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ATI Leadership Proctored Exam latest complete version, all correct answers

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ATI Leadership Proctored Exam 1. A nurse manager is preparing to institute a new system for scheduling staff. Several nurses have verbalized their concern over the possible changes that will occur... . Which of the following is an appropriate method to facilitate the adoption of the new scheduling system? Identify nurses who accept the change to help influence other staff nurses Provide a brief overview of the new scheduling system immediately before its implementation (overview should occur over time) Introduce the new scheduling system by describing how it will save the institution money (giving an incentive) Offer to reassign staff who do no support the change to another unit 2. A client who is febrile is admitted to the hospital of pneumonia. In accordance with the care pathway, antibiotics therapy is prescribed. Which of the following situations requires the nurse to complete a variance report [something like an incident report] with regard to the care pathway? (pg 95) Antibiotic therapy was initiated 2 hr. after implementation of the care pathway A blood culture was obtained after antibiotic therapy had been initiated The route of antibiotic therapy on the care pathway was changed from IV to PO An allergy to penicillin required an alternative antibiotic to be prescribed 3. A nurse should recognize that an incident report is required when (pg 95) A client refused to attend physical therapy A visitor pinches his finger in the clients bed frame A client throws a box of tissues at a nurse A nurse gives a medication 30 min late 4. (6) A nurse is precepting a newly licensed nurse who is caring for a client who is confused and has an IV infusion. The newly licensed nurstye has placed the client in wrist restraints to prevent dislodging the IV catheter. Which of the following questions should the precepting nurse ask? Did you secure the restraints to the side rails of the bed Are you able to insert 2 fingers between the restraints and the client’s skin Did you tie the restraints using a double knot Are you removing the clients restraints every 4 hours 5. Client satisfaction surveys from a surgical unit indicate that pain is not being adequately relieved during the first 12 hr post operatively. The unit manager decides to identify postoperative pain as a quality indicator. Which of the following data sources will be helpful in determining the reason why clients are not receiving adequate pain management after surgery? (pg19) Prospective chart audit Retrospective chart audit Postoperative care policy Pain assessment policy 6. (7) A nurse is caring for an older adult client who has a stage III pressure ulcer. The nurse requests a consultation with the wound care specialist. Which of the following actions by the nurse is appropriate when working with a consultant? (pg 40) Arrange the consultation for a time when the nurse caring for the client is able to be present for the consultation Provide the consultant with subjective opinions and beliefs about the client’s wound care Request the consultation after several wound care treatments are tried Arrange for the wound care nurse specialist to see the client daily to provide the recommended treatment 7. A client is admitted with tuberculosis and placed in a negative pressure room. Which of the following nursing actions is appropriate? Notify the local health department of the admission. Place a sign on the client’s door with the diagnosis Ensure that admitting staff undergo PPD skin tests. Determine who had contact with the client in the last 48 hr. 8. A nurse is caring for a client who is unconscious and whose partner is his health care proxy. The partner has spoken with the provider and wishes to discontinue the client’s feeding tube. The provider states to the nurse, “I will not discontinue this client’s treatment. His partner has no right to make decisions regarding the client’s care.” Which of the following responses by the nurse is appropriate? you should consider speaking with the facility’s ethics committee before making your decision You have the right to make that decision…. The client has designated his partner as health care proxy in his advanced directives. We’ll need to have the nursing supervisor review the client’s advanced directives. 9. A nurse is caring for a client who is unconscious and whose partner is his health care proxy. The partner has spoken with the provider and wishes to discontinue the client’s feeding tube. The provider states to the nurse, “I will not discontinue this client’s treatment. His partner has no right to make decisions regarding the client’s care.” Which of the following responses by the nurse is appropriate? “You should consider speaking with the facility’s ethics committee before making your decision.” “You have the right to make that decision, even if the partner is the client’s health care proxy.” “The client has designated his partner as health care proxy in his advanced directives.” “We’ll need to have the nursing supervisor review the client’s advanced directives.” 