ATI Leadership 2016 B

Client recovering from a StrokeDiscuss patient concerns
Charge notices new nurse does not finish client care tasksSet aside time to plan at start of shift
Two nurses feel the other is not doing fair shareExplore alternative solutions
Charge Nurse is conducting an in service with staff about infection control.. droplet precautionsPertussis
Admitting clients following an earth quakeSucking Chest wound
Group of clients.. Which is priority?2 days post op and 20 mL/hr of urine
Accommodating new bariatric servicesRole Model
Encourage staff
Interprofessional conference for client who is 3 days post op.. Priority?Client refuses to attend PT sessions
Charge nurse evaluating novice.. client on continuous NG tube feeds.. what should be part of plan of care?Use 60 mL syringe to flush
Four clients on Med Surge unit… assess first?Post op total knee and cap refill of 3 seconds
Teaching new nurse about obtaining telephone prescription from a providerRepeat prescription to provider for verification
Notification of Fire on the unit… first action?Assist
Planning care for a client without Advanced Directives.. intervention?Provide client with information about AD
Nurse manager completing a performance improvement audit and determines documentation of client discharge teaching is below benchmark… action to implement first?Determine the factors that interfere with the documentation of client education
Nurse overhears 2 nurses discussing a client’s care. Intervention to take?Report to nurse manager
Case manager is planning a teaching on use of critical pathwayscritical pathways prevent unnecessary expense
Change of shift to an oncoming nurse.. include?time of last pain med
Older adult client who has renal failure decides to stop hemodialysis.. action?Support client’s decision
Nurse manager finds an increase in urinary tract infections. action to take first?Perform a chart review
Observing new nurse perform a sterile dressing change.. APPROPRIATE action?Picks up first glove by grasping folded cuff edge
Administering medication to a client with Crohn’s disease. Client is too tired.Inform client of consequences
Plan of care for a total hip arthroplasty. Action to take?Inform AP of client’s weight bearing status
Home health nurse is planning daily visits and receives lab results.. See first?Platelets 100,00
Nurse talking to daughter of Alzheimer’s patient… daughter is cryingRespite Care options
Education about patient protection and the affordable care act and patient rightsMy insurance coverage no longer has lifetime coverage limits
Discharge teaching to a patinet who is scheduled to receive oxygen at homeVerify flow rate on equipment daily
Client with a terminal illness voices concern about how she will care for herself following dischargecase manager will coordinate
Med Surge nurse is caring for terminally ill patient. Action that demonstrates ethical careCollaborate with client to establish realistic goals
Obtaining a clients informed consent, what is nurse’s role?Confirm voluntary signature
Terminally ill client receiving nutritional support. Adult children disagree and dilemma is referred to ethics committeeassisting in weighing the options involved
Newly licensed nurse about using electronic medical records.My access to client records may be tracked by nurse manager
New nurse caring for a patient with pulmonary tuberculosis.N95 respirator mask when in the client’s room
Assistive Personnel tells the charge nurse that it is unfair she has to take care of all the clients who are incontinentI delegate tasks to personnel based on their job description
Public health nurse is developing recommendations for her supervisor on how to implement evidence based practice to improve community outcomesPhenomenology
Appropriate tasks that a nurse can delegate to an assistive personnelRecord a client’s meal intake
Staff nurse detects alcohol on the breath of another nurse, unsteady gait and occasionally slurred speech.Notify charge nurse
Older adult client with dementia and has become aggressive. Client has been prescribed wrist restraintsApply padded portion of the restraint around the client’s wrist
Nurse manager is reviewing stages of conflict resolution with nursing staffLatent conflict
Perceived conflict
Felt conflict
Manifest Conflict
Conflict aftermath
Developing a plan of care for a school aged whose family is homeless, what is the priority?Child has inflamed fissures at the corners of her mouth
Which instruction from a nurse reflects effective communication regarding delegation of a task to an assistive personnelCheck the urinary output at 1100 for John Doe and report it to me immediately
Nurse is caring for a client who has a mutation of the BRCA2 gene, client states she doesn’t plan to tell her adult daughters. What response displays client advocacyLet’s review what you understand about this test result
Caring for a client who has a sealed radiation therapy implant. Precaution to take?When wearing the lead apron, avoid turning her back to the client
Client in the ED reports weakness, vomiting, diarrhea for past 3 days.Serum potassium level
Nurse manager is conducting an annual performance review. Best strategiesInclude peer evaluations
Self appraisal
Performance checklist
Charge nurse observes that nurse’s behavior has changed over the past few weeks. Which is an indication that the nurse is working while impaired?Isolates herself
New nurse learning about incidence reportsI should complete an incident report for an unexpected client occurrence
Nurse is reviewing a client’s medication administration record and finds that client has not received prescribed dose of Warfarin for past 2 days.Check client’s INR
Information on health care law to a group of newly licensed nurses.The Patient Self Determination act
Assessing a client who is post op and has a PCA. Client is restless, has an elevated pulse, and decreased BP.Modified Trendelenburg
Small spark when plugging in an infusion pump.Tag pump as broken
Charge nurse is planning assignments, which should be assigned to the LPN?Provide enteral feeding to a client who has Crohn’s disease
Massive community disaster and stable clients must be discharged to prepare for new casualties.Client with Multiple sclerosis
Nurse is serving on a committee that is considering the creation of a policy that will allow nurses to insert PICC in the ICU. Consult in planning for this policy?State Nurse Practice Act
Change of shift report, which patient should the nurse assess first?Abdominal surgery 6 hr ago and a HR of 120/min for the last 2 hours
Client is comatose with living will that declines use of artificial enteral feedings but family requests feedings are started.Review clients requests with family
Discharge care for an older adult client who has rheumatoid arthritis. Difficulty buttoning her clothingOccupational therapy
Admitting a client to a cardiac intensive care unit. When does discharge planning begin?At the time of admission
Nurse caring for a client who has a right lower leg DVT and a prescription for application of an aquathermia pad to the right lower legReport if the pad is too warm
Show the client where the power button is
Ensure call light is within reach
Charge nurse observing a new nurse perform an abdominal assessment.Place the client in dorsal recumbent position for the exam
Client with back pain presents to the ED and is provided oxycodone. Staff nurse feels client is seeking drugs and not in distress.Clients are experts on their own pain