ATI RN Leadership 2019 Proctor|Questions with Answers

Document Content and Description Below

ATI RN Leadership 2019 Proctor|Questions with Answers 1. A nurse tells the unit manager, “I am tired of all the changes on the unit. If things don’t get better, I’m going to quit.” Which of ... the following responses by the unit manager is appropriate? a. You should file a written complaint with hospital administration b. Just stick with it a little longer. Things will get better soon c. So, you are upset about all the changes on the unit? d. I think you have a right to be upset. I am tired of the changes, too 2. A charge nurse notices that two staff nurses are not taking meal breaks during theirshifts. Which of the following actions should the nurse take first? a. Provide coverage forthe nurses’ breaks b. Review facility policies for taking scheduled breaks c. Determine the reasons the nurses are not taking scheduled breaks d. Discusstime management strategies with the nurses 3. A client has a new permanent pacemaker inserted. Which of the following home care instructions should the nurse include? a. Regular programming evaluations can be conducted by telephone b. The clientshould avoid using remote control devicesto prevent dysrhythmias c. The client should avoid using a microwave oven to heat food d. Swimming could cause the unit to have an electricalshort 4. A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. I will use an alcohol-based hand cleanser when caring for a client who has C.diff b. I will wear a cover gown when caring for a client who has herpes simplex c. I will wear an N95 respirator mask when caring for a client who is on contact precautions d. I will place a client who requires protective isolation in a negative airflow room 5. A staff nurse is supervising a newly licensed nurse who is preparing to administer an intermittent tube feeding to a client. Which of the following actions by the newly licensed nurse is appropriate? a. Adding colored food dye to the formula b. Flushing the tube with 15 mL of water c. Elevating the head of the bed to a 20-degree angle d. Checking residual volume before each feeding 6. A nurse is preparing an education program about professional codes of ethicsfor nurses. Which of the following information should the nurse plan to include? a. A code of ethics is a step-by-step approach to decision-making b. A code of ethics is a set of principles for nursing practice c. A code of ethics is legally binding d. A code of ethics outlines the nurse’s scope of practice 7. A nurse receives change-of-shift report for the following four clients. Which of the following clients should the nurse assess first? a. An older adult client who has bacterial pneumonia and a new onset of restlessness b. A client who is 1-day postoperative following hip fracture repair and reports a pain level of 6 on a scale from 0 to 10 c. A middle adult client who has diabetes mellitus and a morning blood glucose of 172 mg/dL d. A client who has myasthenia gravis with ptosis and has developed urinary incontinence 8. 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? a. Prophylactic treatmentshould be initiated after a needle-stick during preparation of an injection b. The needle should be recapped to prevent injury during transport to the biohazard container c. I should stop the bleeding as soon as possible following a needle-stick injury d. An incident reportshould be completed if a client receives a stick from her own used needle 9. A case manager is reviewing documentation on several clients and notes a progress report that falsely identifies a client as HIV-positive due to multiple sexual partners. The nurse manager should identify that which of the following torts has occurred? a. Libel b. Battery c. Slander d. Negligence 10. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first? a. Inform the unit manager of the incident b. Review the chart for nonrestraint alternatives for agitation c. Remove the restraints from the client’s wrists d. Speak with the AP about the incident 11. 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 manager using? a. Compromising b. Collaborating c. Cooperating d. Competing 12. A nurse is caring for a client and notices fraying on the electrical cord of the client’s IV pump. Which of the following actions is the priority for the nurse to take? a. Remove the IV pump from the client’s room b. Check the expiration date of the inspection sticker c. Report the problem to the engineering team d. Request a replacement IV pump 13. A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend? a. Pharmacist b. Child protective services c. Social worker d. Respiratory therapist 14. A charge nurse is completing client care assignments. Which of the following assignments is appropriate for a licensed practical nurse? a. A client who requires discharge instructions fortype 1 diabetes mellitus b. A client who requires a blood transfusion to be administered c. A client who is 1 day postoperative and has a continuous bladder irrigation d. A client who is receiving IV chemotherapy 15. A nurse is caring for a client who is comatose and has advance directives designating his adult daughter as his health care proxy. The client’s partner instructsthe nurse to institute CPR if the client experiences cardiac arrest. Which of the following actions should the nurse take? a. Have the partner notify the daughter about changes to the advance directives b. Inform the partner that the staff must follow the client’s advance directives c. Contact the client’s attorney about the partner’s request d. Initiate new advance directives incorporating the partner’s request 16. A nurse from the labor and delivery unit is assigned