Preview Extract
ATI PN LEADERSHIP PROCTORED EXAM 2019 LATEST UPDATE
QUESTIONS AND CORRECT ANSWERS|A GRADED|NEW!!
VERSION 1
1. A nurse is assigned the following four clients for the current shift. Which of the following
clients should the nurse assess first?
A. A client who has a hip fracture and is in Buck’s traction
B. A client who has aspiration pneumonia and a respiratory rate of 28/min
C. A client who has diabetes mellitus stage 2 pressure ulcer on his foot
D. A client who has a C diff infection and needs a stool specimen collected
Answer: D. A client who has a C diff infection and needs a stool specimen collected
Rationale:
C. diff (Clostridium difficile) infection is a serious health concern that requires prompt
identification and management. Collecting a stool specimen is crucial for confirming the
diagnosis and initiating appropriate treatment. Additionally, C. diff infection can be highly
contagious, so timely collection and isolation measures are important to prevent its spread to
others. Therefore, the nurse should prioritize assessing and collecting the stool specimen
from the client with C. diff infection.
2. A nurse is caring for a client who fell and is reporting pain in the left hip with external
rotation of the left leg. The nurse has been unable to reach the provider despite several
attempts over the past 30 min. Which of the following actions should the nurse take?
A. Notify the nursing supervisor about the issues
B. Contact the client’s physical therapist
C. Apply a warm compress to the hip
D. Reposition the client for comfort
Answer: A. Notify the nursing supervisor about the issues
Rationale:
When unable to reach the provider, the nurse should escalate the issue to the nursing
supervisor. The supervisor can then assist in further attempts to contact the provider or
provide guidance on managing the client's pain and hip injury.
3. The mother of a client with breast cancer states, it’s been hard for her, especially after
losing her hair. And it has been difficult to pay for all the treatments. Which of the following
actions is appropriate client advocacy?
A. The nurse investigates potential resources to help the client purchase wig
B. The nurse explains to the mother that most clients with cancer lose their hair
C. The nurse informs the next shift nurse regarding the mother’s concerns.
D. The nurse suggests counseling for the client’s body image issues
Answer: A. The nurse investigates potential resources to help the client purchase wig
Rationale:
Advocacy involves supporting the client's needs and rights. In this situation, the nurse should
explore resources that can help the client afford a wig, which can significantly impact her
self-esteem and emotional well-being. This action demonstrates empathy and proactive
support for the client's concerns.
4. Which of the following items must be discarded in a biohazard waste receptacle?
A. A urinary catheter drainage bag from a client who is post-opt
B. A bed sheet from a client with bacterial pneumonia
C. A perineal pad from a client who is 24-hr post-vaginal delivery
D. An empty IV bag removed from a client who has HIV
Answer: D. An empty IV bag removed from a client who has HIV
Rationale:
Items that have come into contact with potentially infectious materials, such as blood or
bodily fluids, must be disposed of in a biohazard waste receptacle to prevent the spread of
infection. An empty IV bag from a client with HIV may still contain traces of blood or other
bodily fluids and should be disposed of appropriately to ensure infection control.
5. A nurse tells the unit manager, “I am tired of all the changes on the unit. If things don’t get
better, I’m going to quit. “Which of the following responses appropriate?
A. “So you are upset about all the changes on the Unit”
B. “I think you have a right to be upset, I am tired of the changes too”
C. “Just stick with it a little longer. Things will get better soon
D. “ You should file complaints with hospital administrator
Answer: A. “So you are upset about all the changes on the Unit”
Rationale:
This response acknowledges the nurse's feelings and opens up a dialogue about their
concerns. It shows empathy and understanding, which can help the nurse feel heard and
supported.
6. According to the HIPAA regulations, which of the following is a violation of client
confidentiality?
A. Telephone the pharmacy with a prescription for the spouse to pick up
B. Providing a copy of the record to the transporting paramedic
C. Reporting a client’s disposition to the referring provider
D. Informing housekeeping staff that the client is in dialysis unit
Answer: D. Informing housekeeping staff that the client is in dialysis unit
Rationale:
HIPAA regulations require healthcare providers to protect the privacy and confidentiality of
client information. Informing housekeeping staff about a client's location violates their
confidentiality by disclosing protected health information (PHI) to individuals not involved in
the client's care.
7. A Nurse preceptor is evaluating a newly licensed nurse’s competency in assisting with a
sterile procedure. Which of the following actions indicates the nurse is maintaining sterile
technique? (Select all that apply.)
A. Open the sterile pack by first unfolding the flap farthest from her body
B. Rests the cap of a solution container upside down on the sterile field
C. Removes the outside packaging of a sterile instrument before dropping into the sterile field
D. Holds a bottle of a sterile solution 15 cm (6 inches) above the sterile field
E. Places sterile items within 1.25 cm (0.5 inch) border around the edge of the sterile field
Answer: A. Open the sterile pack by first unfolding the flap farthest from her body
C. Removes the outside packaging of a sterile instrument before dropping into the sterile field
D. Holds a bottle of a sterile solution 15 cm (6 inches) above the sterile field
Rationale:
• A. Opening the sterile pack by first unfolding the flap farthest from the body helps prevent
contamination of the sterile contents.
• C. Removing the outside packaging of a sterile instrument before dropping it into the sterile
field ensures that only the sterile instrument is introduced into the field.
• D. Holding a bottle of a sterile solution 15 cm (6 inches) above the sterile field helps
maintain the sterility of the solution by preventing contact with non-sterile surfaces.
