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ATI LEADERSHIP PRACTICE QUESTIONS
A nurse is working w/ an assistive personnel (AP) in a long-term care facility. According to the 5 rights of delegation, which of the following determinations should the nurse make prior to assigning tasks? A. Whether the AP has consented to the performance of delegated tasks B. the pt's willingness to consent to care from the AP C. Whether the task can be more efficiently completed by the nurse D. The degree of supervision that the AP will required to complete the task - CORRECT ANSWER - D. The degree of supervision that the AP will require to complete the task Rationales.... Successful delegation involves assigning the right task to the right person under the right circumstances. The person who will perform the task must be given adequate direction & specification regarding the amount of supervision that will be provided. The right communication of expectations & the right feedback about performance must also be supplied. A. The nurse does not have to obtain consent from the AP when delegating tasks w/in the scope of practice & job descriptions for APs B. Tasks that can be delegated to an AP do not require the pt's consent C. One of the barriers to successful delegation is the belief that no one can do a tasks as efficiently & effectively as the nurse. Due to the time constraints on nurses, tasks that can be done by an AP should be duly delegated A home health nurse is caring for a pt who asks about the purpose of a living will. Which of the following statements should the nurse include in the teaching? A. "It est. who will make health care decisions for the pt if the pt is not about to do so" B. "it allows the pt to express personal wishes regarding health care decisions" C. "It serves as an informed consent form for any procedure prescribed by a provider"
D." It is only valid when a pt is lucid & able to make informed decisions independently" - CORRECT ANSWER - B. It allows the pt to express personal wishes regarding health care decisions Rationales... A living will allows the pt to specify what aspects of care & tx are to be accepted / refused in the event that the pt can no longer communicate those decisions A. this described a health care proxy document, which frequently accompanies a living will but is not considered a part of it C. A living will does not serve the same function as informed consent. Prior to any procedure, consent must always be obtained form the pt, a family member, or a designated health care proxy D. A living will is not valid / necessary when a pt is able to make informed health care decisions independently A nurse manager notes that a full-time nurse has been absent from work 6 times over the last 6 weeks. Using a nonpunitive approach, which of the following actions should the nurse manager take? A. verbally remind the employee about the facility's employment standards B. recommend that the employee review the facility's policy regarding absences C. Inform the employee in writing about the facilities employment policy D. ask the employee for a written action plan after discussing the reasons for these absences - CORRECT ANSWER - A. verbally remind the employee about the facility's employment standards Rationales... Verbal admonishment is the first step in the disciplinary process for this type of infraction. The employee might not know or remember the existing standard, and a verbal reminder may be sufficient to change the employee's behavior B. Recommending that the employee reviews the policy does not ensure that the employee will read & fully understand the employment standards
C. assisted-living facility D. long-term care facility - CORRECT ANSWER - B. adult day care Rationales... Adult day care personnel can proivde constant assistance w/ ADLs while the family member is at work; the pt can live at home during the night & evening hours A. hospice care is only appropriate for a tp who has a terminal illness & a life expectancy of < months C. pts who live in an assisted living facility need to be able to live independently & require minimal assistance. Pts can receive assistance w/ med & are offered one prepared meal a day if needed. An assisted living facility is not an option at this time since the family member wishes to keep the pt at home D. a long-term care facility is not an option at this time since the family member wishes to keep the pt at home A nurse on a med surg unit is planning the care of assigned pts. Which of the following pt's should the nurse attend to first? A. a pt who is newly admitted & is scheduled for indwelling urinary catheter insertion B. a pt who has kidney stones & reports flank pain of 6 on a pain scale of 0- 10 C. a pt dx w/ early stage chronic kidney disease w/ a serum creatinine level of 2.0 mg/dL D. a pt who has a cast newly applied on the forearm & reports tingling on the fingers - CORRECT ANSWER - D. a pt who has a cast newly applied on the forearm & reports tingling of the fingers Rationales... When using the ABC approach to pt care, the nurse should first assess the pt who has a newly applied cast. Tingling, numbness, pallor, paresthesia, and pain are clinical s/s associated w/ compartment syndrome, a serious development in which increased tissue pressure in a confined anatomical space reduces blood flow, leading to ischemia, dysfunction, and eventual necrosis. The nurse should report this finding to the provider immediately
