ATL NUR 2820 TTP Exam 1 Version 2
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Free ATL NUR 2820 TTP Exam 1 Version 2 Questions
A nurse is caring for a group of clients with the help of an assistive personnel (AP). Which of the following determinations must the nurse make before delegating a client care task to the AP?
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The AP's ability to prioritize
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The AP's rapport with the client
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Whether the nurse can more efficiently and effectively complete the task without assistance
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Whether the task is within the AP's scope of practice
Explanation
Correct Answer: (D) Whether the task is within the AP's scope of practice
Before delegating any task, the nurse must first confirm that the task falls within the legally and organizationally defined scope of practice for the assistive personnel, as this is a fundamental safety and legal requirement of the delegation process.
Why Other Options are Incorrect:
A. The AP's ability to prioritize – While relevant to task performance, this is not the essential determination the nurse must make before delegating, as delegation still requires the nurse to guide priorities.
B. The AP's rapport with the client – While helpful for care, rapport is not the primary safety consideration required before delegating a task.
C. Whether the nurse can more efficiently and effectively complete the task without assistance – This is not the guiding principle of delegation, since delegation is meant to appropriately distribute workload according to scope of practice, not solely based on efficiency comparisons.
A nurse is assisting with the discharge planning for a client. Which of the following actions should the nurse take? (Select all that apply)
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Obtain printed instructions for medication self-administration
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Discuss the importance of attending follow-up appointments
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Provide the patient with a list of every medication they received during their stay
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Provide the family with a list of community agencies that can provide assistance
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Determine the client's need for home medical equipment
Explanation
These actions are essential components of comprehensive discharge planning, ensuring the client has the necessary medication instructions, understanding of follow-up care, and appropriate home equipment to safely manage their condition after discharge.
Why the other options are incorrect:
C. Provide the patient with a list of every medication they received during their stay – The client needs a list of medications to take at home going forward, not a comprehensive list of every medication administered during the entire hospital stay, which may include many discontinued or one-time medications not relevant to home care.
D. Provide the family with a list of community agencies that can provide assistance – While community resources may be relevant for some clients, this is not a universal action needed for every discharge plan and depends on individual client needs.
A nurse is implementing Lewin's Change Theory to help a patient modify unhealthy behaviors. After successfully unfreezing old habits and moving through the change process, which nursing action best exemplifies the final stage of Lewin's model?
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Assessing the patient's readiness to change before beginning interventions
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Providing continuous support to maintain the new behavior and prevent relapse
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Identifying and challenging the patient's beliefs that sustain unhealthy behavior
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Planning specific strategies and goals to promote the desired behavior change
Explanation
Correct Answer:
(B) Providing continuous support to maintain the new behavior and prevent relapse
The final stage of Lewin's Change Theory is "refreezing," which involves stabilizing the new behavior by providing ongoing support and reinforcement to help the change become a permanent, sustained part of the patient's routine, preventing reversion to old habits.
Why Other Options are Incorrect:
A. Assessing the patient's readiness to change before beginning interventions – This action corresponds to the "unfreezing" stage, which occurs at the beginning of the change process, not the final stage.
C. Identifying and challenging the patient's beliefs that sustain unhealthy behavior – This also relates to the "unfreezing" stage, where old beliefs and habits are addressed before change occurs.
D. Planning specific strategies and goals to promote the desired behavior change – This corresponds to the "moving" or "changing" stage, which occurs during the transition process, not the final stabilization stage.
In anticipation of discharge, a nurse is teaching the daughter of an older adult client how to change the dressing on the client's venous ulcer. Which teaching strategy is most likely to be effective?
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Explain the procedure clearly and slowly while providing multiple opportunities for the daughter to ask questions.
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Use a multimedia strategy that combines animation and narration.
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Demonstrate and explain the procedure and then have the daughter perform it.
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Provide explicit written and verbal instructions and ask the daughter to explain back to the nurse how to perform the procedure.
Explanation
For a psychomotor skill such as a dressing change, the most effective teaching strategy involves demonstration followed by return demonstration, allowing the daughter to actively perform the procedure under supervision, which reinforces learning and verifies competency far more effectively than verbal or written methods alone.
Why the other options are incorrect:
A. Explain the procedure clearly and slowly while providing multiple opportunities for the daughter to ask questions. – While helpful for understanding, verbal explanation alone does not verify the daughter's ability to actually perform the hands-on skill correctly.