to float to a medical-surgical unit. Which of the following actions should the nurse take first? a. Inform the nursing supervisor of the lack of experience on the medical-surgical unit b. Request orientation to the medical-surgical unit c. Referto the assigned resource nurse regarding client assignments d. Clarify competencies with the medical-surgical change nurse 17. A nurse in the emergency department is preparing a married 17-year-old client for an appendectomy. The client’s parents are en route to the facility but have not spoken with the surgeon. Which of the following actions should the nurse take? a. Have the clientsign the consent form after the surgeon explains the procedure b. Obtain consent from the client’s parents by telephone with another nurse listening as a witness c. Proceed with the preparation because the client signed a general consent form d. Delay the surgery until the parents arrive to sign the consent form 18. Client satisfaction surveys from a surgical unit indicate that pain is not being adequately relieved during the first 12 hr postoperatively. 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 aftersurgery? a. Pain assessment policy - check b. Postoperative care policy c. Prospective chart audit d. Retrospective chart audit 19. A nurse manager is reviewing the nursing code of ethics with the staff nurses. Which of the following statements by a staff nurse indicate understanding of the teaching? (Select all that apply.) a. I have the assistive personnel double-check packed RBCs when other nurses are busy b. I can delegate the removal of an IV catheter to an LPN on the unit c. I will attend continuing education classes for professional growth d. The family of a newly admitted client recently treated me to lunch in the hospital cafeteria e. I administer pain medication to my clients even if they have a history of narcotic addiction 20. A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change-of-shift report? a. The time the client received his last dose of pain medication b. The belief that the client has a difficult relationship with his son c. The client’s preferred time for bathing d. The steps to follow when providing wound care 21. A nurse on a medical-surgical unit is delegating client care. Which of the following tasks should the nurse delegate to assistive personnel? a. Performing a dressing change on a client’s peripherally inserted central catheter b. Instructing a client on self-administration of a tap water enema c. Using a pain rating scale to monitor a client’s pain level d. Suctioning a client’slong-term tracheostomy 22. A nurse on a medical-surgical unit is making staff assignments. Which of the following tasks should the nurse delegate to assistive personnel? a. Pouching a client’s established ostomy b. Updating a family member about a client’s condition c. Reinforcing teaching with a client about a low-sodium diet d. Demonstrating the use of an incentive spirometer to a client 23. A charge nurse is reviewing how to set up a sterile field with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the process? a. I will open the outermost flap of the sterile tray towards my body b. I will place the sterile tray on a bedside table that is raised to just below my waist level c. I can touch the outer 2 inches of the sterile field without gloves d. I will keep the label of the solution bottle facing up when pouring solution into the sterile cup 24. A nurse is providing care for four postoperative clients. The nurse should first assessthe client a. Who reports nausea after the prescribed antiemetic was administered b. Whose urine output has averaged 32 mL/hr for the past 24 hr c. Who reports a pain level of 8 on a scale of 0 to 10 d. Whose pulse has been steadily increasing during the pastshift 25. A charge nurse overhears a provider and a nurse talking about a client’s diagnosis in the cafeteria. Which of the following actions should the nurse take first? a. Remind them that client information is confidential b. Report the incident to the nursing supervisor c. Complete an incident report about the situation d. Discussthe need for client confidentiality at the next staff meeting 26. 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. A nurse refusesto actively participate during an elective abortion procedure scheduled for her client b. A nurse gives prescribed opioids to a client who has a terminal illness and respirations of 8/min c. A nurse explains to a client’s family that a DNR order includes withholding comfort measures d. A nurse informs a confused client who wants to go home that he is going to stay at the facility until he is better 27. The family members of an older adult client are expressing conflict over whether the client should have surgery that is recommended by the provider. The oldest adult child has durable power of attorney for health care for the client. The client is oriented to person, place, and time. Which of the following people has the legal authority to make this health care decision? a. The provider b. The partner c. The client d. The oldest adult child 28. A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet delivered the oxygen tank. Which of the following actions should the nurse take? a. Send an oxygen tank from the facility home with the client b. Instruct the client’s family to contact the insurance provider about the oxygen equipment c. Contactsocialservices about the delivery of the oxygen equipment - check d. Notify the provider about the delayed oxygen tank delivery 29. A nurse in a long-term care facility is assessing a client who has returned from an acute care facility following a brief illness. The nurse observes that the client is confused