ATI Leadership Proctored Study Guide

An occupational therapist should be recommended for a client with osteoarthritis having difficulty buttoning their clothes.

Effective communication example: "Check the urinary output at 11:00 for John Doe and report it to me immediately."

An interpreter should be included in preoperative teaching for a client scheduled for a total knee arthroplasty who speaks a different language than the nurse.

For home health nurse who is planning her daily visits and receives laboratory results for four adult clients, the nurse should first visit the client who has platelets 100,000/mm³.

When considering the creation of a policy that will allow nurses to insert peripherally inserted central catheters in the intensive care unit, the State Nurse Practice Act should be consulted.

Inform assistive personnel of client's weight-bearing status after hip arthroplasty.

To ensure a newly hired assistive personnel is qualified to remove a client's indwelling urinary catheter, the skill competency checklist should be reviewed.

If a client recovering from a stroke declines an recommended extracranial-intracranial bypass, discuss the client's concerns about having the surgery.

Staff members looking at electronic medical records for a celebrity client on another unit should be reminded that this is a breach of confidentiality.

If a nurse manager identifies an increase in ventilator-associated pneumonia after auditing client charts, notify the quality improvement team.

To delegate tasks to an assistive personnel, the nurse should delegate determining a client's intake and output

For hospice care of a client who does not have advance directives, provide the client with information about advance directives.

When staff members verbalize displeasure with changes to accommodate new bariatric services, the charge nurse should role model a positive approach to the changes and redirect the conversation when staff members make negative comments about the changes.

Among four clients on a medical-surgical unit, the priority is a client who has peripheral vascular disease and has an absent pulse in the right foot.

If a client with Crohn's disease wants to skip a dose of medication, inform the client of the consequences of refusing the medication.

A charge nurse observing a newly licensed nurse caring for a client who has pulmonary tuberculosis should expect the nurse to wear an N95 respirator mask when in the client's room.

A newly licensed nurse understands client rights when stating, "Clients on a mental health unit can refuse their medication".

Following a train derailment resulting in multiple clients experiencing life-threatening injuries, the charge nurse on the PACU should identify stable clients for transfer to a surgical unit.

An LPN can provide an enteral feeding to a client who has Crohn's disease.

Needing assessment first after being reported from assistive personnel is "The client who had an indwelling urinary catheter removed 8 hr ago reports an inability to void.”

After a client is transferred from another department on a medical-surgical unit, verify that the client has given informed consent prior to receiving moderate sedation.

To address an increase in urinary tract infections on the unit, the nurse manager should first perform a chart review to gather data about the clients who developed infections.

To address poor attendance at monthly staff meetings, the charge nurse should first explore the reasons that staff are not attending the meetings.

Include advising the client to install grab bars in the bathroom at home in discharge plan for client who had a stroke and now has left-sided weakness.

When a client on a general surgical unit tells a nurse that staff members are not answering the call light promptly and requests to be transferred to another unit, ask the client to verbalize their expectations.

Fulfilling a promise to return with pain medication within 15 minutes demonstrates fidelity.

The charge nurse should respond to a staff nurse thinking a client is seeking drugs: "Clients are the experts on their own pain."

Assign a client who had a right above-the-knee amputation 24 hours ago to a medical nurse from a medical unit with no orthopedic experience asked to work on an orthopedic unit.

When a 19-year-old client who has just been informed that their cancer has metastasized says they do not want to continue chemotherapy, say "I will gather information about palliative care for you."

Anticipate referring the guardian of a newborn who requires apnea monitoring at home to Home Health.

A newly licensed nurse indicates effective use of time-management skills by grouping tasks that are in the same location.

A nurse demonstrates sterile technique when performing a sterile dressing change by placing the sterile package with the top flap opening away from the body.

When a hospitalized client with expressive aphasia's family reports that the nurse failed to obtain written informed consent before inserting an indwelling urinary catheter, respond "This is a procedure that does not require written informed consent."

When caring for a client who has a terminal illness and voices concern about performing self-care after discharge, say "Your case manager will coordinate the resources you will need."

Evaluate the cost effectiveness of a client's clinical pathway upon discharge following hip arthroplasty by using the length of the client's stay.

The charge nurse needs to intervene when a nurse is photocopying their assigned client's diagnostic test results.

