A nurse is teaching client how to use glucometer at home. Which of the following instructions should the nurse include?

Obtain the blood sample from the finger pads

Just before procedure, client asks nurse about risks of procedure. Which of the following actions should the nurse take?

Notify the provider about the client's concerns

Two nurses having loud convo at nurses station about care for a patient. Which of the following actions?

Escort the nurses to the nurses' lounge to continue the discussion

16 y/o has ruptured appendix and requires emergency sx. Accompanied by adult neightbor. What actions should nurse take?

Attempt to notify the client's guardian to obtain consent

A nurse is caring for a group of clients. Which of the following clients should the nurse plan to assess first?

A client who has a nasogastric tube and has crackles in the lungs

The nurse should recognize that which of the following clients is the highest priority?

A client who has PVD and has an absent pedal pulse in the right foot

Which of the following information should the nurse include in the teaching as an example of advocacy?

Recommending a referral for a client who requires physical therapy

The nurse suspects elder abuse. Which of the following actions should the nurse take?

Ask the client's son to go to the waiting area

Which of the following tasks should the nurse plan to delegate to an assistive personnel?

Teaching a client to perform a fingerstick for testing blood glucose levels

Nurse observes AP administer enema. For which of the following actions by the AP should the nurse intervene?

Position the client on her left side with knees flexed

Which of the following tasks is appropriate to assign to a licensed practical nurse?

Administer a nasogastric tube feeding

New nurse floats to unfamiliar unit and does not feel safe to care for clients. Which of the following actions?

Request that the charge nurse modify the assignment

A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive personnel?

Obtaining a stool sample from a client who has renal failure

Which of the following actions indicates the newly licensed nurse is maintaining sterile technique?

Removes outside packaging instrument before dropping it on sterile field, Opens the sterile pack by first unfolding the top flap away from her body

A nurse is prioritizing postpartum care for four clients. Which of the following actions should the nurse take first?

Check uterine tone for a client who received methylergonovine

Which of the following client statements indicates to the nurse an understanding of the pulmonary function test?

I might have to wear a nose clip during this test

Charge nurse discovers staff nurse has made repeated medication errors. Which of the following actions should take 1st

Ask the nurse to describe her medication administration procedure

The client and her partner are asking the nurse about hospice care. Which of the statements by the nurse is appropriate?

Hospice care is multidisciplinary program for clients who are terminally il

Which of the following clients should the nurse evacuate first?

A client who is receiving IV chemotherapy and is ambulatory

Which of the following statements by a staff nurse indicates that the teaching about informed consent was effective?

Consent can be given by a durable power of attorney

Which of the following findings should the nurse identify as increasing the client's risk for falls?

A wheeled office chair at the client's computer desk, A folding chair without arm rests, A throw rug covering some cracked vinyl flooring in the kitchen

A nurse on a medical-surgical unit is caring for four clients. Which of the following findings is the highest priority?

Client who had cardiac catheterization capillary refill in great toe is 4s

Two staff nurses do not take meal breaks. Which of the following actions should the nurse take first?

Determine the reasons the nurses are not taking scheduled breaks

Which of the following resources is the highest priority to have available in response to a bioterrorism event?

A sufficient supply of personal protective equipment

ER charge is supervising nurse floating from med/surg. Which of the following assignments is appropriate for the float?

Perform a urinary catheterization for a client who has experienced CVA

Which of the following is an appropriate task for the AP?

Obtain the weight of a newborn that is receiving formula

For which of the following clients should the nurse collaborate with the facility ethics committee?

An adolescent client whose parents refuse blood transfusion for religious

Nurse observes AP incorrectly transfer client. Which of the following actions should the nurse take first?

Refer the AP to the facility procedure manual

A nurse is planning care for a client who has Addison's disease. Which of the tasks should nurse plan to delegate to AP

Remind the client to change positions slowly

Which of the following clients should the nurse recommend for treatment first?

A client who has two open chest wounds with a left tracheal deviation

Which of the following clients should the nurse recommend to be examined first?

An older adult client who has dyspnea and a respiratory rate of 26/min

Which of the following tasks should the nurse assign to a licensed practical nurse?

Administer a hepatitis B vaccine

Which of the following tasks should the nurse assign to the LPN?

Reinforcing teaching w a client who is learning to selfadminister insulin

After donning sterile gown&gloves, which of the actions by newly licensed nurse demonstrates correct aseptic technique?

The nurse holds her hands above her waist

The nurse should explain that which of the following is an objective of telehealth?

Establishing communication between providers

Which of the following is an appropriate procedure for taking care of aclient's ring?

