Review ATI PN Medical Surgical Leadership

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ATI PN Medical Surgical Leadership

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Total Questions : 51

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Question 1:

A nurse is caring for several clients on a medical-surgical unit. Which of the following client care situations requires the nurse to complete an incident report?

A. The nurse disagrees with the nurse manager about inadequate staffing. B. A staﬀ member has not arrived at the facility to work an assigned shift. C. A client tells the nurse that his dentures are missing. D. The nurse discovers that the client does not have advanced directives.

Answer and Explanation

Choice A:

Isnot a situation that would require an incident report according to the information provided in my sources.

Choice B:

This is not a situation that would require an incident report according to the information provided in my sources.

Choice C:

An incident report should be filed whenever an unexpected event occurs. The rule of thumb is that any time a patient makes a complaint, a medication error occurs, a medical device malfunctions, or anyone— patient, staﬀ member, or visitor—is injured or involved in a situation with the potential for injury, an incident report is required ⁴. In this case, the client's missing dentures would be considered a complaint and would require the nurse to complete an incident report.

Choice D:

Isnot a situation that would require an incident report according to the information provided in my sources.

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Question 2:

The best source of information regarding the roles of the LPN in a med-surg setting is:

A. The facility's Human Resources Department B. The State Board of Nursing. C. Nursing textbooks. D. Coworkers on your unit.

Answer and Explanation

Choice A:

May have information about job descriptions and responsibilities specific to that facility.

Choice B:

The State Board of Nursing is responsible for regulating the practice of nursing within a specific state. It establishes the scope of practice for LPNs and sets the standards for their education, licensure, and practice. Therefore, the State Board of Nursing would be the best source of information regarding the roles of an LPN in a med-surg setting.

Choice C:

May provide general information about the roles of LPNs.

Choice D:

May have personal experience and knowledge about the roles of LPNs in that specific unit, but their information may not be comprehensive or up-to-date.

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Question 3:

Doing no harm is?

A. Justice B. Nonmaleficence C. Beneficence D. Veracity

Answer and Explanation

Choice A:

refers to the fair distribution of benefits and burdens in society.

Choice B:

Nonmaleficence is the ethical principle of doing no harm. It requires healthcare providers to avoid causing harm to their patients and to take steps to prevent harm from occurring.

Choice C:

refers to the obligation to do good and promote the well-being of others.

Choice D:

refers to the obligation to tell the truth and not deceive others.

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Question 4:

A nurse is assigning tasks for the upcoming shift. Which of the following tasks should the nurse delegate to assistive personnel (AP)? (Select all that apply.)

A. Providing postmortem care to a client who has just passed away. B. Instructing a client about the use of a spirometer. C. Suctioning a client's newly inserted tracheostomy. D. Transferring a client to radiology for x-rays. E. Performing a simple dressing change on a client's arm.

Answer and Explanation

Choice A:

Providing postmortem care to a client who has just passed away is a task that can be delegated to assistive personnel (AP). Postmortem care involves cleaning and preparing the body after death and is not a task that requires the specialized skills or judgement of a nurse. It is important to note that while the physical task of postmortem care can be delegated, the nurse is still responsible for providing emotional support and information to the family, coordinating with the morgue or funeral home, and completing any required documentation.

Choice B:

Instructing a client about the use of a spirometer is not a task that should be delegated to assistive personnel. Patient education requires assessment and evaluation of the patient’s understanding, which are nursing responsibilities. A spirometer is a medical device used to measure lung function and is often used after surgery to help prevent complications like pneumonia. Proper use of the spirometer is crucial to its effectiveness, so it is important that the instruction is clear and understood by the patient.

Choice C:

Suctioning a client’s newly inserted tracheostomy is not a task that should be delegated to assistive personnel. Tracheostomy care, especially suctioning, requires specialized skills and knowledge, as well as the ability to assess the patient’s respiratory status. Improper suctioning can cause trauma to the trachea, hypoxia, or infection. Therefore, this task should be performed by a nurse or other licensed healthcare professional.

Choice D:

Transferring a client to radiology for x-rays is a task that can be delegated to assistive personnel. This task involves physical assistance and does not require specialized nursing skills or judgement. However, the nurse should provide the AP with any necessary information about the patient’s condition, mobility, and any precautions that need to be taken during the transfer.

Choice E:

Performing a simple dressing change on a client’s arm is a task that can be delegated to assistive personnel. This task involves changing the bandages on a wound, which is a task that does not require specialized nursing skills or judgement. However, the nurse should ensure that the AP has been properly trained in dressing changes, understands the importance of infection control, and knows when to report any changes in the wound’s appearance.

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Question 5:

What is a nurse's best protection against negligence or malpractice?

A. Asking permission from the managing nurse prior to performing any duties. B. Following the standards of practice. C. Never be alone with a patient. D. Recording patient interactions with your phone.

Answer and Explanation

Choice B:

A nurse's best protection against negligence or malpractice is to follow the standards of practice. These standards define the acceptable level of care that a nurse is expected to provide and are based on current evidence and professional consensus. By adhering to these standards, a nurse can demonstrate that they have provided care that meets the expected level of quality and safety.

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Question 6:

A nurse is delegating tasks to an assistive personnel (AP). Which of the following tasks should the nurse assign to the AP?

