) Client on med/surg is terminally ill and tells nurse she feels hopeless. Appropriate nurse statement? - - correct- - "Tell me what you understand about your illness." Nurse is caring for 4 clients who are 24 hrs post op. Which client is priority? +BG of 110 pre meal, and post meal 160 +wound drainage sanguineous and now serosanguineous +pain of 4/10 and now up to 6/ +BP at 0800 of 138/86 and at 1200 106/60. - - correct- - BP at 0800 of 138/86 and at 1200 106/60.