ATI LEADERSHIP PROCTORED STUDY GUIDE QUESTIONS
AND SOLUTIONS MARKED A+
✔✔Directing - ✔✔Leadership role assumed by a manager that influences and motivates
staff to perform assigned
roles.
✔✔Controlling - ✔✔Evaluation of staff performance and evaluation of unit goals to
ensure identified outcomes are being met.
✔✔Characteristics of managers - ✔✔Hold formal positions of authority and power.
Possess clinical expertise.
Network with members of the team.
Coach subordinates.
Make decisions about the function of the organization, including resources, budget,
hiring, and firing.
✔✔Critical thinking skills - ✔✔Interpretation.
Analysis.
Evaluation.
Inference.
Explanation.
✔✔Critical thinking - ✔✔Reflects upon the meaning of statements, examines available
data, and uses reason to make informed decisions.
Critical thinking is necessary to reflect and evaluate from a broader scope of view.
Sometimes one must think "outside the box" to find solutions that are best for clients,
staff, and organization
✔✔Clinical reasoning - ✔✔Mental process used when analyzing the elements of a
clinical situation and using analysis to make a decision. The nurse continues to use
clinical reasoning to make decisions as the client's situation changes.
✔✔Clinical reasoning supports the clinical decision-making process by - ✔✔Guiding the
nurse through the process of assessing and compiling data.
Selecting and discarding data based on relevance.
Using nursing knowledge to make decisions about client care. Problem solving is a part
of decision-making.
✔✔Clinical judgment - ✔✔Decision made regarding a course of action based on a
critical analysis of data.
Clinical judgment considers the client's needs when deciding to take an action, or
modify an intervention based on the client's response.
✔✔The nurse uses clinical judgment to - ✔✔Analyze data and related evidence.
,Ascertain the meaning of the data and evidence.
Apply knowledge to a clinical situation.
Determine client outcomes desired and/or achieved as
indicated by evidence-based practices.
✔✔Prioritization principles in client care - ✔✔Prioritize systemic before local ("life before
limb"). Prioritizing interventions for a client in shock over interventions for a client who
has a localized limb injury.
Prioritize acute (less opportunity for physical adaptation) before chronic (greater
opportunity for physical adaptation). Prioritizing the care of a client who has a new
injury/illness (e.g., mental confusion, chest pain) or an acute exacerbation of a previous
illness over the care of a client who has a long-term chronic illness.
Prioritize actual problems before potential future problems. Prioritizing administration of
medication to a client experiencing acute pain over ambulation of a client at risk for
thrombophlebitis.
Listen carefully to clients and don't assume. Asking a client who has a new diagnosis of
diabetes mellitus what he feels is most important to learn about disease management.
Recognize and respond to trends vs. transient findings. Recognizing a gradual
deterioration in a client's level of consciousness and/or Glasgow Coma Scale score.
Recognize indications of medical emergencies and complications vs. expected findings.
Recognizing indications of increasing intracranial pressure in a client who has a new
diagnosis of a stroke vs. the findings expected following a stroke.
Apply clinical knowledge to procedural standards to determine the priority action.
Recognizing that the timing of administration of antidiabetic and antimicrobial
medications is more important than administration of some other medications.
✔✔Priority setting frameworks - ✔✔Maslow's hierarchy.
ABC framework.
Safety/risk reduction.
Assessment/data collection first.
Survival potential.
Least restrictive/least invasive.
Acute vs. chronic, urgent vs. nonurgent, stable vs. unstable.
✔✔Maslow's hierarchy - ✔✔Self actualization.
Self esteem.
Need for love and belonging.
Safety and security.
Physiological.
✔✔Using Maslow's hierarchy - ✔✔The nurse should consider this hierarchy of human
needs when prioritizing interventions. For example, the nurse should prioritize a client's:
Need for airway, oxygenation (or breathing), circulation, and potential for disability over
need for shelter.
Need for a safe and secure environment over a need for socialization.
