ATI PRACTICE B LEADERSHIP AND MANAGEMENT
UPDATED ACTUAL EXAM
A nurse is caring for a client who is recovering from a stroke. The provider recommends an
extracranial-intracranial bypass, but the client tells the nurse that he will not have the surgery. Which of
thefollowing actions should the nurse take?
• Inform the client of the consequences of decreased cerebral circulation.
• Initiate a mental health consultation to determine why the client refuses the surgery.
• Discuss with the client his concerns about having the surgery.
• Provide the client with information on additional treatment options. - answerC. Discuss with the client
hisconcerns about having the surgery.
A charge nurse notices a newly hired nurse consistently does not finish client care tasks by the end of the
shift. Which of the following statements should the charge nurse make?
• "You should set aside time to plan your day at the beginning of each shift."
• "You should not take a break until all of your tasks are completed."
• "You should leave your hardest task for the end of the shift."
• "You should save your charting for the end of the shift." - answerA. " You should set aside time to
planyour day at the beginning of each shift."
Two nurses on a unit each contend that the other is not doing a fair share of work. The conflict is
affectingthe functioning of the unit. A charge nurse should recognize that which of the following is an
appropriate approach to this conflict?
• Schedule the nurses to work on alternating shifts.
• Organize a task force to evaluate the situation.
• Tell the nurses that it is their responsibility to cooperate with coworkers.
• Explore alternative solutions to address unit workflow with the nurses. - answerD. Explore
alternativesolutions to address unit workflow with the nurses.
A charge nurse is conducting an in-service with staff members about infection control precautions. The
nurseshould instruct the staff that which of the following clients requires droplet precautions?
• A client who has shigella.
• A client who has measles.
• A client who has toxic shock syndrome
• A client who has pertussis. - answerD. A client who has pertussis.
A nurse in the emergency department is admitting clients following an eartquake. The emergency
disasterplan has been implemented due to the anticipated arrival of a large number of casualities.
Which of the following clients should the nurse recommend the provider evaluate first?
,• A client who has a penetrating head injury and respirations of 4/min.
• A client who has a comminuted fracture of the femur.
• A client who has a 6-inch laceration to the scalp with clotted blood visible.
• A client who has a sucking chest wound. - answerD. A client who has a sucking chest wound.
A nurse is caring for a group of clients on a unit. Which of the following assessment findings should
thenurse recognize as the priority to report to the charge nurse?
• A client who has heart failure and 2+ edema of her lower extremities.
• A client who is 2 days postoperative and has a urine output of 20 mL/hr
• A client who started taking verapamil and has a heart rate of 75/min.
• A client who is receiving morphine and reports nausea. - answerB. A client who is 2 days post
operativeand has a urine output of 20 mL/hr
A nursing unit is undergoing changes to accomodate new bariatric services that will be available to the
unit. Some staff members have verbalized displeasure with the changes. Which of the following actions
should thecharge nurse take? (Select all that apply)
• Role model a positive approach to the changes.
• Redirect the conversation when staff members make negative comments about the changes.
• Encourage staff members who support the changes to discuss the issue with resistant staff.
• Suggest that resistant staff members transfer to a different unit.
• Reprimand staff members who are resistant to the changes. - answerA and C
A case manager is planning an interprofessional conference for a client who is 3 days postoperative
following an open reduction and internal fixation of the right hip. Which of the following concerns is
thepriority for discussion at the confrence?
• The client does not have transportation for discharge home.
• The client refuses to attend physical therapy sessions.
• The client's home health nurse has not completed the home assessment.
• The client describes feelings of depression after his family visits. - answerB. The client refuses to
attendphysical therapy sessions.
A charge nurse is evaluating a plan of care that a novice nurse developed for a client who is to receive a
continuous NG tube feeding. Which of the following interventions should the charge nurse ensure is part
of the plan of care?
• Flush the tube every 8 hours with 0.9% sodium chloride irrigation.
• Use an acidic juice to unclog a blocked tube.
• Add dissolved medications to the enteral feeding.
, • Use a 60 mL syringe to flush out a clogged tube. - answerD. Use a 60 mL syringe to flush out a
cloggedtube
A nurse has just received report on four clients on a medical-surgical unit. Which of the following
clientsshould the nurse plan to assess first?
