NGN ATI LEADERSHIP PROCTORED
EXAM 2024 ACTUAL EXAM 2 WITH
CORRECT ANSWERS
delegation/supervision - Correct Answer ✔✔- *5 rights* bb bb b b bb b bb bb
1. task
2. circumstance
3. person
4. direction and communication bb bb
5. supervision and evaluation bb bb
-based on individual client needs, facility policies and job descriptions, state NPA,
bb bb bb bb bb bb bb bb bb bb bb
professional standards
bb bb
-considertheindividual's education, training,andexperience
b bb bb bb b b
-RNs can delegate to:
bb bb bb
>>other RNs bb
>>LPNs
>>APs
delegating to AP - Correct Answer ✔✔- -ADLs bb bb bb bb b b bb b bb
-bathing
-grooming
-dressing
-toileting
-ambulating
-feedingwithoutswallowingprecautions
b b b
-positioning
-bedmakingbb
-VS for stable clients
bb bb bb
-specimencollection b
,-I&O
>>follow facility policies and stage practice guidelines
bb bb bb bb bb bb
right task - Correct Answer ✔✔- repetitive, requires little supervision, and relatively
bb bb bb b b bb b bb bb bb bb bb bb
noninvasive
bb
right task: AP to assist pt with bedpan and pneumonia
bb bb bb bb bb bb bb bb bb
wrong task: delegate AP to administer a nebilizer to a pt with pneumonia
bb bb bb bb bb bb bb bb bb bb bb bb
right circumstance - Correct Answer ✔✔- -assess health status and complexity of care
bb bb bb b b bb b bb bb bb bb bb bb bb
required by the client
bb bb bb bb
-matchthe complexityof care demands totheskilllevelof thehealthcareteam
bb bb b bb bb bb bb b bb bb bb b bb bb
-considerworkload b
right circustance: delegate to AP to measure VS on stable pt
bb bb bb bb bb bb bb bb bb bb
wrong: delegate AP to measure VS on pt who is post-op and received naloxone to reverse
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
respiratory depression
bb bb
right person - Correct Answer ✔✔- -assess and verify competency of the health care
bb bb bb b b bb b bb bb bb bb bb bb bb bb
team member
bb bb
>>within scope of practice and necessary competence and training
bb bb bb bb bb bb bb bb
-continual performance reviews bb bb
right: delegate a LPN to adminster enteral to a client who has a head injury
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
wrong: delegate an AP to adminster enteral feedings to a client who has a head injury
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
right direction/communication - Correct Answer ✔✔- -data that needs to be collected
bb bb bb b b bb b bb bb bb bb bb bb
-methodand timelinefor reporting(whentoreport concerns/findings
bb bb bb bb bb bb bb bb bb
right: delegate an AP to assist in room X with (something very specific) before X amount of
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
time
bb
wrong: delegate an AP to assist with (something nonspecific) in room x
bb bb bb bb bb bb bb bb bb bb bb
right supervision/evaluation - Correct Answer ✔✔- -directly or indirectly
bb bb bb b b bb b bb bb bb
-clear directionsandexpectations
bb b b
-monitorperformance b
-providefeedback b
-interveneif necessary b bb
-evaluateandidentifyneedsforqualityimprovementactivities
b b b b b b b
right: delegate the ambulation of the client and provide positive feedback to the AP after
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
completion of task
bb bb bb
,wrong: delegate the ambulation of a client to an AP without supervision to determine the
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
need for intervntion and failing to provide feedback to the AP
bb bb bb bb bb bb bb bb bb bb bb
delegating to LPN - Correct Answer ✔✔- -monitoring client findings as input for the RNs bb bb bb bb b b bb b bb bb bb bb bb bb bb bb
ongoing assessment of the client
bb bb bb bb bb
-reinforcingclientteachingfromastandardizedcareplan b b b b bb b b
-performingtracheostomycareandsuction b b b b
-performuncomplicatedwoundcare b b b
-checkingNG tube patency bb bb bb
-administering enteral feedings bb bb
-inserting urinary catheter bb bb
