ATI Leadership Proctored Exam questions, answers and
Rationale| Latest Test Solution
(ALL QUESTIONS and 100% Verified Answers)
1. A nurse manager is preparing to institute a new system for scheduling staff. Severalnurses
have verbalized their concern over the possible changes that will occur. Which of the
following is an appropriate method to facilitate the adoption of the new schedulingsystem?
A. Identify nurses who accept the change to help influence other staff nurses
B. Provide a brief overview of the new scheduling system immediately before it implementation
C. Introduce the new scheduling system by describing how it will save the institutionmoney
D. Offer to reassign staff who do not support the change to another unit
The correct answer is A. Identify nurses who accept the change to help influence other staff nurses. Implementing a new
system or change in a work environment, especially in healthcare settings, can often be met with resistance. However,
identifying early adopters or champions of the change within the staff can help in facilitating acceptance among the rest of
the team. These individuals can influence their peers by demonstrating the benefits and practicality of the new system,
thereby reducing resistance and fostering a smoother transition. The other options are not as effective. Providing a brief
overview (option B) may not give enough information for staff to understand and accept the change. Describing how it will
save the institution money (option C) doesn't directly address the staff's concerns about how the change will affect them.
Offering to reassign staff who do not support the change (option D) could create a negative environment and does not
facilitate adoption of the new system.
2. A client who is febrile is admitted to the hospital for treatment of pneumonia. In accordance
with the care pathway, antibiotic therapy is prescribed. Which of the following situations
requires the nurse to complete a variance report with regard to the carepathway?
A. Antibiotic therapy was initiated 2 hr after implementation of the carepath way
B. A blood culture was obtained after antibiotic therapy has been initiated
C. The route of antibiotic therapy on the care pathway was changed from IV toPO
D. An allergy to penicillin required an alternative antibiotic to beprescribed.
The correct answer is B. A blood culture was obtained after antibiotic therapy has been initiated. A variance
report, or incident report, is a form that is filled out in order to record details of unexpected events that occur at
the hospital, such as injuries to patients, errors in care, and deviations from standard procedures. In this case, best
practice guidelines for pneumonia management recommend obtaining blood cultures prior to the initiation of
antibiotic therapy. This allows for the identification of the specific causative bacteria and tailoring of antibiotic
,therapy based on sensitivity results. If antibiotics are given before the blood culture is obtained, it could affect the
results, potentially leading to less effective treatment. Therefore, obtaining a blood culture after initiating
antibiotics would be a deviation from the care pathway, requiring a variance report.
3. A nurse should recognize that an incident report is required when
A. A client refuses to attend physicaltherapy
B. A visitor pinches his finger in the client’s bedframe
C. A client throws a box of tissues at anurse
D. A nurse gives a med 30 min late
The correct answer is B. A visitor pinches his finger in the client‟s bedframe. An incident report is a form filled out
to record the details of an accident, injury, security incident, or any other type of unexpected event that happens in
a healthcare setting. It's important for risk management and to ensure similar incidents can be prevented in the
future. In this case, a visitor pinching his finger in the client's bedframe is a safety concern that could indicate a
problem with the bedframe design or a need for better safety instructions for visitors. This would warrant an
incident report. The other options do not typically require an incident report. A client refusing to attend physical
therapy (option A) or throwing a box of tissues at a nurse (option C) may require documentation in the patient's
chart and possibly intervention from a supervisor or security, but not necessarily an incident report. Similarly, a
nurse giving a medication 30 minutes late (option D) would be documented in the medical record, but wouldn't
typically require an incident report unless it resulted in harm to the patient.
4. Client satisfactory surveys from a med-surg unit indicate the pain is not being adequately relieved
during the first 12 hr post-opt. The unit manager decides to identify post-opt pain as aquality
indicator. Which of the following data sources will be helpful in determine the reason why clients
are not receiving adequate pain management after surgery?
A. Prospective chart audit
B. Retrospective chart audit
C. Postoperative care policy
D. Pain assessment policy
The correct answer is B. Retrospective chart audit. A retrospective chart audit involves looking back at existing patient
records to identify patterns, outcomes, or potential areas for improvement. In this case, it would allow the unit manager to
review how pain was assessed and managed in the post-operative period, and whether there were any gaps or inconsistencies
that could explain why patients' pain was not being adequately relieved. A prospective chart audit (option A) involves
reviewing patient charts going forward, which may also be useful but would not provide immediate insight into past cases
that have already raised concerns.The postoperative care policy (option C) and pain assessment policy (option D) should
ideally already reflect best practices for pain management, so while they are important resources, they may not directly
explain why current practices are falling short. However, these policies could potentially be revisited if the chart audit
identifies areas of practice that are not aligned with policy.