and agitated. Which of the following actions should the nurse take first? a. Medicate the client with alprazolam b. Reorient the client to his surroundings c. Measure the client’s vitalsigns d. Offerreassurance to the family 30. A nurse is caring for a client who is scheduled for a procedure. Which of the following is an appropriate action when the nurse is witnessing the client signing the consent form? (Select all that apply.) a. Inform the client of available alternative therapies b. Discuss benefits of the procedure with the client c. Ensure the client gives consent voluntarily d. Verify that the client affirms understanding of the procedure e. Confirm the authenticity of the client’s signature 31. A nurse is documenting and completing an incident report after a client falls out of bed. Which of the following actions should the nurse take when completing the documentation? a. Document in nurse’s notes, “Photocopy of incident report sent to risk management” b. Document in incident report, “Client found lying on the floor after falling out of bed” c. Document in incident report, “Entered room and discovered client lying prone on the floor” d. Document in nurse’s notes, “Incident report completed and filed” 32. A nurse is providing discharge instructions to a client who is 2 hr postoperative following cataract surgery on the left eye. Which of the following instructions should the nurse include in the teaching? a. Sleep lying on your right side b. Bend at the waist if you must pick up an object from the floor c. Remove your eye shield before going to bed d. Place an ice pack on your left eye for 2 hours after you get home 33. A client is admitted with tuberculosis and placed in a negative-pressure room. Which of the following nursing actions is appropriate? a. Place a sign on the client’s door with the diagnosis b. Notify the local health department of the admission c. Determine who had contact with the client in the last 48 hr d. Ensure that admitting staff undergo PPD skin tests 34. 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? a. Proceed with treatment without obtaining written consent b. Have the client sign a consent for treatment c. Notify risk management before initiating treatment d. Contact the client’s next of kin to obtain consent for treatment 35. A nurse is preparing a client for surgery. The client has signed the consent form but tells the nurse that she has reconsidered because she is worried about the pain. Which of the following responses by the nurse is appropriate? a. Why didn’t you discuss your concerns with your provider? b. If you have the procedure now, you won’t have to deal with pain and disability later c. You’ll be fine. You’ll receive a prescription for pain medication d. I understand, and it’s not too late to change your mind 36. A charge nurse is evaluating a newly licensed nurse’s understanding of infection control procedures. Which of the following actions demonstrates that the nurse is following the appropriate protocol for a client who has streptococcal pharyngitis? a. Placing the client in a positive-airflow room with 12 air exchanges per hour b. Explaining to the client that he cannot have visitors until his manifestations resolve c. Donning sterile gloves when performing routine oral care d. Wearing a mask when within 1 m (3.3 ft) of the client 37. A nurse is planning to delegate client care assignments. Which of the following tasksshould the nurse plan to delegate to assistive personnel? a. Informing a family of a client’s progress in physical therapy b. Teaching a client to perform a finger-stick for testing blood glucose levels c. Performing postmortem care prior to transferring the client to the morgue d. Advising a client on self-administration of acetaminophen 38. 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? a. Most recent blood glucose reading b. Laboratory testsscheduled for next shift c. Reddened area on the coccyx d. Glasgow Coma Scale score 39. 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 actionsshould the nurse take first? a. Report the incident to OSHA b. Irrigate the exposed area with water c. Remove the client’s clothing d. Don personal protective equipment 40. A nurse is evaluating care for a group of clients. The nurse should consult the provider for which of the following clients? a. A client who requires an IV intermittent bolus dose of vancomycin and has a creatinine level of 1.5 mg/dL b. A client who is ready for discharge after coronary artery stent placement and has a prescription for clopldogrel c. A client who has a pacemaker and whose cardiac monitorshows sinus rhythm with intermittent periods of a wide QRS complex after each pacerspike d. A client who has atrial fibrillation and a rapid ventricular rate of 105/min and is receiving diltiazem IV and weight-based heparin 41. A nurse is planning care for four clients who were classified using a disaster triage tag system following a mass casualty event. Which of the following clients should the nurse identify as the priority? a. A client who has a green tag b. A client who has a black tag c. A client who has a red tag d. A client who has a yellow tag 42. A nurse is delegating tasks to assistive personnel (AP). Which of the following tasks should the nurse assign to the AP? a. Instruct a client about the use of an incentive spirometer b. Check on a client whose telemetry monitor is continuously beeping c. Determine whether an oxygen flow meter is accurately set at 2 L/min via nasal cannula d. Tag a malfunctioning piece of equipment as broken 43. A nurse is assessing a client who had a stroke 2 days ago. Which of the following findings should the nurse identify as a need for a referral to speech