ATI LEADERSHIP FUNDAMENTAL EXAM TEST BANK
ACTUAL EXAM QUESTIONS WITH DETAILED VERIFIED
ANSWERS/A+ GRADE ASSURED
• A patientis brought to the emergency department following a motor-vehicle crash. Drug use is
suspected inthe crash, and a voided urine specimen is ordered. The patientrepeatedly refuses to
provide the specimen. Which of the following is the appropriate action by the nurse?
• Tell the patientthat a catheter will be inserted.
• Document the client’s refusal in the chart.
• Assess the patientfor urinary retention.
• Obtain a provider’s prescription for a blood alcohol level.
• A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to assign
to a licensed practical nurse?
• Pick up the meal trays after lunch.
• Administer a nasogastric tube feeding.
• Plan break times for assistive personnel.
• Determine adequacy of ventilator settings.
• A nurse preceptor is evaluating a newly licensed nurse’s competency in assisting with a sterile
procedure. Which of the following actions indicates the newly licensed nurse is maintaining sterile
technique? (SATA)
• Places sterile items within a 1.25 cm (0.5 in) border around the edges of the sterile field
• Opens the sterile pack by first unfolding the top flap away from her body
• Prepares a container of sterile solution on the field after putting on sterile gloves
• Removes the outside packaging of a sterile instrument before dropping it onto the
sterilefield
• Holds the sterile solution bottle with the label facing up
• A nurse enters a client’s room and identifies that the patientis receiving too much IV fluid because
the IVpump is not working properly. Which of the following actions should the nurse take first?
• Auscultate the client’s lungs.
• Notify the provider.
• Place a faulty equipment tag on the pump.
• Complete an incident report.
• A nurse is planning care for a group of clients and can delegate care to a licensed practical nurse (LPN)
andan assistive personnel. Which of the following tasks should the nurse assign to the LPN?
• Reinforcing teaching with a patientwho is learning to self-administer insulin
• Ambulating a patientwho is scheduled for discharge later in the day
• Administering morphine IV bolus to a patientwho is hr postoperative
• Admitting a new patientwho has chronic back pain to the unit
• A nurse is supervising a newly licensed nurse who is performing surgical asepsis. After donning a
sterile gown and gloves, which of the following actions by the newly licensed nurse demonstrates
correct aseptictechnique?
• The nurse applies goggles.
• The nurse turns her back to the sterile field.
• The nurse holds her hands above her waist.
• The nurse puts on a face mask.
• A nurse who is caring for a group of clients delegates collection of vital signs to an assistive
personnel(AP). Which of the following actions should the nurse take to evaluate the delegated
task?
• Review vital sign trends at the end of the shift.
• Recheck vital signs that are outside the expected reference range.
• Ask the AP to write a summary of the delegated tasks during the shift.
• Compare the vital signs the AP obtained with those taken by another AP on a previous shift.
,• A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive personnel?
• Obtaining a stool sample from a patientwho has renal failure
• Monitoring a patientwho has a fluid restriction
• Assessing a patientwho just returned from hemodialysis
• Reviewing dietary instructions for a patientwho has kidney stones
• A nurse is triaging a group of clients following a disaster. Which of the following clients should the
nurserecommend for treatment first?
• A patientwho has a neck injury and is unable to breathe spontaneously
• A patientwho has two open chest wounds with a left tracheal deviation
• A patientwho has major burns over 75% of her body surface area
• A patientwho has bipolar disorder and is exhibiting signs of hallucination (Class 3)
• A nurse manager is reviewing guidelines for informed consent with the nursing staff. Which of
thefollowing statements by a staff nurse indicates that the teaching was effective?
• “A family member can interpret to obtain informed consent from a patientwho is deaf.”
• “Consent can be given by a durable power of attorney.”
• “Guardian consent is required for an emancipated minor.”
• “The nurse can answer any questions the patienthas about the procedure.”
• A nurse is caring for four clients. For which of the following clients should the nurse collaborate with
thefacility ethics committee?
