lOMoARcPSD| 19431042
ATI Leadership Level 3
1) A nurse is caring for a client who has a tumor. The provider recommends surgery. The client refuses, but the
client's partner wants the surgery performed. Which of the following is the deciding factor in determining if the surgery
will be done?
Whether the client understands the risk of refusing the procedure
Whether the partner is the client's durable power of a orney for health care
Whether the client's refusal is based on a religious belief
Whether the facility ethics commi ee reaches a census on the case
2) A nurse is caring for a client who has a new diagnosis of chlamydia. Which of the following ac ons should the
nurse take?
Report the infec on to the local health department
Ini ate contact precau ons
Instruct the client to use condoms un l the treatment is complete
Apply an an viral cream to the lesions
3) A nurse is caring for a client who has cancer. The client's adult child asks the nurse for informa on about the
client's treatment plan. Which of the following responses should the nurse make?
"I will ask your mother's primary care provider to speak with you."
"What would you like to know about your mother's treatment?"
"You will have to speak directly to your mother about her treatment."
"I cannot provide this informa on to you without your mother's consent."
4) A nurse is assessing an older adult client who was brought to the emergency department by his adult son, who
reports that the client fell at home. The nurse suspect's elder abuse. Which of the following ac ons should the nurse
take? Ask the client's son to go to the wai ng area
File an incident report
Treat and discharge the client
Ask the client about his injuries with the son present
5) A nurse is conduc ng a disaster preparedness drill with a group of nurses who are orien ng to the facility. Which of
the following triage tag colors should the nurse instruct the group to apply to a client who has full thickness burns on
72% of his body? Green
Yellow
Black
Red
6) A nurse on a medica-surgical unit is caring for a client who asks about advance direc ves and states that he wants to
appoint a health care proxy. Which of the following responses should the nurse make?
“You must choose a member of your family to serve as your health care proxy”
“A health care proxy can make decisions for you when you are unable to do so”
“You should appoint a health care proxy before undergoing an invasive procedure”
“It is necessary for an a orney to approve your health care proxy”
7) A hospice nurse is caring for a client who has terminal illness and reports severe pain. A er the nurse administers the
prescribed opioid and benzodiazepine, the client becomes somnolent and di cult to arouse. Which of the following
ac ons should the nurse take?
Con nue the medica on dosages that relieve the client’s pain
Contact the provider about replacing the opioid with an NSAID
Administer the benzodiazepine but withhold the opioid
Withhold the benzodiazepine but con nue the opioid
8) A nurse is orienta ng a newly license nurse about client con den ality. Which of the following statements by the
newly licensed nurse indicates an understanding of the teaching?
“I should encrypt personal health informa on when sending emails”
“I can use another nurse’s password as long as I log o a er using the computer”
, lOMoARcPSD| 19431042
“I should discard personal health informa on documents in the trash before leaving the unit
“I can post the client’s vitals sings in the client’s room”
9) A nurse is delega ng care for a group of clients. Which of the following clients should the nurse assign to the LPN?
A client who is scheduled for an endoscopy later today and requires an enema
A newly admi ed client who has sickle cell anemia and requires the development of an ini al plan of care
A client who had a myocardial infarc on and will be transferring to the unit from the CCU
A newly admi ed client who has diabetes mellitus and requires ini al teaching on self-administra on of insulin 10)
A nurse on a med-surge unit is caring for four clients. The nurse should recognize that which of the following clients is the
priority?
A client who is postopera ve following a laminectomy 12 hour and is unable to void
A client who is scheduled for a tubal liga on in 2 hours and is crying
A client who has peripheral vascular disease and has an absent pulse in the right foot
A client who has type 1 diabetes and needs the rst dressing change for an ulcer
A client who has MRSA and has an axillary temperature of 100.4F nurse manager
is planning to assign care for four clients on a medical surgical unit. Which of the
following clients should the nurse assign to a LPN
a. An older adult who has lung cancer and has periodic episodes of severe dyspnea
b. A middle adult client who has a below the knee amputa on and requires a dressing change
c. A young adult client who is postopera ve, receiving morphine via epidural, and reports pruritus
d. An adolescent who requires teaching regarding insulin administra on nurse manager is planning to assign
care for four clients on a medical surgical unit. Which of the following clients should the nurse assign to a
LPN
a. An older adult who has lung cancer and has periodic episodes of severe dyspnea
b. A middle adult client who has a below the knee amputa on and requires a dressing change
c. A young adult client who is postopera ve, receiving morphine via epidural, and reports pruritus
d. An adolescent who requires teaching regarding insulin administra on
A nurse manager is planning to assign care for four clients on a medical surgical unit. Which
of the following clients should the nurse assign to a LPN
a. An older adult who has lung cancer and has periodic episodes of severe dyspnea
b. A middle adult client who has a below the knee amputa on and requires a dressing change
c. A young adult client who is postopera ve, receiving morphine via epidural, and reports pruritus
d. An adolescent who requires teaching regarding insulin administra on
11) A nurse manager observes assis ve personnel (AP) incorrectly transferring a client to the bedside commode.