10. (10) A nurse is caring for a client who has increased intracranial pressure and is receiving IV corticosteroids. Which of the following information is most important for the nurse to report at shift change? Glasgow coma scale score Most recent blood glucose reading Laboratory tests scheduled for next shift Reddened area on the coccyx 11. (11) A nurse is assigned the following four clients for the current shift. Which of the following clients should the nurse assess first? A client who has a hip fracture and is in Buck’s traction A client who has aspiration pneumonia and a respiratory rate of 28/min (ABC’s) A client who has diabetes mellitus and a stage 2 pressure ulcer on his foot A client who has a Clostridium difficile infection and needs a stool specimen collected 12. (12) A nurse is caring for a client who fell and is reporting pain in the left hip with external rotation of the left leg. The nurse has been unable to reach the provider despite several attempts over the past 30 min. Which of the following actions should the nurse take? Notify the nursing supervisor about the issue Contact the client’s physical therapist Apply a warm compress to the hip Reposition the client for comfort 13. (13) The mother of a client with breast cancer states, “It’s been hard for her, especially after losing her hair. And it has been difficult to pay for all the treatment.” Which of the following actions is appropriate client advocacy? The nurse investigates potential resources to help the client purchase a wig The nurse explains to the mother that most clients with cancer lose their hair The nurse informs the next shift nurse regarding the mother’s concern The nurse suggests counseling for the client’s body image issues 14. (14) Which of the following items must be discarded in a biohazard waste receptacle? A urinary catheter drainage bag from a client who is postoperative A bed sheet from a client with bacterial pneumonia A perineal pad from a client who is 24-hr post-vaginal delivery An empty IV bag removed from a client who has HIV 15. (15) A nurse tells the unit manager, “I am tired of all the changes on the unit. If things don’t bet better now, I’m going to quit.” Which of the following responses by the unit manager is appropriate? “So you are upset about all the changes on the unit?” “I think you have the right to be upset. I am tired of the] changes too” “Just stick with it a little longer. Things will get better soon” “You should file a written complaint with hospital administration” 16. (16) According to HIPPA regulations, which of the following is a violation of client confidentiality? Telephoning the pharmacy with a prescription for the spouse to pick up Providing a copy of the record to the transporting paramedic Reporting a client’s disposition to the referring provider Informing housekeeping staff that the client is in the dialysis unit 17. A nurse preceptor is evaluating a newly licensed nurse’s competency in assisting with a sterile procedure. Which of the following actions indicates the nurse is maintain sterile technique? Select all that apply Opens the sterile pack by first unfolding the flap farthest from her body Rests the cap of a solution container upside down on the sterile field Removes the outside packaging of sterile instrument before dropping it onto the sterile field Holds a bottle of sterile solution 15 cm (6 inches) above the sterile field Places items within a 1.25 cm (0.5-inch) border around the edges of the sterile field 18. nurse is providing care for four postoperative clients. The nurse should assess the client (pg 6) a. whose pulse has been steadily increasing during the past shift b. who is reporting pain level of 8 on a scale of 0-10 c. whose urine output has averaged 32ml/hr for the past 24hrs d. who is reporting nausea after the prescribed antiemetic was administered 19. a nurse is preparing to transcribe a client’s medication prescription in the medical record. Which of the following should the nurse recognize as containing the essential components of a medication order a. NPH insulin 10 units before meals and at bedtime b. Haloperidol (Haldol) 1mg by mouth c. Multivitamin every morning by mouth d. Aspirin 650mg by mouth every 4 hours 20. A nurse is assisting with the orientation of a newly licensed nurse. The newly licensed nurse is having trouble focusing and has difficulty completing care for his assigned clients. Which of the following interventions is appropriate? Recommend that he take time to plan at the beginning of his shift b. Advise him to complete less time consuming tasks first c. Ask other staff members to take over some of his tasks d. Offer to provide care for his clients while he takes a break 20. (21) A nurse in an urgent care clinic is admitting a client who has been exposed to a liquid chemical in an industrial setting. Which of the following actions should the nurse take first (pg 102) Remove the clients clothing Irrigate the exposed area with water (this is done after removing the clothes) Report the incident to OSHA Don personal protective equipment 21. (22) A facility provides annual staff education regarding ethical practice. A charge nurse recognizes a need for further education when which of the following behaviors is observed? A nurse refuses to actively participate during an elective abortion procedure scheduled for her client A nurse gives prescribed opioids to a client who has a terminal