ATI RN Leadership 2023
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Free ATI RN Leadership 2023 Questions
A nurse is conducting an in-service on client advocacy with a group of newly licensed nurses. Which of the following scenarios should the nurse include as examples of client advocacy? (Select all that apply.)
- Initiating IV access on a client who has dementia while he is sleeping.
- Implementing a client's plan of care based upon nursing goals.
- Documenting a client's refusal to take a prescribed medication.
- Obtaining an interpreter for a client who speaks a different language than the nurse.
- Providing written information to a client regarding palliative care.
Explanation
Correct Answer: C) Documenting a client's refusal to take a prescribed medication, D) Obtaining an interpreter for a client who speaks a different language than the nurse, and E) Providing written information to a client regarding palliative care.
C) Documenting a client's refusal respects and upholds the client's right to autonomy and self-determination — a core component of advocacy.
D) Obtaining an interpreter ensures the client can fully understand and participate in their care, advocating for their right to informed communication and decision-making.
E) Providing written information about palliative care ensures the client is fully informed about their options, supporting their right to make educated decisions about their treatment.
A) Initiating IV access on a sleeping client with dementia is a violation of informed consent and autonomy — this is the opposite of advocacy. B) Implementing a plan of care based on nursing goals rather than the client's goals does not represent advocacy, as it centers the nurse's priorities rather than the client's wishes.
A nurse is providing teaching to a client about advance directives. Which of the following client statements indicates to the nurse an understanding of the teaching?
- "Once my advance directives are signed, I no longer make my own decisions."
- "My health care surrogate should be my oldest living child."
- "My living will determines who speaks for me when I am unable to do so."
- "I can alter my advance directives later if I change my mind about treatment."
Explanation
Correct Answer: D) "I can alter my advance directives later if I change my mind about treatment."
Advance directives are not permanent — a client retains the right to revoke or modify them at any time as long as they have decision-making capacity. This statement demonstrates correct understanding of the flexibility of advance directives.
A) Signing advance directives does not remove the client's decision-making authority — they remain in effect only when the client is unable to make decisions. B) A healthcare surrogate can be any trusted individual chosen by the client, not necessarily the oldest child. C) A living will documents treatment wishes; it is a durable power of attorney for healthcare that designates who speaks for the client, not the living will itself.
A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states that they are unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend?
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Pharmacist
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Respiratory therapist
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Social worker
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Child protective services
Explanation
Correct Answer: C) Social worker.
A social worker is the appropriate referral when a client or family faces financial barriers to obtaining necessary medical equipment or medications. Social workers connect families with community resources, financial assistance programs, and insurance options to ensure access to care.
A) A pharmacist manages medication dispensing and counseling but does not address financial barriers to equipment procurement.
B) A respiratory therapist provides education on nebulizer use but cannot address the financial inability to obtain one.
D) Child protective services is not appropriate here — the parent is proactively seeking help, which demonstrates responsible caregiving, not neglect.
A nurse manager is preparing to discuss incident reporting with nursing staff. Which of the following situations should the nurse manager include as a reason to complete an incident report?
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Withholding a client's scheduled medication
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Client concerns regarding meals
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Inability to obtain a client's prescribed medication from pharmacy
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Client refusal of a medication
Explanation
Correct Answer: A) Withholding a client's scheduled medication.
Withholding a scheduled medication without a documented clinical reason or provider order constitutes a medication error and requires completion of an incident report. Incident reports document any event that deviates from standard care and could potentially harm the client.
B) Client concerns about meals are a service or dietary issue, not a patient safety incident requiring a formal report.
C) Inability to obtain medication from pharmacy is a systems/supply issue that should be escalated to the charge nurse or pharmacy, not documented as an incident report.
D) A client's refusal of medication is a legal exercise of autonomy — the nurse documents it in the medical record per protocol, but it does not require an incident report.
A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change-of-shift report?
- The time the client received their last dose of pain medication
- The belief that the client has a difficult relationship with their child
- The steps to follow when providing wound care
- The client's preferred time for bathing
Explanation
Correct Answer: C) The steps to follow when providing wound care.
A change-of-shift report should include clinically relevant, objective information that ensures continuity and safety of care. Wound care instructions are essential clinical information the receiving facility needs to provide consistent, appropriate treatment.
A) The time of the last pain medication dose is relevant for immediate handoff but is more appropriate for a bedside report, not the transfer summary. B) Personal beliefs about the client's family relationships are subjective, unverified, and irrelevant to clinical care — including this would be inappropriate and potentially a confidentiality violation. D) Bathing preferences are a comfort preference that, while noted in care plans, is not priority information for a transfer report.