Which of the following ac ons should the nurse take rst?
Help the AP assist the client with the transfer
Demonstrate the proper client transfer technique to the AP
Instruct the AP to request assistance when unsure about a task
Refer the AP to the facility procedure manual
12) A nurse in the emergency department admits a client who has been exposed to cutaneous anthrax. Which of
the following ac ons should the nurse take?
Prepare to administer an bio cs to the client
Wear an N95 respirator makes while caring for the client
Plan to administer an an viral media on to the client
Place a surgical mask on the client during transfer to the unit
13) A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner
wishes to discon nue the client’s feeding tube, but another family member tells the nurse that they want the client to
con nue receiving treatment. Which of the following responses should the nurse make?
“You should contact the provider about your wishes for your family member”
“You should speak with the facility’s ethics commi ee about your concerns
“We’ll need to have the nursing supervisor review the client’s advance direc ves”
, lOMoARcPSD| 19431042
“As the health care surrogate, the client’s partner can make this decision
14) A nurse is preparing to discharge a client who has end- stage heart failure. the client's partner tells the nurse she
can no longer handle caring for the client. which of the following ac ons should the nurse take?
Ask the provider to delay the client's discharge home for a few more days.
Recommend the partner place the client in a long- term care facility.
Contact the case manager to discuss discharge op ons.
Request another family member assist the client's partner with care.
15) A nurse is providing change-of-shi report for an oncoming nurse. Which of the following informa on should the
nurse include in the report?
“The client is in radiology department for a chest x-ray”
“The client’s partner came to visit him 2 hrs. ago”
“The client has rou ne vital signs prescribed”
“The client is the president of a local bank”
16) 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 ac ons should the nurse take?
Proceed with treatment without obtaining wri en consent
No fy risk management before ini a ng treatment
Have the client sign a consent for treatment
Contact the clients next of to obtain consent for treatment
17) A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet
delivered the oxygen tank. Which of the following ac ons should the nurse take?
Instruct the client’s family to contact the insurance provider about the oxygen equipment
Send an oxygen tank from the facility home with the client
Contact social services about the delivery of the oxygen equipment
No fy the provider about the delayed oxygen tank delivery
18) A nurse on a medical surgical unit is caring for a group of clients with the assistance of a licensed prac cing
nurse and assis ve personnel. Which of the following tasks should the nurse assign to the LPN?
Accompanying a client who just had a wound debridement to physical therapy
Obtaining a urine specimen from an older adult client
Providing postmortem care for a client that just died
Reinforcing dietary teaching with a client who has heart disease
19) ) A nurse manager is leading a discussion about ethical dilemmas. Which of the following situa ons should the
nurse manager include as an example of an ethical dilemma?
A visitor experiences a minor burn a er spilling co ee
A parent wants her 14yr old adolescent to receive radia on treatment against his will
A nurse witnesses another nurse administer an incorrect medica on
A client receives an opera on on the wrong side of her body
20) a nurse is developing a discharge plan for client who is postopera ve and will require a wheelchair in the home.
the nurse should place a referral to which of the following resources to assist the client with this need? Occupa onal
therapy
Social services
Home health
Physical therapy
21) A nurse is caring for a client who requests informa on about the prevalence of Tay-Sachs disease. Which of the
following resources should the nurse use to obtain this informa on?
An evidence-based nursing journal
The client's health care provider
The facili es case manager
A collabora ve, user-edited website
, lOMoARcPSD| 19431042
22) A nurse has just completed assessment char ng on the electronic record for an assigned client. As assis ve
personnel (AP) who just measured the client’s vital signs asks to chart them while the nurse is s ll logged into the
record. Which of the following ac ons should the nurse take?
Recommend the AP come back later when the record is available
Log out so the AP can log in to document the vital signs
O er to chart the vital signs for the AP
Allow the AP to document the vital signs prior to logging out
23) A nurse is preparing a teaching session with a client who speaks a di erent language than the nurse. Which of
the following interven ons should the nurse plan to include?
