ATI Leadership Proctored Exam Latest Graded A+ 70 Questions and Answers

1. A nurse manager is preparing to institute a new system for scheduling staff. Several nurses have verbalized their concern over the possible changes that will occur. Which of the following is an appropriate method to facilitate the adoption of the new scheduling system? A. Identify nurses who accept the change to help influence other staff nurses B. Provide a brief overview of the new scheduling system immediately before it implementation C. Introduce the new scheduling system by describing how it will save the institution money D. Offer to reassign staff who do not support the change to another unit - B. Provide a brief overview of the new scheduling system immediately before it implementation OR A. Identify nurses who accept the change to help influence other staff nurses 2. A client who is febrile is admitted to the hospital for treatment of pneumonia. In accordance with the care pathway, antibiotic therapy is prescribed. Which of the following situations requires the nurse to complete a variance report with regard to the care pathway? A. Antibiotic therapy was initiated 2hr after implementation of the care pathway B. A blood culture was obtained after antibiotic therapy has been initiated C. The route of antibiotic therapy on the care pathway was changed from IV to PO D. An allergy to penicillin required an alternative antibiotic to be prescribed - A. Antibiotic therapy was initiated 2hr after implementation of the care pathway 3. A nurse should recognize that an incident report is required when A. A client refuses to attend physical therapy B. A visitor pinches his finger in the client‟s bed frame C. A client throws a box of tissues at a nurse D. A nurse gives a med 30 min late - A. A client refuses to attend physical therapy 5. Client satisfactory surveys from a med-surg unit indicate the pain is not being adequately relieved during the first 12 hr post-opt. The unit manager decides to identify post-opt 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? A. Prospective chart audit B. Retrospective chart audit ATI Leadership Proctored Exam Latest Graded A+ 70 Questions and Answers C. Post-operative care policy D. Pain assessment policy - D. Pain assessment policy 6. A nurse precepting a newly licenced nurse who is caring for a client who is confused and has an IV infusion. The newly licensed nurse has placed the client in wrist restraints to prevent dislodging the IV catheter. Which of the following questions should the precepting nurse ask? A. "Did you secure the restraints to the side rails of the bed?" B. "Are you able to insert two fingers between the restraint and the client's skin?" C. "Did you tie the restraints using double knot?" D. "Are you removing the client‟s restraints every 4 hr?" - B. "Are you able to insert two fingers between the restraint and the client's skin?" 7. A nurse is caring for an older adult client who has stage III pressure ulcer. The nurse request a consultation with the wound care specialist. Which of the following actions by the nurse is appropriate when working with a consultant? A. Arrange the consultation for time when the nurse is caring for the client is able to be present for consultation B. Provide the consultant with subjective opinions and beliefs about the client's wound care. C. Request the consultation after several wound care treatment tried D. Arrange for the wound care nurse specialist to see the client daily to provide the recommended treatment - A. Arrange the consultation for time when the nurse is caring for the client is able to be present for consultation 8. A client is admitted with TB and placed in a negative pressure room. Which of the following actions is appropriate? A. Notify the local health department of the admission B. Place a sign on the client's door with the diagnosis C. Ensure that admitting staff undergo PPD skin tests D. Determine who had contact with the client in the last 48 hr - D. Determine who had contact with the client in the last 48 hr (maybe wrong) POSSIBLY: A. Notify the local health department of the admission 9. A nurse is caring for a client who is unconscious and whose partner is healthcare proxy. The partner has spoken with the provider and wishes to discontinue the client‟s feeding tube. The provider states the nurse, "I will not discontinue the client‟s treatment. His partner has no right to make decisions regarding the client‟s care. "Which of the following responses by the nurse is appropriate? A. You should consider speaking with the facility's ethics committee before making your decision B. You have the right to make a decision, even if the partner is the client‟s health care proxy C. The client has designated his partner as a health care proxy in his advance directives. D. We‟ll need to have the nursing supervisor review the client‟s advance directives - C. The client has designated his partner as a health care proxy in his advance directives. 10. A nurse is caring for a client who has increased intracranial pressure and is receiving IV corticosteroids. Which of the following info is most important for the nurse to report at shift change? A. Glasglow Coma scale score B. Most recent blood glucose reading C. Lab test scheduled for next shift D. Reddened area on the coccyx - A. Glasglow Coma scale score 11. A nurse is assigned the following four clients for the current shift. Which of the following should the nurse assess first? A. A client who has a hip fracture and is in Buck‟s traction B. A client who has aspiration pneumonia and a respiratory rate of 28/min C. A client who has diabetes mellitus stage 2 pressure ulcer on his foot D. A client who has a C diff infection and needs a stool specimen collected - D. A client who has a C diff infection and needs a stool specimen collected 12. A nurse is caring for a client who fell and is reporting pain in the left hip with external rotation of the left leg. The nurse has been unable to reach the provider despite several attempts over the past 30 min. Which of the following actions should the nurse take? A. Notify the nursing supervisor about the issues B. Contact the client's physical therapist C. Apply a warm compress to the hip D. Reposition the client for comfort - A. Notify the nursing supervisor about the issues 13. The mother of a client with breast cancer states, it's been hard for her, especially after losing her hair. And it has been difficult to pay for all the treatments. Which of the following actions is appropriate for client advocacy? A. The nurse investigates