ATI Comprehensive Predictor Exam Graded A 2025

What can be delegated to Assistive personnel (AP)? ADLs - bathing - grooming - dressing - ambulating - feeding (w/o swallow precautions) - positioning - bed making - specimen collection - I&O - VS (stableclients A nurse on a med surge unit has recieved change of shift report and will care for 4 clients. Which of the following clients needs will the nurse assign to an AP? C. Reapplying a condom catheter for a client who has urinary incontinence A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following info should the nurse share with the AP? Select all: B. The client ambulates with his slippers on over his antiembolic stockings C. The client uses a front wheeled walker when ambulating D. The client had pain meds 30 minutes ago An RN is making assignments for client care to an LPN at the beginning of the shift. Which of the following assignments should the LPN question? D. Replacing the cartridge and tubing on a PCA pump A nurse is preparing an inservice program about delegation. Which of the following elements should she identify when presenting the 5 rights of delegation. Select all: B. Right supervision/evaluation C. Right direction/communication E. Right circumstances A nurse manager of a med surge unit is assigning care responsibilities for the oncoming shift. A client is waiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign the client? B. RN What is the study of conduct and character? Ethics What are the values and beliefs that guide behavior and decision making?-Morals What is the right to make ones own personal decisions, even tho those decisions might not be in the persons best interest-Autonomy What are positive actions to help others-Beneficience What is an agreement to keep promises-Fidelity What is fairness in care delivery and use of resources-Justice What is avoidance of harm or injury-Non-maleficence A nurse is caring for a client who decides not to have surgery despite significant blockages in his coronary arteries. The nurse understands that this clients choice is an example of what principles? A. Fidelity A nurse offers pain meds to a client who is postop prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles? D. Beneficience-D A nurse is instructing a group of nursing students about the responsibilities involved with organ donation and procurement. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the students should understand that this aspect of care delivery is an example of which ethical principle C. Justice A nurse questions a med prescription as too extreme and light of the clients advanced age and unstable status. The nurse understands that this action is an example of which ethical principle D. Nonmalificence Which of the following situations can be identified as an ethical dilemma? C. A family has conflicting feelings about the initiation of enteral tube feedings of their father who is terminally ill Most managers can be categorized as-authoritative, democratic, and laissez faire Authoritative ▪ makes decisions of the group ▪ motivates by coercion ▪ communication occurs down the chain of command ▪ Work output by the staff is usually high-good for crisis situations and bureaucratic settings- Democratic ▪ includes the group when decisions are made ▪ Motivates by supporting star achievements ▪ Communication occurs up and down the chain of command ▪ Work output by staff is usually of good quality-good when cooperation and collaboration is necessary- Laissez faire ▪ makes very few decisions and does little planning ▪ motivation is largely the responsibility of individuals staff members ▪ Communication occurs up and down the chain of command and between group members ▪ Work output is low unless an informal leader evolves from the group ▪ *the use of any of these styles may be appropriate depending on the situation- The nurse should consider the hierarchy of human needs when prioritizing interventions, which are?— ▪ -Physiological needs first (oxygen, shelter, food) - Safety & security needs (physical safety) - Love and belonging - Self esteem - Self actualization The ABC framework identifies, in order, the three basic needs for sustaining life- ▪ Airway ▪ Breathing ▪ Circulation Nurses must follow what code of standards in delegating and assigning tasks- ▪ ANA codes of standards What values would a nurse possess to be a client advocate?- CARE - caring - autonomy - respect - empowerment What do the nurse need to keep in mind about the client when being their advocate?- ▪ Client's religion & culture When should planning discharge process begin? a. at time of admission What is an interdisciplinary team?- ▪ A group of health care professionals from different disciplines Fill in the blank: 1. collaboration is used by interdisciplinary team to make health care decisions about clients with multiple problems. 2. collaboration, which may take place at team meetings, allows the achievement of results that the participants would be incapable of accomplishing if working alone What is the nurse's contribution to an interdisciplinary team?- - knowledge of nursing care & its management - a holistic understanding of the client, her/his healthcare needs & healthcare systems. A four-month-old infant is admitted to the pediatric intensive care unit with a temperature of 105°F (40.5 °C). The infant is irritable, and the nurse observes nuchal rigidity. Which assessment finding would indicate an increase in intracranial pressure? 2. High-pitched cry. A client is receiving total parenteral nutrition (TPN). To determine the client's tolerance of this treatment, the nurse should assess for which of the following? 4. Urine output of at least 30 cc per hour.