A charge nurse in an ED is making assignments for an AP during a shift w/ unexpected staff absences. Which of the following assignments should the charge give to a float AP from the med surg unit? A. escorting pts from the ED to other areas of the facility for tests B. sitting at the reception desk answering telephones & directing pts C. restocking the exam rooms after each pt is discharged D. shadowing an AP who is regularly assigned to the ED - CORRECT ANSWER - A. escorting pts from the ED to other areas of the facility for tests Rationales... Pts in the ED often require transport to other departments. Typically, transporting stable pts is a task that may be delegated to an AP, & escorting pts is likely a normal part of the AP's regular routine A nurse is planning care for several pts. Which of the following pts should the nurse refer to a case manager? A. a pt who has neurological deficits following a stroke B. a married female pt who has delivered a full-term newborn C. a pt who is postop following a cholecystectomy D. a child who has a fracture of the dominant arm - CORRECT ANSWER - A. a pt who has neurological deficits following a stroke Rationales... The nurse should refer this pt to the cast manager for care. A pt who had a stroke will likely require long-term tx. A pt who has ongoing needs for care / rehab should receive care that is directed by a case manager due to the complexity & cost of the pt's needs B. if no complications / social concerns exist, the delivery of a full-term newborn does not require case management C. as long as no complications occur, this procedure does not require a case management approach
Rationales... Under the Uniform Anatomical Gift Act, individuals must be at least 18 yrs or older to make an anatomical gift B. under the UAGA, organ donation can be a provision in a will or done by signing a form designated by the state (on a driver's license). It must be in writing w/ a signature C. under the UAGA an individual can revoke consent for organ donation by either destroying the card / revoking the gift orally in the presence of two witnesses D. under the UAGA, nurses may serve as witnesses for individuals who wish to donate organs A group of providers is participating in a cardiopulmonary resuscitation effort for a pt who is in cardiac arrest. Which of the following types of leadership is required for this group to function efficiently? A. transformational B. participative C. autocratic D. laissez-faire - CORRECT ANSWER - C. autocratic Rationales... Autocratic leadership is most effective in an emergency situation. An autocratic leader will direct & issues commands that are necessary for successful cardiopulmonary resuscitation A. transformational leadership is not appropriate for an emergency situation gives group members responsibilities that will enhance their professional development. In cardiopulmonary resuscitation, one person must organize the group's actions & guide the resuscitation efforts
B. participative leadership, also called "democratic leadership", it not appropriate for an emergency situation. A participative leader serves as a resource person & facilitator & is non-directive. In cardiopulmonary resuscitation, one person must organize the group's actions. D. Laissez-faire leadership is not appropriate for an emergency situation. A laissez-faire leader demonstrates a non-directive approach. In cardiopulmonary resuscitation, one person must organize the group's actions & guide the resuscitation efforts A nurse is preparing a pt for a lumbar puncture. The pt has signed the consent form but tells them nurse that she does not remember what the doctor will do during the procedure. Which of the following actions should the nurse take? A. page the provider stat to come & explain the procedure to the pt B. remind the pt that the doctor will insert a needle to get a sample of fluid from her spine C. explain how the assistant will position the pt for the procedure D. tell the pt that someone will explain the procedure when it is time to begin - CORRECT ANSWER - B. remind the pt that the doctor will insert a needle to get a sample of fluid from her spine Rationales... A signed consent form indicates that the provider informed the pt about the procedure & that at the time the pt understood what to expect. If the pt states she does not remember what to expect, the nurse should clarify any details the provider previously gave the pt. If the pt expresses a further lack of understanding or states that the provider did not inform her, the nurse should either notify the charge nurse or call the provider directly A. the signed consent form indicates that the provider explained the procedure to the pt previously. the nurse should have confirmed this when witnessing the consent C. although the nurse should provide this info, this reponse does not clarify what the provider will do once the pt is in position & directs the focus away from what the pt wants to know D. this response is nontherapeutic, rejects the pt's concern, & fails to ID the need for the nurse to take further action
