ATI Leadership practice

Manager is reviewing Good Samaritan laws with a group of newly licensed nurses. Which statement is appropriate?

"If you render aid in an accident, do not leave the scene until another competent person can take over."

Which tort is the following? Nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.

negligence

Nurse has been reassigned from her regular area of work to a unit that is short staffed. Which action should the nurse take first?

Ask what she will be assigned to do.

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?

Confirms the client appears competent to provide consent.

A coworker puts an arm around a nurse and says "I bet you are a great lover." Which of the following is an appropriate response by the nurse?

"Speaking to me like that makes me uncomfortable."

Client on med/surg is terminally ill and tells nurse she feels hopeless. Appropriate nurse statement?

"Tell me what you understand about your illness."

Which client would the nurse asses first? +NG tube for decompression & gastric aspirate is green with a pH of 5.3 +indwelling cath removed 5 hrs ago and hasn't voided +COPD with cap refill of 4 seconds +late stage cirrhosis with fruity odor breath

A client who had an indwelling urinary catheter removed 5 hours ago and has not voided.

Triaging clients following a mass casualty event. Which should be assessed first?

A client who has severe respiratory stridor and deviated trachea.

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?

A dependent adult admitted for the treatment of a spiral fracture.

Caring for clients at urgent care. Which should be seen immediately?

A middle adult male who is diaphoretic and reports epigastric pain. (Manifestations of acute MI)

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?

A young adult client who has Crohn's disease and is 1 day preoperative for an ileostomy.

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

AP has knowledge & skill to perform task

Manager received client request not to have a specific staff nurse care for her while at the facility. Which is the appropriate action?

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?

Allow time during the workday when each nurse can demonstrate proficiency.

Manager is preparing inservice program about managing conflict for the nurses on the unit. Which is an example of interpersonal conflict?

An experienced nurse is uncivil to a newly licensed nurse. (Interpersonal conflict arises from differing goals and value systems. Ex. incivility and bullying)

Client fell and broke hip while being assisted to the bathroom and says he is going to sue the nurse. The nurse knows that in a legal proceeding, the standard that will be used to determine if the nurse was negligent is which of the following?

Another staff nurse provides testimony about how a reasonable, prudent nurse would have handled the situation.

Client 6 hr postop from total hysterectomy. What part of the SBAR includes oxygen saturation and apical heart rate?

Assessment

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

Autonomy

Charge nurse allows two nurses who are arguing about who gets to go to lunch first to go together. Charge nurse agrees to take care of both client loads while at lunch. Charge nurse is demonstrating which conflict management? +avoiding +competing +compromising +cooperating

Cooperating (resolution of conflict by sacrificing)

Nurse manager preparing for inservice program for the nurses on the unit about the new infusion pump. Which teaching strategies is most effective?

Demonstrate using the device and observe the staff returning the demonstration.

Health Care Proxy -- which statement needs clarification?

I have to choose a family member as my health proxy.

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 statement by the manager is appropriate?

Let's talk about your concerns about the new policy.

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?

No one.

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?

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

Nonmaleficence

Nurse is providing care for a surgeon on a med/surg unit. A nurse from a different unit asks about the surgeon's medical diagnosis. Nurse responds that he is unable to provide the info. Nurse displays which ethical principles? +Utility +Paternalism +Justice +Nonmaleficence

Nonmaleficence

Charge nurse plans to use effective change strategies when implementing a change in nursing procedure on the med/surg unit. Which actions should the charge nurse take during the moving stage of change? +Assess the problem +Use tactics to alert staff nurses that a change is needed +Evaluate the effectiveness of the change +Set a target date

Set a target date. (During the moving stage, the charge nurse should develop the plan for change and set the target date.)

Nurse is leading a team of nurse managers is planning to make a major announcement. Which nonverbal communication technique enhances the importance of the announcement?

Sit in front of the group for the meeting and then stand for the announcement.

RN is delegating care activities to a LPN. Which of the following is priority criterion the RN should consider when delegating? +agency policies for LPN +documented experience level of LPN +documented skill level of LPN +State Nurse Practice Act for LPN

State Nurse Practice Act for LPN

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?

Submit the incident report to the risk manager.

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?

The client's BP and pulse have been fluctuating throughout the day.

Manager is providing an inservice program about delegation to AP with staff nurses on the unit. Which indicates understanding?

The nurse should consider APs level of experience when making delegation decisions.

Nurse is reviewing the process of medication reconciliation with a newly licensed nurse. The nurse should include?

The purpose of medication reconciliation is to prevent adverse medication reactions.

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?

There is a higher risk of infection for our clients associated with artificial nails.

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

one day post op following total abdominal hysterectomy

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

punctured femoral artery

Charge nurse is reviewing the list of tasks that have been delegated to AP by the nurse. Which task should be reassigned to licensed nurse?

removing and cleaning the cannula of a client who has a new tracheostomy.