Involve the client’s partner to assist with the teaching session
Incorporate gestures and hand signals when presen ng informa on
Validate understanding by interpre ng the client’s body language
Provide and interpreter when obtaining consent for the client
24) A nurse on a surgical unit is preparing to transfer a client to a rehabilita on facility. Which of the following
informa on should the nurse include in the change-of-shi report?
The me the client received his last dose of pain medica on
The belief that the client has a di cult rela onship with his son
The steps to follow when providing wound care
The clients preferred me for bathing
25) Nurse on an impa ent care unit is working to help reduce unit costs. Which of the following ac ons is
appropriate to include in the cost-containment plan?
Store opened bo les of normal saline in a refrigerator for up to 48hrs
Wait to dispose of sharps containers un l they are completely full
Use clean gloves rather than sterile gloves for colostomy care
Return unused supplies from the bedside to the unit’s supply stock
26) a nurse is preparing to complete an incident report regarding a medica on error which of the following ac ons
should the nurse plan to take? select all that apply
Include the me the medica on error occurs in the report
Make a copy of the incident report for personal record-keeping
Iden fy the medica on name and dosage administered to the client in the report
Place a copy of the completed report in the client's medical record
Obtain an order from the client's provider to complete the report
27) A nurse is preparing a client for an elec ve mastectomy. The client is wearing a plain gold wedding band. Which of
the following is the appropriate procedure for taking care of the clients' ring?
Agree to keep the ring for the client un l a er the surgery
Place the clients ring in the facility safe
Tape the ring securely to the client's nger
Place the ring in the bag with the clients' clothes
28) A nurse on a medical-surgical unit is evalua ng an assis ve personnel’s (AP) use of infec on control precau ons.
Which of the following ac ons by the AP indicates correct use of the precau ons?
The AP wears a surgical mask when caring for a client who has respiratory tuberculosis
The AP uses alcohol-based hand sani zer a er emptying the bed pan of a client who has Clostridium di cile The
AP bundles the clean side of linen inward when changing the sheets for a client who has infected surgical
wound
The AP removes her gloves before leaving the room of a client who has MRSA
29A nurse is preparing an educa onal program for sta members 2 a new intravenous pump. Iden fy the sequence of
ac ons the nurse should take when developing the program. (Move the steps into the box on the right, placing them in
order of performance).
Determine what skills to teach the sta members
Develop learning objec ves for the program
ATI Leadership Level 3
1) A nurse is caring for a client who has a tumor. The provider recommends surgery. The client refuses, but the
client's partner wants the surgery performed. Which of the following is the deciding factor in determining if the surgery
will be done?
Whether the client understands the risk of refusing the procedure
Whether the partner is the client's durable power of a orney for health care
Whether the client's refusal is based on a religious belief
Whether the facility ethics commi ee reaches a census on the case
2) A nurse is caring for a client who has a new diagnosis of chlamydia. Which of the following ac ons should the
nurse take?
Report the infec on to the local health department
Ini ate contact precau ons
Instruct the client to use condoms un l the treatment is complete
Apply an an viral cream to the lesions
3) A nurse is caring for a client who has cancer. The client's adult child asks the nurse for informa on about the
client's treatment plan. Which of the following responses should the nurse make?
"I will ask your mother's primary care provider to speak with you."
"What would you like to know about your mother's treatment?"
"You will have to speak directly to your mother about her treatment."
"I cannot provide this informa on to you without your mother's consent."
4) A nurse is assessing an older adult client who was brought to the emergency department by his adult son, who
reports that the client fell at home. The nurse suspect's elder abuse. Which of the following ac ons should the nurse
take? Ask the client's son to go to the wai ng area
File an incident report
Treat and discharge the client
Ask the client about his injuries with the son present
5) A nurse is conduc ng a disaster preparedness drill with a group of nurses who are orien ng to the facility. Which of
the following triage tag colors should the nurse instruct the group to apply to a client who has full thickness burns on
72% of his body? Green
Yellow
Black
Red
6) A nurse on a medica-surgical unit is caring for a client who asks about advance direc ves and states that he wants to
appoint a health care proxy. Which of the following responses should the nurse make?
“You must choose a member of your family to serve as your health care proxy”
“A health care proxy can make decisions for you when you are unable to do so”
“You should appoint a health care proxy before undergoing an invasive procedure”
“It is necessary for an a orney to approve your health care proxy”
7) A hospice nurse is caring for a client who has terminal illness and reports severe pain. A er the nurse administers the
prescribed opioid and benzodiazepine, the client becomes somnolent and di cult to arouse. Which of the following
ac ons should the nurse take?
