ATI_AQ-Leadership_and_Management

A nurse is preparing to teach the health care team about the concept of critical pathways. Which of the following statements regarding the purpose of a critical pathway should the nurse plan to include?

"A critical pathway is a multidisciplinary tool that guides client care and bases outcomes on an externally imposed timeline."

A nurse is talking with a family member who is unhappy with the care being delivered to his parent. Which of the following responses should the nurse provide?

"Can you give me a specific example of care that caused dissatisfaction?"

A nurse is caring for a client who asks, "Is the client in the next room in pain? I hear her cry out frequently." Which of the following responses should the nurse make?

"Does the crying out bother you?"

A nurse is interviewing a client who has a new diagnosis of major depression. Which of the following questions is the nurse's priority?

"Have you thought about hurting yourself?"

A nurse is caring for an adult client who is scheduled for a procedure. The client's son asks the nurse what medication is being given to the client. Which of the following responses should the nurse make

"I am sorry, but you'll need to ask your father for that information."

A nurse in a mental health clinic is interviewing a client who has a history of substance use disorder. The client reports his experiences from a previous voluntary hospitalization. Which of the following reported experiences constitutes assault?

"I was threatened with a shot when I refused to take an oral medication I knew would make me groggy."

A nurse is caring for a client who is scheduled for a bilateral mastectomy. The client states, "I don't think I can go through with the surgery after all." Which of the following responses should the nurse offer?

"I will let your surgeon know about your decision."

A nurse is caring for a client with a history of severe multiple sclerosis and asks the nurse about completing a living will. Which of the following statements should the nurse make?

"I will provide the information you need to complete advance directives.

A 13-year-old female adolescent tells the charge nurse in the pediatric unit that she does not want a male nurse assigned to care for her. Which of the following responses should the nurse make

"I'll change the assignment so a female nurse is caring for you today."

A nurse is transporting a client to a surgical suite for a procedure. The client states that he no longer wants to have the surgery. Which of the following responses should the nurse offer?

"Let me call your surgeon while you tell me about your concerns."

A nurse is reinforcing teaching with a client about organ donation. Which of the following statements by the client indicates an understanding of the teaching?

"People age 18 and over have the right to make an organ donation."

A nurse is assisting with the plan of care for a client who has heart failure and lives alone. A referral has been made for a case manager to visit with the client. Which of the following explanations should the nurse give the client about the role of a case manager?

"The case manager will coordinate and plan your care while you recover from your surgery."

A charge nurse is performing a quality-assurance audit on the documentation of several client's charts. Which of the following documentation items should the charge nurse identify as a correct entry in the client's medical record?

"The client ambulated for 10 min, 3 times during the shift."

Nurses working in a long-term care facility inform the nurse manager that the whirlpool bath unit need to be updated in order to make client bathing more efficient. Which of the following responses should the nurse manager provide?

"This purchase will need to be addressed in the capital budget plan for the unit."

A nurse is caring for a client who has breast cancer and is scheduled to have 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 provide?

"Would you like me to have a member of a breast cancer support group visit with you?

A nurse is preparing to administer a client's anticoagulant medication. The client states, "I don't like taking this medication. I always have to get my blood checked." Which of the following responses should the nurse make?

"You can refuse the medication. I will notify your provider."

A charge nurse is assisting with teaching a group of clients in an assisted-living facility about clients' rights. Which of the following pieces of information should the charge nurse include in the teaching

"You can request to review your personal medical records at any time."

A nurse on a pediatric unit is assisting with preparing a list of clients for potential discharge to home due to a local incident involving multiple children. Which of the following clients should the nurse place on the potential discharge list? (select all that apply)

1. A preschooler with asthma who has scattered wheezes that resolve with PRN use of albuterol 2. A school-aged child with a femur fracture in an external fixation device whose pain is controlled with PRN oral codeine 3. An adolescent client who is developmentally delayed, has a PICC line, and needs 6 more weeks of antibiotics

A nurse is reinforcing discharge teaching with a client who has a leg wound infected with methicillin-resistant Staphylococcus aureus (MRSA). Which of the following pieces of information should the nurse include in the teaching?

