Leadership ATI practice A
A CNA tells a charge nurse that it is unfair they have to take care of all the client's who are incontinent. Which of the following responses should the charge nurse make? A. "I delegate tasks to personnel based on their job description" B. "Everyone working here has to care for clients who are incontinent" C. "Let's talk about organizing workflow so you care for fewer of these clients" D. "why do you not want to care for clients who are incontinent"
A
A charge nurse is observing a nurse perform a sterile dressing change for a client. Which of the following actions should the charge nurse identify as demonstrating sterile technique A. the nurse places the sterile package with the top flap opening away from the body B. the nurse pinches the flap on the inside of the package first to open it C. the nurse reaches over the package to open the left flap D. the nurse pulls the last flap of the package away from the body
A
A charge nurse is preparing to observe a newly licensed nurse perform a routine abdominal assessment. Which of the following actions should the charge nurse expect the new nurse to take? A. place the client in a dorsal recumbent position for exam B. auscultate for vascular bruits with the diaphragm of the stethoscope C. begin the assessment by using light palpation over the abdomen D. ensure that the client has a full bladder before beginning the procedure
A
A charge nurse is supervising the care of several clients. Which of the following actions requires intervention by the charge nurse? A. A nurse is photocopying their assigned client's diagnostic results B. A CNA documents a client's vitals on the client's paper-based graphic record C. The unit secretary faxes a client's lab results to the provider D. An RN stays with a client who is reading the medical records that were requested
A
A hospice nurse is planning care for a client who does not have advance directives. Which of the following interventions should the nurse include in the plan of care? A. provide the client with information about advance directives B. encourage the client to contact an attorney to create advance directives C. inform the client that they will need a relative to witness their advance directives D. tell the client that the Joint Commission requires clients to have advance directives
A
A nurse is caring for a client who is terminally ill and receiving nutritional support. The client's adult children disagree about continuing nutritional support. The dilemma is referred to the ethics committee. Which of the following actions should the nurse expect the committee to take? A. assist in weighing the options involved in the decision B. provide a legal representative for the family C. recommend the best course of action for the client D. decide how the nursing team should resolve the dilemma
A
A nurse is developing a plan of care for a school-age child whose family is homeless. Which of the following findings should the nurse identify as the priority? A. The child has red fissures at the corners of their mouth B. The child has several small bruises on both legs C. The child sleeps for about 13 hours each night D. The child is not regularly attending school
A
A nurse is providing preop teaching for a client who is scheduled for a total knee arthroplasty and speaks a different language. Which of the following interprofessional team members should the nurse include in the discussion? A. Interpreter B. Social worker C. Occupational therapist D. Spiritual advisor
A
A nurse is reviewing safe use of a wheelchair with a group of CNAs. which of the following instructions should the nurse include? A. raise the footplate of the wheelchair before transferring the client B. lock the brakes on one wheel of the chair when transferring the client C. push the wheelchair into the elevator with the front wheels first D. stand behind the wheelchair when moving a client down a ramp
A
A nurse manager is teaching about confidentiality requirements to the staff. Which of the following staff comments indicates an understanding of the teaching? A. "change of shift report can be given at client's bedside' B. "I can provide client info over the phone if the caller identifies themselves as family" C. "a client cannot see their medical record because it is considered to be property of the facility' D. "access to client info is limited to direct care providers'
A
A nurse manger needs to address an increased rate of client medication errors. Which of the following strategies represents an authoritarian approach to managing this issue. A. inform the staff of the penalties that can result from med errors B. encourage the staff to have two nurses verify med orders to prevent errors C. provide suggestion boxes for nurses to submit ideas for error prevention D. ask three experienced nurses to help investigate common causes of the errors
A
A nurse on a quality improvement team is implementing a plan to decrease the rate of pressure ulcers in a long-term care facility. Which of the following actions should the team take to evaluate the effectiveness of the plan? A. compare data from client's records regarding skin integrity with established criteria B. measure staff attendance at an educational program on managing pressure injuries C. interview clients regarding their satisfaction with their care D. monitor use of supplies used to prevent pressure injuries