language pathology? a. Altered level of consciousness b. Impaired voluntary cough c. Diminished hand-to-mouth coordination d. Unilateral ptosis 44. A home health nurse is assessing the home environment during an initial visit to a client who has a history of falls. Which of the following findings should the nurse identify as increasing the client’s risk for falls? (Select all that apply.) a. A two-wheeled walker used to assist the client with ambulation b. A folding chair without arm rests c. A throw rug covering some cracked vinyl flooring in the kitchen d. A wheeled office chair at the client’s computer desk e. A raised vinyl seat on the toilet in the bathroom 45. A charge nurse is assessing the room of a newly admitted client who has dysphagia. Which of the following pieces of equipment should the nurse ensure is available in the client’s room? a. Yankauersuction device b. Large-handled utensils c. Nasal cannula and oxygen d. Bite block 46. A nurse is comparing the rate of medication errors on the medical unit to the rate from a medical unit in a magnet hospital. Which of the following quality improvement methods is the nurse using? a. Risk benefit analysis b. Structure audit c. Benchmarking d. Root cause analysis 47. A nurse is providing an in-service about client rights for a group of nurses. Which of the following statements should the nurse include in the in-service? a. A nurse can disclose information to a family member with the client’s permission b. A nurse can apply restraints on a PRN basis c. A nurse isresponsible for informing clients about treatment options d. A nurse can administer medications without consent to a client as part of a research study 48. A nurse in a clinic is teaching a newly licensed nurse about sexually transmitted infections. The nurse should instruct the newly licensed nurse to report which of the following infections to the health department? a. Human papillomavirus b. Trichomoniasis c. Gonorrhea d. Candidiasis 49. A charge nurse is educating a group of newly licensed nurses about the case management approach to client care. Which of the following statements by a newly licensed nurse indicates an understanding of the responsibilities of a nurse in case management? a. Each nurse completes one specific task for a group of clients b. Nurses use critical pathways when caring for clients c. Nurses who have advanced training provide direct care for select clients d. Nurses delegate and supervise assigned tasks 50. A nurse is caring for a client who has signed consent for the removal of a tumor in the left frontal lobe of the brain. The client states, “The tumor is on the right side of my head.” Which of the following actions should the nurse take? a. Tell the client to mark the right side of his head with indelible ink b. Contact the surgery department to validate the operative site c. Continue with the surgery because the client already gave informed consent d. Ask the surgeon to clarify the operative site with the client 51. A nurse on a medical-surgical unit is caring for four clients. The nurse should recognize that which of the following clients is the highest priority? a. A client who has peripheral vascular disease and has an absent pedal pulse in the right foot b. A client who is postoperative following a laminectomy 12 hr ago and is unable to void c. A client who has MRSA and has an axillary temperature of 38 C (101 F) d. A client who is newly diagnosed with pancreatic cancer and is scheduled to begin IV chemotherapy 52. A nurse on a medical-surgical unit is preparing to assign vitalsign measurements for a group of clients. Which of the following clients should the nurse delegate to assistive personnel? a. A client who has just returned to the unit from the PACU b. A client who has a closed head injury and increased intracranial pressure c. A client who has sickle-cell anemia and has completed an infusion of packed RBCs d. A client who reports acute chest pain 53. A nurse is preparing a client forsurgery. The client expresses concern that someone might steal her purse during the procedure. Which of the following actions should the nurse take? a. Tell the client to leave her purse in a drawer of the bedside table b. Offer to store the purse at the nurses’station c. Offer to place the purse in the facility safe d. Place the purse in the clothing bag with the client’s other belongings 54. A case manager observes a family member of a client who has Alzheimer’s disease throwing books on the floor and sobbing while the client is having a diagnostic test. Which of the following actions should the case manager take first? a. Help the caregiver arrange for respite care b. Offer to have a brief talk with the caregiver c. Consultsocialservicesto explore counseling d. Referthe caregiver to a localsupport group 55. A nurse is conducting a disaster preparedness drill with a group of nurses who are orienting to the facility. Which of the following triage tag colors should the nurse instruct the group to apply to a client who has full-thickness burns on 72% of his body? a. Green b. Yellow c. Black d. Red 56. A nurse is caring for a client who has early-stage Alzheimer’s disease. In which of the following actions is the nurse acting as a client advocate? a. Performing an updated cognitive assessment on the client b. Requesting a referral for the client to attend reminiscent therapy sessions c. Providing assistance for the client when ambulating down the hall d. Reorienting the client several timesthroughout the day 57. A nurse is caring for a client who has a prescription for transcutaneous electrical nerve stimulation (TENS). Which of the following members of the interdisciplinary team should the nurse contact