RN ATI Concept Based Assessment Level 4 ALL
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ATI RN Concept - Based Assessment Level 4
A nurse is providing teaching to a client who has a halo device applied to prevent further
cervical spinal cord injury following a diving accident. What info should the nurse include?
"Avoid leaning forward when attempting to stand."
-the weight of the halo device can alter balance. leaning forward could cause the client to fall.
A nurse is working on an interprofessional collaboration plan of care for a client who has a
stage 3 pressure ulcer. Which action should the nurse recognize as the. role of the licensed
practical nurse (LPN)?
Administer pain medication
A nurse manager is facilitating conflict resolution between two nurses who disagree about
the need to make a referral to a social worker. Which conflict management strategies should
the nurse manager use?
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Offer self to constructively facilitate communication.
-The nurse manager will be the impartial third party in this communication
A nurse is having a disagreement with a coworker about a client assignment. When following
the chain of command, which of the following individuals should the nurse contact to discuss
the conflict?
The charge nurse
- When following the chain of command, the nurse should communicate with his immediate
supervisor about any questions and concerns he has, including a conflict with a coworkers.
A triage nurse is prioritizing clients following a mass casualty disaster. Which of the following
clients should the nurse treat first?
A client who is exhibiting manifestations of shock.
-a client exhibiting manifestations of shock requires immediate intervention for survival.
A nurse is caring for a client who has a partial-thickness burn and a prescription for a silver
sulfadiazine cream. Which intervention should the nurse take?
Monitor the client's WBC.
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-A drop in the WBC count can be an indication of an allergic reaction to the silver sulfadiazine
cream
A nurse is preparing to administer nitroglycerin topical ointment to a client who had a
myocardial infarction. Which action should the nurse plan to take? (move steps in order)
1) Cleanse the client's skin and allow it to dry
2) Apply a thin layer of medication ointment to the dosing paper.
3) Spread the medication over a 6.4 by 8.9 cm area of skin
4) Cover the medication site with plastic wrap
5) Remove the medication in 6 hr.
A nurse manager is teaching a group of nurses about professional negligence. Which of the
following situations should the nurse manager include as an example?
Administering heparin to a client who is undergoing a lumbar puncture.
A nurse who administers heparin to client who is undergoing a lumbar puncture is an example
of negligence. Anticoagulant medication can cause bleeding in the lumbar area
A nurse is teaching a client who has been newly diagnosed with systemic lupus
erythematosus (SLE). Which statement by the client indicates an understanding of the
teaching?
"I should inspect my skin daily for cuts and rashes"
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A nurse is caring for a client who has Parkinson's disease. Which of the following actions
should the nurse take to promote the client's mobility?
Instruct the client to perform range-of-motion exercises
- The nurse should instruct the client to perform stretching and range-of-motion exercises to
promote mobility. exercising and walking help to delay the progression of the disease.
A nurse is caring for a client who has had a myocardial infarction and suspects cardiogenic
shock. The nurse should monitor for which of the following manifestations?
Pulmonary Congestion
-Pulmonary congestion is a result of decreased cardiac output due to damage to the cardiac
muscle
A nurse is assessing a client who has a DNR order and has stopped breathing. The family asks
the nurse to resuscitate the client. Which action should the nurse take?
Respect the client's preferences.
A nurse manager is teaching a group of nurses about OSHA. What information should the
nurse include?
Sets standards for hazardous exposures in the workplace.
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