When preparing to observe a newly licensed nurse perform a routine abdominal assessment, expect them to place the client in a dorsal recumbent position for the examination.

A nurse manager planning an in-service for a group of nurses about caring for clients following stem cell transplants should include wearing an N95 respirator mask while caring for these clients.

When caring for a client who is 3 days postoperative following open-heart surgery and will be transferred to the medical-surgical unit, include the client's level of consciousness in the verbal report.

When performing a sterile dressing change on a client who has a central venous catheter, pick up the first sterile glove by grasping the folded cuff edge.

Staff understands confidentiality requirements by commenting "Access to client information is limited to direct care providers.”

Following an earthquake, prioritize a client who has a sucking chest wound for evaluation in the emergency department.

During an orientation class for new clients and their families at a long-term care facility, address:

• The right to be treated with respect and dignity
• The right to full access of the facility
• The right to leave regardless of provider recommendations
• The right to be fully informed of their health conditions

The priority assessment for a client who reports vomiting and diarrhea for the past 6 hours is obtaining the client's serum potassium level.

When there’s a fire, assist clients who are in immediate danger to a safe location.

An ethics committee will assist in weighing the options involved in the decision for disagreement about adult children continuing nutritional support a terminally ill client.

After developing the initial plan for client discharge, determine goals and objectives.

An authoritarian approach to managing an increased rate of client medication errors is informing the staff of the penalties that can result from medication errors.

The priority finding for a school-age child whose family is homeless is that the child has several small bruises on both legs.

If a client has a living will that declines the use of artificial enteral nutrition as a life-sustaining measure, but the client's family has requested that the staff begin tube feedings, review the client's request with the family.

For a client who is 3 days postoperative following an open reduction and internal fixation of the right hip, the priority for discussion at the conference is physical therapy sessions are refused.

If a client who is postoperative and will require a wheelchair in the home, place a referral to social services.

With four clients the priority assessment is a client who has a femur fracture and is reporting feeling short of breath.

To evaluate the effectiveness of a plan to decrease the rate of pressure injuries in a long-term care facility, compare data from clients' records regarding skin integrity with established criteria.

If a client is considering having a tubal ligation and reports being uncertain about if it is the right thing to do, provide information about alternate birth control methods.

The charge nurse should approach conflict by exploring alternative solutions to address unit workflow with the nurses if two nurses on a unit each contend that the other is not doing a fair share of work resulting in conflict affecting the functioning of the unit.

Frequent restroom use is a behavior that indicates that the staff nurse might be working while impaired.

To verify that a client gave informed consent for outpatient surgery, the nurse should ask the client to explain the procedure that is being performed.

When an assistive personnel tells a charge nurse that it is unfair that they have to take care of all the clients who are incontinent, the nurse should say "I delegate tasks to personnel based on their job descriptions.”

During an in-service about client rights for a group of nurses, include that a nurse can disclose information to a family member with the client's permission.

If a nurse manager observes an assistive personnel incorrectly transferring a client to the bedside commode, the nurse should first help the AP assist the client with the transfer.

If a client states he does not understand the procedure when a nurse enters a client's room to witness an informed consent for a gastroscopy, inform the provider that the client requires clarification about the procedure.

If a client is postoperative and will require a wheelchair in the home, place a referral to social services.

When preparing a teaching session with a client who speaks a different language than the nurse, provide an interpreter when obtaining consent from the client.

When observing a newly licensed nurse use aseptic technique when irrigating a client's open abdominal wound, intervene when they open irrigation supplies before removing the soiled dressing.

If the client is at end-stage heart failure and their partner tells the nurse she can no longer handle the client, contact the case manager to discuss discharge options.

In emergency department triage, prioritize a client who has soot markings around each naris following a house fire.

When resolving a conflict between staff members regarding potential changes in policy, a nurse manager's decision to implement the changes she refers regardless of the feelings of those who oppose those changes is competing.

If a client is unconscious following a motor-vehicle crash and requires immediate surgery, transport the client to the operating room without verifying informed consent.

A client who is at 35 weeks of gestation and has a biophysical profile of 6 should be recommended for an interdisciplinary care conference.