Place the client's ring in the facility safe

Patient refuses surgery, partner wants surgery. Which is the deciding factor in determining if the surgery will be done?

Whether the client understands the risk of refusing the procedure

A nurse delegates vitals to an AP. Which of the following actions should the nurse take to evaluate the delegated task?

Recheck vital signs that are outside the expected reference range

The client expresses concern about the cost of blood-glucose monitoring supplies. Which of the following actions?

Refer the client to the social services department

Which of the following statements indicates an understanding of the teaching about restraints?

I will remove a client's restraints every 4 hours

Information for discharge teaching about total knee athroplasty should include

Contact information for the physical therapist, Information about follow-up care

Which of the following clients should the nurse assess first?

A client who reports indigestion and pain in her jaw

studbud

ATI nursing leadership

70 termsStudBud Administration16 plays

Imported from external platform

Flashcards70 cardsFPractice quizPHost liveL

Questions 70

Answers

1
A nurse is teaching client how to use glucometer at home. Which of the following instructions should the nurse include?
Cap the lancet prior to putting it in the trash
Elevate the arm for 1 min before taking the blood sample
Warm the hands prior to piercing the skin.
Obtain the blood sample from the finger pads
2
Just before procedure, client asks nurse about risks of procedure. Which of the following actions should the nurse take?
Notify the provider about the client's concerns
Convey the client's request to the nurse who witnessed the consent
Explain the risks of the procedure to the client
Check if medical record indicates provider explained procedure to client
3
Which of the following diseases should the nurse report to the state health department?
Group B streptococcal disease
Rotavirus
Pertussis
Respiratory syncytial virus
4
Two nurses having loud convo at nurses station about care for a patient. Which of the following actions?
Contact the house supervisor to mediate the conflict
Make arrangements to take over the client's care
Escort the nurses to the nurses' lounge to continue the discussion
Recommend that both nurses be terminated
5
16 y/o has ruptured appendix and requires emergency sx. Accompanied by adult neightbor. What actions should nurse take?
Attempt to notify the client's guardian to obtain consent
Ask the adult neighbor to sign the consent form
Witness the client signing the consent form
Obtain consent from the hospital administrator
6
A nurse is caring for a group of clients. Which of the following clients should the nurse plan to assess first?
A client who has congestive heart failure and has lost 2 lb in the 24 hr
A client who has a new diagnosis of Graves' and TSH level of 0.2 mu/mL
A client who has a nasogastric tube and has crackles in the lungs
A client who has diabetes mellitus and reports paresthesia in fingers/toes
7
The nurse should recognize that which of the following clients is the highest priority?
A client who has PVD and has an absent pedal pulse in the right foot
A client who has MRSA and an axillary temperature of 101F
newly diagnosed with pancreatic cancer and is scheduled to begin IV chemo
A client who is postop following a laminectomy 12 hr ago and cannot void
8
Which of the following information should the nurse include in the teaching as an example of advocacy?
Evaluating a client's home for safety hazards
Recommending a referral for a client who requires physical therapy
Suggesting a client's partner attend a support group for emotional support
Completing an incident report following a medication error
9
The nurse suspects elder abuse. Which of the following actions should the nurse take?
Ask the client about his injuries with the son present
File an incident report
Treat and discharge the client
Ask the client's son to go to the waiting area
10
Which of the following tasks should the nurse plan to delegate to an assistive personnel?
Teaching a client to perform a fingerstick for testing blood glucose levels
Performing post mortem care prior to transferring the client to the morgue
Advising a client on self-administration of acetaminophen
Informing a family of a client's progress in physical therapy
11
Nurse observes AP administer enema. For which of the following actions by the AP should the nurse intervene?
Administers the solution at room temperature
Inserts the tubing 8 cm (3.1 in) into the rectum
Position the client on her left side with knees flexed
Points tubing in the direction of the umbilicus during insertion
12
Which of the following tasks is appropriate to assign to a licensed practical nurse?
Determine adequacy of ventilator settings
Administer a nasogastric tube feeding
Pick up the meal trays after lunch
Plan break times for assisstive personnel
13
New nurse floats to unfamiliar unit and does not feel safe to care for clients. Which of the following actions?
Notify the risk manager.
Request that the charge nurse modify the assignment
Document the concern in the nurse's notes
Accept the assignment with help from assistive personnel on the unit
14
A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive personnel?
Assessing a client who just returned from hemodialysis
Monitoring a client who has a fluid restriction
Obtaining a stool sample from a client who has renal failure
Reviewing dietary instructions for a client who has kidney stones
15
A nurse in a long-term care facility should identify that which will provide security for clients who have dementia?
Turning off room lights at night