, ✔✔Airway breathing circulation (ABC) framework - ✔✔The ABC framework identifies, in
order, the three basic needs for sustaining life.
An open airway is necessary for breathing, so it is the highest priority.
Breathing is necessary for oxygenation of the blood to occur.
Circulation is necessary for oxygenated blood to reach the body's tissues.
The severity of manifestations should also be considered when determining priorities. A
severe
circulation problem can take priority over a minor breathing problem.
Some frameworks also include a "D" for disability and "E" for exposure.
✔✔Airway interventions - ✔✔Identify an airway concern (obstruction, stridor).
Establish a patent airway if indicated.
Recognize that 3 to 5 min without oxygen causes irreversible brain damage secondary
to cerebral anoxia.
✔✔Breathing interventions - ✔✔Assess the effectiveness of breathing (apnea,
depressed respiratory rate).
Intervene as appropriate (reposition, administer naloxone).
✔✔Circulation interventions - ✔✔Identify circulation concern (hypotension, dysrhythmia,
inadequate cardiac output,
compartment syndrome).
Institute appropriate actions to reverse or minimize circulatory alteration.
✔✔Disability interventions - ✔✔Assess for current or evolving disability (neurological
deficits, stroke in evolution).
Implement actions to slow down development of disability.
✔✔Exposure interventions - ✔✔Remove the client's clothing to allow for a complete
assessment or resuscitation.
Implement measures to reduce the risk for hypothermia by providing warm blankets and
IV
solutions and using a heating device if needed.
✔✔Safety/risk reduction - ✔✔Look first for a safety risk. For example, is there a finding
that suggests a risk for airway obstruction, hypoxia, bleeding, infection, or injury?
Next ask, "What's the risk to the client?" and "How significant is the risk compared to
other posed risks?"
Give priority to responding to whatever finding poses the greatest (or most imminent)
risk to the client's physical well-being.
✔✔Assessment/data collection first - ✔✔Use the nursing process to gather pertinent
information prior to making a decision regarding a plan of action. For example,
determine if additional information is needed prior to calling the provider to ask for pain
medication for a client.
AND SOLUTIONS MARKED A+
✔✔Directing - ✔✔Leadership role assumed by a manager that influences and motivates
staff to perform assigned
roles.
✔✔Controlling - ✔✔Evaluation of staff performance and evaluation of unit goals to
ensure identified outcomes are being met.
✔✔Characteristics of managers - ✔✔Hold formal positions of authority and power.
Possess clinical expertise.
Network with members of the team.
Coach subordinates.
Make decisions about the function of the organization, including resources, budget,
hiring, and firing.
✔✔Critical thinking skills - ✔✔Interpretation.
Analysis.
Evaluation.
Inference.
Explanation.
✔✔Critical thinking - ✔✔Reflects upon the meaning of statements, examines available
data, and uses reason to make informed decisions.
Critical thinking is necessary to reflect and evaluate from a broader scope of view.
Sometimes one must think "outside the box" to find solutions that are best for clients,
staff, and organization
✔✔Clinical reasoning - ✔✔Mental process used when analyzing the elements of a
clinical situation and using analysis to make a decision. The nurse continues to use
clinical reasoning to make decisions as the client's situation changes.
✔✔Clinical reasoning supports the clinical decision-making process by - ✔✔Guiding the
nurse through the process of assessing and compiling data.
Selecting and discarding data based on relevance.
Using nursing knowledge to make decisions about client care. Problem solving is a part
of decision-making.
✔✔Clinical judgment - ✔✔Decision made regarding a course of action based on a
critical analysis of data.
Clinical judgment considers the client's needs when deciding to take an action, or
modify an intervention based on the client's response.
✔✔The nurse uses clinical judgment to - ✔✔Analyze data and related evidence.
,Ascertain the meaning of the data and evidence.
Apply knowledge to a clinical situation.
Determine client outcomes desired and/or achieved as
indicated by evidence-based practices.
✔✔Prioritization principles in client care - ✔✔Prioritize systemic before local ("life before
limb"). Prioritizing interventions for a client in shock over interventions for a client who
has a localized limb injury.