, 5. A nurse presenting a newly licensed nurse who is caring for a client who is confused and has
an IV infusion. The newly licensed nurse has placed the client in wrist restraints to prevent
dislodging the IV catheter. Which of the following questions should the precepting nurseask?
A. “Did you secure the restraints to the side rails of thebed?”
B. “Are you able to insert two fingers between the restraint and the client‟s skin?”
C. “Did you tie the restraints using doubleknot?”
D. “Are you removing the client‟s restraints every 4hr?”
The correct answer is B. “Are you able to insert two fingers between the restraint and the client‟s skin?”
When using physical restraints like wrist restraints, it's important to ensure they are not applied too tightly, which could
restrict blood flow and cause injury. The "two finger" rule is a common guideline used to check this - if you can slide two
fingers between the restraint and the person's skin, it's likely not too tight.
Securing the restraints to the side rails of the bed (option A) is not a recommended practice as it can increase the risk of
injury. Tying restraints with a double knot (option C) is discouraged because it can make it more difficult to quickly release
the restraints if needed. While it's important to regularly assess and provide breaks from restraints when possible, removing
them every 4 hours (option D) is not a universal rule and the frequency may depend on individual patient needs and
institutional policy.
6. A nurse is caring for an older adult client who has stage III pressure ulcer. The nurse requesta
consultation with the wound care specialist. Which of the following actions by the nurse is
appropriate when working with aconsultant?
A. Arrange the consultation for time when the nurse is caring for the client is able to be present for
consultation
B. Provide the consultant with subjective opinions and beliefs about the client’s woundcare
C. Request the consultation after several wound care treatment tried
D. Arrange for the wound care nurse specialist to see the client daily to provide the
recommended treatment
The correct answer is A. Arrange the consultation for a time when the nurse caring for the client is able to be present for the
consultation. When working with a consultant, it's important for the nurse who is most familiar with the patient's condition to
be present during the consultation. This allows the nurse to provide relevant information, ask questions, and ensure that they
understand the consultant's recommendations. This approach facilitates better care coordination and continuity of care.
Option B (providing the consultant with subjective opinions and beliefs about the client's wound care) is not recommended as
, consultants should be provided with objective, factual information about the patient's condition. Option C (requesting the
consultation after several wound care treatments have been tried) may delay necessary specialized care. Option D
(arranging for the wound care nurse specialist to see the client daily to provide the recommended treatment) may not be
necessary or feasible, depending on the patient's needs and the consultant's role and availability.
7. A client is admitted with TB and placed in a negative pressure room. Which of the
following actions is appropriate?
A. Notify the local health department of the admission
B. Place a sign on the client’s door with the diagnosis
C. Ensure that admitting staff undergo PPD skin tests
D. Determine who had contact with the client in the last 48hr
The correct answer is A. Notify the local health department of the admission. Tuberculosis (TB) is a communicable disease
that is reportable to public health authorities. When a patient is admitted with TB, the health care facility should notify the
local health department so they can track the disease and implement public health interventions as necessary. Options B, C,
and D are not appropriate actions. Placing a sign on the client's door with the diagnosis (option B) would violate patient
privacy laws. Ensuring that admitting staff undergo PPD skin tests (option C) could be part of a broader occupational health
strategy for TB, but it's not a direct response to a single patient's admission. Determining who had contact with the client in
the last 48 hours (option D) could be relevant for contact tracing if the patient has a confirmed infectious disease, but it's not
the first step in managing a patient with TB upon admission.
8. A nurse is caring for a client who is unconscious and whose partner is health care proxy. The
partner has spoken with the provider and wishes to discontinue the client’s feeding tube. The
providerstatesthenurse,“Iwillnotdiscontinuetheclient‟streatment.Hispartnerhasnorightto make
decisions regarding the client‟s care. “Which of the following responses by the nurse is
appropriate?
