ATI RN Proctored Leadership Form A 2020 (with answers)

Document Content and Description Below

1 A charge nurse for the emergency department is supervising a nurse who has been temporarily reassigned from the medical-surgical unit during a b usy time. Which of the following assignments is most ... appropriate for this nurse? Obtaining a medical history from a client who attempted suicide Collecting a catheter urine specimen from a 2-year-old child with a fever Setting up a trauma room for an incoming motor-vehicle crash victim Performing triage for three clients who have just arrived in the waiting ar ea 2 A nurse should first provide care for which of the following clients? An older adult with dyspnea and a respiratory rate of 22/min A toddler who has a head laceration oozing dark red blood An adult client with large ecchymoses on both legs An adolescent with an injured ankle and pain rated at 10 on a 0-10 scale 3 A client with methicillin-resistant Staphylococcus aureus (MRSA) of the urine is being admitted into the hospital and is placed on contact isolation . Which of the following should cause the charge nurse to intervene? The client is dressed in an isolation gown for transport to x-ray. The door for the isolation room is left open. A nurse checks the client's IV without wearing gloves. A provider uses alcohol-based hand cleanser after providing care. 4 A nurse is caring for a competent client who is newly diagnosed with a t erminal illness. Which of the following statements by the client indicates a correct understanding of advance directives? "From this point on, my partner has control over my health care decisions ." "I am so relieved that the decisions about my care are finalized." "I'm glad that the doctors now can make all the final decisions." "When I can no longer make decisions, people now know what I want." 5 A client who is intoxicated presents to the emergency department and repo rts struggling with depression lately. The next day, the client is ready for discharge and states, “It’s okay. Soon everything will be just fine.” Which o f the following is the nurse's priority action? Ask the client if he is feeling suicidal. Remind the client that change is always possible. Inquire about the client's regular alcohol consumption. Reinforce the need to follow up with the discharge referral. 6 A client diagnosed with an inferior MI 2 days ago suddenly reports nause a and midsternal chest pain. After ensuring that oxygen support is patent, w hich of the following interventions should the nurse anticipate taking next? Assess for S3 heart sounds. Administer a prescribed antiemetic. Notify the primary care provider. Obtain a 12-lead ECG. 7 The staff on an orthopedic unit have implemented a plan to prevent loss of revenue from supply and equipment charges. Which of the following indic ates that the plan is successful? Supplies for dressing changes are kept at the bedside. Billing for the unit has increased in the last quarter. Unused supplies from discharged clients are saved for future use. Documentation of the supplies used for each client is complete. 8 A nurse working in an emergency department has been assigned four clien ts. Which of the following client conditions should be reported to the appr opriate authorities? A female client with deep bruising to her lower leg An adolescent client with Clostridium difficile An older adult client with a stage I pressure ulcer A male client with a bite from an unknown dog 9 A nurse is caring for an older adult client with type 1 diabetes mellitus and a stage II ulcer on his left leg. The client’s medical history indicates t hat he drinks a pint or two of vodka each day. Which of the following should t he nurse include in the client’s plan of care? Coordinate a referral to an outpatient alcohol treatment center. Involve the family in confronting the client about his alcoholism. Teach the family how to monitor and control the client’s alcohol intake. Provide strategies to assist the client in moderating his alcohol intake. 10 A nurse is assigned a non-English speaking client who is scheduled for surgery. Which of the following is the appropriate method for obtaining inf ormed consent from the client? Use a professional interpreter. Request that a family member act as a translator. Ask a bilingual nurse on the unit to assist the client. Provide the consent document in the client's native language. 11 When planning for updates on infection control, fire and safety, and con fidentiality issues, which of the following methods of educational delivery is most efficient? Classes available monthly by the staff development educators Day-long training sessions available twice a year Each unit providing classes at shift changes Self-directed computer-based modules with posttests 12 A charge nurse is assessing staff knowledge about safety procedures reg arding needle stick injuries. Which of the following statements by a nurse indicates appropriate understanding of these safety procedures? "Prophylactic treatment should be initiated after a needle stick during pre paration of an injection." "I should stop the bleeding as soon as possible following a needle stick in jury." "An incident report should be completed if a client receives a stick from her own used needle." "The needle should be recapped to prevent injury during transport to the biohazard container." 