ATI NU2508 Leadership Final Exam

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A nurse is conducting a performance evaluation for an assistive personnel (AP). Which of the following actions by the AP should the nurse identify as requiring further training?

  • A. The AP checks a client's identification band before providing a meal tray.
  • B. The AP reports a client's complaint of pain to the nurse immediately.
  • C. The AP uses an alcohol-based hand rub after assisting a client with ambulation.
  • D. The AP leaves a client's bed in the lowest position without raising side rails for a client at risk for falls.
Correct Answer: D

Rationale: The correct answer is D. Leaving a client's bed in the lowest position without raising side rails for a client at risk for falls is a safety violation. The nurse should identify this action for further training because it puts the client at risk of injury. Lowering the bed and raising side rails are essential fall prevention measures. Checking the client's identification band (A) ensures correct client identification. Reporting client complaints of pain (B) promptly is important for timely intervention. Using hand rub after assisting a client (C) promotes infection control. Options E, F, and G are not provided in the question. In summary, choice D is correct as it pertains to client safety, while the other options demonstrate appropriate nursing actions.

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A charge nurse is planning care for a unit with limited staffing due to a flu outbreak. Which of the following actions should the charge nurse prioritize?

  • A. Assign assistive personnel to provide client education on hand hygiene.
  • B. Ensure all clients receive their scheduled baths on time.
  • C. Reassess clients with unstable vital signs every 2 hours.
  • D. Delegate documentation of intake and output to the unit clerk.
Correct Answer: C

Rationale: The correct answer is C: Reassess clients with unstable vital signs every 2 hours. This is the priority because clients with unstable vital signs require frequent monitoring to detect any deterioration or changes in their condition promptly. This action directly impacts patient safety and allows for timely intervention if needed.
Assigning assistive personnel for client education (A) is important for infection control but may not be the priority during a staffing shortage. Ensuring scheduled baths (B) is important for hygiene but can be delayed if necessary. Delegating documentation of intake and output (D) to the unit clerk is not appropriate as it involves clinical judgment and assessment.

A nurse manager is reviewing the unit's compliance with infection control protocols. Which of the following findings requires immediate intervention?

  • A. An assistive personnel wears gloves while feeding a client.
  • B. A nurse uses hand sanitizer before entering a client's room.
  • C. A nurse reuses a disposable gown after leaving a client's room.
  • D. A client's visitor washes their hands upon entering the room.
Correct Answer: C

Rationale: Reusing a disposable gown violates infection control protocols, as it risks cross-contamination. The other actions align with or exceed standard infection control practices.

A nurse manager is reviewing the admission history of four adults who were admitted to the medical-surgical unit during the shift. Which of the following situations is the nurse required to disclose information to an outside agency about the client or the client's circumstances?

  • A. A young adult client admitted for acute glomerulonephritis following a viral infection
  • B. A dependent adult admitted for the treatment of a spiral fracture
  • C. A young adult client admitted for asthma and has track marks that may indicate IV drug abuse
  • D. An emancipated minor who has acute appendicitis and wants to leave the facility without treatment
Correct Answer: B

Rationale: The correct answer is B because a dependent adult admitted for the treatment of a spiral fracture falls under mandatory reporting requirements for suspected abuse or neglect. The nurse is obligated to disclose information to an outside agency to ensure the safety and well-being of the patient. In cases of suspected abuse or neglect, it is crucial to involve external agencies to investigate and protect the vulnerable adult.

Choices A, C, and D do not necessarily involve mandatory reporting to an outside agency. A young adult with glomerulonephritis or asthma with possible IV drug abuse may not require immediate disclosure unless there is a clear indication of harm or risk to the patient. An emancipated minor with acute appendicitis wanting to leave without treatment raises ethical concerns but may not involve mandatory reporting unless there are specific legal requirements in place.

A nurse is supervising a newly licensed nurse who is caring for a client on a behavioral health unit. Complete the following sentence by using the list of options.

  • A. provide continuous monitoring of this client
  • B. assess for readiness for release from seclusion
  • C. clearly document reason for seclusion then obtain provider prescription for seclusion or restraints
  • D. provide means for hygiene and elimination
  • E. discuss reason for seclusion with client
  • F. offer food and fluids
Correct Answer: A,C

Rationale: The correct answers are A and C. A is important to ensure the safety and well-being of the client, especially in a behavioral health unit where close monitoring is crucial. C is necessary to ensure proper documentation and adherence to protocols when seclusion or restraints are used. B is incorrect as assessing readiness for release from seclusion should only be done by a qualified provider. D is important but not as urgent as continuous monitoring. E is not appropriate as discussing the reason for seclusion with the client may not be beneficial during an acute episode. F is important but providing food and fluids should not be the priority over continuous monitoring and proper documentation.

A nurse is delegating client care assignments for the shift. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?

  • A. Teach a client about low-sodium foods.
  • B. Measure and record intake and output for a client.
  • C. Perform wound irrigation for a client.
  • D. Evaluate pain relief for a client following the administration of a pain medication.
Correct Answer: B

Rationale: The correct answer is B: Measure and record intake and output for a client. This task can be safely delegated to an assistive personnel (AP) as it is a non-invasive and routine task that does not involve critical thinking or interpretation. APs are trained to perform basic tasks like measuring and recording intake and output accurately under the supervision of a nurse. Other choices are incorrect because: A involves providing client education which requires critical thinking and assessment skills, C involves a procedure that requires specific training and skill, and D involves evaluating the effectiveness of pain relief which requires nursing judgment and assessment skills.