Ati Leadership Practice A

ATI Leadership Practice B

RN manager planning daily work/activities for unit. Which is highest priority?

-assign client care to staff
-coordinate staff breaks
-organize daily meetings using appointment book
-review unit’s long term goals

assign client care to staff

Rationale: meeting patient’s needs are first priority (Maslow’s Hierachy).

Which of following RN instructions provides effective communication in task delegation to an AP?

-check the urinary output at 1100 for John Doe and report it to me immediately
-take vitals q2hr for cholecystectomy pt in room 6122
-report if chest tube drainage is excessive for Jane Doe in room 2438
-please notify me of any significant vitals or blood glucose

check the urinary output at 1100 for John Doe and report it to me immediately

Rationale: RN is following 5 rights of delegation, (right direction/communication) by including data to collect client-specific info, time line and detailed communication of findings back to nurse

Pt w/ altered mental status and rt lower leg DVT has Rx for application of aquathermia pad to rt lower leg. Which is priority action to ensure pt safety?

-ask pt to report if aquathermia pad gets too warm
-check the pt’s leg 10 mins after applying pad
-show the pt where the on and off button is located
-ensure that pt is w/in reach of call light

check pt’s leg 10 mins after applying pad

Rationale: greatest risk is injury from heat application and altered mental status; its nurse’s responsibility to f/u after applying this type of device and the priority action

RN on med surg floor has arrived late to work several times in past couple of weeks and the RN case manager is planning to use progressive discipline to address problem. Place the steps in this process in correct sequence.-issue informal verbal reprimand
-give nurse a formal written reprimand
-suspend nurse w/o pay
-terminate nurse’s employment

Rationale: First step is counseling the employee. Manager should ensure nurse understands position expectations. Manager must explain what has to be done to correct behavior. If it continues a written reprimand is issued and nurse must sign acknowledgement of issue discussion. If performance doesn’t improve suspension occurs followed with termination as last step.

Woman brings 15 yr old grandson to ED with reports of abdominal pain; needs immediate appendectomy and parents are unavailable. What’s appropriate action?

-delay procedure until parents can provide consent
-proceed w/surgery via implied consent
-have grandmother sign consent
-obtain consent from pt

have grandmother sign consent

Rationale: Nurse should assist in obtaining consent from grandmother since it’s emergency and parents aren’t available

Nurse is planning discharge for new mother and newborn, who requires apnea monitoring at home. To which community agency should nurse anticipate referring pt?

-child protective services
-public health
-home health
-women, infants and children

home health

Rationale: home health agency can provide visiting nurses who will help new mother learn necessary skills and assess progress of infant

Nurse manager notices increase in health care associated infections on unit. Using process of auditing quality control, which action should be taken first?

-identify relevant data to the criteria for best unit practices
-decide how to collect data that contributes to audit
-use benchmarks to establish practice standards
-perform root cause analysis of problem

use benchmarks to establish practice standards

Rationale: first step is to use benchmarks to establish standards when using quality control process

Nurse has 4 pts, which is highest priority ?

-older adult w/CVA 2 days ago and facial droop
-adult w/ femur fracture reporting SOB
-school age child crying of pain do to appendectomy last nite
-adult with T-tube of 300mL greenish brown drainage over 12hr

adult w/ femur fracture reporting SOB

Rationale: this is highest priority (ABC approach)

Nurse caring for 4 pts, which requires most immediate intervention?

-pt w/ COPD and O2 sat of 89%
-newly admitted pt reporting 3 day hx of nausea/vomitting
-post-op knee replacement pt reporting pain 8/10
-pt w/hx of esophageal varices w/ diaphoresis and pallor

pt w/hx of esophageal varices w/ diaphoresis and pallor

Rationale: manifestations indicate that pt could be hemorrhaging from ruptured esophageal varices (Urgent vs. Non-urgent approach)

Newly hired AP is asked to remove pt’s indwelling urinary catheter, what should be done to ensure AP is qualified for task?

-show AP how to remove indwelling urinary catheter
-review AP’s skill competency checklist
-ask AP if she knows how to remove indwelling urinary catheter
-pair newly hired AP with more experienced AP

review AP’s skill competency checklist

Rationale: checklist should validate if she has demonstrated ability to safely perform procedure

2 nurses contend that the other is not doing fair share of work affecting the functionality of unit. Charge nurse should recognize what as appropriate approach to this conflict?