A. Youshouldconsiderspeakingwiththefacility‟sethicscommitteebeforemaking your
decision
B. You have the right to make decision, even if the partner is the client’s health care proxy
C. The client has designated his partner as health care proxy in his advance directives
D. We‟ll need to have the nursing supervisor review the client‟s advance directives
Rationale| Latest Test Solution
(ALL QUESTIONS and 100% Verified Answers)
1. A nurse manager is preparing to institute a new system for scheduling staff. Severalnurses
have verbalized their concern over the possible changes that will occur. Which of the
following is an appropriate method to facilitate the adoption of the new schedulingsystem?
A. Identify nurses who accept the change to help influence other staff nurses
B. Provide a brief overview of the new scheduling system immediately before it implementation
C. Introduce the new scheduling system by describing how it will save the institutionmoney
D. Offer to reassign staff who do not support the change to another unit
The correct answer is A. Identify nurses who accept the change to help influence other staff nurses. Implementing a new
system or change in a work environment, especially in healthcare settings, can often be met with resistance. However,
identifying early adopters or champions of the change within the staff can help in facilitating acceptance among the rest of
the team. These individuals can influence their peers by demonstrating the benefits and practicality of the new system,
thereby reducing resistance and fostering a smoother transition. The other options are not as effective. Providing a brief
overview (option B) may not give enough information for staff to understand and accept the change. Describing how it will
save the institution money (option C) doesn't directly address the staff's concerns about how the change will affect them.
Offering to reassign staff who do not support the change (option D) could create a negative environment and does not
facilitate adoption of the new system.
2. A client who is febrile is admitted to the hospital for treatment of pneumonia. In accordance
with the care pathway, antibiotic therapy is prescribed. Which of the following situations
requires the nurse to complete a variance report with regard to the carepathway?
A. Antibiotic therapy was initiated 2 hr after implementation of the carepath way
B. A blood culture was obtained after antibiotic therapy has been initiated
C. The route of antibiotic therapy on the care pathway was changed from IV toPO
D. An allergy to penicillin required an alternative antibiotic to beprescribed.
The correct answer is B. A blood culture was obtained after antibiotic therapy has been initiated. A variance
report, or incident report, is a form that is filled out in order to record details of unexpected events that occur at
the hospital, such as injuries to patients, errors in care, and deviations from standard procedures. In this case, best
practice guidelines for pneumonia management recommend obtaining blood cultures prior to the initiation of
antibiotic therapy. This allows for the identification of the specific causative bacteria and tailoring of antibiotic
,therapy based on sensitivity results. If antibiotics are given before the blood culture is obtained, it could affect the
results, potentially leading to less effective treatment. Therefore, obtaining a blood culture after initiating
antibiotics would be a deviation from the care pathway, requiring a variance report.
3. A nurse should recognize that an incident report is required when
A. A client refuses to attend physicaltherapy
B. A visitor pinches his finger in the client’s bedframe
C. A client throws a box of tissues at anurse
D. A nurse gives a med 30 min late
The correct answer is B. A visitor pinches his finger in the client‟s bedframe. An incident report is a form filled out
to record the details of an accident, injury, security incident, or any other type of unexpected event that happens in
a healthcare setting. It's important for risk management and to ensure similar incidents can be prevented in the
future. In this case, a visitor pinching his finger in the client's bedframe is a safety concern that could indicate a
problem with the bedframe design or a need for better safety instructions for visitors. This would warrant an
incident report. The other options do not typically require an incident report. A client refusing to attend physical
therapy (option A) or throwing a box of tissues at a nurse (option C) may require documentation in the patient's
chart and possibly intervention from a supervisor or security, but not necessarily an incident report. Similarly, a
nurse giving a medication 30 minutes late (option D) would be documented in the medical record, but wouldn't
typically require an incident report unless it resulted in harm to the patient.
4. Client satisfactory surveys from a med-surg unit indicate the pain is not being adequately relieved
during the first 12 hr post-opt. The unit manager decides to identify post-opt pain as aquality
indicator. Which of the following data sources will be helpful in determine the reason why clients
are not receiving adequate pain management after surgery?
A. Prospective chart audit
B. Retrospective chart audit
C. Postoperative care policy
D. Pain assessment policy
The correct answer is B. Retrospective chart audit. A retrospective chart audit involves looking back at existing patient
records to identify patterns, outcomes, or potential areas for improvement. In this case, it would allow the unit manager to
review how pain was assessed and managed in the post-operative period, and whether there were any gaps or inconsistencies
that could explain why patients' pain was not being adequately relieved. A prospective chart audit (option A) involves
reviewing patient charts going forward, which may also be useful but would not provide immediate insight into past cases
that have already raised concerns.The postoperative care policy (option C) and pain assessment policy (option D) should
ideally already reflect best practices for pain management, so while they are important resources, they may not directly
explain why current practices are falling short. However, these policies could potentially be revisited if the chart audit
identifies areas of practice that are not aligned with policy.