Con nue the medica on dosages that relieve the client’s pain
Contact the provider about replacing the opioid with an NSAID
Administer the benzodiazepine but withhold the opioid
Withhold the benzodiazepine but con nue the opioid
8) A nurse is orienta ng a newly license nurse about client con den ality. Which of the following statements by the
newly licensed nurse indicates an understanding of the teaching?
“I should encrypt personal health informa on when sending emails”
“I can use another nurse’s password as long as I log o a er using the computer”
, lOMoARcPSD| 19431042
“I should discard personal health informa on documents in the trash before leaving the unit
“I can post the client’s vitals sings in the client’s room”
9) A nurse is delega ng care for a group of clients. Which of the following clients should the nurse assign to the LPN?
A client who is scheduled for an endoscopy later today and requires an enema
A newly admi ed client who has sickle cell anemia and requires the development of an ini al plan of care
A client who had a myocardial infarc on and will be transferring to the unit from the CCU
A newly admi ed client who has diabetes mellitus and requires ini al teaching on self-administra on of insulin 10)
A nurse on a med-surge unit is caring for four clients. The nurse should recognize that which of the following clients is the
priority?
A client who is postopera ve following a laminectomy 12 hour and is unable to void
A client who is scheduled for a tubal liga on in 2 hours and is crying
A client who has peripheral vascular disease and has an absent pulse in the right foot
A client who has type 1 diabetes and needs the rst dressing change for an ulcer
A client who has MRSA and has an axillary temperature of 100.4F nurse manager
is planning to assign care for four clients on a medical surgical unit. Which of the
following clients should the nurse assign to a LPN
a. An older adult who has lung cancer and has periodic episodes of severe dyspnea
b. A middle adult client who has a below the knee amputa on and requires a dressing change
c. A young adult client who is postopera ve, receiving morphine via epidural, and reports pruritus
d. An adolescent who requires teaching regarding insulin administra on nurse manager is planning to assign
care for four clients on a medical surgical unit. Which of the following clients should the nurse assign to a
LPN
a. An older adult who has lung cancer and has periodic episodes of severe dyspnea
b. A middle adult client who has a below the knee amputa on and requires a dressing change
c. A young adult client who is postopera ve, receiving morphine via epidural, and reports pruritus
d. An adolescent who requires teaching regarding insulin administra on
A nurse manager is planning to assign care for four clients on a medical surgical unit. Which
of the following clients should the nurse assign to a LPN
a. An older adult who has lung cancer and has periodic episodes of severe dyspnea
b. A middle adult client who has a below the knee amputa on and requires a dressing change
c. A young adult client who is postopera ve, receiving morphine via epidural, and reports pruritus
d. An adolescent who requires teaching regarding insulin administra on
11) A nurse manager observes assis ve personnel (AP) incorrectly transferring a client to the bedside commode.
Which of the following ac ons should the nurse take rst?
Help the AP assist the client with the transfer
Demonstrate the proper client transfer technique to the AP
Instruct the AP to request assistance when unsure about a task
Refer the AP to the facility procedure manual
12) A nurse in the emergency department admits a client who has been exposed to cutaneous anthrax. Which of
the following ac ons should the nurse take?
Prepare to administer an bio cs to the client
Wear an N95 respirator makes while caring for the client
Plan to administer an an viral media on to the client
Place a surgical mask on the client during transfer to the unit
13) A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner
wishes to discon nue the client’s feeding tube, but another family member tells the nurse that they want the client to
con nue receiving treatment. Which of the following responses should the nurse make?
“You should contact the provider about your wishes for your family member”
“You should speak with the facility’s ethics commi ee about your concerns
“We’ll need to have the nursing supervisor review the client’s advance direc ves”
, lOMoARcPSD| 19431042
“As the health care surrogate, the client’s partner can make this decision
14) A nurse is preparing to discharge a client who has end- stage heart failure. the client's partner tells the nurse she
can no longer handle caring for the client. which of the following ac ons should the nurse take?
Ask the provider to delay the client's discharge home for a few more days.
Recommend the partner place the client in a long- term care facility.
Contact the case manager to discuss discharge op ons.
Request another family member assist the client's partner with care.
15) A nurse is providing change-of-shi report for an oncoming nurse. Which of the following informa on should the
nurse include in the report?
“The client is in radiology department for a chest x-ray”
“The client’s partner came to visit him 2 hrs. ago”
“The client has rou ne vital signs prescribed”
“The client is the president of a local bank”
16) 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 ac ons should the nurse take?