An incident resulting in permanent harm, such as paralysis or death, is a sentinel event. Sentinel events are a high priority & indicate the need for an immediate investigation B. the committee should review this incident & policies to reduce the risk & occurrence of falls in the facility; a pt fall that does not result in injury is not a sentinel event C. the committee should review the incident & policies to promote culturally competent care; this type of adverse event is not ID as a sentinel event D. the nurse should ID this type of incident as a near-miss, which happens when an error is caught & prevented before it occurs A nurse is performing a safety audit on all equipment used on the unit. Which of the following items should the nurse ID as a safety hazard? A. an electrical cord that is taped to the floor B. a protective cover that is placed over an unused outlet C. an electrical cord that is frayed toward the plug D. an electrical plug that has 3 prongs - CORRECT ANSWER - C. an electrical cord that is frayed toward the plug Rationales... the nurse should ID that an electrical cord that is frayed toward the plug is damaged & should not be used. Using an electrical cord that is damaged can increase the pt's risk of acquiring an electrical shock A. an electrical cord taped to the floor prevents others from tripping over the cord / damaging it B. a protective cover places over an unused outlet prevents young children from playing w/ the outlet
D. an electrical plug w/ 3 prongs is a grounded piece of equipment, which provides a path of low resistance to stray electric currents. This is the only type of electrical equipment that should be used After entering a pt's room, a nurse notices the pt has fallen on the bathroom floor. Which of the following actions should the nurse perform first? A. obtain support from another nurse B. check the pt for injuries C. file an incident report D. notify the pt's provider - CORRECT ANSWER - B. check the pt for injuries Rationales.. The greatest risk to this pt is an injury from falling on the floor; the first action the nurse should take is to look for skin tears, cuts, or bruises & to obtain the pt's vital signs A. the nurse should obtain support from another nurse before filing the incident report if additional info / a witness is needed; the nurse should take another action first C. the nurse should file an incident report to record the pt's fall & to prevent future falls; the nurse should take another action first D. the nurse should notify the pt's provider about the fall & communicate whether the pt was injured & needed tx; the nurse should take another action first A nurse manager is implementing a team nursing approach on his unit, hiring LPNs & AP is additional staff. Which of the following actions should the nurse manager take to facilitate acceptance of this change? A. develop a plan for the change & present it during a staff meeting B. explain that this change is a request from the admin & will be carried out C. hire new LPNs & APs & gradually integrate them into the staff
A. clostridioides difficile B. candidiasis C. vancomycin-resistant staphylococcus aureus D. trichomoniasis - CORRECT ANSWER - C. vancomycin-resistant staph aureus Rationales.. the nurse should follow policy & procedure for reporting a pt who has vancomycin-resistant S. aureus (a communicable disease) to the CDC. A. the nurse should implement contact precautions for a pt who has C. difficile; the nurse does not need to report this infection to the CDC B. the nurse should contact the provider to prescribed med to treat a candidiasis infection; the nurse does not need to report this infection to the CDC D. the nurse should inform the pt of the tx guidelines for trichomoniasis that are available from the CDC & provide teaching about the pt's prescription; trichomoniasis is not a communicable disease that needs to be reported to the CDC A nurse is creating a plan of care for a pt who adheres to Kosher dietary laws. Which of the following food selections should the nurse recommend? A. backed pork chop B. cheeseburger C. ham & cheese omelet D. grilled salmon - CORRECT ANSWER - D. grilled salmon Rationales.. The nurse should recommend grilled salmon for a pt who observes Kosher dietary laws. Grilled salmon is a fish w/ fins & scales, which can be consumed. Seafood w/ shells, such as lobster / crab is prohibited
A nurse is assisting a provider w/ an amniotomy on a pt who is in labor. Which of the following is the priority nursing assessment following the procedure? A. color of amniotic fluid B. fetal heart rate C. uterine contraction pattern D. odor of amniotic fluid - CORRECT ANSWER - B. fetal heart rate rationales.. The greatest risk to this pt is an injury from umbilical cord prolapse following artificial rupture of the membranes; the nurse should monitor the fetal heart rate for bradycardia, which can indicate an increased risk of umbilical cord prolapse A. the nurse should assess the color of the amniotic fluid for blood / meconium stool to check for fetal distress C. the nurse should assess the pt's uterine contraction pattern to determine if oxytocin should be given to stimulate contractions D. the nurse should assess the odor of the amniotic fluid to check for infection A charge nurse on a med surg unit is assigning pt care to the upcoming shift. Which of the following tasks should the nurse delegate to an AP? SATA A. performing colostomy care B. measuring a pt's intake & output C. interpreting a pt's lab values following surgery D. providing postmortem care to a pt E. checking nasogastric tube patency - CORRECT ANSWER - B. measuring a pt's intake & output D. providing postmortem care to a pt Rationales..