Setting alarms on exits
Using a facility
Restricting space to reduce pacing
16
Which of the following actions indicates the newly licensed nurse is maintaining sterile technique?
Removes outside packaging instrument before dropping it on sterile field
Places sterile items within 0.5 in) border around edges of sterile field
Prepares container of sterile solution onfield after putting sterile gloves
Opens the sterile pack by first unfolding the top flap away from her body
17
A nurse is prioritizing postpartum care for four clients. Which of the following actions should the nurse take first?
Assist a client who requests help breastfeeding her 4-hr-old newborn
Instruct a client who has an episiotomy about a sitz bath
Administer RH immune globulin to a client who is Rhnegative+6 hr postpartum
Check uterine tone for a client who received methylergonovine
18
Which of the following client statements indicates to the nurse an understanding of the pulmonary function test?
I will be given contrast dye during this test
I might have to wear a nose clip during this test
I will run on a treadmill during this test
I might have a tube inserted into my airway during the test
19
Charge nurse discovers staff nurse has made repeated medication errors. Which of the following actions should take 1st
Identify education opportunities for the nurse regarding safe medication
Review with the nurse the principles of medication administration
Ask the nurse to describe her medication administration procedure
Notify the risk management department of the situation.
20
The client and her partner are asking the nurse about hospice care. Which of the statements by the nurse is appropriate?
Hospice care prolongs the life expectancy of clients who are terminally ill
Hospice care is helpful for clients at various stages of chronic illness
Hospice care is multidisciplinary program for clients who are terminally il
Hospital access is no longer available for clients who are in hospice care
21
Which of the following clients should the nurse evacuate first?
A client 1 day postoperative following thoracic surgery and chest tube
A client who is confused and restrained for safety
A client who is receiving IV chemotherapy and is ambulatory
A client who is in Buck's traction for a left hip fracture
22
Client is receiving too much IV fluid because IV pump is not working. Which of the actions should the nurse take first?
Auscultate the client's lungs
Complete an incident report
Place a faulty equipment tag on the pump
Notify the provider
23
Which of the following statements by a staff nurse indicates that the teaching about informed consent was effective?
The nurse can answer any questions the client has about the procedure
A family member can interpret informed consent from a client who is deaf
Guardian consent is required for an emancipated minor
Consent can be given by a durable power of attorney
24
Which of the following findings should the nurse identify as increasing the client's risk for falls?
A wheeled office chair at the client's computer desk
A folding chair without arm rests
A throw rug covering some cracked vinyl flooring in the kitchen
A two-wheeled walker used to assist the client with ambulation
25
A nurse on a medical-surgical unit is caring for four clients. Which of the following findings is the highest priority?
A client whose TPN was discontinued 4 hr ago and is requesting clear liquid
A client who has COPD and has an oxygen saturation of 90%
Client who had cardiac catheterization capillary refill in great toe is 4s
A client who had a cholecystectomy 6 hr ago and is requesting pain med
26
Two staff nurses do not take meal breaks. Which of the following actions should the nurse take first?
Discuss time management strategies with the nurses
Review facility policies for taking scheduled breaks
Provide coverage for the nurses' breaks
Determine the reasons the nurses are not taking scheduled breaks
27
The nurse should explain that preventing client injury by removing a fall hazard demonstrates which ethical principle?
Autonomy
Utility
Veracity
Nonmaleficence
28
Which of the following resources is the highest priority to have available in response to a bioterrorism event?
A sufficient supply of personal protective equipment
A system for tracking client information
A network for communication between staff members and families
A mental health specialist on the response team
29
Nurse notices client received additional dose of medication. Which of the following actions should the nurse take first?
Observe the client's condition
Notify the provider
Complete an incident report
Inform the nursing supervisor
30
Which of the following findings should indicate the need for referral to an occupational therapist after stroke?
Facial drooping
Memory loss
Receptive aphasia
Unilateral neglect
31
ER charge is supervising nurse floating from med/surg. Which of the following assignments is appropriate for the float?
Set up a trauma room for an incoming client who was in a motorvehicle crash
Administer IV nitroglycerin to a client who is experiencing chest pain
Perform a urinary catheterization for a client who has experienced CVA
Complete a SADPERSONS assessment scale for client who has attempted suicide
32
Which of the following is an appropriate task for the AP?
Show a new mother how to change the newborn's diaper
Answer the parents' questions about newborn circumcision
Obtain the weight of a newborn that is receiving formula
Inspect the skin of a newborn who is receiving phototherapy
33
For which of the following clients should the nurse collaborate with the facility ethics committee?
A young adult client who is participating in a medical research study
