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, ATI RN LEADERSHIP PROCTORED EXAM A
ACTUAL NGN QUESTIONS AND CORRECT ANSWERS
1. An assistive personnel tells a charge nurse that it is unfair that they have to take
care of all the clients who are incontinent. Which of the following responses should
the charge nurse make?
A. I delegate tasks to personnel based on their job descriptions
B. Everyone working here has to care for clients who are in continent
C. Let's talk about organizing the workflow so you care for fewer of these clients
D. Why do you not want to care for clients who are in continent.?
Answer: A. I delegate tasks to personnel based on their job descriptions.
This response addresses the AP's concerns and provides clear information about
,the charge nurse's responsibility when delegating tasks.
2. A nurse on a MedSurg 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 two hours and is crying
B. A client who has PVD and absent pulse in right foot
C. A client who has T1DMN needs first dressing change for ulcer
D. A client who has MR essay and axillary temp of 38°C
Answer: B. A client who has peripheral vascular disease and absent pulse in right foot.
When using the airway, breathing, circulation approach to client care, the nurse determines
that the priority finding is an absent pulse, which indicates no blood flow to the extremity.
3. Which of the following instructions provided by a nurse reflects effective
communication regarding delegation of a task to an AP?
A. Take vital signs every two hours for the client you had a choleycystectomy in room
6122
B. Check the UO at 11 o'clock for John Doe and report it to me immediately
C. Report to me if the chest tube drainage is excessive for Jane doe in room 2438
D. Please notify me of any clients who is vital signs or blood glucose levels are
significant
,Answer: B. Check the Urinary Output at 1100 for John Doe and report it to me immediately
This instruction follows the five rights of delegation by including the requirements for right
direction/communication:
the data to collect, client-specific information, a timeline for coat collection, and the expectatio
for communicating the findings back to the nurse
,4. A client on a general surgical unit tells the nurse that staff members are not
answering the call light promptly. The client request to be transferred to another unit.
Which of the following actions should the nurse take first?
A. Notify charge nurse of clients request to transfer
B. Assured client that their concern has been shared with the staff
C. Tell client that future calls will be answered in timely manner
D. Ask client to verbalize their expectations
Answer: D. Ask 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.
5. A nurse is caring for a client who is recovering from a stroke. The provider
recommends extracranial-intracranial bypass, but the client tells the nurse that he
will not have the surgery. Which of the following action should the nurse take?
A. Informed the client of consequences of decreased cerebral circulation
B. Initiate mental health consult to determine why client refuses surgery
C. Discussed clients concerns about having the surgery
D. Provide client with information on additional treatment options
Answer: C. Discuss clients concerns about having the surgery.
,The nurse should ask the client relevant questions to determine their concerns regarding havin
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 these concerns to the
provider for further discussion if needed.
6. A charge nurse is supervising the care of several clients. Which of the following
actions requires intervention by the charge nurse?
A. A nurse photocopying their assigned clients diagnostic test results
B. AP documents a client VS on clients paper-based graph record
C. Unit secretary faxing clients lab results to the provider
D. RN stays with client who is reading the medical records that were request- ed
Answer: A. Nurse photocopying their assigned clients diagnostic test results
7. A nurse is receiving report from the AP assigned to the nurse's group of clients.
Which of the following statements from the EAP indicates the client the nurse
should assess first
A nurse is receiving report from the AP assigned to the nurses group of clients. Which of
the following statements from the AP indicates the client the nurse should assess first?
,A. Client who had ABD surgery three days ago and reporting feeling consti- pated
B. Client who had hip surgery reports pain 4/10
C. Client indwelling urinary catheter removed eight hours ago reports inability to void
D. Client who is scheduled for discharge today states they are ready to sign their
paper
Answer: C. Client who had indwelling urinary catheter removed eight hours ago reports inabilit
to void.
Not voiding for 6 to 8 hr after indwelling urinary catheter removal indicates this client is at risk
for urinary retention, which can cause a UTI.
8. A nurse manager is planning an in-service for a group of nurses about caring for
clients following stem cell transplant.Which of the following instruc- tions should the
nurse manager include in the teaching?
A. Assigned to clients who have had a stem cell transplant to the same room
B. Obtain rectal temp Q4 hours
C. Where an N 95 respirator mask while caring for these clients
D. Place clients in positive pressure airflow rooms
Answer: D. Place clients and positive pressure airflow rooms.
The patient requires protective equipment precautions following a stem cell trans-
,plant in a private, positive pressure airflow room. The room air is filtered through a HEPA filt
and the air flow rate is set at more than 12 error exchanges per hour
9. 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 a priority?
A. Child has red fissures at the corners of their mouth
B. Child has several small bruises on both legs
C. Child sleeps for 13 H hour each night
D. Child is not regularly attending school
Answer: A. Child has red fissures at the corners of the mouth.
Use Maslow's hierarchy of needs, this can indicate a vitamin B deficiency which is a
physiological need.
10. A charge nurse recognizes a trend of poor attendance at monthly staff
meetings. To address this issue, which of the following actions should the nurse
charge nurse take first?
A. Write a memorandum emphasizing the importance of attending staff meet- ings
,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 the staff are not attending the meetings.
According to evidence-based practice, the nurse should first identify the reasons that staff are no
attending the meetings. This allows the nurse to address the specific problems identified by the
staff.
11. A nurse walks into the nurses station and sees several staff members looking at
the electronic medical record EMR record of 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 administrative restriction be placed on the clients record access
D. Prepare a memo for facility ethics committee
Answer: A. Remind the staff members that this is a breach of confidentiality.
When using the urgent vs nonurgent approach to client care, the nurse determines that the firs
action is to intervene immediately to prevent any further breach in confidentiality.
, 12. A nurse is providing preoperative teaching for a client who is scheduled for a total
knee arthroplasty (TKA) and speaks a different language than the nurse. Which of
the following inter-professional team members should the nurse include in the
discussion?
Answer: Interpreter
13. A nurse is reviewing a client's clinical pathway upon discharge following hip
arthroplasty. Which of the following information can assist the nurse in evaluating
the cost effectiveness of the care?
A. The age of client
B. Availability of community support groups
C. Length of clients stay
D. Type of insurance the client carries
Answer: C. The length of clients 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.
14. 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 clients incision Q8 hours for first 48 hours
B. Inform AP of clients weight bearing status
10 /
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