13 A nurse at a long-term care facility is planning a fall prevention progra m for the residents. Which of the following should be included in the plan? Keep the four side rails up on beds at night. Apply vest restraints on residents who are confused. Accompany residents older than 85 during ambulation. Institute rounds every 2 hr during the day to offer toileting. 14 A nurse is providing discharge instructions to a client who had a mastec tomy and is going home with a drain. Which of the following statements is ap propriate to include in the instructions? "Begin performing stretching exercises the day after you get home." "Keep the incision dry until the stitches are removed." "Notify the primary care provider if there is numbness at the surgical site. " "Follow a low-sodium diet to prevent lymphedema." 15 A client is admitted to the hospital and makes end-of-life care decisions prior to the arrival of her family. The family arrives and asks the nurse to change the client's mind regarding end-of-life care. Which of the following actions should the nurse take? Facilitate a meeting with the client and the family. Have the family meet with the primary care provider. Request a social service consult for the client and family. Inform the family that the client's decisions are final. 16 A nurse who is caring for clients on the medical-surgical unit delegates collection of vital signs to an assistive personnel (AP). Which of the follow ing nursing actions is important in ensuring safe client care? The nurse looks at vital sign trends at the end of the shift. The nurse rechecks an abnormal blood pressure measurement. The nurse asks the AP to report any unusual findings. The nurse accompanies the AP during vital sign collection. 17 A nurse working in a rehabilitation facility is caring for a client with p araplegia from a spinal cord injury. An interdisciplinary team is scheduled to meet and discuss the client's needs. Which of the following concerns is the h ighest priority for the nurse to report to the team? The client has experienced a decrease in appetite. The client lives alone in a second-story apartment. The client has a stage I pressure ulcer on his heel. The client reports fatigue during occupational therapy. 18 An RN is planning client assignments for an assistive personnel (AP). T he RN should assign the AP to the care of a client who requires assessment of nasogastric tube output. feeding due to difficulty swallowing after a stroke. help with bathing and toileting following hip surgery. colostomy irrigations and bag changes. 19 A disaster is occurring, and the charge nurse on a medical-surgical uni t must determine which clients can be discharged. Which of the following cl ients should the nurse recommend for discharge? A client with a troponin level of 3 ng/mL A client with a deep vein thrombosis and an INR of 2.0 A client who is 1 day postoperative following gastrectomy A client who reports numbness on the left side of the face 20 A charge nurse suspects that a staff nurse has a problem with opioid abus e. Which of the following is the appropriate action for the nurse to take? Assign clients who are not prescribed opioids to the nurse. Collect data to support further action. Arrange for another nurse to witness the nurse administer opioids. Report the nurse to the state board of nursing. 21 An RN has just received report for four clients. The nurse should plan to first assess the client who has pain uncontrolled by PCA morphine. a newly discovered nonblanching reddened area on the right hip. a nonpatent gastric tube used for bolus feedings. refused to go for a scheduled gastrointestinal diagnostic procedure. 22 A nurse is preparing to witness the informed consent of a client who is to undergo a gastrectomy. The client has a question regarding the postoperat ive diet. Which of the following should the nurse do? Review the surgeon's instructions regarding the procedure. Reassure the client that there will be time to review the diet after surgery. Notify a registered dietician and have her explain the diet to the client. Answer the question and have the client sign the surgical permit. 23 On admission, a female client who is Muslim tells the female charge nur se that she wants only female nurses to provide her care. Which of the foll owing actions should the charge nurse take first? Consult with the nursing supervisor. Explain that clients are not allowed to pick caregivers. Explore the basis for this request with the client. Provide the client's care herself. 24 A triage nurse in an emergency department should assign priority to a cli ent arriving with a laceration of the right index finger with profuse bleeding. sudden onset of left-sided paralysis and slurred speech. severe vomiting and diarrhea with dehydration. a burn of the right lower forearm with significant edema and blistering. 25 A fire is discovered in the hospital, and the charge nurse has orders to evacuate. Which of the following clients should be evacuated first? A client who is in Buck's traction for a left hip fracture A client who is 1 day post thoracic surgery with a chest tube A client who is confused and restrained for safety A client who is ambulatory and receiving an infusion of chemotherapy 26 A client is brought to the emergency department (ED) following a motor- vehicle crash. Drug use is suspected in the crash, and a voided urine speci men is ordered. The client repeatedly refuses to provide the specimen. Whic h of the following is the appropriate action by the nurse? Document the client's refusal in the chart. Tell the client that a catheter will be inserted. Keep the client in the ED until a specimen is provided. Assess the client for urinary retention. 