-administering medications b b
>>not IV meds bb bb
responding to inappropriate delegation - Correct Answer ✔✔- *DO NOT DELEGATE*: bb bb bb bb bb b b bb b bb bb bb
-nursingprocess b
-clienteducation b
-tasks thatrequireclinical judgementtoLPNsor APs
bb bb bb bb b b b bb
*CONSIDER*:
-predictabilityofoutcome b b
-potentialforharm b b
-complexityof care b bb
-needfor problem solvingandinnovation
bb bb bb b bb
-levelof interaction withthe client
b bb bb bb bb
when a nurse receives an unsafe assignment - Correct Answer ✔✔- -bring the
bb bb bb bb bb bb bb bb b b bb b bb bb
assignment to the attention of the scheduling/charge nurse and negotiate a new
bb bb bb bb bb bb bb bb bb bb bb bb
assignment
bb
-if unresolved takeit upchainof command
bb bb bb bb bb bb bb
-fileawritten protest tothe assignment
bb bb bb bb bb bb
>>assignment despite objection bb bb
>>document of practice situations bb bb bb
-failure to accept the assignment without following the proper channels can be considered
bb bb bb bb bb bb bb bb bb bb bb bb
client abandonment
bb bb
inappropriate use of restraints - Correct Answer ✔✔- *assualt*: threatening to place a bb bb bb bb bb b b bb b bb bb bb bb bb
NG tube in a pt who is refusing to eat
bb bb bb bb bb bb bb bb bb bb
*battery*: restraining a pt and administering an injection against his wishesbb bb bb bb bb bb bb bb bb bb
*false imprisonment*: using restraints on a competent client to prevent his leaving the
bb bb bb bb bb bb bb bb bb bb bb bb
health care facility
bb bb bb
reporting information to the provider (ch. 2) - Correct Answer ✔✔- should be fostered to
bb bb bb bb bb bb bb bb b b bb b bb bb bb bb
create a climate of mutual respect and collaborative practice
bb bb bb bb bb bb bb bb bb
, *-assessmentdataintegraltochangesinclientstatus b b b b b b b
-recommendationsforchanges intheplanofcare b b bb b b bb b
-clarificationofprescriptions* b b
*Qualities*:
-goodcommunication
b
-assertiveness
-conflict negotiation skills
bb bb
-leadership skills bb
-professional presence bb
-decision-makingandcriticalthinking b b b
Decision-making styles: bb
*decisive* - Correct Answer ✔✔- the team uses a minimum amount of data and
bb bb b b bb b bb bb bb bb bb bb bb bb bb
generates one option
bb bb bb
Decision-making styles: bb
*flexible* - Correct Answer ✔✔- the team uses a limited amount of data and generates
bb bb b b bb b bb bb bb bb bb bb bb bb bb bb
several options
bb bb
Decision-making styles: bb
*Hierarchical* - Correct Answer ✔✔- the team uses a large amount of data and generates bb bb b b bb b bb bb bb bb bb bb bb bb bb bb
one option
bb bb
Decision-making styles: bb
*integrative* - Correct Answer ✔✔- the team uses a large amount of data and generates bb bb b b bb b bb bb bb bb bb bb bb bb bb bb
several options
bb bb
breach of confidentiality (ch. 3) - Correct Answer ✔✔- -nurses who disclose client
bb bb bb bb bb bb b b bb b bb bb bb bb
information to an unauthorized person can be liable for invasion of privacy, defamation, or
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
slander
bb
-*HIPAA rights ofpts* bb bb bb
>>client is able to obtain a copy of their medical record and to submit requests to amend
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
erroneous or incomplete information
bb bb bb bb
>>a requirement for health care and insurance providers to provide written information
bb bb bb bb bb bb bb bb bb bb bb
about how medical information is used and how it is shared with other entities
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
-->permissionmustbeobtainedbeforeinformationisshared b b b b b b b
>>the pt has the right to privacy and confidentiality
bb bb bb bb bb bb bb bb
*components of privacy rule* - Correct Answer ✔✔- -only healthcare team members bb bb bb bb bb b b bb b bb bb bb bb
directly responsible for the client's care are allowed access to the patients records.
