ATI LEADERSHIP PROCTORED EXAM
1. Which patient is most likely to need long-term nursing care management?
a) 72-yr-old who had a hip replacement after a fall at home
b) 64-yr-old who developed sepsis after a ruptured peptic ulcer
c) 76-yr-old who had a cholecystectomy and bile duct drainage
d) 63-yr-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)
ANS: D
Osteoarthritis and obesity are chronic problems that will require planning for
long-term interventions such as physical therapy and nutrition counseling.
The other patients have acute problems that are not likely to require long-term
management.
2. An older adult being admitted is assessed at high risk for falls. Which
action should the nurse take first?
a) Use a bed alarm system on the patient’s bed.
b) Administer the prescribed PRN sedative medication.
c) Ask the health care provider to order a vest restraint.
d) Place the patient in a “geri-chair” near the nurse’s station.
ANS: A
The use of the least restrictive restraint alternative is required. Physical or
chemical restraints may be necessary, but the nurse’s first action should be an
alternative such as a bed alarm.
3. An older adult patient presents with a broken arm and visible scattered
bruises healing at different stages. Which action should the nurse take
first?
a) Notify an elder protective services agency about possible abuse.
b) Make a referral for a home assessment visit by the home health nurse.
c) Have the family member stay in the waiting area while the patient is
assessed.
d) Ask the patient how the injury occurred and observe the family
member’s reaction.
, ANS: C
The initial action should be assessment and interviewing of the patient. The
patient should be interviewed alone because the patient will be unlikely to give
accurate information if the abuser is present. If abuse is occurring, the patient
should not be discharged home for a later assessment by a home health nurse.
The nurse needs to collect and document data before notifying the elder
protective services agency.
4. The family of an older patient with chronic health problems and
increasing weakness is considering placement in a long-term care (LTC)
facility. Which action by the nurse will be most helpful in assisting the
patient to make this transition?
a) Have the family select a LTC facility that is relatively new.
b) Ask the patient’s preference for the choice of a LTC facility.
c) Explain the reasons for the need to live in LTC to the patient.
d) Request that the patient be placed in a private room at the facility.
ANS: B
The stress of relocation is likely to be less when the patient has input into the
choice of the facility. The age of the long-term care facility does not indicate a
better fit for the patient or better quality of care. Although some patients may
prefer a private room, others may adjust better when given a well-suited
roommate. The patient should understand the reasons for the move but will
make the best adjustment when involved with the choice to move and the
choice of the facility.
5. The nurse manages the care of older adults in an adult health day care
center. Which action can the nurse delegate to unlicensed assistive
personnel (UAP)?
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a) Obtain information about food and medication allergies from patients.
b) Take blood pressures daily and document in individual patient records.
c) Choose social activities based on the individual patient needs and desires.
d) Teach family members how to cope with patients who are
cognitively impaired.
ANS: B
1. Which patient is most likely to need long-term nursing care management?
a) 72-yr-old who had a hip replacement after a fall at home
b) 64-yr-old who developed sepsis after a ruptured peptic ulcer
c) 76-yr-old who had a cholecystectomy and bile duct drainage
d) 63-yr-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)
ANS: D
Osteoarthritis and obesity are chronic problems that will require planning for
long-term interventions such as physical therapy and nutrition counseling.
The other patients have acute problems that are not likely to require long-term
management.
2. An older adult being admitted is assessed at high risk for falls. Which
action should the nurse take first?
a) Use a bed alarm system on the patient’s bed.
b) Administer the prescribed PRN sedative medication.
c) Ask the health care provider to order a vest restraint.
d) Place the patient in a “geri-chair” near the nurse’s station.
ANS: A
The use of the least restrictive restraint alternative is required. Physical or
chemical restraints may be necessary, but the nurse’s first action should be an
alternative such as a bed alarm.
3. An older adult patient presents with a broken arm and visible scattered
bruises healing at different stages. Which action should the nurse take
first?
a) Notify an elder protective services agency about possible abuse.
b) Make a referral for a home assessment visit by the home health nurse.
c) Have the family member stay in the waiting area while the patient is
assessed.
d) Ask the patient how the injury occurred and observe the family
member’s reaction.
, ANS: C
The initial action should be assessment and interviewing of the patient. The
patient should be interviewed alone because the patient will be unlikely to give
accurate information if the abuser is present. If abuse is occurring, the patient
should not be discharged home for a later assessment by a home health nurse.
The nurse needs to collect and document data before notifying the elder
protective services agency.
4. The family of an older patient with chronic health problems and
increasing weakness is considering placement in a long-term care (LTC)
facility. Which action by the nurse will be most helpful in assisting the
patient to make this transition?
a) Have the family select a LTC facility that is relatively new.
b) Ask the patient’s preference for the choice of a LTC facility.
c) Explain the reasons for the need to live in LTC to the patient.
d) Request that the patient be placed in a private room at the facility.
ANS: B
The stress of relocation is likely to be less when the patient has input into the
choice of the facility. The age of the long-term care facility does not indicate a
better fit for the patient or better quality of care. Although some patients may
prefer a private room, others may adjust better when given a well-suited
roommate. The patient should understand the reasons for the move but will
make the best adjustment when involved with the choice to move and the
choice of the facility.
5. The nurse manages the care of older adults in an adult health day care
center. Which action can the nurse delegate to unlicensed assistive
personnel (UAP)?
TestBankWorld.org
a) Obtain information about food and medication allergies from patients.
b) Take blood pressures daily and document in individual patient records.
c) Choose social activities based on the individual patient needs and desires.
d) Teach family members how to cope with patients who are
cognitively impaired.
ANS: B
