2023 LEADERSHIPATI PROCTORED EXAM FORM A, B, C,
D AND E(5 LATEST VERSIONS)/ATI LEADERSHIP
PROCTORED FORM A, B, C, D ACTUAL EXAM EACH
FORM CONTAINS 70 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES|AGRADE
delegation/supervision - ANSWER: *5 rights*
1. task
2. circumstance
3. person
4. direction and communication
5. supervision and evaluation
-based on individual client needs, facility policies and job descriptions, state NPA,
professional standards
-consider the individual's education, training, and experience
-RNs can delegate to:
>>other RNs
>>LPNs
>>APs
delegating to AP - ANSWER: -ADLs
-bathing
-grooming
-dressing
-toileting
-ambulating
-feeding without swallowing precautions
-positioning
-bed making
-VS for stable clients
-specimen collection
-I&O
>>follow facility policies and stage practice guidelines
right task - ANSWER: repetitive, requires little supervision, and relatively noninvasive
right task: AP to assist pt with bedpan and pneumonia
wrong task: delegate AP to administer a nebilizer to a pt with pneumonia
right circumstance - ANSWER: -assess health status and complexity of care required
by the client
,-match the complexity of care demands to the skill level of the health care team
-consider workload
right circustance: delegate to AP to measure VS on stable pt
wrong: delegate AP to measure VS on pt who is post-op and received naloxone to
reverse respiratory depression
right person - ANSWER: -assess and verify competency of the health care team
member
>>within scope of practice and necessary competence and training
-continual performance reviews
right: delegate a LPN to adminster enteral to a client who has a head injury
wrong: delegate an AP to adminster enteral feedings to a client who has a head
injury
right direction/communication - ANSWER: -data that needs to be collected
-method and time line for reporting (when to report concerns/findings
right: delegate an AP to assist in room X with (something very specific) before X
amount of time
wrong: delegate an AP to assist with (something nonspecific) in room x
right supervision/evaluation - ANSWER: -directly or indirectly
-clear directions and expectations
-monitor performance
-provide feedback
-intervene if necessary
-evaluate and identify needs for quality improvement activities
right: delegate the ambulation of the client and provide positive feedback to the AP
after completion of task
wrong: delegate the ambulation of a client to an AP without supervision to
determine the need for intervntion and failing to provide feedback to the AP
delegating to LPN - ANSWER: -monitoring client findings as input for the RNs ongoing
assessment of the client
-reinforcing client teaching from a standardized care plan
-performing tracheostomy care and suction
-perform uncomplicated wound care
-checking NG tube patency
-administering enteral feedings
-inserting urinary catheter
,-administering medications
>>not IV meds
responding to inappropriate delegation - ANSWER: *DO NOT DELEGATE*:
-nursing process
-client education
-tasks that require clinical judgement to LPNs or APs
*CONSIDER*:
-predictability of outcome
-potential for harm
-complexity of care
-need for problem solving and innovation
-level of interaction with the client
when a nurse receives an unsafe assignment - ANSWER: -bring the assignment to the
attention of the scheduling/charge nurse and negotiate a new assignment
-if unresolved take it up chain of command
-file a written protest to the assignment
>>assignment despite objection
>>document of practice situations
-failure to accept the assignment without following the proper channels can be
considered client abandonment
inappropriate use of restraints - ANSWER: *assualt*: threatening to place a NG tube
in a pt who is refusing to eat
*battery*: restraining a pt and administering an injection against his wishes
*false imprisonment*: using restraints on a competent client to prevent his leaving
the health care facility
reporting information to the provider (ch. 2) - ANSWER: should be fostered to create
a climate of mutual respect and collaborative practice
*-assessment data integral to changes in client status
-recommendations for changes in the plan of care
-clarification of prescriptions*
*Qualities*:
-good communication
-assertiveness
-conflict negotiation skills
-leadership skills
-professional presence
-decision-making and critical thinking
, Decision-making styles:
*decisive* - ANSWER: the team uses a minimum amount of data and generates one
option
Decision-making styles:
*flexible* - ANSWER: the team uses a limited amount of data and generates several
options
Decision-making styles:
*Hierarchical* - ANSWER: the team uses a large amount of data and generates one
option
Decision-making styles:
*integrative* - ANSWER: the team uses a large amount of data and generates several
options
breach of confidentiality (ch. 3) - ANSWER: -nurses who disclose client information to
an unauthorized person can be liable for invasion of privacy, defamation, or slander
-*HIPAA rights of pts*
>>client is able to obtain a copy of their medical record and to submit requests to
amend erroneous or incomplete information
>>a requirement for health care and insurance providers to provide written
information about how medical information is used and how it is shared with other
entities
-->permission must be obtained before information is shared
>>the pt has the right to privacy and confidentiality
*components of privacy rule* - ANSWER: -only healthcare team members directly
responsible for the client's care are allowed access to the patients records.