bb bb bb bb bb bb bb bb bb bb bb bb bb
>>nurses may not share information with other clients or staff not involved in the patient
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
care
bb
-clients have a right to read and obtain a copy fo their medical record, and agency policy
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
should be followed when the client requests to read or have a copy of the record
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
EXAM 2024 ACTUAL EXAM 2 WITH
CORRECT ANSWERS
delegation/supervision - Correct Answer ✔✔- *5 rights* bb bb b b bb b bb bb
1. task
2. circumstance
3. person
4. direction and communication bb bb
5. supervision and evaluation bb bb
-based on individual client needs, facility policies and job descriptions, state NPA,
bb bb bb bb bb bb bb bb bb bb bb
professional standards
bb bb
-considertheindividual's education, training,andexperience
b bb bb bb b b
-RNs can delegate to:
bb bb bb
>>other RNs bb
>>LPNs
>>APs
delegating to AP - Correct Answer ✔✔- -ADLs bb bb bb bb b b bb b bb
-bathing
-grooming
-dressing
-toileting
-ambulating
-feedingwithoutswallowingprecautions
b b b
-positioning
-bedmakingbb
-VS for stable clients
bb bb bb
-specimencollection b
,-I&O
>>follow facility policies and stage practice guidelines
bb bb bb bb bb bb
right task - Correct Answer ✔✔- repetitive, requires little supervision, and relatively
bb bb bb b b bb b bb bb bb bb bb bb
noninvasive
bb
right task: AP to assist pt with bedpan and pneumonia
bb bb bb bb bb bb bb bb bb
wrong task: delegate AP to administer a nebilizer to a pt with pneumonia
bb bb bb bb bb bb bb bb bb bb bb bb
right circumstance - Correct Answer ✔✔- -assess health status and complexity of care
bb bb bb b b bb b bb bb bb bb bb bb bb
required by the client
bb bb bb bb
-matchthe complexityof care demands totheskilllevelof thehealthcareteam
bb bb b bb bb bb bb b bb bb bb b bb bb
-considerworkload b
right circustance: delegate to AP to measure VS on stable pt
bb bb bb bb bb bb bb bb bb bb
wrong: delegate AP to measure VS on pt who is post-op and received naloxone to reverse
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
respiratory depression
bb bb
right person - Correct Answer ✔✔- -assess and verify competency of the health care
bb bb bb b b bb b bb bb bb bb bb bb bb bb
team member
bb bb
>>within scope of practice and necessary competence and training
bb bb bb bb bb bb bb bb
-continual performance reviews bb bb
right: delegate a LPN to adminster enteral to a client who has a head injury
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
wrong: delegate an AP to adminster enteral feedings to a client who has a head injury
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
right direction/communication - Correct Answer ✔✔- -data that needs to be collected
bb bb bb b b bb b bb bb bb bb bb bb
-methodand timelinefor reporting(whentoreport concerns/findings
bb bb bb bb bb bb bb bb bb
right: delegate an AP to assist in room X with (something very specific) before X amount of
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
time
bb
wrong: delegate an AP to assist with (something nonspecific) in room x
bb bb bb bb bb bb bb bb bb bb bb
right supervision/evaluation - Correct Answer ✔✔- -directly or indirectly
bb bb bb b b bb b bb bb bb
-clear directionsandexpectations
bb b b
-monitorperformance b
-providefeedback b
-interveneif necessary b bb
-evaluateandidentifyneedsforqualityimprovementactivities
b b b b b b b
right: delegate the ambulation of the client and provide positive feedback to the AP after
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
completion of task
bb bb bb
,wrong: delegate the ambulation of a client to an AP without supervision to determine the
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
need for intervntion and failing to provide feedback to the AP
bb bb bb bb bb bb bb bb bb bb bb
delegating to LPN - Correct Answer ✔✔- -monitoring client findings as input for the RNs bb bb bb bb b b bb b bb bb bb bb bb bb bb bb
ongoing assessment of the client
bb bb bb bb bb
-reinforcingclientteachingfromastandardizedcareplan b b b b bb b b
-performingtracheostomycareandsuction b b b b
-performuncomplicatedwoundcare b b b
-checkingNG tube patency bb bb bb
-administering enteral feedings bb bb
-inserting urinary catheter bb bb