An older adult client who has advanced directives on file
An adolescent client whose parents refuse blood transfusion for religious
A middle adult client who leaves the facility against medical advice
34
Nurse observes AP incorrectly transfer client. Which of the following actions should the nurse take first?
Instruct the AP to request assistance when unsure about a task
Demonstrate the proper client transfer technique for the AP
Refer the AP to the facility procedure manual
Help the AP assist the client with the transfer
35
A nurse is planning care for a client who has Addison's disease. Which of the tasks should nurse plan to delegate to AP
Decide how often to measure vital signs
Determine the client's muscle strength prior to ambulation
Remind the client to change positions slowly
Explain to the client about a 24-hr urine specimen collection
36
Which of the following clients should the nurse recommend for treatment first?
A client who has bipolar disorder and is exhibiting signs of hallucination
A client who has a neck injury and is unable to breathe spontaneously
A client who has two open chest wounds with a left tracheal deviation
A client who has major burns over 75% of her body surface area
37
Which of the following clients should the nurse recommend to be examined first?
A toddler who has a 2 cm (0.79 in) head laceration oozing dark red blood
An adolescent client who has an injured ankle and reports a pain level of 8
An adult client who has large ecchymosis on both legs
An older adult client who has dyspnea and a respiratory rate of 26/min
38
Which of the following tasks should the nurse assign to a licensed practical nurse?
Conduct the newborn hearing screening
Obtain vital signs
Perform a New Ballard screening
Administer a hepatitis B vaccine
39
Which of the following tasks should the nurse assign to the LPN?
Reinforcing teaching w a client who is learning to selfadminister insulin
Admitting a new client who has chronic back pain to the unit
Ambulating a client who is scheduled for discharge later in the day
Administering morphine IV bolus to a client who is __ hr postoperative
40
After donning sterile gown&gloves, which of the actions by newly licensed nurse demonstrates correct aseptic technique?
The nurse holds her hands above her waist
The nurse applies goggles
The nurse puts on a face mask
The nurse turns her back to the sterile field
41
The nurse should explain that which of the following is an objective of telehealth?
Providing medication reconciliation
Establishing communication between providers
Developing client treatment protocols
Assessing client needs
42
Which of the following solutions should the nurse recommend to clean the equipment after CDIFF?
Triclosan
Isopropyl alcohol
Chlorhexidine
Chlorine bleach
43
Which of the following is an appropriate procedure for taking care of aclient's ring?
Place the client's ring in the facility safe
Tape the ring securely to the client's finger
Agree to keep the ring for the client until after surgery
Place the ring in the bad with the client's clothing
44
Patient refuses surgery, partner wants surgery. Which is the deciding factor in determining if the surgery will be done?
Whether the partner is client's durable power of attorney for health care
Whether the facility ethics committee reached a consensus on the case
Whether the client understands the risk of refusing the procedure
Whether the client's refusal is based on religious belief
45
A nurse delegates vitals to an AP. Which of the following actions should the nurse take to evaluate the delegated task?
Recheck vital signs that are outside the expected reference range
Ask the AP to write a summary of the delegated tasks during the shift
Compare the vital signs with those taken by another AP on a previous shift
Review vital sign trends at the end of the shift
46
The client expresses concern about the cost of blood-glucose monitoring supplies. Which of the following actions?
Provide the client with a week's worth of supplies from the hospital
Refer the client to the social services department
Recommend the client reuse the testing lancets
Ask the provider about the possibility of less frequent monitoring
47
Which of the following statements indicates an understanding of the teaching about restraints?
A provider can write a prescription for restraints 'as needed'
I should tie the restraints using a square knot
I will remove a client's restraints every 4 hours
I need to tie the restraint to the part of the bed frame that moves
48
Which of the following actions should the nurse preceptor take first to demonstrate appropriate time management?
Determine client care goals
Complete required tasks
Document assessment data
Review the client's new laboratory values
49
Information for discharge teaching about total knee athroplasty should include
Contact information for the physical therapist
Medication guidelines information
Information about follow-up care
Advance directives information
50
Nurse finds pile of newspapers in clients home+explains need to discard for safety+client agrees. What strategy was used
Smoothing
Accommodating
Collaborating
Compromising
51
Which of the following clients should the nurse assess first?
A client who reports feeling lightheaded when stands up from lying position
A client who reports an urge to void but has not urinated
A client who reports indigestion and pain in her jaw
A client who reports a headache with sensitivity to light
52
Results for documenting client education are low. Which of the following strategies should nurse manager implement first
Train LPNs to reinforce teaching w clients using standardized teaching plan
Include documentation of client education as part nurses annual performance
