ATI NU2508 Leadership Final Exam

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A nurse is teaching a class on torts. The nurse should include which of the following situations as an example of negligence?

  • A. A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving.
  • B. A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.
  • C. A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge.
  • D. A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the potato chips.
Correct Answer: C

Rationale: The correct answer is C because administering medication without the client's knowledge and against their refusal constitutes a breach of the duty of care and violates the client's autonomy and right to make decisions about their own treatment. This is an example of negligence as it goes against the ethical principle of informed consent. Choices A, B, and D do not meet the criteria for negligence as they involve actions taken in the best interest of the client, such as preventing harm or reporting concerning findings to the provider. In choice A, the nurse is trying to prevent harm by applying restraints to a client who is making a potentially harmful decision. In choice B, the nurse is identifying and reporting a concerning clinical finding promptly. In choice D, the nurse is attempting to educate the client and prevent harm related to dietary restrictions.

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A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?

  • A. Withholding a dose of narcotic pain medication when the client has respiratory depression
  • B. Discussing advance directives with the client and the client's family
  • C. Providing comfort care measures to the client
  • D. Allowing the client's family unlimited visitation at the time of death
Correct Answer: A

Rationale: Correct Answer: A

Rationale: Nonmaleficence is the ethical principle of doing no harm. In this scenario, withholding a dose of narcotic pain medication when the client has respiratory depression aligns with this principle as administering the medication could further compromise the client's respiratory status and potentially harm them. By withholding the medication, the nurse is prioritizing the client's safety and well-being.

Summary of Incorrect Choices:
B: Discussing advance directives is important but does not directly relate to nonmaleficence in this context.
C: Providing comfort care measures is essential but does not specifically demonstrate the principle of nonmaleficence.
D: Allowing unlimited visitation may support emotional well-being but does not directly address the principle of nonmaleficence.

A nurse is triaging clients following a mass casualty event. Which of the following clients should the nurse assess first?

  • A. A client who has a small circular partial-thickness burn of the left calf
  • B. A client who has a massive head injury and is experiencing seizures
  • C. A client who has a splinted open fracture of left medial malleolus
  • D. A client who has severe respiratory stridor and a deviated trachea
Correct Answer: D

Rationale: The correct answer is D: A client who has severe respiratory stridor and a deviated trachea. This client should be assessed first because stridor indicates airway obstruction, which can rapidly progress to respiratory failure. A deviated trachea suggests a possible tension pneumothorax, a life-threatening condition requiring immediate intervention to prevent further deterioration. Assessing and managing the airway takes priority over other injuries.

Incorrect choices:
A: A small circular partial-thickness burn of the left calf is a lower priority as it does not pose an immediate threat to life compared to airway compromise.
B: A massive head injury with seizures is serious but managing the airway is the priority in this scenario.
C: A splinted open fracture of the left medial malleolus is important but does not pose an immediate threat to life compared to airway and breathing concerns.

A nurse manager is addressing a conflict between a nurse and a client's family member who is upset about visiting hour restrictions. Which of the following statements by the nurse manager is appropriate?

  • A. I understand your frustration, and I'll review the visiting policy with you.
  • B. You need to follow the hospital rules or leave the premises.
  • C. The nurse was just following orders, so please speak to me instead.
  • D. Visiting hours are non-negotiable to ensure client safety.
Correct Answer: A

Rationale: Correct Answer: A
Rationale: Option A demonstrates empathy towards the family member's frustration and willingness to address their concerns by reviewing the visiting policy. This approach shows respect and understanding, fostering a positive relationship and potential resolution.
Summary:
B: This response is dismissive and confrontational, not conducive to resolving conflict.
C: Passing blame to the nurse and redirecting the issue does not address the family member's concerns effectively.
D: While prioritizing client safety is important, this response lacks empathy and does not address the family member's feelings.

A nurse manager is preparing an inservice program about managing conflict for the nurses on the unit. The nurse manager should identify which of the following examples as interpersonal conflict?

  • A. An experienced nurse is uncivil to a newly licensed nurse
  • B. A nurse is uncertain about joining a professional nursing organization
  • C. Nurses on the unit disagree about what time of day daily client weights should be obtained
  • D. A nurse who just lost his spouse does not want to be assigned to care for a terminally ill client
Correct Answer: A

Rationale: The correct answer is A because it involves a direct conflict between two individuals, the experienced nurse and the newly licensed nurse. This type of conflict is interpersonal in nature as it pertains to personal interactions and relationships. The experienced nurse's uncivil behavior towards the newly licensed nurse indicates a clash of personalities or communication styles.

Choice B is incorrect as it does not involve a conflict between individuals but rather an internal struggle of the nurse deciding whether to join a professional organization. Choice C is incorrect as it describes a disagreement among nurses about a work-related task, which is more of an intragroup conflict. Choice D is incorrect as it represents a personal issue of the nurse dealing with grief, not a conflict with another individual.

A nurse is preparing to discharge a client who has a new prescription for warfarin. Which of the following tasks should the nurse delegate to an assistive personnel (AP)?

  • A. Teach the client about dietary restrictions with warfarin.
  • B. Provide the client with written discharge instructions.
  • C. Assist the client with packing personal belongings.
  • D. Schedule a follow-up appointment for the client.
Correct Answer: C

Rationale: Assisting the client with packing personal belongings is a non-clinical task within the AP's scope of practice. Teaching, providing instructions, and scheduling appointments require nursing expertise.