1. Cleanse the wound with tap water 2. Discard soiled bandages in a moisture-proof bag

A charge nurse is preparing a departmental in-service session about radioactive implants for a group of staff nurses. Which of the following pieces of information should the charge nurse include in the presentations? (select all that apply)

1. Clients should be placed in a private room 2. Staff should wear a dosimeter badge when caring for the client 3. Clients should be on bed rest

A nurse is caring for a group of client on a medical-surgical unit. Which of the following tasks should the nurse delegate to an assistive personnel? (Select all that apply)

1. Collecting a stool specimen 2. Measuring oral intake 3. Providing postmortem care

A nurse manager is evaluating the time-management strategies of a newly licensed nurse. Which of the following actions taken by the nurse are effective time-management strategies? (Select all that apply)

1. Completing a task before beginning another task 2. Taking time to plan care at the beginning of the shift 3. Mentally visualizing a procedure prior to gathering equipment

A nurse suspects that a coworker is coming to shifts under the influence of alcohol. Which of the following behaviors in the workplace are consistent with substance use disorder? (Select all that apply)

1. Extended lunch periods and breaks 2. Calling in sick frequently on Mondays or Fridays 3. Decreased concern regarding personal appearance and grooming 4. Excessive use of cologne or mouthwash

A nurse is preparing to insert an indwelling urinary catheter for a female client. The nurse has performed hand hygiene, positioned the client, opened and organized the equipment, and donned sterile gloves. In which order should the nurse implement the remaining actions?

1. Lubricate the catheter's tip 2. Cleanse the meatus 3. Insert the catheter 4. Inflate the retention balloon 5. Collect a urine specimen LCIIC

A charge nurse on a medical-surgical unit is assigning client care for the upcoming shift. Which of the following tasks should the nurse delegate to an assistive personnel? (Select all that apply)

1. Measuring a client's intake and output 2. Providing postmortem care to a client

A charge nurse is preparing for an in-service session about client advocacy for a group of staff nurses. Which of the following situations should the nurse include as an example of client advocacy? (select all that apply)

1. Notifying the provider when a client has questions about the procedure 2. Helping a client make a list of questions she would like to ask the provider 3. Clarifying the dosage of a medication prescribed for a client who has impaired liver function 4. Carrying out the end-of-life wishes outlined in the living will of an older client who has end-stage renal disease

A nurse in a medical-surgical unit is planning care for a group of clients. Which of the following clients should the nurse attend to first

A client who has a cast newly applied on the forearm and reports tingling of the fingers

A charge nurse on a medical-surgical unit is making client assignments for the oncoming shift. Which of the following clients should the charge nurse assign to a licensed practical nurse (LPN)?

A client who has a prescription for irrigation of an indwelling urinary catheter

A nurse is preparing to care for a group of clients after receiving a change-of-shift report. From which of the following clients should the nurse collect data first

A client who has emphysema and reports dyspnea

A nurse is contributing to the plan of care for several clients. Which of the following clients should the nurse refer to a case manager?

A client who has neurological deficits following a stroke

A nurse is reinforcing teaching with a newly hired nurse about violations of client rights. Which of the following should the nurse include as an example of a violation of client rights?

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

A nurse is selecting clients for discharge following an environmental disaster. Which of the following clients should the nurse expect?

A client who is 1 day postoperative following an inguinal hernia repair

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following clients should the nurse attend to first?

A client who is receiving cephalexin and reports dyspnea

A nurse is prioritizing care for a group of clients. The nurse should plan to attend to which of the following clients first?

A client who requires endotracheal suctioning

A nurse manager is observing the staff working on the unit. Which of the following observations should the nurse manager recognize as an example of paternalism?

A nurse practitioner withholding information from a client who is dying to avoid causing the client distress

A charge nurse is conducting an in-service session on ethics for a group of newly licensed nurses. Which of the following situations should the charge nurse include as an example of the ethical principle of veracity?