-4 The client is exhibiting symptoms of myxedema. The nursing assessment should reveal 2. decreased temperature. A nonstress test is scheduled for a client at 34-weeks gestation who developed hypertension, periorbital edema, and proteinuria. Which of the following nursing actions should be included in the care plan in order to BEST prepare the client for the diagnostic test? 3. Instruct client to push a button when she feels fetal movement. Which of the following nursing interventions is MOST important for a 45-year-old woman with rheumatoid arthritis? 4. Assist her with heat application and ROM exercises.-4 The nurse is caring for a young adult admitted to the hospital with a severe head injury. The nurse should position the patient 1. with his neck in a midline position and the head of the bed elevated 30°. The nurse is teaching a 40-year-old man diagnosed with a lower motor neuron disorder to perform intermittent self-catheterization at home. The nurse should instruct the client to 2. perform the Valsalva maneuver(holding breath and bearing down) before doing the catheterization. A client is being discharged with sublingual nitroglycerin (Nitrostat). The client should be cautioned by the nurse to 4. avoid abrupt changes in posture.-4 A 38-year-old woman is returned to her room after a subtotal thyroidectomy for treatment of hyperthyroidism. Which of the following, if found by the nurse at the patient's bedside, is nonessential? 1. Potassium chloride for IV administration. A nurse recognizes that an initial positive outcome of treatment for a victim of sexual abuse by one parent would be that the client 3. verbalizes that s/he is not responsible for the sexual abuse. An adolescent client is ordered to take tetracycline HCL (Achromycin) 250 mg PO bid. Which of the following instructions should be given to this client by the nurse? 2. "Wear sunscreen and a hat when outdoors." After a client develops left-sided hemiparesis from a cerebral vascular accident (CVA), there is a decrease in muscle tone. Which of the following nursing diagnoses would be a priority to include in his care plan? 2. Alteration in skin integrity related to decrease in tissue oxygenation. A client has a history of oliguria, hypertension, and peripheral edema. Current lab values are: BUN -25, K+ -4.0 mEq/L. Which nutrient should be restricted in the client's diet? 1. Protein. An extremely agitated client is receiving haloperidol (Haldol) IM every 30 minutes while in the psychiatric emergency room. The MOST important nursing intervention is to 1. monitor vital signs, especially blood pressure, every 30 minutes. The nurse is caring for clients in the skilled nursing facility. Which of the following clients require the nurse's IMMEDIATE attention? 1. A client admitted for a cerebral vascular accident (CVA) whose prescription for warfarin (Coumadin) expired two days ago. The nurse is observing care given to a client experiencing severe to panic levels of anxiety. The nurse would intervene in which of the following situations? 3. The staff helps the client identify thoughts or feelings that occurred prior to the onset of the anxiety. A 69-year-old client is undergoing his second exchange of intermittent peritoneal dialysis (IPD). Which of the following would require an intervention by the nurse? 3. The dialysate outflow is cloudy. The clinic nurse is performing diet teaching with a 67-year-old client with acute gout. The nurse should teach the client to limit his intake of 1. red meat and shellfish. A client is scheduled for a left lower lobectomy. The physician has ordered diazepam (Valium) 2 mg IM for anxiety. The nurse would determine that the medication is appropriate if the client displays which of the following symptoms? 3. Restlessness and increased heart rate. A 59-year-old woman with bipolar disorder is receiving haloperidol (Haldol) 2 mg PO tid. She tells the nurse, "Milk is coming out of my breasts." Which of the following responses by the nurse is BEST? 3. "You are experiencing a side effect of Haldol." The physician orders ranitidine hydrochloride (Zantac) 150 mg PO qd for a client. The nurse should advise the client the BEST time to take this medication is 4. at hs.-4 (HOURS OF SLEEP) If a client develops cor pulmonale (right-sided heart failure), the nurse would expect to observe 3. peripheral edema and anorexia. The nurse is performing triage on a group of clients in the emergency department. Which of the following clients should the nurse see FIRST? 2. A 19-year-old with a fever of 103.8°F (39.8°C) who is able to identify her sister but not the place and time. The nurse in the outpatient clinic teaches a client with a sprained right ankle to walk with a cane. What behavior, if demonstrated by the client, would indicate that teaching was effective? 2. The client holds the cane in her left hand. A client returns to his room following a myelogram. The nursing care plan should include which of the following? 1. Encourage oral fluid intake. The nurse is caring for a patient following an appendectomy. The patient takes a deep breath, coughs, and then winces in pain. Which of the following statements, if made by the nurse to the patient, is BEST? 1. "Take three deep breaths, hold your incision, and then cough." A young woman is transferred to a psychiatric crisis unit with a diagnosis of a dissociative disorder. The nurse knows which of the following comments by the client is MOST indicative of this disorder? 4. "I don't know who I am and I don't know where I live." A 23-year-old man is admitted with a subdural hematoma and cerebral edema after a motorcycle accident. Which of the following symptoms should the nurse expect to see INITIALLY? 4. Decreased level of consciousness. The nursing team includes two RNs, one LPN/LVN, and one nursing assistant. The nurse should consider the assignments appropriate if the nursing assistant is assigned to care for 1. a client with Alzheimer's requiring assistance with feeding. An elderly client is returned to her room after an open reduction and internal fixation of the left femoral head after a fracture. It is MOST important for the nursing care plan to include that the client 4. cough and deep breathe.-4