ATI Leadership Practice Proctored Exam

1. A nurse tells the unit manager, "I am tired of all the changes on the unit. If things don't get better, I'm going to quit." Which of the following responses by the unit manager is appropriate? - o "So you are upset about all the changes on the unit?" 2. A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first? - o Determine the reasons the nurses are not taking scheduled breaks 3. A client has a new permanent pacemaker inserted. Which of the following home care instructions should the nurse include? - o Regular programming evaluations can be conducted by telephone 4. A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? - o "I will wear a cover gown when caring for a client who has herpes simplex." 5. A staff nurse is supervising a newly licensed nurse who is preparing to administer an intermittent tube feeding to a client. Which of the following actions by the newly licensed nurse is appropriate? - o Checking residual volume before each feeding 6. A nurse is preparing an education program about professional codes of ethics for nurses. Which of the following information should the nurse plan to include? - o A code of ethics is a set of principles for nursing practice 7. A nurse receives change-of-shift report for the following four clients. Which of the following clients should the nurse assess first? - o An older adult client who has bacterial pneumonia and a new onset of restlessness 8. A charge nurse is assessing staff knowledge about safety procedures regarding needlestick injuries. Which of the following statements by a nurse indicates appropriate understanding of these safety procedures? - o "An incident report should be completed if a client receives a stick from her own used needle." 9. A case manager is reviewing documentation on several clients and notes a progress report that falsely identifies a client as HIV-positive due to multiple sexual partners. The nurse manager should identify that which of the following torts has occurred? - o Libel 10. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first? - o Remove the restraints from the client's wrists 11. To resolve a conflict between staff members regarding potential changes in policy, a nurse manager decides to implement the changes she prefers regardless of the feelings of those who oppose those changes. Which of the following conflict resolution strategies is the nurse manager using? - o Competing 12. A nurse is caring for a client and notices fraying on the electrical cord of the client's IV pump. Which of the following actions is the priority for the nurse to take? - o Remove the IV pump form the client's room 13. A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states that she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend? - o Social worker 14. A charge nurse is completing client care assignments. Which of the following assignments is appropriate for a licensed practical nurse? - o A client who is 1 day postoperative and has a continuous bladder irrigation 15. A nurse is caring for a client who is comatose and has advance directives designating his adult daughter as his health proxy. The client's partner instructs the nurse to institute CPR if the client experiences cardiac arrest. Which of the following actions should the nurse take first? - o Inform the partner that the staff must follow the client's advance directives 16. A nurse from the labor and delivery unit is assigned to float to a medicalsurgical unit. Which of the following actions should the nurse take first? - o Request orientation to the medical-surgical unit 17. A nurse in the emergency department is preparing a married 17-year-old client for an appendectomy. The client's parents are en route to the facility but have not spoken with the surgeon. Which of the following actions should the nurse take first? - o Have the client sign the consent form after the surgeon explains the procedure 18. Client satisfaction surveys from a surgical unit indicate that pain is not being adequately relieved during the first 12 hours postoperatively. The unit manager decides to identify postoperative pain as a quality indicator. Which of the following data sources will be helpful in determining the reason why clients are not receiving adequate pain management after surgery? - o Pain assessment policy 19. A nurse manager is reviewing the nursing code of ethics with the staff nurses. Which of the following statements by a staff nurse indicates understanding of the teaching? (select all that apply) - o "I can delegate the removal of an IV catheter to an LPN on the unit." o "I will attend continuing education classes for professional growth." o "I administer pain medication to my clients even if they have a history of narcotic addiction." 20. A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change-of-shift report? - o The time the client received his last dose of pain medication 21. A nurse on a medical-surgical unit is delegating client care. Which of the following tasks should the nurse delegate to assistive personnel? - o Using a pain rating scale to monitor a client's pain level 22. A nurse on a medical-surgical unit is making staff assignments. Which of the following tasks should the nurse delegate to assistive personnel? - o Pouching a client's established ostomy 23. A charge nurse is reviewing how to set up a sterile field with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the process? - o "I will keep the label of the solution bottle facing up when pouring solution into the sterile cup." 24. A nurse is providing care for four postoperative clients. The nurse should first assess the client - o Whose pulse has been steadily increasing during the past shift 25. A charge nurse overhears a provider and a nurse talking about a client's diagnosis in the cafeteria. Which of the following actions should the nurse take first? - o Remind them that client information is confidential 26. A facility provides annual staff education regarding ethical practice. A charge nurse recognizes a need for further education when which of the following behaviors is observed? - o A nurse explains to a client's family that a DNR order includes withholding comfort measures 27. The family members of an older adult client are expressing conflict over whether the client should have surgery that is recommended by the provider. The oldest adult child has durable power of attorney for health care for the client. The client is oriented to person, place and time. Which of the following people has the legal authority to make this health decision? - o The client 28. A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet delivered the oxygen tank. Which of the following actions should the nurse take? - o Contact social services about the delivery of the oxygen equipment 29. A nurse is a long-term facility is assessing a client who has returned from an acute care facility following a brief illness. The nurse observes that the client is confused and agitated. Which of the following actions should the nurse take first? - o Reorient the client to his surroundings 30. A nurse is caring for a client who is scheduled for a procedure. Which of the following is appropriate when the nurse is witnessing the client signing the consent form? (select all that apply): - o Ensure the client gives consent voluntarily o Verify that the client affirms understanding of the procedure o Confirm the authenticity of the client's signature 31. A nurse is documenting and completing an incident report after a client falls out of bed. Which of the following actions should the nurse take when completing the documentation? - o Document in the incident report, "Entered room and discovered client lying prone on the floor." 32. A nurse is providing discharge instructions to a client who is 2 hr postoperative following cataract surgery on the left eye. Which of the following instructions should the nurse include in the teaching? - o "sleep on your right side." 33. A client is admitted with tuberculosis and placed in a negative-pressure room. Which of the following actions is appropriate? - o Notify the local health department of the admission 34. A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take first? - o Proceed with treatment without obtaining written consent 35. A nurse is preparing a client for surgery. The client has signed the consent form but tells the nurse that she has reconsidered because she is worried about the pain. Which of the following response by the nurse is appropriate? - o "I understand, and it's not too late to change your mind." 36. A charge nurse is evaluating a newly licensed nurse's understanding of infection control procedures. Which of the following actions demonstrates that the nurse is following the appropriate protocol for a client who has streptococcal pharyngitis? - o Wearing a mask when within 1 m(3.3 ft) of the client 37. A nurse is planning to delegate client care assignments. Which of the following tasks should the nurse plan to delegate to assistive personnel? - o Performing postmortem care prior to transferring the client to the morgue 38. A nurse is caring for a client who has increased intracranial pressure and is receiving IV corticosteroids. Which of the following information is the most important for the nurse to report at shift change? - o Glasgow Coma Scale score 39. A nurse in an urgent care clinic is admitting a client who has been exposed to a liquid chemical in an industrial setting. Which of the following actions should the nurse take first? - o Don personal protective equipment 40. A nurse is evaluating care for a group of clients. Th nurse should consult the provider for which of the following clients? - o A client who requires an IV intermittent bolus dose of vancomycin and has a creatinine level of 1.5 mg/dL