A nurse truthfully answers the client's questions about upcoming chemotherapy

A nurse on a pediatric unit is recommending clients for discharge following a school bus crash in the community. Which of the following clients should be recommended for discharge?

A preschooler who has tonsillitis and has been receiving oral antibiotics for 24 hr

A nurse is speaking will the family member of a client who has early Alzheimer's disease. The family member would like to keep the client living at home, but the client requires assistance while the family member is away at work. Which of the following services should the nurse include in the discussion?

Adult day care

A nurse is assisting with the admission of a client who has measles. The nurse should identify that this client should be placed in which of the following types of isolation?

Airborne

A nurse is caring for a group of clients who have mobility issues. Which of the following clients is at the greatest risk for a complication?

An 80-year-old client who has a fractured hip

A nurse enters the room of an older client and finds him attempting to crawl over the side rail. Which of the following actions should the nurse take?

Ask an assistive personnel to sit with the client

A nurse is caring for a client who refuses to take her prescribed oral medication. The nurse states, "If you don't take this pill, "I'm going to give you the medication by injection."

Assault

A nurse is caring for a client who is undergoing the 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?

Case manager

A nurse is reviewing the medication administration record for a client and notes that the nurse from the previous shift gave double the dose of antihypertensive medication prescribed to the client. Which of the following actions should the nurse perform first?

Check on the client's condition

A nurse enters a client's room and finds the client lying on the floor next to the bed. Which of the following actions should the nurse take first?

Check the client for injuries

A nurse finds a client standing next to his bed with the side rails raised. The client is visibly confused and not wearing an identification bracelet, and his IV is detached. The client states, "I can't remember my name." After assisting the client back into bed, which of the following actions should the nurse perform next?

Check the client for injury

A nurse is entering a client's room and notices the client has fallen on the bathroom floor. Which of the following actions should the nurse take first?

Check the client for injury

A nurse is participating in an ethics committee meeting about a client who has a history of alcohol use disorder and needs a liver transplant. Which of the following actions should the committee take first?

Collect information related to the issue

A charge nurse finds an increased incidence of health-care-associated infections (HAIs) on a long-term care unit. Which of the following actions is the charge nurse's priority?

Conduct a chart review to gather data about clients who developed HAIs

A nurse is planning to perform a negotiation to manage a conflict between herself and another staff member. Which of the following actions should the nurse plan to take?

Create a solution in which all parties are satisfied

A nurse is assisting with planning care for a group of clients. Which of the following actions should the nurse plan to take

Delegate the administration of an intermittent tube feeding to a second licensed practical nurse (LPN)

A nurse manager has established staff nurse committees to address unit issues, instituted an open-door policy for talking about concerns, and supported the professional development of all staff members. Which of the following leadership styles is this nurse manager displaying?

Democratic

A nurse is assisting the provider with an amniotomy for a client who is in labor. Which of the following data is the priority for the nurse to collect following the procedure?

Fetal heart rate

A nurse is contributing to the plan of care for a client who adheres to Kosher dietary laws. Which of the following food selections should the nurse recommend?

Grilled salmon

A nurse manager observes a nurse entering the room of a client who is on contact precautions without donning personal protective equipment (PPE). Which of the following is the priority action for the nurse manager to take?

Have the nurse exit the room and don proper PPE

A nurse is preparing an IM injection for a client who is preoperative when another client suddenly calls for assistance. The nurse asks another nurse to give the injection because an assistive personnel is waiting to take the client to surgery. Which of the following actions should the second nurse take?

Help the other client requesting so that the first nurse can give the prepared injection

A nurse is having difficulty completing care and documentation without staying past the end of her shift. The nurse manager suggests focusing in time-management skills. Which of the following strategies should the nurse plan to incorporate?

Identify tasks in order of their priority

A charge nurse is coordinating the evacuation of clients from a facility following a bomb threat. Which of the following actions should the nurse when implementing the evacuation process?

Instruct clients who are able to ambulate to leave

A nurse is documenting data about a client at a computer terminal in the nurse's station when he has to leave the area to assist another client.