A
A nurse receives notification of a fire on the unit. Which of the following actions should the nurse take first A. assist the clients who are in the immediate danger to a safe location B. close the doors and windows on the unit C. attempt to extinguish the fire using an ABC extinguisher D. discontinue the oxygen use for clients who can breathe without it
A
A nurse walks into the nurse's station and sees several staff members are looking at the EHR for a celebrity client on another unit. Which of the following actions should the nurse take first? A. Remind the staff members that this is a breach of confidentiality B. Discuss the issue with the nurse manager C. Request that an administrative restriction be placed on the client's record access D. Prepare a memo for the facility ethics committee
A
A nursing unit is undergoing changes to accommodate new bariatric services that will be available on the unit. Some staff members have verbalized displeasure with the changes. Which of the following should the charge nurse do? (Select all that apply.) A. role model a positive approach to the changes B. redirect the conversation when staff members make negative comments about the changes C. encourage staff members who support the changes to discuss the issue with resistant staff D. suggest that resistant staff members transfer to a different unit E. reprimand staff members who are resistant to changes
A, C
A nurse is conducting an orientation class for new clients and their families at the long term care facility. Which of the following client rights should the nurse address at the orientation? (SATA) A. the right to be treated with respect and dignity B. the right to full access of the facility C. the right to refuse their meds D. the right to leave regardless of provider recommendations E. the right to be fully informed of their health conditions
A, C, D, E
A case manger is planning an interprofessional conference for a client who is 3 days postop following an open reduction and internal fixation of the right hip. Which of the following concerns is the priority for discussion at the conference? A. The client does not have transportation for discharge home B. The client refuses to attend physical therapy sessions C. The client's home health nurse has not completed the home assessment D. The client describes feelings of depression after family visits
B
A charge nurse is planning client care assignments for a unit. Which of the following should the nurse assign the LPN? A. determine the swallowing ability of a client who had a stroke B. Provide an enteral feeding to a client with Crohn's disease C. develop a teaching plan for a client who has a new diagnosis of type 2 diabetes D. weigh a client who is 3 days postop following coronary artery bypass grafting
B
A charge nurse observes that a staff nurse's behavior has changed over the past few weeks. Which of the following behaviors should the charge nurse identify as an indication that the staff nurse might be working while impaired? A. spends free time conversing with other staff members at the nurse's station B. frequent use of restroom C. asks other nurses to administer pain meds for their clients D. delegates tasks to assistive personnel
B
A nurse asks a newly hired CNA to remove a client's indwelling cath. Which of the following actions should the nurse take to ensure the CNA is qualified to perform the task? A. Show the CNA how to remove an indwelling cath B. Review the CNA's skill competency list C. Ask the CNA is they know how to remove a foley D. pair the newly hired CNA with an experienced CNA
B
A nurse is caring for a 19 yr old who has just been informed that their cancer has metastasized. The client tells the nurse that they do not want to continue chemotherapy. Which of the following responses should the nurse make? A. "I will have the provider discuss treatment options with your parents' B. "I will gather info about palliative care for you" C. "I will contact you spiritual advisor to discuss this decision with you' D. "I will contact your parents about becoming your designees in your durable power of attorney"
B
A nurse is caring for a client who is 3 days post op following open heart surgery and will be transferred to the med-surge unit. Which of the following info should the nurse plan to include in the verbal report? A. the client's dressing change schedule B. the client's level of consciousness C. the client's VS from the previous shift D. the client's occupation
B
A nurse is caring for a client who is hospitalized and has expressive aphasia. The client's family reports that the nurse failed to obtain written informed consent before inserting an indwelling cath. Which of the following responses should the nurse make? A. "procedures prescribed by the provider do not require consent" B. "this is a procedure that does not require written informed consent' C. "you are right. I will discuss this issue with the charge nurse' D. "would you mind signing the informed consent form for the procedure at this time?"