27 A primary care provider recommends surgery for a client with a tumor. T he client is refusing, but the spouse wants the surgery performed. Which of the following is the deciding factor in determining if the surgery will be done? Whether the spouse is the client's durable power of attorney for health car e Whether the client's refusal is based on religious belief Whether the client understands the risk of refusing the procedure Whether the facility ethics committee reaches a consensus on the case 28 A nurse is teaching a client how to use a finger-stick glucometer at hom e. Which of the following instructions should the nurse include? Use an alcohol pad at the site after taking the sample. Cap the lancet prior to putting it in the trash. Obtain the sample from the finger pads. Warm the hands prior to taking the blood sample. 29 A nurse notes a new prescription in a client's medical record for oral d igoxin (Lanoxin) 2.5 mg to be given daily. The nurse questions the dosage of the prescription, and the provider confirms the dosage as written. Which of the following responses by the nurse is appropriate? Verify that the client's apical pulse is greater than 60/min. Check the client's serum digoxin and potassium levels. Hold the medication and contact the nursing supervisor. Request an order for telemetry monitoring. 30 A case manager is caring for an older adult client with type 1 diabetes m ellitus, chronic renal failure, and limited visual acuity. The client lives a lone and has children who visit infrequently. Which of the following should t he case manager recognize as the highest priority consideration? Nutritional resources Financial assistance Medication monitoring Housekeeping assistance 31 A nurse is caring for a client who sustained multiple injuries in a motor -vehicle crash, which was reported in the local newspaper. A newspaper report er calls for an update on the client's condition. The nurse tells the reporte r that the client has had surgery and is stable. The nurse has committed an a ct of slander. libel. willful neglect. invasion of privacy. 32 A charge nurse overhears an exchange between a client and a staff nurse. Which of the following statements by the staff nurse indicates a need for f urther education on client rights? "I can't discuss with you the medical care of the client in the next bed." "You shouldn't read your medical chart because you won't understand the terminology." "You cannot be transferred to your preferred facility until we are notified that there is space available." "I will request a list of the hospital's charges for services for you to revie w." 33 A nurse receives report on four clients. Which of the following clients sh ould the nurse attend to first? A client admitted this morning with unstable angina A client who vomited once at the end of the last shift A client who has an Hgb of 7 g/dL and an Hct of 26% A client who is currently trying to climb out of bed 34 A nurse on an orthopedic unit is assigned to work with a new assistive personnel (AP). The AP is delegated the task of transferring a client with a knee replacement from the bed to a chair. Which of the following is the m ost appropriate method of ensuring the new AP can perform the action safely? Teach proper technique for this skill to the AP. Ask the AP if he has prior experience with this skill. Review the AP's skills checklist. Watch the AP demonstrate the skill. 35 During discharge teaching, a nurse learns that a client does not have tr ansportation for a follow-up appointment with the primary care provider. Whi ch of the following is the most appropriate action by the nurse? Provide the client with information regarding public transportation. Refer the client to a social worker for transportation options. Call the primary care provider to reschedule the appointment. Encourage the client to seek transportation from family after discharge. 36 The husband and children of an older adult female client are expressing conflict over whether the client should receive surgery that is recommended by the primary care provider. The oldest son has durable power of attorney f or health care for both his mother and father. The client is oriented to per son, place, and time. Which of the following people has the legal authority to make this health care decision? The husband The oldest son The primary care provider The client 37 A nurse is caring for four clients. Which of the following tasks can be d elegated to an assistive personnel? Assessing a client who just returned from hemodialysis Reviewing dietary instructions for a client with kidney stones Obtaining a stool sample from a client with renal failure Monitoring a client with a fluid restriction 38 A charge nurse on a medical-surgical unit is responsible for supervising the care provided by the unit staff. Which of the following is the most effec tive method for determining the learning needs of the unit staff? Ask unit staff to complete a skills checklist. Require attendance at annual competency updates. Perform direct observation of provided care. Implement a peer review process on the unit. 39 A charge nurse notices that two staff nurses take no breaks during their regular 8-hr shifts. Which of the following should the charge nurse plan to d o? Give them overtime pay for the break times. Ensure coverage for enforced break times. Assign the two staff nurses the same break times. Allow them to take their breaks while charting. 