ATI RN Leadership 2023
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Free ATI RN Leadership 2023 Questions
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.
1015: Nurse manager notified of incident. Inflammation visible on employee's right hand and forearm. Employee states, "My skin is burning."
Select 3 actions the nurse manager should identify as the priority:
- Facilitate medical treatment of the exposure.
- Identify the chemical involved.
- Review with staff on where to obtain information about chemicals used in the workplace.
- Consult the material safety data sheet.
- Encourage use of personal protective equipment when handling chemicals.
- Provide training related to safe handling of chemicals.
Explanation
Correct Answer: A) Facilitate medical treatment of the exposure, B) Identify the chemical involved, and D) Consult the material safety data sheet.
Facilitating medical treatment is the most urgent action because the employee is showing active signs of a chemical burn — visible inflammation and a burning sensation. Prompt treatment can limit tissue damage and prevent further complications.
Identifying the chemical involved is essential because the appropriate medical treatment, decontamination procedure, and antidote (if any) depend entirely on which specific cleaning agent caused the exposure. Without this information, treatment may be delayed or inappropriate.
Consulting the material safety data sheet (MSDS/SDS) provides critical information about the chemical's toxicity, first aid measures, required PPE, and handling precautions. This directly informs both the medical team treating the employee and the nurse manager managing the incident.
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Suspected child neglect
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A client who has a Clostridioides difficile infection
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Suspected elder abuse
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A client who has a tuberculosis infection
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A client who has an HIV infection
Explanation
Suspected child neglect and suspected elder abuse are both situations involving vulnerable populations that require mandatory reporting to protective services to ensure their safety, while tuberculosis is a reportable communicable disease that must be reported to public health authorities to help control and prevent its spread.
Why the other options are incorrect:
B. Clostridioides difficile infection, while requiring infection control precautions, is not typically a nationally mandated reportable condition to public health authorities in the same way as tuberculosis.
E. HIV infection reporting requirements vary, but routine HIV infection alone is generally protected under stricter confidentiality regulations and is not categorized alongside the other mandatory reporting situations described in this scenario.
A nurse is caring for a client who received pain medication 1 hr ago and reports pain as 8 on a scale of 0 to 10. Which of the following actions should the nurse take first?
- Ask the client what has helped relieve their pain in the past.
- Obtain a prescription for additional pain medication.
- Document the finding in the client's medical record.
- Re-evaluate the client's pain status in 1 hr.
Explanation
Correct Answer: A) Ask the client what has helped relieve their pain in the past.
When a client continues to report severe pain (8/10) after medication, the nurse should first perform a thorough pain assessment, which includes asking what has previously helped. This follows the nursing process — assess before intervening — and may reveal non-pharmacological comfort measures that can provide immediate relief while further pharmacological options are explored.
B) Obtaining a new prescription is premature without first completing a full pain assessment and exploring all available options. C) Documentation is important but is never the first clinical action. D) Re-evaluating in 1 hour is inappropriate when the client is reporting an 8/10 pain level — this requires immediate action, not delayed reassessment.
A charge nurse overhears a staff nurse discussing a client's diagnosis in the cafeteria. Which of the following responses should the charge nurse make?
- "Please stop discussing the client in a public area."
- "Do you understand the HIPAA regulations?"
- "We should discuss your concerns with the client's care team."
- "I will need to notify the client's provider about this breach of confidentiality."
Explanation
Correct Answer: A) "Please stop discussing the client in a public area."
The immediate priority is to stop the confidentiality breach as it is actively occurring. Directly and professionally asking the nurse to stop discussing the client in a public area is the most appropriate first response — it addresses the behavior in real time and prevents further disclosure.
B) Questioning whether the nurse understands HIPAA is confrontational and does not immediately stop the breach. C) Discussing concerns with the care team is irrelevant to this situation — there is no care team concern, this is a confidentiality violation. D) Notifying the provider is not necessary or appropriate — this is a staff conduct issue managed by the charge nurse and nurse manager, not the client's provider.
A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?
- Proceed with treatment without obtaining written consent.
- Notify risk management before initiating treatment.
- Have the client sign a consent for treatment.
