ATI RN
ATI RN Leadership 2023 Exam 2 Questions
Extract:
Client admitted earlier that day, refuses two medications stating, 'I've never taken these before.'
Question 1 of 5
A nurse in a rehabilitation facility is administering medications to a client who was admitted earlier that day. The client refuses two of the medications, stating, 'I've never taken these before.' Which of the following actions should the nurse take first?
Correct Answer: C
Rationale: The correct answer is C: Compare the client's medication administration record with the prescriptions on the transfer orders. This is the first action the nurse should take to ensure the medications the client is refusing are indeed prescribed for them. By comparing the medication administration record with the transfer orders, the nurse can verify the accuracy of the prescribed medications and address any discrepancies. Consulting the pharmacist (choice
A) or calling the provider (choice
B) may be necessary but should come after verifying the current prescriptions. Reviewing the intended purpose of the medications with the client (choice
D) is important but should be done after confirming the prescribed medications.
Extract:
Client receiving heparin with aPTT of 34 seconds; Client has orthostatic hypotension receiving IV fluids; Client has Type 1 diabetes using insulin pump; Client at risk for pressure ulcers with albumin level of 4.2 g/dL.
Question 2 of 5
A nurse working on a medical-surgical unit is managing the care of four clients. The nurse should schedule an interdisciplinary conference for which of the following clients?
Correct Answer: D
Rationale: The correct answer is D because the client is at risk for pressure ulcers with an albumin level of 4.2 g/dL. This interdisciplinary conference is needed to involve various healthcare professionals to develop a comprehensive care plan to prevent pressure ulcers. The interdisciplinary team may include nurses, dietitians, wound care specialists, and physical therapists. A low albumin level indicates poor nutrition and increases the risk of pressure ulcers.
Choices A, B, and C do not require an interdisciplinary conference as they can be managed by the nurse independently or with the healthcare provider. Option A is within the therapeutic range for aPTT with heparin therapy. Option B may require adjustments in IV fluids but does not necessitate a conference. Option C is routine care for a client with Type 1 diabetes using an insulin pump.
Extract:
Client receiving nasogastric tube; Client with chest tube; Client for lumbar puncture; Client post-esophagogastroduodenoscopy.
Question 3 of 5
A charge nurse is observing a newly licensed nurse provide care to four clients. Which of the following actions requires intervention by the charge nurse?
Correct Answer: A
Rationale: The correct answer is A because elevating the head of the client's bed to 30° before inserting a nasogastric tube helps prevent aspiration by promoting proper positioning and facilitating tube insertion. Elevating the head of the bed reduces the risk of the tube entering the trachea instead of the esophagus.
Choices B, C, and D are incorrect because maintaining the chest tube below the insertion site when ambulating, assisting the client into a fetal position for a lumbar puncture, and assessing gag reflex post-procedure are all appropriate and safe nursing actions that do not require intervention.
Extract:
Multigravida client with preeclampsia receiving misoprostol; Client with gestational diabetes receiving biweekly nonstress tests; Client at 32 weeks with premature rupture of membranes; Primigravida client 1 day postoperative following Cesarean with PCA pump.
Question 4 of 5
A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit?
Correct Answer: D
Rationale: The correct answer is D. The primigravida client post-Cesarean section with a PCA pump requires specialized knowledge and skills related to pain management and postoperative care, making it appropriate for an RN with medical-surgical experience.
A: Preeclampsia and misoprostol induction require obstetrical expertise.
B: Gestational diabetes and nonstress tests are routine obstetrical procedures.
C: Premature rupture of membranes at 32 weeks requires obstetrical monitoring.
E, F, G: No additional information provided.
In summary, choice D is the most appropriate assignment for the RN due to the specialized postoperative care required, while the other choices involve routine obstetrical care that can be managed by OB-trained staff.
Extract:
Client fell while ambulating, gait belt not in place.
Question 5 of 5
A charge nurse observes a client fall while ambulating with an assistive personnel and notes that the client's gait belt was not in place. When reviewing the incident report, the charge nurse finds that the report does not mention the gait belt. Which of the following ethical principles should the charge nurse follow?
Correct Answer: C
Rationale: The correct answer is C: Veracity. Veracity refers to truthfulness and honesty in communication. In this scenario, the charge nurse should follow the ethical principle of veracity by ensuring that the incident report accurately reflects the absence of the gait belt during the client's fall. By being truthful in documenting this detail, the charge nurse upholds transparency and accountability in patient care.
Rationale for why other choices are incorrect:
A: Nonmaleficence - Nonmaleficence refers to the duty to do no harm. While it is essential to prevent harm, the primary issue here is about honesty in reporting the incident accurately.
B: Fidelity - Fidelity involves being faithful and loyal to commitments and obligations. Although important in nursing practice, it is not directly related to the situation described.
D: Beneficence - Beneficence is the duty to do good and promote the well-being of others. While important in patient care, it is not the most relevant ethical principle in this specific