-schedule nurses to work alternating shifts
– organize task force to eval situation
– tell nurses its their responsibility to cooperate w/ each other
-explore alternative solutions to address unit workflow with nurses

explore alternative solutions to address unit workflow with nurses

Rationale: exploring alternatives allows nurses to collaborate and has high probability that they will reach solution

Urgent care nurse notices that all pts are not receiving pain assessment , what is priority?

-check pt satisfaction surveys for feedback
-post article on pain assessment on bulletin board
-document finding on incident report
-report issue to nurse manager

report issue to nurse manager

Rationale: its’s nurse manager’s responsibility to ensure standards of care are met

RN is precepting newly hired RN on advanced care directive, what statement should RN make?

-staff who provide advanced directive must be trained by facility legal dept
-pt’s power of attorney must be in agreement w/ pt’s advance directive
-advance directive must be signed by provider to be valid
-there must be documentation in medical record about whether pt has advance directives

there must be documentation in medical record about whether pt has advance directives

-Rationale: advance directives must be documented in pt’s med records in order to provide medical care based on pt’s wishes

Which of the following demonstrates effective time management ?

-waiting to document pt care until the end of the shift
-grouping activities for several pts in the same location
-obtaining clean linens upon request by pt
-planning time consuming pt care activities for later in the shift

grouping activities for several pts in the same location

Rationale: demonstrates time effective skills

Case manager is planning interdisciplinary conference for 3 day pot op pt w/ORIF of rt hip. What is highest priority for discussion?

-pt doesn’t have transportation for discharge home
-pt refuses to attend PT sessions
-pt’s home health RN hasn’t completed home assessment
-pt describes feelings of depression after family visits

pt refuses to attend PT sessions

Rationale: greatest risk is post-op complications due to immobility, so pt’s refusal of PT is priority

Charge nurse is managing conflict with nurse who doesn’t agree w/ assignment, which statement is example of conflict resolution known as smoothing?

-would you accept assignment if we reassign you a pt who has total care needs

ATI leadership practice B

A nurse is developing a plan of care for a school-age child whose family is homeless. Which of the following findings should the nurse identify as the priority?The Child has inflamed fissures at the corners of her mouth
A nurse on a med-surg unit is caring for a client who is terminally ill. Which of the following actions demonstrates that the nurse is practicing in an ethical manner when caring for the client?Collaborate with the client to establish realistic goals for his end-of-life care.
A charge nurse observes that a staff nurse’s behavior has changed over the past few weeks. Which of the following behaviors should the charge nurse identify as an indication that the staff nurse is working while impaired?Isolates herself from other staff members
A nurse in an ED is admitting clients following an earthquake. the emergency disaster plan has been implemented due to the anticipated arrival of a large number of casualties. which of the following clients should the nurse recommend the provider evaluate first?A client who has a sucking chest wound.
A nurse is teaching a newly licensed nurse about incidents reports. which of the following statements by the newly licensed nurse indicates an understanding of the teaching?I should complete an incident report for an unexpected client occurrence.
A nurse is assigning care for four clients. which of the following tasks should the nurse plan to delegate to an AP?Record a client’s meal intake.
A nurse is observing a newly licensed nurse perform a sterile dressing change on a clinet who has a central venous catheter. Which of the following is an appropriate action by the newly licensed nurse?Picks up first sterile glove by grasping the folded cuff edge
A nurse overhears two staff members in the facility elevator discussing a client’s care. Which of the following interventions should the nurse take?Report the incident to the nurse manager.
A nurse receives notification of a fire on the unit. Which of the following actions should the nurse take first?Assist clients who are in immediate danger to a safe location.
A public health nurse is developing a list of recommendations for her supervisor on how to use EBP to improve community outcomes. Which of the following should the nurse recommend as a qualitative research method?Phenomenlogy
A client presents to an emergency department and reports weakness, vomiting, and diarrhea for the past 3 days. Which of the following is the priority assessment for this client?serum potassium level
A nurse manager is conducting an annual performance review for a staff nurse. Which of the following strategies should the nurse use in the review process? (Select all that apply)Include peer evaluations completed by an AP, have the nurse conduct a self-appraisal prior to the review, complete a performance checklist