• A middle adult patientwho leaves the facility against medical advice
• An older adult patientwho has advanced directives on file
• A young adult patientwho is participating in a medical research study
• An adolescent patientwhose parents refuse a blood transfusion for religious reasons
• A nurse in an ambulatory care setting is orient a newly licensed nurse who is preparing to return a call
to a client. The nurse should explain that which of the following is an objective of telehealth?
• Assessing patientneeds
• Developing patienttreatment protocols
• Providing medication reconciliation
• Establishing communication between providers (Community Health pg. 75)
• A nurse is providing discharge teaching to a patientwho has a new diagnosis of diabetes. The
patientexpresses concern about the cost of blood-glucose monitoring supplies. Which of the
following actionsshould the nurse take?
• Refer the patientto the social services department.
• Provide the patientwith a week’s worth of supplies from the hospital (still needs help paying
after)
• Ask the provider about the possibility of less frequent monitoring (pt needs to monitor often)
• Recommend the patientreuse the testing lancets (breaks the safety & infection protocol)
• A charge nurse is receiving change-of-shift report. Which of the following situations should the
chargenurse address first?
• A nurse on the previous shift wrote an incident report about a medication error.
• Two staff members have called to say they will be absent.
• Transport assistance is unavailable to take a patientto occupational therapy.
• The emergency department nurse is waiting to give report on a new admission.
• A nurse who is precepting a newly licensed nurse is discussing the patientassignment for the shift.
Which ofthe following actions should the nurse preceptor take first to demonstrate appropriate time
management?
• Complete required tasks.
• Review the client’s new laboratory values.
• Determine patientcare goals (set/plan goals)
• Document assessment data.
• A charge nurse is reviewing information about HIPAA with a group of staff nurses. Which of the
followingstatements by a staff nurse indicates understanding?
• “Clients who participate in research studies forfeit their HIPAA right to privacy.”
• “HIPAA allows facility-specific coding of patienthealth care information to ensure privacy.”
, • “HIPAA prohibits the uploading of photographs of client’s providers to social media sites.”
• “HIPAA allows clients to request a review of their own medical records.”
• A nurse is caring for a patientwho has a tumor. The provider recommends surgery. The
patientrefuses, 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 patientunderstands the risk of refusing the procedure
• Whether the facility ethics committee reached a consensus on the case
• Whether the partner is the client’s durable power of attorney for health care
• Whether the client’s refusal is based on religious belief
• A charge nurse is planning the care of four newborns. An assistive personnel and licensed practical
nurseare available for staffing. Which of the following tasks should the nurse assign to a licensed
practical nurse?
• Conduct the newborn hearing screening. (RN assessment)
• Administer a hepatitis B vaccine.
• Perform a New Ballard screening. (RN assessment)
• Obtain vital signs. (CNA)
• During a staff meeting a unit manager reviews the results for documenting patienteducation and finds
that they are below the benchmark. Which of the following strategies should the nurse manager
implement first?
• Train LPNs to reinforce teaching with clients using a standardized teaching plan.
• Determine factors that interfere with the documentation of patienteducation.
• Include documentation of patienteducation as part of unit nurses’ annual performance
evaluation.
• Offer incentives for the staff once the unit’s results are back in adherence with the benchmark.
• A nurse is explaining ethics and values to a newly licensed nurse. The nurse should explain that
preventingpatientinjury by removing a fall hazard demonstrates which of the following ethical
principles?
• Utility
• Autonomy
• Nonmaleficence
• Veracity
• A nurse is caring for a group of clients. Which of the following clients should the nurse plan to assess
first?
• A patientwho has congestive heart failure and has lost 0.9 kg (2 lb) in the past 24 hr (improvement)
• A patientwho has diabetes mellitus and reports paresthesia in his fingers and toes
(ABC--circulation)
• A patientwho has a nasogastric tube and has crackles in the lungs (ABC--airway)
• A patientwho has a new diagnosis of Graves’ disease and a TSH level of 0.2 microunits/mL
• A charge nurse is planning to evacuate clients on the unit because there is a fire on another floor.