B
A nurse is caring for a client who is scheduled for outpatient surgery. Which of the following actions should the nurse take to verify the client gave informed consent? A. verify that the client understands the risks of surgery B. ask the client to explain the procedure that is being performed C. answer the client's questions about the outcomes of the surgery D. determine if the client understands the benefits of the procedure
B
A nurse is caring for four clients. Which of the following assessment findings is priority? A. a client who has facial drooping following a stroke 8 hours ago B. a client who has a femur fracture and reports feeling short of breath C. a client who had an appendectomy 12 hours ago and reports pain as 5 on a scale of 0-10 D. a client who had an open cholecystectomy 4 days ago and has serosanguinous drainage on the wound dressing.
B
A nurse is planning discharge care for a client who had a stroke and now has left-sided weakness. Which of the following interventions should the nurse include in the plan of care? A. request crutches from a medical equipment provider B. advise the client to install grab bars in the bathroom at home C. encourage the client to allow a home care aide to perform ADL's for them D. contact hospice to provide follow-up care for the client
B
A nurse is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following actions should the nurse plan to take? A. assess the client's incision q8 hours for the first 48 hours B. inform the CNA of the client's weight bearing status C. instruct the client to cross their legs at the ankles when sitting in a chair D. Teach the client's partner to assist the client to flex the hip at least 120 degrees each hour
B
A nurse manager finds that there has been an increase in urinary tract infections on the unit. The address this problem, which of the following actions should the nurse manager take first? A. conduct an in-service that reviews proper cath insertion and maintenance B. perform a chart review to gather data about the clients who developed infections C. observe each staff nurse perform a urinary cath insertion D. require completion of a self-paced instruction program
B
Which of the following instructions provided by a nurse reflects effective communication regarding delegation of a task to a CNA? A. "Take vitals every 2 hours for the client who had a cholecystectomy in room 6122' B. "Check the urinary output at 1100 for John Doe and report it to me immediately" C. "Report to me if the chest drainage is excessive for Jane Doe in room 2438" D. "Please notify me of any clients whose vital signs of blood glucose levels are significant"
B
A nurse on a med-surge unit is caring for four clients. The nurse should recognize that which of the following clients is the priority? A. a client who is scheduled for a tubal ligation in 2 hours and is crying B. A client who has peripheral vascular disease and has an absent pulse in the right foot C. A client who has type 1 diabetes and needs the first dressing change for an ulcer D. A client who has MRSA and has an axillary temperature of 100.4F
B. A client who has peripheral vascular disease and has an absent pulse in the right foot
A charge nurse is leading a committee that is revising the policy for patient discharge. After developing the initial plan, which of the following actions should the nurse take next? A. set target dates for completion B. identify areas of support C. determine goals and objectives D. implement recommended strategies
C
A charge nurse is observing a newly licensed nurse's use of time-management skills. Which of the following actions by the newly licensed nurse indicates effective use of this skill? A. Documents client tasks at the end of the shift B. gathers supplies as needed while completing an activity C. group tasks that are in the same location D. skips breaks throughout the day to complete work on time
C
A charge nurse recognizes a trend of poor attendance at monthly staff meetings. To address this issue, which of the following actions should the charge nurse take first? A. Write a memo emphasizing the importance of attending staff meetings B. Appoint a task force to promote attendance at the meetings C. Explore the reasons that staff are not attending the meetings D. Reduce the number of meetings the staff are required to attend
C
A facility has been notified of a train derailment resulting in multiple clients experiencing life-threatening injuries. The external disaster plan has been activated. Which of the following actions should the charge nurse on the PACU take? A. Take extra wheelchairs to the ER B. Send PACU CNA's to help with triage C. identify stable clients for transfer to a surgical unit D. report to the command center for further instructions
C
A home health nurse is planning her daily visits and receives lab results for our four adult clients. The nurse should first visit the client who has which of the following values? A. dig 1.0 B. WBC 6,000 C. Platelets 100,000 D. Potassium 4.0
C