potential resources to help the client purchase wig B. The nurse explains to the mother that most clients with cancer lose their hair C. The nurse informs the next shift nurse regarding the mother‟s concerns. D. The nurse suggests counseling for the client‟s body image issues - A. The nurse investigates potential resources to help the client purchase wig 14. Which of the following items must be discarded in a biohazard waste receptacle? A. A urinary catheter drainage bag from a client who is post-opt B. A bed sheet from a client with bacterial pneumonia C. A perineal pad from a client who is 24-hr post-vaginal delivery D. An empty IV bag removed from a client who has HIV - D. An empty IV bag removed from a client who has HIV 15. A nurse tells the unit manager, "I am tired of all the changes on the unit. If things don‟tget better, I‟m going to quit. "Which of the following responses appropriate? A. "So you are upset about all the changes on the Unit" B. "I think you have a right to be upset, I am tired of the changes too" C. "Just stick with it a little longer. Things will get better soon D. " You should file complaints with hospital administrator - A. "So you are upset about all the changes on the Unit" 16. According to the HIPAA regulations, which of the following is a violation of client confidentiality? A. Telephone the pharmacy with a prescription for the spouse to pick up B. Providing a copy of the record to the transporting paramedic C. Reporting a client‟s disposition to the referring provider D. Informing housekeeping staff that the client is in dialysis unit - D. Informing housekeeping staff that the client is in dialysis unit 17. A Nurse preceptor is evaluating a newly licensed nurse‟s competency in assisting with a sterile procedure. Which of the following actions indicates the nurse is maintaining sterile technique? (Select all that apply.) A. Open the sterile pack by first unfolding the flap farthest from her body B. Rests the cap of a solution container upside down on the sterile field C. Removes the outside packaging of a sterile instrument before dropping into the sterile field D. Holds a bottle of a sterile solution 15 cm (6 inches) above the sterile field E. Places sterile items within 1.25 cm (0.5 inch) border around the edge of the sterile field - A. Open the sterile pack by first unfolding the flap farthest from her body C. Removes the outside packaging of a sterile instrument before dropping into the sterile field D. Holds a bottle of a sterile solution 15 cm (6 inches) above the sterile field E. Places sterile items within 1.25 cm NOTE: OTHER SOURCES LIST ONLY A & C as the correct answers. 18. A nurse is providing care for 4 post-opt clients. The nurse should first assess the client A. Whose pulse has been steadily increasing during the past shift B. Who is reporting a pain level of 8 on a scale of 0 to 10. C. Whose urine output averaged 32 ml/hr for the past 24 hr D. Who is reporting nausea after the prescribed antiemetic was administered - B. Who is reporting a pain level of 8 on a scale of 0 to 10. 19. A nurse is preparing to transcribe a client‟s med prescription in the medical record. Which of the following should the nurse recognize as containing the essential components of a medication order? A. NPH insulin 10 Units before and at bedtime B. Haloperidol (Hadol) 1mg per mouth C. Multivit every morning by mouth D. Aspirin 650 mg by mouth every 4hr - D. Aspirin 650 mg by mouth every 4hr 20. A nurse is assisting with orientation of a newly licensed nurse. The newly licensed nurse is having trouble focusing and has difficulty completing care for his assigned clients. Which of the following interventions is appropriate? A. Recommend that he takes time to plan at the beginning of shift B. Advise him to complete less time-consuming tasks first C. Ask other staff members to take over some of his staffs D. Offer to provide care for his clients while he takes a break - A. Recommend that he takes time to plan at the beginning of shift 21. 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? A. Remove the client‟s clothing B. Irrigate the exposed area with water C. Report the incident to OSHA D. Don personal protective equipment - B. Irrigate the exposed area with water 22. 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? A. A nurse refuses to actively participate during an elective abortion procedure scheduled for her client. B. A nurse gives prescribed opioids to a client who has a terminal illness and respirations of 8/min C. A nurse explains to a client's family that a DNR order includes withholding comfort measures D. A nurse informs a confused client who wants to go home that he is going to stay at the facility until he is better - C. A nurse explains to a client's family that a DNR order includes withholding comfort measures 23. A nurse is an ambulatory care setting is orienting 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 tele health? A. Assessing client needs B. Providing med reconciliation C. Establishing communication between providers D. Developing client treatment protocols - 24. Which of the following put a hospital at the highest risk of infringement of client record confidentiality? A. A nurse clusters documentation of care for multiple clients? B. A provider and nurse access client info using one access code C. Paper-based charts are stored at the nurse's station D. A nurse performs electronic documentation outside a client‟s room - C. Paper-based charts are stored at the nurse's station 25. Which of the following observations requires a charge nurse to intervene and demonstrate safe handling techniques? A. A nurse cleans up blood spill with a 1:10 bleach solution B. A nurse uses googles to perform tracheostomy suctioning C. A nurse disconnects an indwelling urinary catheter from the drainage bag to collect a specimen D. A nurse places a mask on a client with TB before transport to the radiology department - 26. Which of the following should lead a nurse to suspect abuse that must be reported? A. A school-age child has several bruises on her lower legs. B. A toddler cries whenever his parents enters the hospitals room. C. An Adolescent admitted to the emergency won‟t speak to his parents D. A preschool child who was previously toilet trained now requires diapers in the hospital - B. A toddler cries whenever his parents enters the hospitals room. 27. A parish nurse is making referral to a community meal delivery program for a member of the congregation. This is an example of which of the following functions of the parish nurse? A. Liaison