- Contact the client's next of kin to obtain consent for treatment.
Explanation
Correct Answer: A) Proceed with treatment without obtaining written consent.
When a client is disoriented and unable to provide informed consent, and faces a life-threatening emergency such as a cardiac arrhythmia, implied consent applies. The law assumes that a reasonable person would consent to emergency treatment. Delaying care to obtain consent could result in serious harm or death.
B) Notifying risk management is not required before initiating emergency treatment — doing so would cause dangerous delays. C) A disoriented client lacks the capacity to provide valid informed consent. D) Contacting next of kin is appropriate when time permits in non-immediate situations, but in an acute emergency, treatment must begin immediately without waiting for surrogate consent.
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Compare practices with exemplary organizations.
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Assess the results of client care.
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Evaluate nursing care processes.
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Conduct a smaller version of a proposed study.
Explanation
Benchmarking involves comparing an organization's current practices and performance against those of recognized best-practice or exemplary organizations to identify strategies for improvement, making this the defining action of a benchmark study.
Why the other options are incorrect:
B. Assessing the results of client care describes an outcome audit, which evaluates internal outcomes rather than comparing practices to an external standard.
C. Evaluating nursing care processes describes a process audit, which focuses on internal care delivery methods rather than external comparison.
D. Conducting a smaller version of a proposed study describes a pilot study, which is used to test feasibility before a larger-scale implementation, not a benchmark study.
A nurse manager is planning an in-service for a group of nurses on torts in health care. Which of the following scenarios should the nurse include as an example of battery?
- Failing to put up side rails on the bed of a client who is confused
- Telling a client they have to receive an injection if they will not take oral medication
- Threatening to apply wrist restraints to control a client who is agitated
- Inserting a feeding tube against the wishes of a client who refuses to eat
Explanation
Correct Answer: D) Inserting a feeding tube against the wishes of a client who refuses to eat.
Battery is defined as the intentional, unauthorized, harmful or offensive touching of another person without their consent. Inserting a feeding tube against a client's expressed refusal constitutes battery — an actual physical act performed without consent.
A) Failing to put up side rails on a confused client is an example of negligence — a failure to act within the standard of care.
B) Telling a client they must receive an injection is an example of coercion, which may relate to assault (creating fear of unwanted contact) but is not battery as no physical act has occurred.
C) Threatening to apply restraints without following through is an example of assault — the threat of unwanted contact — not battery.
A nurse is caring for a client who has a terminal illness. The client tells the nurse that they want their sibling to make their health care decisions when they are unable to. Which of the following documents should the nurse discuss with the client?
- Do-not-resuscitate (DNR) prescription
- Informed consent
- Living will
- Durable power of attorney
Explanation
Correct Answer: D) Durable power of attorney.
A durable power of attorney for healthcare (also called a healthcare proxy) is a legal document that designates a specific person — in this case, the sibling — to make medical decisions on the client's behalf when they are unable to do so. This directly addresses the client's expressed wish.
A) A DNR is a provider order that addresses resuscitation preferences, not decision-making authority. B) Informed consent is a process for agreeing to a specific treatment, not a document for designating a decision-maker. C) A living will documents the client's own treatment preferences but does not designate another person to make decisions.
A nurse is caring for a client who is receiving medication via an infusion pump. The nurse notices the pump did not infuse the medication over the programmed amount of time. Which of the following actions should the nurse implement?
- Closely monitor the pump during next medication administration.
- Report pump malfunction to Clinical Engineering.
- Return infusion pump to the equipment storage room.
- Document incident report in the client's electronic medical record.
Explanation
Correct Answer: B) Report pump malfunction to Clinical Engineering.
When medical equipment malfunctions, it must be immediately removed from service and reported to Clinical Engineering (biomedical engineering) for inspection, repair, and documentation. This protects the current client and prevents harm to future patients.
A) Continuing to monitor a malfunctioning pump without removing it from service puts the client at ongoing risk. C) Returning it to the storage room without reporting the malfunction endangers other clients who may use the same equipment. D) Incident reports are documented separately from the client's medical record — they should never be noted in the electronic medical record as this creates legal complications.
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