• A client who has COPD and an oxygen saturation level of 92%.
• A client who is postoperative following a total knee arthroplasty and has a capillary refill of 4 seconds.
• A client who has diabetes mellitus and a blood glucose of 150 mg/dL
• A client who is 12 hr postoperative following abdominal surgery and has absent bowel sounds. -
answerB.A client who is postoperative following a total knee arthroplasty and has a capillary refill of 4
seconds.
An oxygen saturation of 92% is nonurgent because it is an expected finding for a client who has COPD;
therefore, another client is the nurse's priority.
When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority
is aclient who has a capillary refill of 4 seconds following a total knee arthroplasty. Capillary refill should
be 3 seconds or less.
A blood glucose of 150 mg/dL is nonurgent because it is an expected finding for a client who has
diabetesmellitus; therefore, another client is the nurse's priority.
Absent bowel sounds is nonurgent because it is an expected finding for a client following abdominal
surgery;therefore, another client is the nurse's priority.
A nurse is teaching a newly licensed nurse about the guidelines for obtaining a telephone prescription
from aprovider. Which of the following statements by the newly licensed nurse indicates an
understanding of the teaching?
• "I should repeat the prescription back to the provider for verification."
• "I should have the pharmacist contact the provider to obtain a new prescription."
• "The provider does not have to sign a presciption if the pharmacist approves it."
• "The provider may leave telephone prescriptions with a student nurse if a licensed nurse is
unavailable." - answerA. I should repeat the prescription back to the provider for verification."
The nurse should repeat all prescriptions back to the provider to confirm the information obtained is
correct.The nurse is responsible for requesting prescriptions from the provider.
The provider must sign all prescriptions within the time frame the health care facility specifies.
Student nurses are not allowed to accept a telephone prescription from a provider. Many facilities only
allowregistered nurses to take telephone prescriptions.
A nurse receives notification of a fire on the unit. Which of the following actions should the nurse take first?
• Assist clients who are in immediate danger to a safe location.
• Close doors and windows on the unit.
UPDATED ACTUAL EXAM
A nurse is caring for a client who is recovering from a stroke. The provider recommends an
extracranial-intracranial bypass, but the client tells the nurse that he will not have the surgery. Which of
thefollowing actions should the nurse take?
• Inform the client of the consequences of decreased cerebral circulation.
• Initiate a mental health consultation to determine why the client refuses the surgery.
• Discuss with the client his concerns about having the surgery.
• Provide the client with information on additional treatment options. - answerC. Discuss with the client
hisconcerns about having the surgery.
A charge nurse notices a newly hired nurse consistently does not finish client care tasks by the end of the
shift. Which of the following statements should the charge nurse make?
• "You should set aside time to plan your day at the beginning of each shift."
• "You should not take a break until all of your tasks are completed."
• "You should leave your hardest task for the end of the shift."
• "You should save your charting for the end of the shift." - answerA. " You should set aside time to
planyour day at the beginning of each shift."
Two nurses on a unit each contend that the other is not doing a fair share of work. The conflict is
affectingthe functioning of the unit. A charge nurse should recognize that which of the following is an
appropriate approach to this conflict?
• Schedule the nurses to work on alternating shifts.
• Organize a task force to evaluate the situation.
• Tell the nurses that it is their responsibility to cooperate with coworkers.
• Explore alternative solutions to address unit workflow with the nurses. - answerD. Explore
alternativesolutions to address unit workflow with the nurses.
A charge nurse is conducting an in-service with staff members about infection control precautions. The
nurseshould instruct the staff that which of the following clients requires droplet precautions?
• A client who has shigella.
• A client who has measles.
• A client who has toxic shock syndrome
• A client who has pertussis. - answerD. A client who has pertussis.
A nurse in the emergency department is admitting clients following an eartquake. The emergency
disasterplan has been implemented due to the anticipated arrival of a large number of casualities.
Which of the following clients should the nurse recommend the provider evaluate first?
,• A client who has a penetrating head injury and respirations of 4/min.
• A client who has a comminuted fracture of the femur.