Charge nurse observes a nurse insert an indwelling urinary catheter in a female. Which action should the charge nurse intervene? +separates the client's labia with her dominant hand +coats indwelling urinary catheter with lubricant +provides perineal care prior to inserting urinary catheter +applies sterile drape prior to inserting urinary catheter

separates the client's labia with her dominant hand

Place the steps in order for fire emergency. *Pull the fire alarm *Confine the fire *Extinguish the fire *Rescue the clients

Rescue the clients. Pull the fire alarm. Confine the fire. Extinguish the fire.

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

Respite Care

Nurse has assigned client care activities to AP. Which statement indicates a need for assistance in establishing priorities?

"I have my assignment and will start with room 1 and work my way to room 10."

Teaching a newly licensed nurse about methods to reduce costs of client care. Which statement indicates understanding of the teaching?

"I should encourage clients to receive an annual flu immunization." (Prevent the need for treatment and hospitalization necessary with flu)

Client family member requests to view the client's medical record. What is the appropriate response?

"The client must provide permission to share the records with you."

Which tasks should the nurse assign to the LPN and which to the AP? +providing postmortem care for a client +measuring a client's I&O +obtaining a client's weight +inserting a nasogastric tube

+AP--providing postmortem care for a client +AP--measuring a client's I&O +AP--obtaining a client's weight +LPN--inserting a nasogastric tube

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

+Check on the client hourly. +Instruct the client in the use of the call light +Apply an ambulation alarm to the client's leg

Nurse is planning to assign tasks for a group of clients. Which of the tasks should be assigned to AP? +ambulate an older client with hypertension +provide discharge instructions for a client with new skin graft +perform an admission assessment on a client +check a blood product with another nurse prior to admin +weight a client who has heart failure

+ambulate an older client with hypertension +weight a client who has heart failure

Nurse finds a client did not receive a scheduled dose of furosemide (Lasix). Which would the nurse include in the incident/variance report? +date of incident +name of provider who prescribed the medication +potential adverse effects to the medication +time the client was to receive the medication +client's vital signs

+date of incident +time client was to receive medication +client's vital signs

A nurse is obtaining informed consent from a client who is preop. What actions should be taken? +establish client is able to pay for surgery +explain the surgical procedure to the client +validate the signature is authentic +verify the client understand the surgery +confirm the consent is voluntary

+validate the signature is authentic +verify the client understand the surgery +confirm the consent is voluntary

Which client does the nurse assess first? +Client with Crohn's, calcium of 10mg/dL and a headache. +Client with T2D, given glipizide and a BG of 68 mg/dL +Client with acute glomerulonephritis and given erythromycin and has reddish-brown urinary output +Client given acyclovir for cellulitis and pain in affected leg

Client with T2D, given glipizide and a BG of 68 mg/dL

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

Client with lumbosacral spinal tumor (client not at risk for dysphagia)

Caring for a client scheduled for surgery. What is the nurse role in regards to informed consent?

Determining the client's level of understanding about the procedure.

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?

Disaster drills should be held on a regular basis.

A nurse manager has received info from the facility's risk management department that a former client is pursing a lawsuit. The manager should anticipate a deposition will be required during which phase of legal process?

Discovery phase

Nurse providing discharge teaching for a client who has a new prescription for home oxygen. Which instructions should the nurse include?

Do not adjust the oxygen flow rate. (Other info from the question that I didn't know.) +check oxygen system daily +store unused oxygen tanks upright +avoid wool or materials that can generate static electricity to reduce the risk of fire.

Nurse suspects that a coworker is diverting opioid analgesics. Which is the adverse effect of opioid medications? Euphoria Rhinorrhea Hallucinations Dilated pupils

Euphoria

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?

Explain the risk the client faces if she leaves the facility.

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?

Explaining the operative procedure, risks, and benefits.

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?

Gather data about the nurse's work performance and attendance history.

Charge nurse is discussing disaster response with nursing staff. Which indicates an understanding of the Hospital Incident Command System (HICS)?

HICS identifies facility responsibilities and channels of reporting.

Preparing to witness informed consent for a client who is preoperative. Client asks "Are there other options besides surgery?" Which response is appropriate?

Have you discussed other treatments with your provider?

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?

I need to talk to you about the unit policies regarding client assignments.

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?

I need to talk to you about unit expectations regarding delegating and completing tasks.

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?

I plan to continue nursing my baby until he is at least a year old.

Caring for a client with advanced lung cancer. Provider recommends hospice. Which statement indicates a correct understanding of hospice care?

I should expect the hospice team to help me manage my dyspnea.

Nurse is serving on continuous quality improvement committee that has been assigned to develop a program to reduce the number of medication admin errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

Review the events leading up to each medication administration error.

Nurse checks with AP on the unit throughout the shift to determine if they are completing tasks. This is which rights of delegation?

Right Supervision

Nurse in ED receives report from an emergency responder who states a client is being transported following exposure to "dirty bomb". Nurse should prepare to care for a client that has been exposed to which of the following types of agents?

Radiologic (Dirty bomb combines radiologic agents with an explosive device, resulting in immediate effects of radiation exposure.)