A nurse is attending an interprofessional team conference for a client who experienced a stroke. For which of the following findings should the team request a prescription for a referral to the occupational therapist?
- The client is experiencing dysarthria.
- The client enjoys helping to prepare meals.
- The client has extreme difficulty swallowing.
- The client has four new medications.
Explanation
Correct Answer: B) The client enjoys helping to prepare meals.
Occupational therapy focuses on helping clients regain the ability to perform activities of daily living (ADLs), including instrumental ADLs such as meal preparation. A client who enjoys and wants to participate in cooking is an ideal candidate for OT to rebuild functional independence in this area.
A) Dysarthria (difficulty speaking) is addressed by a speech-language pathologist, not an occupational therapist. C) Extreme difficulty swallowing (dysphagia) is also managed by a speech-language pathologist. D) Managing multiple new medications falls under the scope of the nurse and pharmacist, not occupational therapy.
A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first?
- Review facility policies for taking scheduled breaks.
- Determine the reasons the nurses are not taking scheduled breaks.
- Discuss time management strategies with the nurses.
- Provide coverage for the nurses' breaks.
Explanation
Correct Answer: B) Determine the reasons the nurses are not taking scheduled breaks.
Before implementing any intervention, the charge nurse must first assess the situation by determining why the nurses are not taking breaks. The cause could be staffing shortages, excessive workload, time management issues, or unit culture — each requiring a different solution. Assessment always precedes intervention.
A) Reviewing policies is a step that may follow once the reason is identified. C) Discussing time management assumes the problem is skill-based without first assessing the cause. D) Providing coverage is a practical solution but should only be implemented after understanding the underlying reason.
A charge nurse is making assignments for a medical-surgical unit. Which of the following clients is appropriate to assign to a licensed practical nurse?
- A client who has emphysema and has an oxygen saturation level of 92%
- A client who is scheduled to start oral nutrition 2 days after a cerebrovascular accident
- A client who has dehydration and is being admitted from the emergency department
- A client who is scheduled to receive 2 units of RBCs following a hip replacement
Explanation
Correct Answer: D) A client who is scheduled to receive 2 units of RBCs following a hip replacement.
An LPN can care for stable clients with predictable conditions. A post-hip replacement client receiving a blood transfusion is considered stable with an anticipated care need, which falls within the LPN's scope of practice in most states, including monitoring during transfusion under RN supervision.
A) A client with emphysema and an O₂ sat of 92% is experiencing respiratory compromise and requires RN-level assessment and intervention. B) A client starting oral nutrition after a cerebrovascular accident requires complex swallowing assessment and neurological monitoring — RN scope. C) A newly admitted client requires a full initial assessment, which is exclusively within the RN's scope of practice.
A nurse is planning discharge for a client following a hip arthroplasty. The client tells the nurse that she lives alone. Which of the following actions should the nurse take first?
- Report the information to the provider.
- Contact the case manager for a consultation.
- Document the client's living situation in the medical record.
- Determine the specific needs of the client.
Explanation
Correct Answer: D) Determine the specific needs of the client.
The nurse must first assess the client's specific needs before planning or coordinating discharge. A client living alone after hip arthroplasty may need assistance with mobility, ADLs, wound care, or medication management — but the nurse must determine exactly what those needs are before making referrals or notifications.
A) Reporting to the provider is appropriate but comes after needs are assessed. B) Contacting the case manager is the next logical step after the assessment is complete. C) Documentation is important but follows assessment and intervention planning.
A nurse is preparing a shift assignment for an assistive personnel (AP) on the unit. Which of the following tasks should the nurse assign to the AP?
- Administer the initial bolus feeding to a client who has an NG tube.
- Collect a urine specimen from a newly admitted client.
- Check a client's pain level 30 min after receiving acetaminophen.
- Instruct a client to splint an abdominal incision.
Explanation
Correct Answer: B) Collect a urine specimen from a newly admitted client.
Collecting a urine specimen is a routine, non-clinical task that does not require clinical judgment and falls within the AP's scope of practice. It is a standard delegable task.
A) Administering an initial bolus tube feeding requires clinical assessment and is within the RN or LPN scope of practice — not appropriate for an AP. C) Checking a client's pain level after medication requires clinical evaluation and judgment to assess the effectiveness of treatment — an RN responsibility. D) Instructing a client to splint an incision is patient education, which is exclusively within the RN's scope of practice.
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