A nurse is assigning care for four clients. Which of the following tasks should the nurse plan to delegate to a CNA? A. instruct the client how to take their BP B. Administer SQ meds C. determine a client's intake and output D. provide a status update to a client's family member
C
A nurse is caring for a client who has a terminal illness and voices concern about performing self-care after discharge. Which of the following statements should the nurse make? A. "A social worker will address your concerns after discharge" B. "You should plan to go to a skilled nursing facility after discharge" C. "Your case manager will coordinate the resources you will need' D. "You will need hospice care until you feel stronger"
C
A nurse is caring for a client who is recovering from a stroke. The provider recommends an extracranial-intracranial bypass, but the client tells the nurse that he will not have the surgery. Which of the following actions should the nurse take? A. Inform the client of the consequences of decreased cerebral circulation B. Initiate a mental health consultation to determine why they client refuses the surgery C. Discuss the client's concerns about having the surgery D. Provide the client with information on additional treatment options
C
A nurse is observing a new nurse perform a sterile dressing change on a client who has a central cath. Which of the following actions should the new nurse take? A. open the top flap of the sterile package towards the body B. maintain a 1.25 cm border around the edges of the sterile field C. pick up the first sterile glove by grasping the folding cuff edge D. remove soiled dressings using sterile gloves
C
A nurse is planning the discharge of a newborn who requires apnea monitoring at home. To which of the following community agencies should the nurse anticipate referring the guardian of the newborn? A. child protective services B. public health C. home health D. women, infants, and children
C
A nurse is receiving report from the CNA assigned to the nurse's group of clients. Which of the following statements from the CNA indicates the client the nurse should assess first? A. "The client who has abdominal surgery 3 days ago is reporting feeling constipated' B. "The client who had the hip replacement reports pain as a 4 on a scale of 0-10" C. "The client who had an indwelling cath removed 8 hours ago reports inability to void" D. "The client who is scheduled for discharge today states they are ready to sign their paperwork"
C
A nurse is reviewing a client's clinical pathway upon discharge following hip arthroplasty. Which of the following info can assist the nurse in evaluating the cost effectiveness of the care? A. the age of the client B. the availability of community support groups C. the length of the client's stay D. the type of insurance the client carries
C
A nurse on a medical-surge unit is caring for a client transferred from another department. The nurse should verify that the client has given informed consent prior to which of the following procedures A. removal of staples from a surgical wound B. providing sputum specimen C. receiving moderate sedation D. collection of a blood specimen for ABG's
C
A nurse in an emergency department is admitting clients following an earthquake. The emergency disaster plan has been implemented due to the anticipated arrival of a large number of casualties. Which of the following clients should the nurse recommend the provider evaluate first? A. a client who has a penetrating head injury and respiratory rate of 4/min B. a client who has a comminuted fracture of the femur C. a client who has a 15.2 cm laceration to the scalp with clotted blood visible D. a client who has a sucking chest wound
D
A nurse is caring for a client who has osteoarthritis and reports difficulty buttoning their clothes. The nurse should recommend a referral for the client to which of the following members of the interprofessional team? A. podiatrist B. social worker C. paramedical tech D. occupational therapist
D
A charge nurse is observing a new nurse who is caring for a client who has pulmonary TB. The charge nurse should expect the new nurse to take which of the following actions? A. place the client on droplet precautions B. place the client in a room with positive pressure airflow C. wear a surgical mask when taking the client out of the room D. wear and N95 respirator mask when in the client's room
D
A client is considering having a tubal ligation, and she tells the nurse that she is uncertain if it is the right thing to do. Which of the following is an appropriate response by the nurse? A. provide information about alternate birth control methods B. ask if the client has discussed the decision with their partner C. emphasize the benefits of having the procedure D. discuss the client's feelings about the procedure
D
A client on a general surgical unit tells a nurse that staff members are not answering the call light properly. The client requests to be transferred to another unit. Which of the following actions should the nurse take first? A. notify the charge nurse of the client's request for transfer B. Assure the client that their concern has been shared with staff C. Tell the client that future calls will be answered in a timely manner D. Ask the client to verbalize their expectations
