ATI Leadership Exam 2019

1. A client is brought to the emergency department following a motor-vehicle crash. Drug use is suspected in the crash, and a voided urine specimen is ordered. The client repeatedly refuses to provide the specimen. Which of the following is the appropriate action by the nurse? - b. Document the client's refusal in the chart. 2. A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to assign to a licensed practical nurse? - b. Administer a nasogastric tube feeding. 3. A nurse preceptor is evaluating a newly licensed nurse's competency in assisting with a sterile procedure. Which of the following actions indicates the newly licensed nurse is maintaining sterile technique? (SATA) - b. Opens the sterile pack by first unfolding the top flap away from her body d. Removes the outside packaging of a sterile instrument before dropping it onto the sterile 4. A nurse enters a client's room and identifies that the client is receiving too much IV fluid because the IV - a. Auscultate the client's lungs. 5. A nurse is planning care for a group of clients and can delegate care to a licensed practical nurse (LPN) and an assistive personnel. Which of the following tasks should the nurse assign to the LPN? - a. Reinforcing teaching with a client who is learning to self-administer insulin 6. A nurse is supervising a newly licensed nurse who is performing surgical asepsis. After donning a sterile gown and gloves, which of the following actions by the newly licensed nurse demonstrates correct aseptic technique? - c. The nurse holds her hands above her waist. 7. A nurse who is caring for a group of clients delegates collection of vital signs to an assistive personnel (AP). Which of the following actions should the nurse take to evaluate the delegated task? - b. Recheck vital signs that are outside the expected reference range. 8. A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive personnel? - a. Obtaining a stool sample from a client who has renal failure 9. A nurse is triaging a group of clients following a disaster. Which of the following clients should the nurse recommend for treatment first? - b. A client who has two open chest wounds with a left tracheal deviation 10. Anursemanagerisreviewingguidelinesforinformedconsentwiththenursingstaff.Whic hofthe following statements by a staff nurse indicates that the teaching was effective? - b. "Consent can be given by a durable power of attorney." 11. Anurseiscaringforfourclients.Forwhichofthefollowingclientsshouldthenursecollabo ratewiththe facility ethics committee? - d. An adolescent client whose parents refuse a blood transfusion for religious reasons 12. A nurse in an ambulatory care setting is orient a newly licensed nurse who is preparing to return a call to a client. The nurse should explain that which of the following is an objective of telehealth? - d. Establishing communication between providers (Community Health pg. 75) 13. Anurseisprovidingdischargeteachingtoaclientwhohasanewdiagnosisofdiabetes.Thec lient expresses concern about the cost of blood-glucose monitoring supplies. Which of the following actions should the nurse take? - a. Refer the client to the social services department. 14. Achargenurseisreceivingchange-ofshiftreport. Whichofthefollowingsituationsshouldthecharge nurse address first? - d. The emergency department nurse is waiting to give report on a new admission. 15. Anursewhoispreceptinganewlylicensednurseisdiscussingtheclientassignmentforthes hift.Whichof the following actions should the nurse preceptor take first to demonstrate appropriate time management? - c. Determine client care goals (set/plan goals) 16. AchargenurseisreviewinginformationaboutHIPAAwithagroupofstaffnurses.Whicho fthefollowing statements by a staff nurse indicates understanding? - d. "HIPAA allows clients to request a review of their own medical records." A nurse is caring for a client who has a tumor. The provider recommends surgery. The client refuses, but the client's partner wants the surgery performed. Which of the following is the deciding factor in determining if the surgery will be done? - a. Whether the client understands the risk of refusing the procedure Achargenurseisplanningthecareoffournewborns.Anassistivepersonnelandlicensedpr acticalnurse are available for staffing. Which of the following tasks should the nurse assign to a licensed practical nurse? - b. Administer a hepatitis B vaccine. During a staff meeting a unit manager reviews the results for documenting client education and finds that they are below the benchmark. Which of the following strategies should the nurse manager implement first? - b. Determine factors that interfere with the documentation of client education. A nurse is explaining ethics and values to a newly licensed nurse. The nurse should explain that preventing client injury by removing a fall hazard demonstrates which of the following ethical principles? - Nonmaleficenc A nurse is caring for a group of clients. Which of the following clients should the nurse plan to assess first? - c. A client who has a nasogastric tube and has crackles in the lungs (ABC--airway) A charge nurse is planning to evacuate clients on the unit because there is a fire on another floor. Which of the following clients should the nurse evacuate first? - d. A client who is receiving IV chemotherapy and is ambulatory Anurseenterstheroomofaclientwhoisunconsciousandfindsthattheclient'ssonisreadin gher electronic medical records from a monitor located at the bedside. Which of the following actions should the nurse take first? - d. Log out the computer so that the client's son is unable to view his mother's information. Anurseispreparingaclientforcardiaccatheterization.Justbeforetheprocedure,theclient asksthenurse about the risks of the procedure. Which of the following actions should the nurse take? - d. Notify the provider about the client's concerns. A nurse is prioritizing care after receiving change-of-shift report on four clients. Which of the following clients should the nurse assess first? - c. A client who reports indigestion and pain in her jaw 26. Achargenursenoticesthattwostaffnursesarenottakingmealbreaksduringtheirshifts.W hichofthe following actions should the nurse take first? - b. Determine the reasons the nurses are not taking scheduled breaks. Assess first 27. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage bone cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care? - Has data been collected about specific client needs related to turning? (Assessment of holistic 28. A nurse is preparing to transfer a client from the emergency department to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the background portion of the report? - b. The client's vital signs 29. Anurseisplanningdischargeforaclientwhohasrheumatoidarthritis.Whichofthefollowi ngstatements by the client should the nurse identify as an indication that a referral to an occupation therapist is necessary? - d. "I will need assistance with bathing." 30. A nurse in the emergency department is caring for a 16-year-old client who reports abdominal pain and is accompanied by an adult neighbor. The provider diagnoses a ruptured appendix and states that the client requires an emergency appendectomy. Which of the following actions should the nurse? - d. Attempt to notify the client's guardian to obtain consent. 31. A nurse on a medical-surgical unit is caring for four clients. Which of the following findings is the highest priority? - a. A client who had a cardiac catheterization whose capillary refill in the great toe is 4 seconds 32. Achargenursesuspectsthatastaffnurseischemicallyimpaired.Whichofthefollowingact ionsshould the charge nurse take? - b. Collect data about the staff nurse to support further action. 33. Anurseisassessingaclient'scomprehensionofapulmonaryfunctiontestpriortotheproce dure.Whichof the following client statements indicates to the nurse an understanding of the procedure? - b. "I might have to wear a nose clip during this test." Anurseintheemergencydepartmentistriagingfourclients.Whichofthefollowingclients shouldthe nurse recommend to be examined first? - c. An older adult client who has dyspnea and a respiratory rate of 26/min 35. Ahomehealthnursefindspilesofnewspapersinthehallwayofaclient'shome.Thenurseex plainsthe need to discard the newspapers for safety reasons. The client agrees to move the newspapers into the living room. Which of the following conflict resolution strategies has the nurse used? - a. Collaborating