ATI LPN
Study Guide for Fundamentals of Nursing Care: Concepts, Connections & Skills
Chapter 5 : DOCUMENTATION Questions
Question 1 of 5
Choose the correct answer(s). In some questions, more than one answer is correct. Select all that apply. Which of the following charting 'omissions' (meaning they were not charted) would carry potential legal risks just by the nature of the omission?
Correct Answer: B,C,D,F
Rationale: Omitting a rash/swelling (
B), hemophilia history (
C), medication order (
D), or NPO order (F) poses legal risks due to potential harm. Meal time (
A) and oral intake instruction (E) are less critical.
Question 2 of 5
Choose the correct answer(s). In some questions, more than one answer is correct. Select all that apply. You can safely delegate documentation of certain data to an unlicensed staff member. Which of the following data cannot be delegated?
Correct Answer: A
Rationale: Medication administration documentation (
A) cannot be delegated, as it requires a licensed professional. Vital signs (
B) and flow sheet items (C,
D) can typically be delegated to unlicensed staff.
Question 3 of 5
Indicate whether the following statements are True (T) or False (F). Statistics such as rates of hospital-acquired infections, mortality rates, success rates of specific procedures, and number of incidents and accidents serve as factors of a medical facility's reputation.
Correct Answer: A
Rationale: True (T): These statistics are key indicators of a facility's performance and influence its reputation.
Question 4 of 5
Indicate whether the following statements are True (T) or False (F). Failure to document administration of a medication does not carry a potential legal risk.
Correct Answer: B
Rationale: False (F): Failing to document medication administration poses a legal risk due to potential patient harm and accountability issues.
Question 5 of 5
Indicate whether the following statements are True (T) or False (F). A federal law known as OBRA mandates that an extensive assessment form called the MDS must be completed on every patient admitted to the hospital.
Correct Answer: B
Rationale: False (F): OBRA mandates the MDS for long-term care facilities, not hospitals.