Prioritize acute (less opportunity for physical adaptation) before chronic (greater
opportunity for physical adaptation). Prioritizing the care of a client who has a new
injury/illness (e.g., mental confusion, chest pain) or an acute exacerbation of a previous
illness over the care of a client who has a long-term chronic illness.
Prioritize actual problems before potential future problems. Prioritizing administration of
medication to a client experiencing acute pain over ambulation of a client at risk for
thrombophlebitis.
Listen carefully to clients and don't assume. Asking a client who has a new diagnosis of
diabetes mellitus what he feels is most important to learn about disease management.
Recognize and respond to trends vs. transient findings. Recognizing a gradual
deterioration in a client's level of consciousness and/or Glasgow Coma Scale score.
Recognize indications of medical emergencies and complications vs. expected findings.
Recognizing indications of increasing intracranial pressure in a client who has a new
diagnosis of a stroke vs. the findings expected following a stroke.
Apply clinical knowledge to procedural standards to determine the priority action.
Recognizing that the timing of administration of antidiabetic and antimicrobial
medications is more important than administration of some other medications.
✔✔Priority setting frameworks - ✔✔Maslow's hierarchy.
ABC framework.
Safety/risk reduction.
Assessment/data collection first.
Survival potential.
Least restrictive/least invasive.
Acute vs. chronic, urgent vs. nonurgent, stable vs. unstable.
✔✔Maslow's hierarchy - ✔✔Self actualization.
Self esteem.
Need for love and belonging.
Safety and security.
Physiological.
✔✔Using Maslow's hierarchy - ✔✔The nurse should consider this hierarchy of human
needs when prioritizing interventions. For example, the nurse should prioritize a client's:
Need for airway, oxygenation (or breathing), circulation, and potential for disability over
need for shelter.
Need for a safe and secure environment over a need for socialization.
, ✔✔Airway breathing circulation (ABC) framework - ✔✔The ABC framework identifies, in
order, the three basic needs for sustaining life.
An open airway is necessary for breathing, so it is the highest priority.
Breathing is necessary for oxygenation of the blood to occur.
Circulation is necessary for oxygenated blood to reach the body's tissues.
The severity of manifestations should also be considered when determining priorities. A
severe
circulation problem can take priority over a minor breathing problem.
Some frameworks also include a "D" for disability and "E" for exposure.
✔✔Airway interventions - ✔✔Identify an airway concern (obstruction, stridor).
Establish a patent airway if indicated.
Recognize that 3 to 5 min without oxygen causes irreversible brain damage secondary
to cerebral anoxia.
✔✔Breathing interventions - ✔✔Assess the effectiveness of breathing (apnea,
depressed respiratory rate).
Intervene as appropriate (reposition, administer naloxone).
✔✔Circulation interventions - ✔✔Identify circulation concern (hypotension, dysrhythmia,
inadequate cardiac output,
compartment syndrome).
Institute appropriate actions to reverse or minimize circulatory alteration.
✔✔Disability interventions - ✔✔Assess for current or evolving disability (neurological
deficits, stroke in evolution).
Implement actions to slow down development of disability.
✔✔Exposure interventions - ✔✔Remove the client's clothing to allow for a complete
assessment or resuscitation.
Implement measures to reduce the risk for hypothermia by providing warm blankets and
IV
solutions and using a heating device if needed.
✔✔Safety/risk reduction - ✔✔Look first for a safety risk. For example, is there a finding
that suggests a risk for airway obstruction, hypoxia, bleeding, infection, or injury?
Next ask, "What's the risk to the client?" and "How significant is the risk compared to
other posed risks?"
Give priority to responding to whatever finding poses the greatest (or most imminent)
risk to the client's physical well-being.
✔✔Assessment/data collection first - ✔✔Use the nursing process to gather pertinent
information prior to making a decision regarding a plan of action. For example,
determine if additional information is needed prior to calling the provider to ask for pain
medication for a client.