B. Use a multimedia strategy that combines animation and narration. – While multimedia can supplement learning, it does not provide the hands-on practice and direct verification of skill competency needed for a psychomotor task.
D. Provide explicit written and verbal instructions and ask the daughter to explain back to the nurse how to perform the procedure. – Verbal teach-back confirms cognitive understanding but does not verify that the daughter can physically and correctly perform the psychomotor skill of the dressing change.
A charge nurse is making the daily assignments for a medical-surgical unit. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?
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Reinforcing central line IV catheter's dressing
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Preoperative admission assessment
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Obtaining vital signs
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Instructing a patient how to use a walker
Explanation
Obtaining routine vital signs is a task within the scope of practice for assistive personnel and does not require the clinical judgment or specialized skill that the other listed tasks demand.
Correct Answer Is:
C
Why the other options are incorrect:
A. Reinforcing central line IV catheter's dressing – This task involves sterile technique and clinical judgment related to an invasive device, requiring a licensed nurse.
B. Preoperative admission assessment – Assessment is a nursing responsibility that requires clinical judgment and cannot be delegated to an AP.
D. Instructing a patient how to use a walker – Patient teaching requires nursing knowledge and judgment and is not within the scope of practice for an AP.
In providing a change-of-shift report to the oncoming nurse, which is the main objective for ensuring effective communication during a patient hand-off?
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Promoting patient safety
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Avoiding lawsuits
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Facilitating quality improvement
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Ensuring documentation is complete
Explanation
The primary objective of effective communication during a patient hand-off is to promote patient safety by ensuring the oncoming nurse has accurate and complete information necessary for continued safe care.
Why the other options are incorrect:
B. Avoiding lawsuits – While clear communication may reduce liability risk, this is a secondary benefit rather than the main objective of the hand-off process.
C. Facilitating quality improvement – Quality improvement may be an indirect outcome, but it is not the primary purpose of a change-of-shift report.
D. Ensuring documentation is complete – While documentation is important, the main goal of the hand-off communication itself is to ensure continuity and safety of patient care, not simply completing documentation.
A client has been recently diagnosed and hospitalized for type 1 diabetes. The multidisciplinary health care team has been preparing her for discharge. What is the primary purpose of discharge planning?
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Supplying ongoing patient education
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Ensuring continuity of care
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Providing accurate medical treatment
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Verifying prescribed medications
Explanation
Correct Answer:
(B) Ensuring continuity of care
The primary purpose of discharge planning is to ensure continuity of care as the client transitions from the hospital setting to home or another care environment, coordinating necessary resources, education, and follow-up to support ongoing management of the condition.
Why Other Options are Incorrect:
A. Supplying ongoing patient education – While education is a component of discharge planning, it is not the overarching primary purpose; it serves the broader goal of continuity of care.
C. Providing accurate medical treatment – Medical treatment occurs throughout hospitalization and is not specifically the primary focus of discharge planning itself.
D. Verifying prescribed medications – Medication verification is one task within discharge planning but is not the primary overall purpose of the process.
A nurse is caring for a group of patients on a medical-surgical unit. Which of the following patients should the nurse attend to first?
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A patient who is receiving metoclopramide and reports diarrhea
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A patient who is receiving erythromycin and reports epigastric pain
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A patient who is receiving cephalexin and reports dyspnea
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A patient who is receiving tamsulosin and reports feeling dizzy
Explanation
Correct Answer:
(C) A patient who is receiving cephalexin and reports dyspnea
Dyspnea in a client receiving an antibiotic such as cephalexin may indicate a serious allergic reaction, including anaphylaxis, which is a life-threatening emergency requiring immediate nursing attention.
Why Other Options are Incorrect:
A. A patient who is receiving metoclopramide and reports diarrhea – Diarrhea can be an expected side effect of metoclopramide and is not immediately life-threatening.
B. A patient who is receiving erythromycin and reports epigastric pain – Epigastric pain is a common, expected side effect of erythromycin and is not an emergent concern compared to respiratory distress.
D. A patient who is receiving tamsulosin and reports feeling dizzy – Dizziness is a known side effect of tamsulosin due to its effect on blood pressure, but it is not as immediately life-threatening as potential respiratory compromise.
A nurse is caring for a group of patients on a medical-surgical unit. Which of the following tasks should the nurse delegate to an assistive personnel (AP)? Select all that apply.