A. Assisting the client in selecting a low-residue diet. B. Performing a complex dressing change. C. Reviewing the steps of self-blood glucose monitoring with a client. D. Obtaining vital signs on clients who are stable.

Answer and Explanation

Choice D:

Assistive personnel (AP), also known as unlicensed assistive personnel (UAP), can perform tasks such as recording vital signs ¹. Obtaining vital signs on clients who are stable [d] is a task that can be delegated to an AP.

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Question 7:

A nurse observes two assistive personnel (AP) arguing over who should go on break first. The nurse interrupts the conversation and states that one AP can take a break now, but the other AP will get to take an early lunch. Which of the following types of conﬂict management is the nurse demonstrating?

A. Cooperating B. Compromising C. Competing D. Avoiding

Answer and Explanation

Choice A:

involves one party giving in to the demands of the other party in order to maintain harmony.

Choice B:

In this situation, the nurse is demonstrating the compromising style of conﬂict management. Compromising involves finding a middle ground where both parties give up something in order to reach a mutually acceptable solution. In this case, the nurse suggests that one AP can take a break now, but the other AP will get to take an early lunch. This solution allows both APs to have some of their needs met while also making concessions.

Choice C:

involves one party trying to win at the expense of the other party.

Choice D:

involves avoiding or withdrawing from the conﬂict altogether.

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Question 8:

A nurse requests that an assistive personnel (AP) change all the linens and give bed baths to four clients on the unit. The previous day, the AP was not able to complete these same tasks. Which of the following actions should the nurse take in addressing this situation?

A. Oﬀer to help the AP complete the tasks. B. Assign a more qualified staﬀ member to the tasks. C. Plan a more reasonable job assignment. D. Set a time frame for the AP to complete the tasks.

Answer and Explanation

Choice A:

Offering to help the AP complete the tasks may seem like a good solution in the short term. However, this approach does not address the underlying issue, which is that the AP was not able to complete these tasks the previous day. The nurse’s role is to delegate tasks appropriately and ensure that all tasks are completed in a timely manner. If the nurse takes over the AP’s tasks, it could lead to an imbalance in the workload and could potentially overburden the nurse. Therefore, while this choice may seem helpful, it is not the most effective solution to the problem.

Choice B:

Assigning a more qualified staff member to the tasks could be a potential solution if the AP’s inability to complete the tasks was due to a lack of skills or knowledge. However, without more information, it’s not clear that this is the case. Furthermore, this approach could lead to resentment among staff if it appears that tasks are not being distributed fairly. Therefore, while this choice could be a potential solution, it is not the most effective solution given the information provided.

Choice C:

Planning a more reasonable job assignment is the most effective solution to this problem. If the AP was not able to complete the tasks the previous day, it suggests that the workload was too heavy or the tasks were too complex. By reassessing the job assignment and making it more manageable, the nurse can ensure that all tasks are completed in a timely manner. This approach respects the abilities and limitations of the AP, promotes a fair distribution of tasks, and ensures the best care for the clients.

Choice D:

Setting a time frame for the AP to complete the tasks could be a potential solution if the issue was that the tasks were not completed in a timely manner. However, if the AP was not able to complete the tasks at all, simply setting a time frame may not resolve the issue. This approach could also add unnecessary pressure on the AP, which could lead to rushed or substandard work. Therefore, while this choice could be a potential solution, it is not the most effective solution given the information provided.

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Question 9:

A nurse is receiving a change-of-shift report for four clients. Which of the following findings should the nurse identify as the priority?

A. A client who had a blood transfusion and has a blood pressure of 138/76 mm Hg. B. A client who has skeletal traction for a femur fracture and reports incisional discomfort of 4 on a scale of 0 to 10. C. A client who is 4 hours postoperative following a total hip arthroplasty and has a urinary output of 15 ml/hr

Answer and Explanation

Choice A:

A client who had a blood transfusion and has a blood pressure of 138/76 mm Hg. This client is stable. The blood pressure is within normal range, indicating that the client is not experiencing a transfusion reaction, which could cause hypotension. Therefore, this client is not the highest priority.

Choice B:

A client who has skeletal traction for a femur fracture and reports incisional discomfort of 4 on a scale of 0 to 10. While pain management is an important aspect of client care, a pain level of 4 indicates that the client’s pain is manageable. Therefore, this client is not the highest priority.

Choice C:

A client who is 4 hours postoperative following a total hip arthroplasty and has a urinary output of 15 mL/hr. This client is showing signs of oliguria, which could indicate a serious complication such as hypovolemia or acute kidney injury. This client is the highest priority because these complications can lead to further serious issues such as shock or end-organ damage if not addressed promptly.

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Question 10:

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

A. Collecting intake and output. B. Evaluating pain relief after administering pain medication. C. Providing a central line dressing change. D. Selecting a menu for a low-sodium diet.

Answer and Explanation

Choice A:

Assistive personnel (AP), also known as unlicensed assistive personnel (UAP), can perform tasks such as recording vital signs ¹. Collecting intake and output [a] is a task that can be delegated to an AP.

Choice B:

involves assessing the eﬀectiveness of a medical intervention, which is typically the responsibility of a licensed nurse.

Choice C:

is a complex task that requires specialized knowledge and skills.

Choice D:

involves dietary planning, which is typically the responsibility of a licensed nurse or a registered dietitian.

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Total Questions : 51

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ATI PN Medical Surgical Leadership

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