Proceed with treatment without obtaining wri en consent
No fy risk management before ini a ng treatment
Have the client sign a consent for treatment
Contact the clients next of to obtain consent for treatment
17) A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet
delivered the oxygen tank. Which of the following ac ons should the nurse take?
Instruct the client’s family to contact the insurance provider about the oxygen equipment
Send an oxygen tank from the facility home with the client
Contact social services about the delivery of the oxygen equipment
No fy the provider about the delayed oxygen tank delivery
18) A nurse on a medical surgical unit is caring for a group of clients with the assistance of a licensed prac cing
nurse and assis ve personnel. Which of the following tasks should the nurse assign to the LPN?
Accompanying a client who just had a wound debridement to physical therapy
Obtaining a urine specimen from an older adult client
Providing postmortem care for a client that just died
Reinforcing dietary teaching with a client who has heart disease
19) ) A nurse manager is leading a discussion about ethical dilemmas. Which of the following situa ons should the
nurse manager include as an example of an ethical dilemma?
A visitor experiences a minor burn a er spilling co ee
A parent wants her 14yr old adolescent to receive radia on treatment against his will
A nurse witnesses another nurse administer an incorrect medica on
A client receives an opera on on the wrong side of her body
20) a nurse is developing a discharge plan for client who is postopera ve and will require a wheelchair in the home.
the nurse should place a referral to which of the following resources to assist the client with this need? Occupa onal
therapy
Social services
Home health
Physical therapy
21) A nurse is caring for a client who requests informa on about the prevalence of Tay-Sachs disease. Which of the
following resources should the nurse use to obtain this informa on?
An evidence-based nursing journal
The client's health care provider
The facili es case manager
A collabora ve, user-edited website
, lOMoARcPSD| 19431042
22) A nurse has just completed assessment char ng on the electronic record for an assigned client. As assis ve
personnel (AP) who just measured the client’s vital signs asks to chart them while the nurse is s ll logged into the
record. Which of the following ac ons should the nurse take?
Recommend the AP come back later when the record is available
Log out so the AP can log in to document the vital signs
O er to chart the vital signs for the AP
Allow the AP to document the vital signs prior to logging out
23) A nurse is preparing a teaching session with a client who speaks a di erent language than the nurse. Which of
the following interven ons should the nurse plan to include?
Involve the client’s partner to assist with the teaching session
Incorporate gestures and hand signals when presen ng informa on
Validate understanding by interpre ng the client’s body language
Provide and interpreter when obtaining consent for the client
24) A nurse on a surgical unit is preparing to transfer a client to a rehabilita on facility. Which of the following
informa on should the nurse include in the change-of-shi report?
The me the client received his last dose of pain medica on
The belief that the client has a di cult rela onship with his son
The steps to follow when providing wound care
The clients preferred me for bathing
25) Nurse on an impa ent care unit is working to help reduce unit costs. Which of the following ac ons is
appropriate to include in the cost-containment plan?
Store opened bo les of normal saline in a refrigerator for up to 48hrs
Wait to dispose of sharps containers un l they are completely full
Use clean gloves rather than sterile gloves for colostomy care
Return unused supplies from the bedside to the unit’s supply stock
26) a nurse is preparing to complete an incident report regarding a medica on error which of the following ac ons
should the nurse plan to take? select all that apply
Include the me the medica on error occurs in the report
Make a copy of the incident report for personal record-keeping
Iden fy the medica on name and dosage administered to the client in the report
Place a copy of the completed report in the client's medical record
Obtain an order from the client's provider to complete the report
27) A nurse is preparing a client for an elec ve mastectomy. The client is wearing a plain gold wedding band. Which of
the following is the appropriate procedure for taking care of the clients' ring?
Agree to keep the ring for the client un l a er the surgery
Place the clients ring in the facility safe
Tape the ring securely to the client's nger
Place the ring in the bag with the clients' clothes
28) A nurse on a medical-surgical unit is evalua ng an assis ve personnel’s (AP) use of infec on control precau ons.
Which of the following ac ons by the AP indicates correct use of the precau ons?
The AP wears a surgical mask when caring for a client who has respiratory tuberculosis
The AP uses alcohol-based hand sani zer a er emptying the bed pan of a client who has Clostridium di cile The
AP bundles the clean side of linen inward when changing the sheets for a client who has infected surgical
wound
The AP removes her gloves before leaving the room of a client who has MRSA
29A nurse is preparing an educa onal program for sta members 2 a new intravenous pump. Iden fy the sequence of
ac ons the nurse should take when developing the program. (Move the steps into the box on the right, placing them in
order of performance).
Determine what skills to teach the sta members
Develop learning objec ves for the program