illness and respiration of 8/min A nurse explains a client’s family that a DNR order includes withholding comfort measures A nurse informs a confused client who wants to go home that he is going to stay at the facility until he is better 22. (23) A nurse in an ambulatory setting is orienting a newly licensed nurse who is preparing to return a call to a client. The nurse should explain that which of the following is an objective of telehealth? Assessing client needs Providing medication reconciliation Establishing communication between providers Developing client treatment protocols 23. (24) Which of the following puts a hospital at the highest risk for infringement of client record confidentiality? A nurse cluster documentation of care for multiple clients A provider and nurse access client information using one access code (everyone should have their own access code) Paper-based charts are stored at the nurses’ station A nurse performs electronic documentation outside a client’s room 24. (27) A parish nurse is making a referral to a community meal delivery program for a member of the congregation. This is an example of which of the following functions of the parish nurse? Liaison Pastoral care provider Health educator Personal health counselor 25. (28) A nurse performing triage during a mass casualty incident should recognize that which of the following clients should be transported to the hospital first? (98) A client who reports substernal chest pain radiating to the neck A client who has an open fracture of the femur A client who has a 4-inch laceration on the forearm A client who has a penetrating head injury and fixed and dilated pupils 26. (31) A client who has substance use disorder is admitted to the mental health unity and reports that he has been depressed lately. When preparing the discharge the next day, the client states, “it’s okay. Soon everything will be just fine.” Which of the following is the nurse’s priority action? Ask the client if he has considered hurting himself Provide the client with information about alcoholics anonymous Encourage the client to participate in physical activities Reinforce the need to follow up with the discharge referral 27. (33) A nurse manager smells alcohol on the breath of a nurse who is starting a shift. Which of the following actions should the nurse manager take first? Report the situation to the director of nursing Have a blood alcohol level drawn from the nurse Document a factual description of the situation Remove the nurse form the unit 28. (34) A nurse observes a paper bag at the bedside of a client. This finding suggests that the client is receiving treatment for which of the following respiratory disorders? Asthma Hyperventilation (bring back the CO2 to stabilize blood pH) Stridor Atelectasis 29. (35) A nurse is preparing to discharge a client back to a long-term care facility after he was admitted to an acute care facility 2 days ago for pneumonia. Which of the following information should the nurse include in the verbal transfer report? Laboratory results within the expected reference range List of regularly prescribed medications Date of last bowel movement Level of consciousness 30. (36) A nurse who is precepting a newly licensed nurse is discussing the client assignment for the shift. Which of the following actions should the nurse preceptor take first to demonstrate appropriate time management? Review the client’s new laboratory values Document assessment data Complete required tasks Determine client care goals 31. (39) A case manager working in a rehabilitation unit is discharging to home a client who has a spinal cord injury at vertebral level C-7. Which of the following is the priority action when creating the discharge plan? Select strategies for cost-effective home care Identify the client’s ability to perform activities of daily living Provide educational handouts related to care requirements Recommend community resources available to assist with client care 32. (40) A nurse is preparing to complete morning assessments on several assigned clients. Which of the following clients should the nurse plan to assess first? A client who has a nasogastric tube to intermittent suction and reports nausea A client who has an early morning blood glucose of 220 mg/dL (very abnormal glucose level) A client who had a bladder scan that indicated 250 mL of urine in the bladder A client who is 3 days postoperative and whose dressing has serosanguinous drainage 33. (42) An RN is planning client assessments for a licensed practical nurse (LPN) and three assistive personnel. The RN should assign the LPN to the client who requires Recording of daily intake and output Assistance with meals A complete bed bath Frequent dressing changes 34. (44) A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive personnel? Assessing a client who just returned for hemodialysis Reviewing dietary instructions for a client with kidney stones Obtaining a stool sample from a client with renal failure Monitoring a client with fluid restriction 35. (48) An older adult client is awaiting surgery for a fractured right hip. The nurse should recognize that which of the following can be delegated to an assistive personnel? Turning the client Recording the client’s vital signs Determining the client’s pain level Checking