Nurse should delegate collection of which of the following specimens to the AP? +Wound drainage for culture +Urine from the indwelling catheter +Blood of PaCO2 +random stool specimen

Random stool specimen

Nurse has several tasks to delegate to an assistive personnel. Which of the following tasks should the nurse ask the AP to perform first?

Take an arterial blood gas specimen to the laboratory.

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?

Check to see if the elbow restraint is in place for an infant who is postoperative from a surgical correction of a cleft palate.

Which client should nurse plan to care for first? +needs assistance with a bath +requesting a referral for home health services +asking about his PCA pump that contains morphine +has questions about his new prescription

Client asking about his PCA pump that contains morphine.

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.

Client discovers that his dentures are missing.

Nurse is planning a community diabetes mellitus management program. Which goal should the nurse include in the program?

Client will have decreased incidence of foot amputations.

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 6/10 +BP at 0800 of 138/86 and at 1200 106/60.

BP at 0800 of 138/86 and at 1200 106/60.

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?

Check the client's medical record for the providers prescription.

A nurse working in an ED is caring for a client who has been exposed to sarin gas following a bioterrorism attack. Which of the following interventions should the nurse plan to take? +vigorously rub the skin following a decontamination shower +initiate seizure precautions +provide respiratory support with a plastic oral airway +prepare to admin amyl nitrate

Initiate seizure precautions. (Sx of sarin gas exposure include neurologic responses including insomnia, impaired judgement, LOC, and seizures.)

Client in ER with compression fracture of spinal vertebra. Client given IV morphine in transport. Neuro determined urgent surgery needed. Staff is unable to reach family. Which action should the nurse anticipate neurosurgeon taking?

Invoking implied consent.

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?

It must be very frustrating when you don't have what you need to perform the procedure.

Nurse demonstrates adherence to the ethical principle of fidelity by doing which of the following?

Keeping an appointment with a client.

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

Nonmaleficence

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?

Notify the nursing supervisor of the concerns.

Nurse should identify which of the following as a triage officer during the time of a disaster? +Members of FEMA +Responding Law Enforcement +Representatives from the American Red Cross +Nurses and other emergency medical personnel

Nurses and other emergency medical personnel

Nurse on med/surg is planning to delegate tasks to an adult volunteer. Which task should the charge nurse avoid assigning to the volunteer?

Observing a postoperative client who is confused.

A nurse and experienced LPN are caring for clients. Which tasks can the LPN do?

Obtain vital signs from a client who is 6 hrs post op. Administer a tap water enema to a client who is preop. Catheterizing a client who has not voided in 8 hrs. (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.)

Which lab finding requires follow up? BUN 15 mg/dL Platelet count 60,000/mm3 WBC 6,000/mm3 Hemoglobin 14 g/dL

Platelet count 60,000/mm3

Nurse is planning to delegate a task to an AP. Which actions should the nurse plan to take? +assess the APs ability to follow the client's teaching plan +determine the social skills of the AP +Evaluate the ability of the AP to work with peers +Provide a clear description of the task to the AP

Provide a clear description of the task to the AP

Charge nurse is planning to conduct a performance appraisal of staff member on her unit. Which following actions should the nurse take?

Provide the staff member with a copy of the appraisal form in advance.

Nurse prepares to bathe a client. Which action should the nurse take?

Pull the curtain around the client's bed.

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?

Quality of nursing care provided.

Nurse overhears two APs from med/surg discussing a client in the cafeteria. Which of the following is the priority nursing action?

Quietly tell the APs that this is not appropriate.

Nurse puts in for a promotion and the hiring manager insinuates that if there was a sexual relationship between the two of them, the nurses promotion would get increased consideration. Which of the following actions should the nurse take?

Tell the hiring manager in clear terms that this conduct causes feelings of discomfort and that the behavior should stop immediately.

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

Transferring client to discharge location.

A volunteer assigned to the peds unit reports to the charge nurse for an assignment. Which assignment is unsafe for the volunteer?

Transporting a school age client who is in traction to another department.

Nurse experiences a needle stick injury. First action by nurse?

Wash the site of injury with soap and water.

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?

What do you think your spouse would have wanted ?

Nurse manager observes an unknown man in a laboratory coat making copies of a client's medical record. Which of the following actions should the nurse plan to take first? +notify security +approach the man and ask why he is making copies +inform the nursing supervisor +report the observation to the nurse caring for that client

approach the man and ask why he is making copies

Which is priority action of the nurse? +taking telephone Rx about a client who is to be transferred from PACU +assessing a client who experiences unilateral calf pain when ambulating +reinforcing a client's dressing for the surgical site of an above the knee amputation +reassuring the partner of a client who sustained a closed head injury

assessing a client who experiences unilateral calf pain when ambulating

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.

b. Compare the number of medication errors before and after the action was implemented.

Administering an antibiotic to a client who refuses it is an example of which tort? +assault +false imprisonment +negligence +battery

battery (physical contact without client's consent.)

Nurse should plan to place a child who is postoperative from an appendectomy with which of the following children? +sickle cell crisis +streptococcal pharyngitis +head injury +new diagnosis of T1D

child with new diagnosis of T1D