40 A staff nurse reports for a regularly scheduled shift and finds that the un it is short of staff. The charge nurse insists that the nurse care for five cli ents who are high acuity despite the staff nurse's objections. Which of the fol lowing actions should the staff nurse take? Care for the five clients as best as possible. Delegate initial shift assessments to assistive personnel. Call nurses from the float pool to report to the unit. Notify the nurse manager of the situation. 41 A client with a draining foot ulcer is being prepared for discharge hom e with the family. The nurse observes another nurse changing the client's w ound dressing. Which of the following actions requires intervention to main tain safe handling of contaminated material? The old dressing is placed on a nearby table. Gloves are discarded after removing the old dressing. Sterile supplies are opened prior to the procedure. The wound is irrigated into a clean basin. 42 A nurse is assigned four clients. Which of the following client needs take s priority? A client’s intravenous site has infiltrated. A client’s capillary blood glucose is 250 mg/dL. A client reports a frontal headache rated at 7 out of 10. A client is refusing a scheduled nebulizer treatment. 43 A client had a cerebrovascular accident (stroke) 2 days ago. Which of th e following assessments should a nurse recognize as indicating a need for a referral to a speech and language pathologist? Altered level of consciousness Unilateral facial drooping Persistent coughing while drinking Left-sided hemiparesis 44 A nurse in an outpatient clinic is taking a medical history on a new cl ient. The client takes multiple medications each day but cannot remember th e names. Which of the following is the most appropriate response by the nur se? "What is the name and phone number of your primary doctor?" "You should make a list of all your medications for future use." "Next time you come to the clinic, bring the medications with you." "What conditions are you taking medications for?" 45 A nurse manager wants to implement a new safety program. Which of the following actions will best facilitate the program’s success? Indicate that the change is mandatory. Offer rewards to staff members who comply. Involve staff in planning its implementation. Tell staff to report problems to management. 46 A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to assign to a licensed practical nurse? Plan break times for assistive personnel. Pick up the meal trays after lunch. Administer a nasogastric tube feeding. Determine adequacy of ventilator settings. 47 A new graduate nurse is taking a telephone medication order from a prima ry care provider and is having difficulty hearing the provider's prescriptio n. Which of the following is the most appropriate action by the nurse? Repeat the order back to the provider. Ask the charge nurse to take the order. Consult the pharmacist for clarification. Ask the provider to come write the order. 48 A nurse enters an adolescent’s room after some visiting classmates leave. The nurse notes a small fire in the client’s waste paper basket. Which of th e following is the nurse’s priority action? Use the client’s telephone to report the fire. Assist the client out of the area immediately. Cover the waste paper basket with a bedpan. Use the nearest fire extinguisher to put out the fire. 49 An older adult client with terminal cancer is brought to the emergency d epartment with acute pneumonia. The client has a valid living will that indi cates comfort measures only should be used. Which of the following is approp riate to include in the client's plan of care based on the living will? Titrate oxygen to maintain an oxygen saturation of 92%. Prepare the client for IV dopamine (Intropin) to maintain blood pressure. Administer oral chemotherapy to the client. Contact the immediate family for care-giving decisions. 50 A charge nurse notices that staff nurses are having difficulty using ne w IV pumps for medication administration. Which of the following actions by the charge nurse is most appropriate? Contact the staff education department for an in-service for the staff. Assume responsibility for IV medication administration during the shift. Instruct the staff nurses to administer IV medications without the pumps. Request assistance from the nursing supervisor. 