ATI LEADERSHIP PROCTORED EXAM TEST BANK WITH RATIONALES (NGN)

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26.A nurse in an 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?... A. Availability of resources, such as fire extinguishers Rationale:Structure audits evaluate the availability of resources. B. Nursing staff ratios Rationale:Structure audits measure staffing ratios. C. Quality of nursing care provided Rationale:Process audits evaluate the quality of care nurses provide. They also determine if the care provided by nurses is consistent with established facility policy. D. Length of facility stay for a cohort of clients Rationale:Outcome audits measure the outcome of the care provided and include elements such as morbidity, mortality, and length of facility stay. 27.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 of the following clients should the nurse recommend for discharge? A. A young adult client who has Crohn's disease and is 1 day preoperative for an ileostomy Rationale:A client who is scheduled for an elective surgery is medically stable and is not bedridden; therefore, the nurse should recommend this client for discharge. B. An adolescent client who was admitted 24 hr ago due to a spontaneous pneumothorax Rationale:A client who has a pneumothorax is unstable and needs rest, oxygen, and observation. If the client’s condition becomes worse, a chest tube may be required. Therefore, the nurse should not recommend this client for discharge. C. A middle adult who is 36 hr postoperative from an open laminectomy Rationale:A client who is postoperative from an open laminectomy is at risk for complications, especially 24 to 48 hr after surgery. Therefore, this client is not stable and the nurse should not recommend this client for discharge. D. An older adult client who was admitted for diabetic ketoacidosis and his most recent ABGs show his pH is now 7.32 Rationale:Diabetic ketoacidosis is a serious complication of diabetes mellitus. It usually develops in conjunction with an infection, but it can also develop due to poor nonadherence to prescribed care. This client’s pH is below the expected reference range; therefore, this client is not stable and the nurse should not recommend this client for discharge. 28.A nurse is caring for a client who is preoperative. The nurse signs as a witness on the client's consent form. The nurse’s signature on the consent form indicates which of the following? A. Determines the client does not have a mental illness Rationale:Clients who have a mental illness have the right to make decisions about their health care unless they have been found to be incompetent by a court of law. B. Confirms the client appears competent to provide consent Rationale:By signing as a witness on a procedural consent form, the nurse is confirming the client was the one who signed the consent form and that he seems to be competent to give consent. C. Asserts the nurse has explained the risks and benefits of the procedure Rationale:It is the responsibility of the provider to explain the risks and benefits of the procedure to the client. D. Records that the client’s spouse agrees the procedure is necessary Rationale:Although support from the client’s spouse can be a factor when the client considers surgery, the ethical principle autonomy is a fundamental principle and it supports the client’s right to selfdetermination. 29.A nurse has been reassigned from her regular area of work to a unit that is short staffed. Which of the following actions should the nurse take first? A. Ask what she will be assigned to do. Rationale:Before accepting the assignment, the nurse should clarify the complexity of the assignment, such as how many clients she will be assigned to care for, what skills are needed, and what resources are available to her. B. Determine if she has the skills to complete the assignment. Rationale:The nurse should perform a self-evaluation to determine if there are discrepancies between expectations and skills. Discrepancies can lead to unsafe client care. C. Identify her options. Rationale:After the nurse gains knowledge about the assignment and completes a self-evaluation, the nurse can either accept or refuse the assignment. D. Notify the nurse manager about her concerns for client safety. Rationale:The nurse should not notify the nurse manager about her concerns for client safety until she has determined she has the skills to safely provide client care. 30.A nurse manager hears a staff nurse on the unit speak openly about her dislike of a recent policy change regarding client care. When discussing the issue with the nurse, which of the following statements by the nurse manager is appropriate? A. “Let’s talk about your concerns about the new policy.” Rationale:The nurse manager should meet with the nurse to allow an open forum for the nurse to verbalize the reasons for her reluctance to adopt the new policy. B. “Why didn’t you voice your concerns before the new policy was implemented?” Rationale:This statement is accusatory and will likely make the nurse defensive. C. “Being open to change is an expectation of the nurses who work on this unit.” Rationale:While being open to change is an expectation of a professional nurse, this statement does not address the issue. It avoids the issue at hand. D. “You should support this policy change because it was based on evidence-based practice.” Rationale:Evidence-based practice is the use of knowledge from research to support delivery of nursing care. Its use is important when nurses consider a policy change related to client care; however, this statement does not address the issue. It avoids the issue at hand. 31.A nurse is caring for a client who falls in his room. After the nurse assesses the client, notifies the client’s provider, and completes an incident report, which of the following actions should the nurse take? A. Make a copy of the incident report for the provider [Show More]

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