-administering medications b b
>>not IV meds bb bb
responding to inappropriate delegation - Correct Answer ✔✔- *DO NOT DELEGATE*: bb bb bb bb bb b b bb b bb bb bb
-nursingprocess b
-clienteducation b
-tasks thatrequireclinical judgementtoLPNsor APs
bb bb bb bb b b b bb
*CONSIDER*:
-predictabilityofoutcome b b
-potentialforharm b b
-complexityof care b bb
-needfor problem solvingandinnovation
bb bb bb b bb
-levelof interaction withthe client
b bb bb bb bb
when a nurse receives an unsafe assignment - Correct Answer ✔✔- -bring the
bb bb bb bb bb bb bb bb b b bb b bb bb
assignment to the attention of the scheduling/charge nurse and negotiate a new
bb bb bb bb bb bb bb bb bb bb bb bb
assignment
bb
-if unresolved takeit upchainof command
bb bb bb bb bb bb bb
-fileawritten protest tothe assignment
bb bb bb bb bb bb
>>assignment despite objection bb bb
>>document of practice situations bb bb bb
-failure to accept the assignment without following the proper channels can be considered
bb bb bb bb bb bb bb bb bb bb bb bb
client abandonment
bb bb
inappropriate use of restraints - Correct Answer ✔✔- *assualt*: threatening to place a bb bb bb bb bb b b bb b bb bb bb bb bb
NG tube in a pt who is refusing to eat
bb bb bb bb bb bb bb bb bb bb
*battery*: restraining a pt and administering an injection against his wishesbb bb bb bb bb bb bb bb bb bb
*false imprisonment*: using restraints on a competent client to prevent his leaving the
bb bb bb bb bb bb bb bb bb bb bb bb
health care facility
bb bb bb
reporting information to the provider (ch. 2) - Correct Answer ✔✔- should be fostered to
bb bb bb bb bb bb bb bb b b bb b bb bb bb bb
create a climate of mutual respect and collaborative practice
bb bb bb bb bb bb bb bb bb
, *-assessmentdataintegraltochangesinclientstatus b b b b b b b
-recommendationsforchanges intheplanofcare b b bb b b bb b
-clarificationofprescriptions* b b
*Qualities*:
-goodcommunication
b
-assertiveness
-conflict negotiation skills
bb bb
-leadership skills bb
-professional presence bb
-decision-makingandcriticalthinking b b b
Decision-making styles: bb
*decisive* - Correct Answer ✔✔- the team uses a minimum amount of data and
bb bb b b bb b bb bb bb bb bb bb bb bb bb
generates one option
bb bb bb
Decision-making styles: bb
*flexible* - Correct Answer ✔✔- the team uses a limited amount of data and generates
bb bb b b bb b bb bb bb bb bb bb bb bb bb bb
several options
bb bb
Decision-making styles: bb
*Hierarchical* - Correct Answer ✔✔- the team uses a large amount of data and generates bb bb b b bb b bb bb bb bb bb bb bb bb bb bb
one option
bb bb
Decision-making styles: bb
*integrative* - Correct Answer ✔✔- the team uses a large amount of data and generates bb bb b b bb b bb bb bb bb bb bb bb bb bb bb
several options
bb bb
breach of confidentiality (ch. 3) - Correct Answer ✔✔- -nurses who disclose client
bb bb bb bb bb bb b b bb b bb bb bb bb
information to an unauthorized person can be liable for invasion of privacy, defamation, or
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
slander
bb
-*HIPAA rights ofpts* bb bb bb
>>client is able to obtain a copy of their medical record and to submit requests to amend
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
erroneous or incomplete information
bb bb bb bb
>>a requirement for health care and insurance providers to provide written information
bb bb bb bb bb bb bb bb bb bb bb
about how medical information is used and how it is shared with other entities
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
-->permissionmustbeobtainedbeforeinformationisshared b b b b b b b
>>the pt has the right to privacy and confidentiality
bb bb bb bb bb bb bb bb
*components of privacy rule* - Correct Answer ✔✔- -only healthcare team members bb bb bb bb bb b b bb b bb bb bb bb
directly responsible for the client's care are allowed access to the patients records.
bb bb bb bb bb bb bb bb bb bb bb bb bb
>>nurses may not share information with other clients or staff not involved in the patient
bb bb bb bb bb bb bb bb bb bb bb bb bb bb
care
bb
-clients have a right to read and obtain a copy fo their medical record, and agency policy
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
should be followed when the client requests to read or have a copy of the record
bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb bb