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Measuring oral intake
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Collecting a stool specimen
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Changing a sterile dressing
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Providing instructions about using a spirometer
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Providing postmortem care
Explanation
Correct Answer:
(A, B, E) Measuring oral intake; Collecting a stool specimen; Providing postmortem care
Measuring oral intake, collecting a routine stool specimen, and providing basic postmortem care are all tasks that fall within the scope of practice for assistive personnel, as they do not require nursing judgment, sterile technique, or client teaching.
Why Other Options are Incorrect:
C. Changing a sterile dressing – This task requires sterile technique and clinical judgment, making it inappropriate to delegate to an AP.
D. Providing instructions about using a spirometer – Patient teaching requires nursing knowledge and judgment and cannot be delegated to an AP.
Clinical Scenario: You are the RN caring for Mr. Robert Johnson, a 74-year-old patient admitted three days ago with community-acquired pneumonia and an acute COPD exacerbation. The provider has written discharge orders for today. The charge nurse states, "The emergency department has several patients waiting for beds. We need to discharge Mr. Johnson by noon if he is safe to go home." Mr. Johnson lives alone. His daughter lives two hours away and works full-time.
Patient History: COPD; Hypertension; Type II Diabetes; Osteoarthritis; Former smoker (45 pack-years)
Current Assessment: BP 132/76; HR 88; RR 20; Temperature 98.4°F; SpO2 91% on room air; Pain 2/10; Lung Sounds: Fine crackles at bases, diminished bilaterally; Mobility: Ambulates with walker; Orientation: Alert & Oriented x4
Provider Orders: Discharge home today; Levofloxacin PO; Prednisone taper; Albuterol inhaler; Continue home medications; Follow-up with PCP in one week; Home oxygen evaluation before discharge; Physical therapy evaluation; Medication education; Teach incentive spirometer use
Shift Information: During discharge teaching, Mr. Johnson states, "I don't think I can afford these new medications. I get confused about all these inhalers." "My daughter can't pick me up until tonight." Later, the respiratory therapist reports, "His oxygen saturation dropped to 86% while walking." The LPN assigned to your team says, "I'm really busy with another patient. Can you just finish all the discharge teaching yourself?" Meanwhile, the UAP asks, "Do you still want me to walk Mr. Johnson in the hallway?"
Indicate whether each finding is Expected, Needs Immediate Attention, or Requires Follow-Up.
Finding | Expected | Needs Immediate Attention | Requires Follow-Up
- Uses a walker — Expected
- Confused about inhalers — Requires Follow-Up
- Cannot afford medications — Requires Follow-Up
- Oxygen saturation 86% with ambulation — Expected
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Uses a walker — Expected
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Confused about inhalers — Requires Follow-Up
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Cannot afford medications — Requires Follow-Up
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Oxygen saturation 86% with ambulation — Expected
Explanation
Mr. Johnson's use of a walker is an expected, stable baseline finding given his history of osteoarthritis and does not represent a new concern. His confusion about the new inhaler regimen and his stated financial difficulty affording medications are both important discharge barriers, but they are not immediately life-threatening; they require follow-up through reinforced medication education and a social work/case management referral before or shortly after discharge. In contrast, a significant drop in oxygen saturation to 86% during ambulation represents a safety-threatening hypoxemic event that needs immediate attention, since discharging a client with this degree of desaturation on exertion — especially without a completed home oxygen evaluation — poses an acute risk.
Correct Answer Is:
Uses a walker — Expected; Confused about inhalers — Requires Follow-up; Cannot afford medications — Requires Follow-up; Oxygen saturation 86% with ambulation — Needs Immediate Attention
Why the other options are incorrect:
Classifying "Uses a walker" as needing immediate attention or follow-up would be inaccurate, since it is a stable, longstanding mobility aid consistent with his known osteoarthritis history, not a new or urgent problem.
Classifying "Confused about inhalers" or "Cannot afford medications" as needing immediate attention would overstate the urgency; these are real barriers to safe self-care at home but do not pose an immediate physiological threat, making follow-up (education, resource referral) the appropriate category.
Classifying "Oxygen saturation 86% with ambulation" as expected or only requiring follow-up would be unsafe, since this level of desaturation on exertion is not a normal or low-priority finding for a client being discharged home and must be addressed immediately, particularly since the ordered home oxygen evaluation has not yet been completed.
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