Determine factors that interfere with the documentation of client education
Offer incentives for the staff once the unit's results are back
53
Which of the following should nurse identify as an indication that a referral to an occupation therapist is necessary?
I need some help planning my meals to maintain my weight
I am tired of having pain in my joints all the time
I'm having difficulty climbing the stairs at my house
I will need assistance with bathing
54
Client refuses to provide urine specimen after suspected drug use in a motor-vehicle crash. Appropriate action?
Document the client's refusal in the chart
Tell the client that a catheter will be inserted
Assess the client for urinary retention
Obtain a provider's prescription for a blood alcohol level
55
A charge nurse suspects staff nurse is chemically impaired. Which of the following actions should the charge nurse take?
Collect data about the staff nurse to support further action
Counsel the staff nurse about substance use
Report the staff nurse to the facility ethics committee
Assign clients who are not prescribed narcotics to the staff nurse
56
A charge nurse is receiving change-of-shift report. Which of the following situations should charge nurse address first?
Two staff members have called to say they will be absent
Transport assistance is unavailable to take client to occupational therapy
nurse on the previous shift wrote an incident report about medication error
The emergency department nurse is waiting to give report on a new admission
57
When using SBAR, which of the following information should the nurse include in the background portion of the report?
The client's vital signs
A prescribed consultation
The client's code status
The client's name
58
Which of the following statements by a staff nurse indicates understanding?
Clients who participate in research studies forfeit HIPAA right to privacy
HIPAA prohibits uploading photographs of clients providers to social media
HIPAA allows clients to request a review of their own medical records
HIPAA allows facilityspecific coding of client health care info for privacy
59
Which of the following assessments should the nurse make before delegating care?
Has the AP checked the client's pain level prior to turning her?
Does AP have time to change clients central IV line dressing after turning?
Is client's family present so the AP can show them how to turn the client?
Has data been collected about specific client needs related to turning?
60
Nurse administers opioid+benzodiazepine, client becomes somnolent and difficult to arouse. What action should nurse take
Continue the medication dosages that relieve the client's pain
Administer the benzodiazepine but withhold the opioid
Withhold the benzodiazepine but continue the opioid
Contact the provider about replacing the opioid with an NSAID
61
The nurse should explain that advance directives include which of the following?
A form with directions for contacting next of kin
Instructions regarding treatments the client desires or does not desire
Information regarding organ donation
Information regarding the disposition of the client's body upon death
62
Which of the following can be delegated to an assistive personnel for an elderly pt waiting surgery for fractures hip?
Checking the pulses of the client's right foot
Determining the client's pain level
Turning the client
Recording the client's vital signs
63
Which of the following infections should the nurse include when discussing illnesses requiring droplet precautions?
Mumps
Rubeola
Varicella
Rotavirus
64
The client arrives to ED disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take?
Notify risk management before initiating treatment
Proceed with treatment without obtaining written consent
Contact the client's next of kin to obtain consent for treatment
Have the client sign a consent for treatment
65
Which of the following statements by the client indicates an understanding of the teaching anout TB?
I need to have a TB skin test done once per year
I should wear a mask while around my family
I should have a sputum culture done every 2 to 4 weeks
I need to take my prescribed medication for 3 months
66
Which of the following infections should the nurse report to the state health department?
Pediculosis capitis
Chlamydia trachomatis
Candida albicans
Impetigo contagiosa
67
Progress report falsey idenitifies client as HIV+ due to multiple sex partners. Nurse manager should identify
Battery
Slander
Negligence
Libel
68
Client is unconscious and finds son reading EMR from bedside. Which of the following actions should the nurse take first
Report possible violation of client confidentiality to the nurse manager
Complete incident report regarding breach of the client's confidentiality
Recommend son meet with provider to get info about his mother's condition
Logout computer so the client's son cannot view his mother's information
69
When client's partner asks how respite service can help, which of the following responses by the nurse is appropriate?
This service delivers meals and supplies to reduce errands away from home
The clinicians help reduce the severity of your wife's physical problems
It makes it possible for you to have time away from caring for your wife
Service offers psychological interventions during+after your wife's illness
70
Which of the following statements by a nurse indicates an understanding of the role of a client advocate?
I will adhere to the provider's prescribed treatments
Empower the clients to make informed healthcare decisions
I will suggest the best course of action for clients who are indecisive
I should take responsibility for coordinating clients care

ATI nursing leadership Flashcards | StudBud