the pulses of the client’s right foot 36. (49) To resolve a conflict between staff members regarding potential changes in policy, a nurse manager, decides to implement the changes she prefers regardless of the feelings of those who oppose those changes. Which of the following conflict-resolution strategies is the nurse using? Compromising Collaborating Cooperating Competing 37. (52) A charge nurse is assessing staff knowledge about safety procedures regarding needle stick injuries. Which of the following statements by a nurse indicates appropriate understanding of these safety procedures? (pg95) “Prophylactic treatment should be initiated after a needle stick during preparation of an injection” “I should stop the bleeding as soon as possible following a needle stick injury” “An incident report should be completed if a client receives a stick from her own needle” “The needle should be recapped to prevent injury during transport to the biohazard container” 38. (53) A nurse on a medical surgical unit is caring for a group of clients with the assistance of a licensed practical nurse (LPN) and an assistive personnel. Which of the following tasks should the nurse assign to the LPN? Obtain a urine specimen from an older adult client Providing postmortem care for a client who has just died Accompanying a client who just had a wound debridement to physical therapy Reinforcing dietary teaching with a client who has heart disease 39. (55) A home health nurse is assessing the home environment of client who is on continuous oxygen therapy. Which of the following findings requires the nurse to intervene? The oxygen machine has a grounded plug The family keeps a spare oxygen tank in the room The windows of a client’s room are open The client is covered with a woolen blanket 40. (56) A nurse is teaching a client how to use a finger-stick glucometer at home. Which of the following instructions should the nurse include? Elevate the arm for 1 min before taking the blood sample Cap the lancet prior to putting it in the trash Obtain the blood sample form the finger pads Warm the hands prior to piercing the skin 41. (57) A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take? Contact the client’s next of kin to obtain consent for treatment Proceed with treatment without obtaining written consent (cardiac arrhythmia can be an emergency situation) Have the client sign a consent for treatment Notify risk management before initiating treatment 42. (59) While auditing the medical records of clients currently on an oncology unity, the nurse manager finds that six of the 15 records lack documentation regarding advance directives. Which of the following is the priority action for the nurse to take? Reinforce the potential consequences of not having this information on record to the nursing staff Ask nurses who are caring for clients without this information in the medical record to obtain it Meet with nursing staff to review the policy regarding advanced directives Remind the nurses to obtain this information during the admission process 43. (60)A client is admitted with COPD. Which of the following findings should the nurse report to the provider? Oxygen saturation 89% on room air White blood cell count 9000/mm3 Report of dyspnea on exertion Bilateral crackles on auscultation of lungs 44. (61) A charge nurse notices that two staff nurses are not taking meal breaks during their regular 8-hr shifts. Which of the following actions should the nurse take first? Provide coverage for the nurses’ breaks Determine the reasons the nurses are not taking schedules breaks Discuss time management strategies with the nurses Review facility policies for taking scheduled breaks 45. (62) A nurse is caring for a client who has anorexia nervosa. Which of the following interdisciplinary team members should be consulted in regard to this client’s care? Select all that apply Occupational therapist Nutritional therapist Physical therapist Mental health counselor Case manager 46. (65) A client scheduled for a tubal ligation procedure starts to cry as she is wheeled into the surgical suite. Which of the following nursing statements is an appropriate nursing response? “It’s not too late to cancel surgery if you want to” “This won’t take long and it will be over before you know it” “Why did you make the decision to have this procedure” “You shouldn’t be worried because the procedure is very safe” 47. (66) A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority? A client who has raised red skin rash on his arms, neck, and face A client who reports right-sided flank pain and is diaphoretic A client who reports shortness of breath and left neck and should pain A client who has active bleeding from a puncture wound of the left groin area 48. (68) A nurse is evaluating a newly licensed nurse who is administering a vitamin K (Aquamephyton) injection to a newborn. Which of the following actions by the newly licensed nurse indicates understanding of the teaching? Select all that apply Selects the dorsogluteal site to administer the injection Cleans the injection site with alcohol Applies gentle pressure at the site after injections Aspiration the syringe for blood return after needle insertion Inserts the needle at a 45 degree angle [Show More]

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