ATI RN
ATI NU2508 Leadership Final Exam Questions
Extract:
Question 1 of 5
An assistive personnel (AP) reports to the nurse that a client who is 3 days postoperative following an abdominal hysterectomy has a dressing that is saturated with blood. Which of the following tasks should the nurse delegate to the AP?
Correct Answer: D
Rationale: The correct answer is D: Obtain vital signs. Vital signs are essential to assess the client's overall condition and determine the urgency of the situation. The AP can measure and report the vital signs to the nurse promptly. Palpating for bladder distention (choice
A) requires a higher level of assessment and may indicate a complication postoperatively. Observing the incision site (choice
B) involves assessing for signs of infection or other complications, which should be done by a nurse. Changing the abdominal dressing (choice
C) requires sterile technique and assessment skills beyond the AP's scope.
Therefore, delegating these tasks to the AP could delay necessary interventions.
Question 2 of 5
A nurse is working with an assistive personnel (AP) to care for a group of clients on the pediatric unit. Which of the following tasks should the nurse have the AP perform first?
Correct Answer: A
Rationale: The correct answer is A: Check to see if the elbow restraint is in place for an infant postoperative from a surgical correction of a cleft palate. This task should be performed first because it involves the safety and well-being of the infant. Elbow restraints are crucial post-surgery to prevent the infant from inadvertently touching or injuring the surgical site. Ensuring the elbow restraint is in place promptly is essential to prevent complications and promote healing.
The other choices are incorrect because they do not prioritize the immediate safety and well-being of a postoperative infant. Washing the hair of an adolescent, collecting a stool sample, and engaging a toddler in play are important tasks but can be done after ensuring the safety of the postoperative infant. It is crucial to prioritize tasks based on the urgency and potential impact on the client's health and safety.
Question 3 of 5
A nurse is caring for four clients who are postoperative from surgery 24 hr ago. At 1200 the nurse assesses the clients. Which of the following clients is the nurse's priority?
Correct Answer: D
Rationale: The correct answer is D. The nurse's priority is the client whose blood pressure dropped significantly from 138/86 mm Hg to 106/60 mm Hg. This indicates a potential issue with perfusion and could be a sign of hypovolemic shock, which is a life-threatening condition requiring immediate intervention to prevent further complications. Monitoring and addressing this client's blood pressure is crucial to prevent deterioration.
Choice A is not the priority because pain management can be addressed after ensuring the client's physiological stability.
Choice B indicates a normal progression in wound healing and does not require immediate attention.
Choice C, while showing an increase in blood glucose levels, does not pose an immediate threat to the client's health compared to a significant drop in blood pressure as in
Choice D.
Question 4 of 5
A nurse on the pediatric unit is providing room assignments for children who are to be admitted to the unit. The nurse should plan to place a child who is postoperative from an appendectomy with which of the following clients?
Correct Answer: C
Rationale: The correct answer is C. Placing the postoperative appendectomy child with a child who has a new diagnosis of type 1 diabetes mellitus is appropriate because both conditions typically require close monitoring but do not pose an immediate risk to each other. The child with appendectomy may need pain management and wound care, while the child with diabetes may need monitoring of blood glucose levels and insulin administration. Placing the postoperative child with a child experiencing sickle cell crisis (
A) could be risky due to the potential for infection and stress on both children. Placing the child with a head injury (
B) with a postoperative child could be dangerous as the child with a head injury may need a quiet environment and close monitoring for any neurological changes. Placing the child with streptococcal pharyngitis (
D) with a postoperative child could increase the risk of infection for the postoperative child.
Question 5 of 5
A charge nurse plans to use effective change strategies when implementing a change in a nursing procedure on the medical-surgical unit. Which of the following actions should the charge nurse take during the moving stage of change?
Correct Answer: A
Rationale: The correct answer is A: Set a target date. During the moving stage of change, setting a target date is crucial to create a sense of urgency and maintain momentum. It provides a clear timeline for implementation, ensuring accountability and focus. This action helps prevent delays and keeps the change process on track.
Choice B is incorrect because alerting staff nurses about the need for change is more relevant during the unfreezing stage.
Choice C is incorrect as evaluating effectiveness typically occurs during the refreezing stage.
Choice D is incorrect as assessing the problem is part of the initial stages of change management, not the moving stage.