D
A client who has back pain presents to the ER and is provided a prescription for oxycodone. A staff nurse tells the charge nurse they think the client is seeking drugs and is not actually in distress. Which of the following responses should the charge nurse make? A. "It sounds like nonpharmacological interventions would be best for this patient" B. "Let's withhold the oxy until we can consult with the provider" C. "contact mental health services to arrange a consultation" D. "clients are the experts on their own pain"
D
A nurse from a medical unit is asked to work on an orthopedic unit. The medical nurse has no orthopedic experience. Which of the following clients should be assigned to the medical nurse? A. a client who is in balanced skeletal traction B. a client who had a total hip arthroplasty 3 days ago C. a client who had a fractured femur with a new cast D. a client who had a right above the knee amputation 24 hours ago
D
A nurse is caring for a client who is comatose. The client has a living will that declines the use of artificial enteral nutrition as a life sustaining measure, but the client's family has requested that the staff begin tube feedings. Which of the following actions should the nurse take? A. insert the tube and begin feedings per family's request B. ask the provider to discuss the issues with the family C. report the dilemma to the facility's dietician D. review the client's request with the family
D
A nurse is caring for a client who report vomiting and diarrhea for the past 6 hours. The nurse should identify that which of the following assessments is priority? A. auscultate the clients bowel sounds B. measure the clients temp C. check the clients urine specific gravity D. obtain the clients serum potassium level
D
A nurse is caring for a client who requests pain meds. The nurse fulfills a promise to return with the meds within 15 mins. The nurse is demonstrating which of the following ethical principles? A. beneficience B. utility C. justice D. fidelity
D
A nurse is preparing to administer medication to a client who has Crohn's disease. The client state "I want to skip this dose of my medication. I am too tired to take it". Which of the following actions should the nurse take? A. leave the med on the client's bedside table to take later B. return in 1 hour to administer the med C. mix the med in applesauce to administer to the client D. inform the client of the consequences of refusing the med
D
A nurse is serving on a committee that is considering the creation of a policy that will allow nurses to insert peripherally inserted catheters in the ICU. Which of the following resources should the nurse consult in planning for this policy. A. national league for nursing B. American academy of nursing C. agency for healthcare research and quality D. state nurse practice act
D
A nurse manager is auditing client charts and identifies an increase in ventilator-associated pneumonia. Which of the following actions should the nurse manager take? A. report the findings to the hospital ethics committee B. alert central supply C. fill out an incident report D. notify the quality improvement team
D
A nurse manager is planning an in-service for a group of nurses about caring for clients following stem cell transplants. Which of the following instructions should the nurse manager include in the teaching? A. Assign two clients who have had a stem cell transplant to the same room B. Obtain a rectal temp on client's q4 hours C. Wear an N95 respirator mask while caring for these clients D. Place clients in positive pressure airflow rooms
D
A nurse on a mental health unit is teaching a newly licensed nurse about client rights. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? A. "A nurse can provide basic treatment information to the client's employer" B. "A nurse can inform the client about their risks and benefits of ECT" C. "Clients on a mental health unit who are admitted voluntarily cannot leave against medical advice" D. "Clients on a mental health unit can refuse their meds"
D
Two nurses on a unit each contend that the other is not doing a fair share of work. The conflict is affecting the functioning of the unit. A charge nurse should approach this conflict is which of the following ways? A. schedule the nurses to work on alternating shifts B. organize a task force to evaluate the situation C. tell the nurses that it is their responsibility to cooperate with coworkers D. explore the alternative solutions to address unit workflow with the nurses
D
A nurse on a med-surge unit has arrived late to work multiple times over the past several weeks. Identify the sequence the nurse manager should follow when disciplining the employee: A. provide a written reprimand B. terminate the nurse's employment C. temporarily remove the nurse from scheduled shifts D. Schedule a meeting with the nurse
D, A, C, B