51 Which of the following actions taken by a nurse constitutes battery? Failing to put up side rails on a confused client's bed Telling a client who refused his oral medication that he will be given an i njection Inserting a feeding tube against the wishes of a client who refuses to eat Threatening to apply wrist restraints to control a client who is agitated 52 A visiting nurse is evaluating the home environment of an older adult c lient. Which of the following should the nurse recognize as an environmenta l hazard? The house has a short staircase covered with plush carpet. There is a household pet that wears a bell around its neck. Papers are scattered on the floor throughout the living room. The curtains in living areas are closed during the day. 53 A client states she will go home alone following her left hip pinning sur gery. The most appropriate action for the nurse to take is to chart the client’s comment in the medical record. contact the case manager for a consultation. call the primary care provider and report this information. use therapeutic communication to help the client verbalize her concerns. 54 A nurse finds a client lying on the floor of his hospital room. The clien t states that he slipped off the commode while trying to sit down. The client has no injuries and is stable upon assessment. After assisting the client ba ck to bed, which of the following should the nurse do? Restrain the client in bed. Complete an incident report. Administer a PRN sedative. Notify the risk manager. 55 A nurse is assigned to the care of four clients. Which of the following si tuations indicates the need for an interdisciplinary conference? A client with end-stage renal disease wants to die at home. A client states that he has just lost his job. A client indicates a desire to go home by taxi. A client relates difficulty getting up from the commode seat. 56 Which of the following tasks is appropriate for a nurse to delegate to an assistive personnel? Instruct a client who is in labor about breathing techniques. Measure oral intake for a client with dehydration. Inspect a preschooler for bruising and skin marks. Evaluate pain relief for a client who has received pain medication. 57 A nurse receives an order to transfer a client in the telemetry unit to the medical unit. After confirming bed availability on the receiving unit, which o f the following is the nurse's priority action? Call the family to inform them of the transfer. Provide client report to the receiving nurse. Contact the dietary department with transfer information. Inform the billing department of the client's change in status. 58 Which of the following puts a hospital at the highest risk for infringemen t of client record confidentiality? A nurse clusters documentation of care for multiple clients. A provider and nurse access client information using one access code. Paper-based charts are stored at the nurses' station. A nurse performs electronic documentation outside a client's room. 59 Two nurses are having a loud verbal discussion at the nurses' station abo ut not wanting to care for a client with drug-resistant tuberculosis. Which o f the following actions should the charge nurse take? Make arrangements to take over the client's care. Escort the nurses to the nurses' lounge to continue the discussion. Initiate disciplinary action for the nurses who are having the argument. Contact the house supervisor to mediate the conflict. 60 According to Health Insurance Portability and Accountability Act (HIPAA) regulations, which of the following is a violation of client confidentialit y? Calling in a prescription to a pharmacy for the spouse to pick up Providing a copy of the record to the transporting paramedic Reporting a client’s disposition to the referring primary care provider Informing housekeeping staff that the client is in the dialysis unit 61 A nurse is reading a chart at the nurses' station, and the unit clerk sud denly snatches the chart from the nurse. The unit clerk has a history of simi lar rude behavior when under stress. Which of the following should the nurse do? Report the unit clerk’s behavior to the nurse manager. Understand that the unit clerk's behavior is due to stress. Assume unit clerk responsibilities to avoid confrontation. Discuss the behavior with the unit clerk at the end of the shift. 62 A facility has identified an increase in nosocomial UTIs on the medical- surgical unit. A nurse is participating in a quality improvement process to address this problem. Which of the following should be the first step in the process? Develop a tool to track the ongoing incidence of UTIs. Analyze collected data on UTI incidence. Outline a goal of decreasing UTI incidence over the next year. Identify interventions to reduce the incidence of UTIs. 63 Which of the following items must be discarded in a biohazard waste rec eptacle? A urinary catheter drainage bag from a client who is postoperative A bedsheet from a client with bacterial pneumonia A peripad from a client who is 24-hr post vaginal delivery An empty IV bag removed from a client who has HIV 64 Which of the following statements made by a client who is in a clinical research study indicates proper understanding? “I’m in the study so I get the newest medicine.” “My participation will likely benefit others in the future.” “I will receive better care by being in the study.” “This is the best available treatment for my condition.” 65 A client who is being discharged requires home oxygen. The equipment company has not yet delivered the oxygen tank. The nurse should send a hospital oxygen tank home with the client. keep the client until the tank arrives. refer the issue to the home health care agency at discharge. give the equipment company's contact information to the client. [Show More]

Last updated: 2 years ago

Preview 1 out of 25 pages