When receiving a verbal prescription from the provider for a client who is having increased pain, transcribe "Morphine sulfate 10 mg IV q 4 hr IV prn for pain" in the client's medical record.

Immediately report a decreased level of consciousness for a client who has meningitis.

When in a train crash emergency, tag a client who has an asymmetrical thorax as emergent.

An ethical dilemma example that a nurse manager should include in a discussion with an ethical dilemma is a parent wants her 14-year-old adolescent to receive radiation treatment against his will

If a client has dysphagia ensure the assistive personnel instruct the client to place her chin toward her chest when swallowing.

Distracting the client and quickly administers the injection when a client reports acute pain but refuses IM medication is an example of battery.

A newly licensed nurse understands client confidentiality by saying, “I should encrypt personal health information when sending emails.”

Inadequate food supply or Low pain tolerance issues should be addressed first for planning discharge following coronary artery bypass grafting surgery.

When observing that an assistive personnel has applied wrist restraints to a client who is agitated and does not have a prescription for restraints, remove the restraints from the client's wrists.

A licensed practical nurse can be delegated to provide to a client who is scheduled for an endoscopy later today and requires an enema

When a newly licensed nurse is having trouble focusing and has difficulty completing care for his assigned clients, recommend that he take time to plan at the beginning of his shift.

If a client wanders through the halls yelling obscenities at staff, other clients, and visitors, contact a family member to come and sit with the client

A health care proxy can make decisions for you when you are unable to do so.

Correct use of precautions is indicated when the AP is bundling the client side of linen inward when changing the sheets for a client who has an infected surgical wound.

When teaching a newly licensed nurse about delegating tasks to assistive personnel, say “If you are unsure about an AP's ability, observe them performing the task.”

Prepare to administer antibiotics to the client exposed to cutaneous anthrax.

Include “The client is in the radiology department for a chest x-ray" in a change-of-shift report for an oncoming nurse.

Notify the provider about the delayed oxygen tank delivery, when preparing to discharge a client who requires home oxygen, but the equipment company has not yet delivered the oxygen tank.

A client statement indicating the potential need for a referral to an occupational therapist post-op a left leg below the knee amputation is “I am worried about taking care of my toddler at home"

If a client with cancer's adult child asks the nurse for information about the client's treatment plan, say "I cannot provide this information to you without your mother's consent.”

A sufficient supply of personal protective equipment is priority to have available in response to a bioterrorism event.

The nurse manager should address three staff members having called to say they will be absent first.

The newly licensed nurse demonstrates understanding of droplet precautions by saying, “I will wear a surgical mask within 3 feet of the client."

When a nurse enters the hallway and discovers a visitor looking at a client's medical information on a computer, first close the documentation program on the computer.

Ensuring safe care, a licensed practical nurse should places food on the stronger side of the client's mouth.

The client setting the water heater set to 49 degrees Celsius/120 degrees Fahrenheit indicates an understanding of home safety for older adults.

For an assistive personnel failing to follow facility protocol when discarding contaminated linens, discuss the issue.

Assign the AP to obtain vital signs from a client who has a blood pressure of 110/68 mm Hg to delegate tasks to an assistive personnel after receiving change-of-shift report.

If a client in a long-term care facility reports the assistive personnel repositioned him in bed using excessive force, contact the nurse manager

Instruct the AP to discontinue the conversation if a nurse overhears them discussing a client's care in the cafeteria.

You have the client sign the Against Medical Advice form if they have type 1 diabetes that they have decided to go home.

The nurse should report Pertussis to the state health department.

Before delegating bathing and turning of a newly admitted client who has end-stage bone cancer to an experienced assistive personnel, asses if data has been collected about specific client needs related to turning.

When a hospice client becomes somnolent and difficult to arouse after the nurse administers the prescribed opioid and benzodiazepine, the nurse should continue the medication dosages that relieve the client's pain or Withhold the benzodiazepine but continue the opioid

Report the infection to the local health department for a new diagnosis of chlamydia

Firstly assess a client who has Alzheimer's disease and bacterial pneumonia with newly onset restlessness with 4 clients .

Assessing client needs is an objective of telehealth.

When a client is unconscious and their partner wishes to discontinue the client's feeding tube,.but another family member tells the nurse that they want the client to continue receiving treatment, say, “As the health care surrogate, the client's partner can make this decision."