Log off the computer before leaving the nurses' station

A charge nurse is making the daily assignments for a medical-surgical unit. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?

Measuring vital signs

A charge nurse overhears a unit nurse say that the charge nurse is giving preferential treatment to nurses on the night shift. Which of the following action should the charge nurse take to response to the conflict assertively?

Meet one-on-one with the unit nurse to discuss these concerns

A nurse enters a client's room and discovers a small fire in a trash can. Which of the following actions should the nurse take first?

Move the client out of the rooM

A nurse is administering medications to a client who is recovering from a stroke and has right-sided paralysis. The nurse places the client's medications on the left side of his mouth and administered the pills individually. Which of the following ethical principles is the nurse displaying?

Nonmaleficence

A nurse s assisting with the informed consent process for a client who is scheduled for a below-the-knee amputation. The client asks the nurse, "Why are they making me have this surgery today? I don't understand why this is happening." Which of the following actions should the nurse take?

Notify the provider of the client's commentS

A nurse is caring for a client who had a stroke and requires assistance performing ADLs. The nurse should collaborate with which of the following members of the interprofessional care team when caring for this client?

Occupational therapist

A nurse is a member of a quality-improvement committee seeking to reduce the risk of adverse events in a health care facility. When reviewing recently submitted incident reports, which of the following incidents should the nurse identify as an sentinel event?

Paralysis of a client's lower extremities occurred following epidural anesthesia

A charge nurse is preparing assignments for the upcoming shift. Which of the following tasks should the charge nurse delegate to an assistive personnel (AP)?

Perform a simple dressing change is within the AP's range of function. Therefore, the charge nurse can delegate this task to an AP

A nurse is receiving report on a client who has Clostridium difficile and is being transferred from another unit. Which of the following precaution should the nurse take?

Perform hand hygiene with non-antimicrobial soap and water after performing client care

An RN is preparing assignments for the upcoming shift. Which of the following tasks should the charge nurse delegate to a licensed practical nurse (LPN)?

Perform tracheostomy suctioning for a client who is stable

A nurse is collecting data from a client who has recently been prescribed lithium carbonate. Which of the following findings is the nurse's priority?

Poor motor coordination

A nurse participating in a continuous quality-improvement program is reviewing medical records to determine the time of first postoperative ambulation of clients who had abdominal surgery. This nurse is participating in which of the following types of quality evaluation?

Process

While orientating newly licensed nurses to a facility, a nurse manager is emphasizing the importance of practicing within standards of care. To which of the following legal concepts is the manager referring?

Professional negligence

A nurse is assisting with the transfer of an older adult client to a long-term care facility. To promote continuity of care, which of the following actions should the nurse plan to take?

Provide a written summary of the client's nursing plan to the long-term care facility

A nurse is assisting a charge nurse with teaching a group of unit nurses about alternative restraints for clients who are confused and wandering. Which of the following pieces of information should the nurse include when reinforcing the teaching?

Provide the client with a rocking chair

A nurse is discussing palliative care with the family of a client who is terminally ill. Which of the following should the nurse include as the purpose of palliative care

Providing comfort measures

A nurse is planning to delegate the postoperative care of a client following an appendectomy. Which of the following actions should the nurse assign to an assistive personnel (AP)?

Recording urinary output after emptying the indwelling urinary catheter

A nurse is preparing a client for a lumbar puncture. The client has signed the consent form but tells the nurse that she does not remember what the doctor will do during the procedure. Which of the following actions should the nurse take?

Remind the client that the doctor will insert a needle to get a sample of fluid from her spine

A school nurse is assisting with the care of a child who has multiple bruises to his trunk and extremities. The child reports falling out of a tree 2 days ago, but the nurse's clinical findings show patterns of bruising not typically sustained from a fall from a tree. Which of the following actions should the nurse take

Report the findings to local police and social service agencies

A nurse suspects that a coworker might be in an impaired state when providing care to clients. Which of the following actions should the nurse take

Report these observations to the nurse manager

A charge nurse in a long-term care facility notes that several staff members are late in completing an annual mandatory educational session about extremity restraint safety. Which of the following actions should the charge nurse plan to take?

