ATI RN
Client Safety Nursing Skill Template Questions
Question 1 of 5
A client has just been intubated for placement on a mechanical ventilator. What is the first assessment of the tube placement?
Correct Answer: D
Rationale: The correct answer is D: End tidal CO2 monitoring. This is the first assessment of tube placement because it provides immediate feedback on the effectiveness of ventilation. End tidal CO2 monitoring measures the amount of CO2 exhaled, indicating proper placement in the airway. If the tube is correctly positioned, CO2 will be detected. Chest X-Ray (A) is not immediate and delays intervention. Auscultation (B) may not always confirm placement. Pulse oximetry (C) can be misleading as oxygen saturation can be maintained even with incorrect tube placement.
Question 2 of 5
A nurse has been reassigned from her regular area of work to a unit that is short staffed. Which of the following actions should the nurse take first?
Correct Answer: A
Rationale: Rationale: - A. Asking what she will be assigned to do first helps the nurse clarify her responsibilities and prioritize tasks effectively. - B. Determining skills can wait until knowing the assigned tasks. - C. Identifying options is not urgent compared to knowing immediate tasks. - D. Notifying the manager can be done after understanding her duties. Summary: The nurse should first ask about her assignment to understand her immediate responsibilities before assessing her skills or considering other options.
Question 3 of 5
A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's death. Which of the following ethical principles should the nurse use to support the decision not to administer the medication?
Correct Answer: B
Rationale: The correct answer is B: Nonmaleficence. Nonmaleficence is the ethical principle that emphasizes the duty to do no harm to the patient. In this situation, by not administering the pain medication, the nurse is ensuring that the client is not being harmed or hastened towards death. Administering the medication would be to alleviate suffering, not to hasten death. A: Utilitarianism focuses on maximizing overall good for the majority. In this case, it could be argued that administering the medication would provide the greatest good for the client, but it does not directly address the concern of potentially hastening death. C: Fidelity pertains to being faithful to commitments and maintaining trust. While important, it does not directly address the immediate ethical dilemma of administering pain medication in this situation. D: Veracity relates to truthfulness and honesty. While crucial in communication with the client, it is not the primary ethical principle to consider in this specific scenario.
Question 4 of 5
An RN is assigning responsibilities for his team. Which client should he assume responsibility for?
Correct Answer: C
Rationale: The correct answer is C because as an RN, the highest priority is ensuring comfort and pain management for a client actively dying. This client requires immediate attention to provide IV pain medication for symptom management and dignity in the dying process. Option A is incorrect as ambulation can be delegated to other team members. Option B is incorrect as a client in protective isolation can be managed by following infection control protocols. Option D is incorrect as a dressing change for a stable postoperative client can be delegated. Prioritizing end-of-life care aligns with the RN's scope of practice and ethical duty.
Question 5 of 5
A nurse is caring for a client who has severe head injuries and is declared brain dead. The transplant coordinator has spoken with the client's family about organ donation. The client's spouse states she is confused and does not know what she should do. Which of the following responses by the nurse is appropriate?
Correct Answer: B
Rationale: Correct Answer: B Rationale: 1. Asking the spouse what the brain-dead client would have wanted respects the client's autonomy and allows the family to make a decision in alignment with the client's wishes. 2. This approach considers the emotional and ethical aspects of organ donation, ensuring that the decision is not solely based on external factors or pressure. 3. It promotes shared decision-making and empowers the spouse to make a choice that reflects the client's values and beliefs. Summary: - Option A is incorrect as it uses guilt and societal pressure to influence the decision, which is not ethical. - Option C is incorrect as it dismisses the spouse's confusion and oversimplifies the issue by focusing solely on religious beliefs. - Option D is incorrect as it manipulates emotions and does not address the spouse's confusion or the client's wishes.