• A client who has a 6-inch laceration to the scalp with clotted blood visible.
• A client who has a sucking chest wound. - answerD. A client who has a sucking chest wound.
A nurse is caring for a group of clients on a unit. Which of the following assessment findings should
thenurse recognize as the priority to report to the charge nurse?
• A client who has heart failure and 2+ edema of her lower extremities.
• A client who is 2 days postoperative and has a urine output of 20 mL/hr
• A client who started taking verapamil and has a heart rate of 75/min.
• A client who is receiving morphine and reports nausea. - answerB. A client who is 2 days post
operativeand has a urine output of 20 mL/hr
A nursing unit is undergoing changes to accomodate new bariatric services that will be available to the
unit. Some staff members have verbalized displeasure with the changes. Which of the following actions
should thecharge nurse take? (Select all that apply)
• Role model a positive approach to the changes.
• Redirect the conversation when staff members make negative comments about the changes.
• Encourage staff members who support the changes to discuss the issue with resistant staff.
• Suggest that resistant staff members transfer to a different unit.
• Reprimand staff members who are resistant to the changes. - answerA and C
A case manager is planning an interprofessional conference for a client who is 3 days postoperative
following an open reduction and internal fixation of the right hip. Which of the following concerns is
thepriority for discussion at the confrence?
• The client does not have transportation for discharge home.
• The client refuses to attend physical therapy sessions.
• The client's home health nurse has not completed the home assessment.
• The client describes feelings of depression after his family visits. - answerB. The client refuses to
attendphysical therapy sessions.
A charge nurse is evaluating a plan of care that a novice nurse developed for a client who is to receive a
continuous NG tube feeding. Which of the following interventions should the charge nurse ensure is part
of the plan of care?
• Flush the tube every 8 hours with 0.9% sodium chloride irrigation.
• Use an acidic juice to unclog a blocked tube.
• Add dissolved medications to the enteral feeding.
, • Use a 60 mL syringe to flush out a clogged tube. - answerD. Use a 60 mL syringe to flush out a
cloggedtube
A nurse has just received report on four clients on a medical-surgical unit. Which of the following
clientsshould the nurse plan to assess first?
• A client who has COPD and an oxygen saturation level of 92%.
• A client who is postoperative following a total knee arthroplasty and has a capillary refill of 4 seconds.
• A client who has diabetes mellitus and a blood glucose of 150 mg/dL
• A client who is 12 hr postoperative following abdominal surgery and has absent bowel sounds. -
answerB.A client who is postoperative following a total knee arthroplasty and has a capillary refill of 4
seconds.
An oxygen saturation of 92% is nonurgent because it is an expected finding for a client who has COPD;
therefore, another client is the nurse's priority.
When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority
is aclient who has a capillary refill of 4 seconds following a total knee arthroplasty. Capillary refill should
be 3 seconds or less.
A blood glucose of 150 mg/dL is nonurgent because it is an expected finding for a client who has
diabetesmellitus; therefore, another client is the nurse's priority.
Absent bowel sounds is nonurgent because it is an expected finding for a client following abdominal
surgery;therefore, another client is the nurse's priority.
A nurse is teaching a newly licensed nurse about the guidelines for obtaining a telephone prescription
from aprovider. Which of the following statements by the newly licensed nurse indicates an
understanding of the teaching?
• "I should repeat the prescription back to the provider for verification."
• "I should have the pharmacist contact the provider to obtain a new prescription."
• "The provider does not have to sign a presciption if the pharmacist approves it."
• "The provider may leave telephone prescriptions with a student nurse if a licensed nurse is
unavailable." - answerA. I should repeat the prescription back to the provider for verification."
The nurse should repeat all prescriptions back to the provider to confirm the information obtained is
correct.The nurse is responsible for requesting prescriptions from the provider.
The provider must sign all prescriptions within the time frame the health care facility specifies.
Student nurses are not allowed to accept a telephone prescription from a provider. Many facilities only
allowregistered nurses to take telephone prescriptions.
A nurse receives notification of a fire on the unit. Which of the following actions should the nurse take first?
• Assist clients who are in immediate danger to a safe location.
• Close doors and windows on the unit.
