ATI Leadership Proctored Retake Exam
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this test consisting of 70 multiple-choice ques with Ans
1. A nurse on a med-surge unit is caring for four clients. The nurse should
recognize that which of the following clients is the priority?
A. a client who is scheduled for a tubal ligation in 2 hours and is crying
B. A client who has peripheral vascular disease and has an absent pulse in the right
foot
C. A client who has type 1 diabetes and needs the first dressing change for an ulcer
D. A client who has MRSA and has an axillary temperature of 100.4F
Answer: B. A client who has peripheral vascular disease and has an absent pulse in the right
foot
When using ABCs approach to client care, the nurse determines that the priority finding is an
absent pulse, which indicates no blood flow to the extremity.
2. Which of the following instructions provided by a nurse reflects effective
communication regarding delegation of a task to an AP?
A. "Take vitals every 2 hours for the client who had a cholecystectomy in room 6122'
,B. "Check the urinary output at 1100 for John Doe and report it to me imme- diately"
C. "Report to me if the chest drainage is excessive for Jane Doe in room 2438"
D. "Please notify me of any clients whose vital signs of blood glucose levels are
significant"
Answer: B. "Check the urinary output at 1100 for John Doe and report it to me immediately"
Follows the Five Rights of Delegation by including the requirements for right di-
rection/communication: the data to collect, client-specific information, a timeline for collection,
and the expectation for communicating the findings back to the nurse.
3. A client on a general surgical unit tells a nurse that staff members are
not answering the call light properly. The client requests to be transferred to another
unit. Which of the following actions should the nurse take first?
A. notify the charge nurse of the client's request for transfer
B. Assure the client that their concern has been shared with staff
C. Tell the client that future calls will be answered in a timely manner
D. Ask the client to verbalize their expectations
Answer: D. Ask the client to verbalize their expectations
The first action the nurse should take using the nursing process is to assess; therefore, the first
action the nurse should take is to assess the client's feelings and clarify expectations.
4. 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 the following actions should the nurse take?
A. Inform the client of the consequences of decreased cerebral circulation
B. Initiate a mental health consultation to determine why they client refuses the
surgery
,C. Discuss the client's concerns about having the surgery
D. Provide the client with information on additional treatment options
Answer: C. Discuss the client's concerns about having the surgery
The nurse should ask the client relevant questions to determine their concerns regarding having
the surgery. By asking relevant, open-ended questions, the nurse can help the client clarify their
thoughts and feelings about the surgery. The nurse can then relay concerns to the provider for
further discussion if needed.
5. A charge nurse is supervising the care of several clients. Which of the following
actions requires intervention by the charge nurse?
A. A nurse is photocopying their assigned client's diagnostic results
B. A CNA documents a client's vitals on the client's paper-based graphic record
C. The unit secretary faxes a client's lab results to the provider
D. An RN stays with a client who is reading the medical records that were requested
Answer: A. A nurse is photocopying their assigned client's diagnostic results
Photocopying diagnostic test results is a breach of the clients confidentiality and privacy
6. A nurse is receiving report from the CNA assigned to the nurse's group of clients.
Which of the following statements from the CNA indicates the client the nurse should
assess first?
A. "The client who has abdominal surgery 3 days ago is reporting feeling
constipated'
B. "The client who had the hip replacement reports pain as a 4 on a scale of 0-10"
C. "The client who had an indwelling cath removed 8 hours ago reports inability
to void"
D. "The client who is scheduled for discharge today states they are ready to sign their
,paperwork"
Answer: C. "The client who had an indwelling cath removed 8 hours ago reports inability to
void"
Not voiding for 6-8 hours after indwelling urinary catheter removal indicates this
client is at risk for urinary retention, which can cause a UTI. Overdistention of the bladder can
cause damage to the mucosa. Therefore, the nurse should assess this client first and report
findings to the provider.
7. A nurse manager is planning an in-service for a group of nurses about caring for
clients following stem cell transplants. Which of the following in- structions should the
nurse manager include in the teaching?
A. Assign two clients who have had a stem cell transplant to the same room
B. Obtain a rectal temp on client's q4 hours
C. Wear an N95 respirator mask while caring for these clients
D. Place clients in positive pressure airflow rooms
Answer: D. Place clients in positive pressure airflow rooms
The nurse should place a client who requires protective environment precautions following a
stem cell transplant in a private, positive-pressure airflow room. The room air is filtered through a
HEPA filter and the airflow rate is set at more than 12 air exchanges each hour.
8. A nurse is developing a plan of care for a school-age child whose family is homeless.
Which of the following findings should the nurse identify as the priority?