Send an e-mail to each nonadherent employee with a link to upcoming educational sessions

An experienced nurse is serving as a mentor to a newly licensed nurse.

Serve as a guide and teacher for the newly licensed nurse in an established relationship

A charge nurse in a skilled nursing facility notes several recent conflicts among staff members on different shifts. Which of the following strategies should the nurse plan to use to resolve these conflicts?

Set up a series of meetings for all staff members to attend to discuss issues

A nurse working in a mental health facility is assisting with the discharge of a client who has schizophrenia and requires housing assistance. Which of the following referrals should the nurse recommend to the provider?

Social worker

A nurse in a provider's office observes a newly licensed nurse taking a client's health history while in the waiting area. Which of the following actions should the nurse perform?

Speak to the nurse immediately in private

A nurse is part of a facility committee charged with developing and implementing new documentation forms. The nurse should recognize which of the following factors as a potential restraining force for implementing this change

Staff resistance to learning new forms of documentation

A nurse is walking with a client who falls after the wheel on a facility-issued walker becomes dislodged. Which of the following actions should the nurse take regarding the completed incident report?

Submit the variance to the risk manager

A nurse is contributing to the plan of care for a client who has Alzheimer's disease with moderate cognitive decline. Which of the following interventions should the nurse include to orient the client to the present?

Talk with the client about scheduled daily activities

A charge nurse is planning a performance appraisal interview for a newly hired assistive personnel (AP). Which of the following factors should the charge nurse take into consideration?

The AP should have a copy of the performance standards before the appraisal interview

A nurse is assisting with teaching a group of unit nurses about the Health Insurance Portability and Accountability Act (HIPAA).Which of the following pieces should the nurse include in the teaching

The Security Rule provides a uniform level of security to protect client records

A nurse is evaluating a client's understanding of discharge teaching about dressing changes. Which of the following actions by the client indicates an understanding of the teaching?

The client does not ask questions when given the opportunity

A nurse is reinforcing teaching about a living will who has end-stage breast cancer. Which of the following pieces of information should the nurse include in the teaching?

The client has the right to change the living will at any time

A charge nurse is providing teaching to a new staff nurse regarding delegation to assistive personnel (AP). Which of the following pieces of information should the charge nurse include in the teaching?

The nurse should be familiar with the task he/she plans to delegate

A nurse is reinforcing teaching with a newly licensed nurse about the informed consent process for a client who is scheduled for a surgical procedure. Which of the following pieces of information should the nurse include in the teaching?

The person who will perform the procedure is responsible for obtaining informed consent

A nurse is assisting with making assignments on a medical-surgical unit. Which of the following tasks should the nurse assign to an assistive personnel (AP)?

Transferring a client who is postoperative from a bed to a chair

A nurse is walking down the unit when she sees smoke coming from the central supply room. After activating the fire alarm, which of the following actions should the nurse take?

Turn off sources of oxygen near the fire

A nurse is following policy and procedure for reporting a client who has a communicable disease. Which of the following infections should the nurse plan to report to the CDC?

Vancomycin-resistant Staphylococcus aureus

A nurse in a community health clinic is planning an in-service session on nationally notifiable infectious conditions. Which of the following conditions should the nurse include?

Varicella

A nurse manager is planning to discipline a nurse who has been absent from work 6 times in the past 6 weeks for various reasons. Because this is the first instance of a potential problem with the employee, the nurse manager decides to utilize a nonpunitive approach to the absenteeism. Which of the following actions should the nurse manager plan to take?

Verbally remind the employee about the facility's employment standards

A nurse is reviewing informed consent with a client who is scheduled for a cardiac catheterization. Which of the following tasks is the responsibility of the nurse?

Verify the client understands the procedure being performed

A nurse overhears 2 nurses discussing a conflict they are having about who should complete certain client-care tasks. The nurses agree that they are tired of the conflict and will let the nurse manger decide who should complete the tasks. The nurse should identify this outcome as which of the following approaches to conflict management?

Win-yield