>>nurses may not share information with other clients or staff not involved in the
patient care
-clients have a right to read and obtain a copy fo their medical record, and agency
policy should be followed when the client requests to read or have a copy of the
record
-no part of the client record can be copied except for authorized exchange of
documents between health care institutions
>>transfer from a hospital to an extended care facility
>>exchange of documents between a general practitioner and a specialist during a
consult
-client records must be kept in a secure area to prevent inappropriate access to
information
-client information may not be disclosed to unauthorized individuals, including family
members who request it and individuals who call on the phone
>>many hospitals use a code system in which information is only disclosed to
individuals who can provide the code
>>nurses should ask any individual inquiring about a client's health status for the
code and disclose information only when that code is
D AND E(5 LATEST VERSIONS)/ATI LEADERSHIP
PROCTORED FORM A, B, C, D ACTUAL EXAM EACH
FORM CONTAINS 70 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES|AGRADE
delegation/supervision - ANSWER: *5 rights*
1. task
2. circumstance
3. person
4. direction and communication
5. supervision and evaluation
-based on individual client needs, facility policies and job descriptions, state NPA,
professional standards
-consider the individual's education, training, and experience
-RNs can delegate to:
>>other RNs
>>LPNs
>>APs
delegating to AP - ANSWER: -ADLs
-bathing
-grooming
-dressing
-toileting
-ambulating
-feeding without swallowing precautions
-positioning
-bed making
-VS for stable clients
-specimen collection
-I&O
>>follow facility policies and stage practice guidelines
right task - ANSWER: repetitive, requires little supervision, and relatively noninvasive
right task: AP to assist pt with bedpan and pneumonia
wrong task: delegate AP to administer a nebilizer to a pt with pneumonia
right circumstance - ANSWER: -assess health status and complexity of care required
by the client
,-match the complexity of care demands to the skill level of the health care team
-consider workload
right circustance: delegate to AP to measure VS on stable pt
wrong: delegate AP to measure VS on pt who is post-op and received naloxone to
reverse respiratory depression
right person - ANSWER: -assess and verify competency of the health care team
member
>>within scope of practice and necessary competence and training
-continual performance reviews
right: delegate a LPN to adminster enteral to a client who has a head injury
wrong: delegate an AP to adminster enteral feedings to a client who has a head
injury
right direction/communication - ANSWER: -data that needs to be collected
-method and time line for reporting (when to report concerns/findings
right: delegate an AP to assist in room X with (something very specific) before X
amount of time
wrong: delegate an AP to assist with (something nonspecific) in room x
right supervision/evaluation - ANSWER: -directly or indirectly
-clear directions and expectations
-monitor performance
-provide feedback
-intervene if necessary
-evaluate and identify needs for quality improvement activities
right: delegate the ambulation of the client and provide positive feedback to the AP
after completion of task
wrong: delegate the ambulation of a client to an AP without supervision to
determine the need for intervntion and failing to provide feedback to the AP
delegating to LPN - ANSWER: -monitoring client findings as input for the RNs ongoing
assessment of the client
-reinforcing client teaching from a standardized care plan
-performing tracheostomy care and suction
-perform uncomplicated wound care
-checking NG tube patency
-administering enteral feedings
-inserting urinary catheter
,-administering medications
>>not IV meds
responding to inappropriate delegation - ANSWER: *DO NOT DELEGATE*:
-nursing process
-client education
-tasks that require clinical judgement to LPNs or APs
*CONSIDER*:
-predictability of outcome
-potential for harm
-complexity of care
-need for problem solving and innovation
-level of interaction with the client
when a nurse receives an unsafe assignment - ANSWER: -bring the assignment to the
attention of the scheduling/charge nurse and negotiate a new assignment
-if unresolved take it up chain of command
-file a written protest to the assignment
>>assignment despite objection
>>document of practice situations
-failure to accept the assignment without following the proper channels can be
considered client abandonment
inappropriate use of restraints - ANSWER: *assualt*: threatening to place a NG tube
in a pt who is refusing to eat
*battery*: restraining a pt and administering an injection against his wishes
*false imprisonment*: using restraints on a competent client to prevent his leaving
the health care facility
reporting information to the provider (ch. 2) - ANSWER: should be fostered to create
a climate of mutual respect and collaborative practice
*-assessment data integral to changes in client status
-recommendations for changes in the plan of care
-clarification of prescriptions*
*Qualities*:
-good communication
-assertiveness
-conflict negotiation skills
-leadership skills
-professional presence
-decision-making and critical thinking
, Decision-making styles:
*decisive* - ANSWER: the team uses a minimum amount of data and generates one
option
Decision-making styles:
*flexible* - ANSWER: the team uses a limited amount of data and generates several
options
Decision-making styles:
*Hierarchical* - ANSWER: the team uses a large amount of data and generates one
option
Decision-making styles:
*integrative* - ANSWER: the team uses a large amount of data and generates several
options
breach of confidentiality (ch. 3) - ANSWER: -nurses who disclose client information to
an unauthorized person can be liable for invasion of privacy, defamation, or slander
-*HIPAA rights of pts*
>>client is able to obtain a copy of their medical record and to submit requests to
amend erroneous or incomplete information
>>a requirement for health care and insurance providers to provide written
information about how medical information is used and how it is shared with other
entities
-->permission must be obtained before information is shared
>>the pt has the right to privacy and confidentiality
*components of privacy rule* - ANSWER: -only healthcare team members directly
responsible for the client's care are allowed access to the patients records.
>>nurses may not share information with other clients or staff not involved in the
patient care
-clients have a right to read and obtain a copy fo their medical record, and agency
policy should be followed when the client requests to read or have a copy of the
record
-no part of the client record can be copied except for authorized exchange of
documents between health care institutions
>>transfer from a hospital to an extended care facility
>>exchange of documents between a general practitioner and a specialist during a
consult
-client records must be kept in a secure area to prevent inappropriate access to
information
-client information may not be disclosed to unauthorized individuals, including family
members who request it and individuals who call on the phone
>>many hospitals use a code system in which information is only disclosed to
individuals who can provide the code
>>nurses should ask any individual inquiring about a client's health status for the
code and disclose information only when that code is