, 5. A nurse presenting a newly licensed nurse who is caring for a client who is confused and has
an IV infusion. The newly licensed nurse has placed the client in wrist restraints to prevent
dislodging the IV catheter. Which of the following questions should the precepting nurseask?
A. “Did you secure the restraints to the side rails of thebed?”
B. “Are you able to insert two fingers between the restraint and the client‟s skin?”
C. “Did you tie the restraints using doubleknot?”
D. “Are you removing the client‟s restraints every 4hr?”
The correct answer is B. “Are you able to insert two fingers between the restraint and the client‟s skin?”
When using physical restraints like wrist restraints, it's important to ensure they are not applied too tightly, which could
restrict blood flow and cause injury. The "two finger" rule is a common guideline used to check this - if you can slide two
fingers between the restraint and the person's skin, it's likely not too tight.
Securing the restraints to the side rails of the bed (option A) is not a recommended practice as it can increase the risk of
injury. Tying restraints with a double knot (option C) is discouraged because it can make it more difficult to quickly release
the restraints if needed. While it's important to regularly assess and provide breaks from restraints when possible, removing
them every 4 hours (option D) is not a universal rule and the frequency may depend on individual patient needs and
institutional policy.
6. A nurse is caring for an older adult client who has stage III pressure ulcer. The nurse requesta
consultation with the wound care specialist. Which of the following actions by the nurse is
appropriate when working with aconsultant?
A. Arrange the consultation for time when the nurse is caring for the client is able to be present for
consultation
B. Provide the consultant with subjective opinions and beliefs about the client’s woundcare
C. Request the consultation after several wound care treatment tried
D. Arrange for the wound care nurse specialist to see the client daily to provide the
recommended treatment
The correct answer is A. Arrange the consultation for a time when the nurse caring for the client is able to be present for the
consultation. When working with a consultant, it's important for the nurse who is most familiar with the patient's condition to
be present during the consultation. This allows the nurse to provide relevant information, ask questions, and ensure that they
understand the consultant's recommendations. This approach facilitates better care coordination and continuity of care.
Option B (providing the consultant with subjective opinions and beliefs about the client's wound care) is not recommended as
, consultants should be provided with objective, factual information about the patient's condition. Option C (requesting the
consultation after several wound care treatments have been tried) may delay necessary specialized care. Option D
(arranging for the wound care nurse specialist to see the client daily to provide the recommended treatment) may not be
necessary or feasible, depending on the patient's needs and the consultant's role and availability.
7. A client is admitted with TB and placed in a negative pressure room. Which of the
following actions is appropriate?
A. Notify the local health department of the admission
B. Place a sign on the client’s door with the diagnosis
C. Ensure that admitting staff undergo PPD skin tests
D. Determine who had contact with the client in the last 48hr
The correct answer is A. Notify the local health department of the admission. Tuberculosis (TB) is a communicable disease
that is reportable to public health authorities. When a patient is admitted with TB, the health care facility should notify the
local health department so they can track the disease and implement public health interventions as necessary. Options B, C,
and D are not appropriate actions. Placing a sign on the client's door with the diagnosis (option B) would violate patient
privacy laws. Ensuring that admitting staff undergo PPD skin tests (option C) could be part of a broader occupational health
strategy for TB, but it's not a direct response to a single patient's admission. Determining who had contact with the client in
the last 48 hours (option D) could be relevant for contact tracing if the patient has a confirmed infectious disease, but it's not
the first step in managing a patient with TB upon admission.
8. A nurse is caring for a client who is unconscious and whose partner is health care proxy. The
partner has spoken with the provider and wishes to discontinue the client’s feeding tube. The
providerstatesthenurse,“Iwillnotdiscontinuetheclient‟streatment.Hispartnerhasnorightto make
decisions regarding the client‟s care. “Which of the following responses by the nurse is
appropriate?
A. Youshouldconsiderspeakingwiththefacility‟sethicscommitteebeforemaking your
decision
B. You have the right to make decision, even if the partner is the client’s health care proxy
C. The client has designated his partner as health care proxy in his advance directives
D. We‟ll need to have the nursing supervisor review the client‟s advance directives