Using clean gloves rather than sterile gloves for colostomy care is appropriate to include in a cost-containment plan.

Identify clients who are at risk for falls as the first part of the quality improvement process after assessing an increase in client falls.

Document an objective description of the situation when the nurse manager observes a licensed practical nurse who has a strong odor of alcohol on their breath.

When preparing to complete an incident report regarding a medication error:

• Include the time the medication error occurred in the report
• Identity the medication name and dosage administered to the client in the report

Log out so the AP can log in to document the vital signs if the assistive personnel asks to chart a client's vital signs while you are charged on the electronic record for the assigned client.

“I understand, and it's not too late to change your mind" is appropriate when preparing a client for surgery and they say they reconsidered because she if worried.

With full thickness burns on 72% of his body, triage is black.

Benchmarking.is used when medicine error rates are compared to medicine error rates in other hospitals.

To reduce falls institute rounds every 2 hr during the day to offer toileting

Respect the clients decision if they are alert and oriented if they say no to surgery.

Elder abuse: the nurse should ask the sons to wait in the waiting room and speak to the patient alone.

Priority: peripherial vascular decease-absent pulse Proceed without the consent

Which task: reinforcing dietary needs for someone with heart disese

Include parent wont let teen make the correct decision and let them have radiation.

Evidence based journal for Tay-Sachs

Time of last med of pain and wound care

Store in the faculty safe

Program to help the pump

Develop learning

What skills to teaching?

Identify resources available

Reciew evaluations for the program

Provide a social worker for new dx toddlers to do discharge plan

Must wear a mask

Assign to people who already know surgical

Highest priority: showder pain and shortness of breath and bleeding

Ask the therapist for the assistance

Surgical if within3ft

Chin downward when feeding

The team is: metal/nut/occ

Confidential includes: dialysis care to house keeping

Client and the lv fluids with hypo

Find out how and why they are not on break

Provide the oral hygiene for ng tub patient

Care giver patient needs assistance: talk tot therapist

Name in black round

Change the protocol when the low fiber diet to patient

When rating monitoring

See language when impaired

Why the ape are afraid

The conousiness

Stable for disaster

Need assistance for medical

Close the Windows

Healing of the wounds

Talks to the doctors

Help the fall program

Remove the client

Twice to wash.

Confused is first

Formulate a question

Help the nurses by

Native language if the patient is a foringner

POA is part of your directive

Documenting a refuse

Translate for patients

Waiting to make report to nurses

Right now

Assistance

Urin out put

Complete menu

Vital sign

Crohns for medical info

Noityd doctors

Steriled hand always helps

Consent is the gesture you make

Blood for teen

Critical pay for patient

They know critical pathways

Needs fresh oxygen

7 yr HX with MDI and suicide

Nurse manager

Benchmark the infection

Gonorrhea

PT

Patient has all the right to the treatment

Make sure the air born staff are not carrying the disease

Client does not have comfort to hold it in

The neck

Lung

Bath

A chest tubs is a form to help the tubs

4 every 24

Frame of the bed

Patient has terminal but help there hospice family.

Give to partner

Provider

Nose clip on

Fall from contension

Concussion

Know hippa

Change

Contention

Hba1c

Path

Help know the risks the patient has given

Elevated

Talk to childs patient

Docs name

Sig

Ask people to take to lounge

Specially and specifically

Ask if you are a volunteer nurse please help our

You have to do what must be done

Living will do

Medicals if all for their chart

Complications if you don’t follow

Meet at a good time

Put the incident

Deny pt

Follow veracity

Dressing.

For occupational therapist: needs help getting dressed

Help them spit

Overdose is not healthy

If patient don’t understand refuse the plan

Medic review is always very important

Patient lacks funds you send patients to social worker

Is that they don’t know so not on movement

Always know the medicine

Need help now.

It did hurt you and tell them it don’t hurt I understand there pain.

Know national rates for each individual.

Comparing and controlling

Patient confused

Assistance

Client has to have choice of living or not.

Air flow-patient has

Don’t leave at risk

You need to make sure your gowns are working

Lung levels

Need the help

Partner

Always

Respite

Hospice

Social

Scheduled for that same day

Can you come In