for assistance? a. Occupational therapist b. Respiratory therapist c. Pharmacist d. Physical therapist 58. A nurse is caring for a client who has a pressure ulcer on the coccyx. Which of the following findings indicates the need for a referral to a wound care specialist? a. Minimal signs of induration at the wound edges b. Presence of granulated tissue over the wound c. Presence of slough in the wound bed d. Epithelialization noted in areas of tissue loss 59. A nurse is planning discharge for a client who has a new diagnosis of COPD and lives alone. Which of the following actions is the nurse’s priority? a. Suggest participating in a community support group b. Provide printed materialsfor new prescriptions c. Set up appointments for in-home physical therapy d. Request a referral for a home safety assessment 60. A charge nurse witnesses an assistive personnel (AP) giving an oral medication to a client who has dysphagia. Upon questioning, the AP states that a nurse poured the medication into a cup and asked the AP to give it to the client. Which of the following actions should the charge nurse take first? a. Reinforce facility policy regarding medication administration with the AP b. Discuss the situation with the nurse who poured the medication c. Complete the appropriate documentation of the incident d. Auscultate the client’s breath sounds 61. A nurse is observing assistive personnel (AP) administer a 0.9% sodium chloride enema to an adult client. For which of the following actions by the AP should the nurse intervene? a. Administers the solution at room temperature b. Positions the client on her left side with knees flexed c. Inserts the tubing 8 cm (3.1 in) into the rectum d. Points tubing in the direction of the umbilicus during insertion 62. A nurse is preparing to transfer a client to the radiology department using a wheelchair. Which of the following actions should the nurse take? a. Leave a transfer belt in place until the client returns from radiology b. Keep the footplates lowered throughout the transfer process c. Push the wheelchair into the elevator, large wheelslast d. Test the locks on both wheels of the chair prior to transfer 63. A nurse manager is preparing to institute a new system for scheduling staff. Several nurses have verbalized 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? a. Introduce the new scheduling system by describing how it willsave the institution money b. Offer to reassign staff who do not support the change to another unit c. Identify nurses who accept the change to help influence other staff nurses - check d. Provide a brief overview of the new scheduling system immediately before its implementation 64. A nurse is planning discharge for a client following a hip arthroplasty. The client tellsthe nurse that she lives alone. Which of the following actions should the nurse take first? a. Report the information to the provider b. Contact the case manager for a consultation c. Determine the specific needs of the client d. Document the client’s living situation in the medical record 65. A charge nurse is making assignments for a medical-surgical unit. Which of the following clients is appropriate to assign to a licensed practical nurse? a. A client who has emphysema and has an oxygen saturation level of 92% b. A client who is scheduled to start oral nutrition 2 days afterstroke c. A client who is scheduled to receive 2 units of RBCs following a hip replacement d. A client who has dehydration and is being admitted from the emergency department 66. A nurse enters a client’s room and identifies that the client is receiving too much IV fluid because the IV pump is not working properly. Which of the following actions should the nurse take first? a. Place a faulty equipment tag on the pump b. Auscultate the client’slungs c. Complete an incident report d. Notify the provider 67. A nurse is discussing advance directives with a client. Which of the following statements by the client indicates an understanding of advance directives? a. I know I have the right to determine if I remain on a breathing machine b. I know I’ll need a lawyer to change them later, so I want to get them right c. I trust my doctor,so I’m going to leave it to him to do what’s best for me d. By naming a health care proxy, I give up the right to make my own medical decisions 68. A nurse manager is receiving report and is faced with the following situations that require intervention. Which of the following should the nurse manager address first? a. Two nurses had a heated disagreement about a scheduling issue b. No transport assistance is available to take a client to physical therapy c. Three staff members have called to say they will be absent d. A client is refusing care from assistive personnel of the opposite gender 69. A nurse is considering placing wrist restraints on a client who has cognitive deficits and has pulled out his IV catheter. Before using wrist restraints, which of the following actions must the nurse take first? a. Attempt lessrestrictive alternatives b. Explain the procedure to the client and his family c. Obtain a prescription for restraints from the provider d. Document the indications for using wrist restraints 70. Nurses on an inpatient care unit are working to help reduce unit costs. Which of the following actions is appropriate to include in the cost-containment plan? a. Return unused supplies from the bedside to the unit’s supply stock b. Wait to dispose ofsharps containers until they are completely full c. Use clean gloves rather than sterile gloves for colostomy care d. Store opened bottles of normal saline in a refrigerator for up to 48 h [Show More]

Last updated: 1 year ago

Preview 1 out of 15 pages