Which ofthe following clients should the nurse evacuate first?
• A patientwho is in Buck’s traction for a left hip fracture (can’t necessarily move too much)
• A patientwho is 1 day postoperative following thoracic surgery and has a chest tube
(possiblephysical instability)
• A patientwho is confused and restrained for safety (still needs continual nursing care/assessment)
• A patientwho is receiving IV chemotherapy and is ambulatory
• A nurse enters the room of a patientwho is unconscious and finds that the client’s son is reading her
electronic medical records from a monitor located at the bedside. Which of the following actions should
thenurse take first?
• Recommend the son meet with the provider to get information about his mother’s condition.
• Report the possible violation of patientconfidentiality to the nurse manager.
• Complete an incident report regarding the breach of the client’s confidentiality.
• Log out the computer so that the client’s son is unable to view his mother’s information.
• A nurse is preparing a patientfor cardiac catheterization. Just before the procedure, the patientasks the
nurseabout the risks of the procedure. Which of the following actions should the nurse take?
, • Explain the risks of the procedure to the client.
• Convey the client’s request to the nurse who witnessed the consent.
• Check to see if the medial record indicates the provider explained the procedure to the client.
• Notify the provider about the client’s concerns.
• A nurse is prioritizing care after receiving change-of-shift report on four clients. Which of the
followingclients should the nurse assess first?
• A patientwho reports a headache with sensitivity to light
• A patientwho reports an urge to void but has not urinated during the prior shift
• A patientwho reports indigestion and pain in her jaw
• A patientwho reports feeling lightheaded when he stands up from a lying position
• A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of
thefollowing actions should the nurse take first?
• Discuss time management strategies with the nurses.
• Determine the reasons the nurses are not taking scheduled breaks. Assess first
• Provide coverage for the nurses’ breaks.
• Review facility policies for taking scheduled breaks.
• A nurse is preparing to delegate bathing and turning of a newly admitted patientwho has end-stage
bone cancer to an experienced assistive personnel (AP). Which of the following assessments should
the nursemake before delegating care?
• Has the AP checked the client’s pain level prior to turning her? (RN only - do not delegate
what you can EAT = evaluate, assess, teach)
• Is the client’s family present so the AP can show them how to turn the client? (this is
not necessary)
• Has data been collected about specific patientneeds related to turning? (Assessment of
holisticcare r/t pt needs and what the experienced AP can do)
• Does the AP have the time to change the client’s central IV line dressing after turning her?
(APcannot change dressings)
• A nurse is preparing to transfer a patientfrom the emergency department to a medical-surgical unit using
the SBAR communication tool. Which of the following information should the nurse include in the
backgroundportion of the report?
• A prescribed consultation -under situation
• The client’s vital signs
• The client’s name -under situation
• The client’s code status -under situation
• A nurse is planning discharge for a patientwho has rheumatoid arthritis. Which of the following
statementsby the patientshould the nurse identify as an indication that a referral to an occupation
therapist is necessary?
• “I need some help planning my meals to maintain my weight.”
• “I am tired of having pain in my joints all the time.”
• “I’m having difficulty climbing the stairs at my house.”
• “I will need assistance with bathing.”
• A nurse in the emergency department is caring for a 16-year-old patientwho reports abdominal pain
and isaccompanied by an adult neighbor. The provider diagnoses a ruptured appendix and states that
the patientrequires an emergency appendectomy. Which of the following actions should the nurse?
• Ask the adult neighbor to sign the consent form.
• Obtain consent from the hospital administrator.
• Witness the patientsigning the consent form.
• Attempt to notify the client’s guardian to obtain consent.
• A nurse on a medical-surgical unit is caring for four clients. Which of the following findings is the
highest priority?
• A patientwho had a cardiac catheterization whose capillary refill in the great toe is 4
seconds
• A patientwho has COPD and has an oxygen saturation of 90%
• A patientwho had a cholecystectomy 6 hr ago and is requesting pain medication
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