D. justice is based on the principle that everyone should be treated similarly & fairly. This is an important ethical principle but is not the basis for informed consent A nurse is completing an incident report after administering an incorrect dose of med to a pt, even though the pt experienced no ill effects from the error. What is the purpose of completing the incident report? A. alerting the facility admin of a possible litigation situation B. tracking employee performance for possible disciplinary action C. providing a detailed report of the occurrence for the pt's family D. ID situations that contribute ot eh occurrence of med errors - CORRECT ANSWER - D. ID situations that contribute to the occurrence of med errors Rationales.. the purpose of completing incidence reports is to ID factors that contribute to the occurrence of the problem. This one aspect of quality-improvement efforst in health care facilities A. incident reports are not completed to alter the facility admin of possible litigation situations B. using incident reports as a means for employee discipline will hinder the reporting of problems & inhibits the finding of solutions to improve the quality of pt care C. an incident report should not be given to the pt's family as a means of providing detailed info about the error A nurse is participating in an ethics committee meeting about a pt who has a hx of alcohol use disorder & needs a liver transplant. Which of the following actions should the committee take first? A. collect info r/t the issue B consider the possible choices of action C. make a decision regarding transplant recommendation D. justify the recommendation for or against a transplant - CORRECT ANSWER - A. collect info r/t the issue
Rationales.. According to EBP, the committee should take the first step in ethical decision-making by ID th ethical issue & problem. This step includes asking questions to define the issue & the complexities of the situation B. the 2nd step in ethical decision-making involves ID & analyzing all of the available alternatives for action, even if the actions seem unlikely C. the 3rd step in ethical decision-making involves selecting one of the alternative actions to follow. The committee should apply ethical principles to make the best decision possible D. this is the final step in ethical decision making. The committee should specify reasons for the action selected & be able to present the ethical basis behind the decisions made A charge nurse is observing a group of newly licensed nurses. Which of the following actions should the charge nurse report to the nurse manager as a violation of HIPAA? A. assigning a pt who requested a private room to a semi-private room due to unavailability B. placing a pt who is confused in restraints C. talking about pts w/ other nurses in the cafeteria D. wheeling a pt who is wearing a sheet down the hall into the shower room - CORRECT ANSWER - C. talking about pts w/ other nurses in the cafeteria Rationales.. The nurse should not discuss info about pts A nurse is updating the plan of care for a pt who has celiac disease. Which of the following dietary selections should the nurse recommend for the pt? A. whole-wheat tortilla w/ black beans B. baked chicken & rice
A. collecting a stool specimen B. providing instructions about using a spirometer C. measuring oral intake D. providing postmortem care E. changing a sterile dressing - CORRECT ANSWER - A. collecting a stool specimen C. measuring oral intake D. providing postmortem care Rationales.. These tasks do not require assessment, analysis, or teaching & are w/in the range of function for an AP A nurse manager is planning staff development activities for the unit's new UAP. Which of the following activities should the nurse manager perform first? A. determine the learning needs of the UAPs B. admin a skills pretest to the new UAPs C. provide the new UAP's w/ a performance checklist D. ask the UAPs about any weaknesses they may have - CORRECT ANSWER - A. determine the learning needs of the UAPs Rationales.. The nurse should apply the nurseing process priority-setting framework to plan pt care & prioritize nursing actions. Assessing or collecting additional data will provide the nurse w/ the knowledge to make an appropriate decision A nurse is caring for a pt who is dying & unstable to make decisions for himself. The pt's adult kids disagree about his code status. Which of the following sources should the nurse depend on for decisions regarding the pt's end of life care?
A. the pt's oldest child B. the attending provider C. the pt's health care proxy D. the facility's ethics committee - CORRECT ANSWER - C. the pt's health care proxy Rationales.. If the pt connot speak for himself, the nurse should follow the directions of the pt's health care proxy, as this is the person the pt chose to make decisions under these circumstances A. if the pt does not have advance directives / has not named a health care proxy, the family may be asked to make end of life decisions B. the attending provider may offer suggestions on end of life care, but the pt or the pt's health care proxy directs treatment D. in the absence of advance directions, the facility's ethics committee may be called upon to intervene if a conflict occurs regarding end of life decisions A charge nurse is planning a department in-service training session about radioactive implants for a group of staff nurses. Which of the following points should the charge nurse include in the presentation? SATA A. pts should be places in a private room B. throw away an implant that has fallen out in the pt's trash can C. staff members should wear a dosimeter badge when caring for the pt D. pts should be on bed rest E. children over the age of yrs can visit if they are accompanied by an adult - CORRECT ANSWER - A. pt's should be placed in a private room C. staff members should wear a dosimeter badge when caring for the pt D. pt's should be on bed rest Rationales..