A. The child has red fissures at the corners of their mouth
B. The child has several small bruises on both legs
C. The child sleeps for about 13 hours each night
D. The child is not regularly attending school
Answer: A. The child has red fissures at the corners of their mouth
,Using Maslow's hierarchy of needs, the nurse should determine that the priority finding is red
fissures at the corners of the child's mouth. This can indicate a vitamin B deficiency, which is a
physiology need.
9. A charge nurse recognizes a trend of poor attendance at monthly staff meetings. To
address this issue, which of the following actions should the charge nurse take first?
A. Write a memo emphasizing the importance of attending staff meetings
B. Appoint a task force to promote attendance at the meetings
C. Explore the reasons that staff are not attending the meetings
D. Reduce the number of meetings the staff are required to attend
Answer: C. Explore the reasons that staff are not attending the meetings
The nurse should first identify the reasons that staff are not attending the meetings.
This allows the nurse to address the specific problems identified by the staff.
10. A nurse walks into the nurse's station and sees several staff members are looking at
the EHR for a celebrity client on another unit. Which of the following actions should the
nurse take first?
A. Remind the staff members that this is a breach of confidentiality
B. Discuss the issue with the nurse manager
C. Request that an administrative restriction be placed on the client's record access
D. Prepare a memo for the facility ethics committee
Answer: A. Remind the staff mem- bers that this is a breach of confidentiality
When using the urgent v nonurgent approach to client care, the nurse determines that the first
action is to intervene immediately to prevent any further breach in confidentiality.
11. A nurse is providing preop teaching for a client who is scheduled for a total knee
arthroplasty and speaks a different language. Which of the following interprofessional team
,members should the nurse include in the discussion?
A. Interpreter
B. Social worker
C. Occupational therapist
D. Spiritual advisor
Answer: A. Interpreter
The nurse should plan to request an interpreter for the client. The role of the inter- preter is to
interpret between the language spoken by the client and the language spoken by the nurse.
12. A nurse is reviewing a client's clinical pathway upon discharge following hip
arthroplasty. Which of the following info can assist the nurse in evaluating the cost
effectiveness of the care?
A. the age of the client
B. the availability of community support groups
C. the length of the client's stay
D. the type of insurance the client carries
Answer: C. the length of the client's stay
The client's clinical pathway is a standardized approach to assist the nurse to provide cost-effective
client care and shorten the length of stay.
13. A nurse is reviewing the plan of care for a client following a total hip arthroplasty.
Which of the following actions should the nurse plan to take?
A. assess the client's incision q8 hours for the first 48 hours
,B. inform the CNA of the client's weight bearing status
C. instruct the client to cross their legs at the ankles when sitting in a chair
D. Teach the client's partner to assist the client to flex the hip at least 120 degrees
each hour
Answer: B. inform the CNA of the client's weight bearing status
AP can assist clients with ambulation in most cases with appropriate delegation from the nurse
The nurse should inform the AP of postop prescriptions for weight-bearing as part of safe care
delegation.
14. A case manger is planning an interprofessional conference for a client who is 3 days
postop following an open reduction and internal fixation of the right hip. Which of the
following concerns is the priority for discussion at the conference?
A. The client does not have transportation for discharge home
B. The client refuses to attend physical therapy sessions
C. The client's home health nurse has not completed the home assessment
D. The client describes feelings of depression after family visits
Answer: B. The client refuses to attend physical therapy sessions
The greatest risk is postop complications due to immobility, such as atelectasis or pneumonia;
therefore, the priority for discussion is the client's refusal to participate in PT.
15. A nurse is caring for a client who has osteoarthritis and reports difficulty buttoning
their clothes. The nurse should recommend a referral for the client to which of the
following members of the interprofessional team?
A. podiatrist
B. social worker
C. paramedical tech
, D. occupational therapist
Answer: D. OT
The nurse should recommend a referral to an OT for a client who has OA and reports difficulty with
ADLs. OT can assist the client with exercises to help the client complete these tasks.
16. A charge nurse is observing a newly licensed nurse's use of time-man- agement
skills. Which of the following actions by the newly licensed nurse indicates effective
use of this skill?
A. Documents client tasks at the end of the shift
B. gathers supplies as needed while completing an activity
C. group tasks that are in the same location
D. skips breaks throughout the day to complete work on time
Answer: C. group tasks
that are in the same location
The newly licensed nurse should group tasks that are in the same location to effectively use
time. This prevents the nurse from going back and forth from one area to another. This action
promotes effective time-management skills.
17. A nurse is caring for a client who requests pain meds. The nurse fulfills a promise to
return with the meds within 15 mins. The nurse is demonstrating which of the following
ethical principles?
A. beneficience
B. utility
C. justice
D. fidelity
Answer: D. Fidelity
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