8. A nurse is providing care for 4 post-opt clients. The nurse should first assess the client
A. Whose pulse has been steadily increasing during the past shift
B. Who is reporting a pain level of 8 on a scale of 0 to 10.
C. Whose urine output averaged 32 ml/hr for the past 24 hr
D. Who is reporting nausea after the prescribed antiemetic was administered
Answer: B. Who is reporting a pain level of 8 on a scale of 0 to 10.
Rationale:
Assessing the client reporting a pain level of 8 on a scale of 0 to 10 should be the nurse's first
priority. Pain management is a crucial aspect of postoperative care, and assessing and
addressing the client's pain is essential for their comfort and recovery.
9. A nurse is preparing to transcribe a client’s med prescription in the medical record. Which
of the following should the nurse recognize as containing the essential components of a
medication order?
A. NPH insulin 10 Units before and at bedtime
B. Haloperidol (Hadol) 1mg per mouth
C. Multivit every morning by mouth
D. Aspirin 650 mg by mouth every 4hr
Answer: D. Aspirin 650 mg by mouth every 4hr
Rationale:
A medication order should include the medication name (Aspirin), dose (650 mg), route (by
mouth), and frequency (every 4 hours). This prescription contains all the essential
components necessary for safe administration.
10. A nurse is assisting with orientation of a newly licensed nurse. The newly licensed nurse
is having trouble focusing and has difficulty completing care for his assigned clients. Which
of the following interventions is appropriate?
A. Recommend that he takes time to plan at the beginning of shift
B. Advise him to complete less time-consuming tasks first
C. Ask other staff members to take over some of his staffs
D. Offer to provide care for his clients while he takes a break
Answer: A. Recommend that he takes time to plan at the beginning of shift
Rationale:
Taking time to plan at the beginning of the shift can help the newly licensed nurse organize
his thoughts and prioritize tasks, which may improve his ability to focus and complete care
for his assigned clients.
11. A nurse in an urgent care clinic is admitting a client who has been exposed to a liquid
chemical in an industrial setting, which of the following actions should the nurse take first?
A. Remove the client’s clothing
B. Irrigate the exposed area with water
C. Report the incident to OSHA Don personal protective equipment.
Answer: B. Irrigate the exposed area with water
Rationale:
The first priority when a client has been exposed to a chemical is to remove the chemical
from the skin by irrigating the exposed area with water. This helps to minimize further
absorption of the chemical and reduce the risk of injury.
12. A facility provides annual staff education regarding ethical practice. A charge nurse
recognizes a need for further education when which of the following behaviors is observed?
A. A nurse refuses to actively participate during an elective abortion procedure scheduled for
her client.
B. A nurse gives prescribed opioids to a client who has a terminal illness and respirations of
8/min
C. A nurse explains to a client’s family that a DNR order includes withholding comfort
measures
D. A nurse informs a confused client who wants to go home that he is going to stay at the
facility until he is better
Answer: C. A nurse explains to a client’s family that a DNR order includes withholding
comfort measures
Rationale:
A Do Not Resuscitate (DNR) order does not include withholding comfort measures. Comfort
measures are provided to ensure the client's comfort and dignity, even if resuscitation is not
attempted. This behavior indicates a misunderstanding of ethical practice and the principles
of end-of-life care.
13. A nurse is an ambulatory care setting is orienting 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 tele health?
A. Assessing client needs
B. Providing med reconciliation
C. Establishing communication between providers
D. Developing client treatment protocols
Answer: C. Establishing communication between providers
Rationale:
One of the objectives of telehealth is to establish communication between healthcare
providers, allowing for efficient and timely exchange of information and collaboration in
client care.
14. Which of the following put a hospital at the highest risk of infringement of client record
confidentiality?
A. A nurse clusters documentation of care for multiple clients?
B. A provider and nurse access client info using one access code
C. Paper-based charts are stored at the nurse’s station
D. A nurse performs electronic documentation outside a client’s room
Answer: C. Paper-based charts are stored at the nurse’s station
Rationale:
Storing paper-based charts at the nurse's station increases the risk of unauthorized access and
potential infringement of client record confidentiality, especially if the charts are not securely
stored or monitored.
15. Which of the following observations requires a charge nurse to intervene and demonstrate
safe handling techniques?
A. A nurse cleans up blood spill with a 1:10 bleach solution
B. A nurse uses googles to perform tracheostomy suctioning
C. A nurse disconnects an indwelling urinary catheter from the drainage bag to collect a
specimen
D. A nurse places a mask on a client with TB before transport to the radiology department
Answer: C. A nurse disconnects an indwelling urinary catheter from the drainage bag to
collect a specimen
Rationale:
Disconnecting an indwelling urinary catheter from the drainage bag to collect a specimen can
introduce bacteria into the urinary tract and increase the risk of infection. Safe handling
techniques for collecting specimens from indwelling urinary catheters should involve using a
sterile technique to maintain the integrity of the catheter system.
16. Which of the following should lead a nurse to suspect abuse that must be reported?
A. A school-age child has several bruises on her lower legs.
B. A toddler cries whenever his parents enters the hospitals room.
C. An Adolescent admitted to the emergency won’t speak to his parents
D. A preschool child who was previously toilet trained now requires diapers in the hospital
Answer: B. A toddler cries whenever his parents enters the hospitals room.
Rationale:
This behavior may indicate fear or discomfort around the parents, which could be a sign of
abuse. It is important for the nurse to further assess the situation and consider reporting it if
abuse is suspected.
17. A parish nurse is making referral to a community meal delivery program for a member of
the congregation. This is an example of which of the following functions of the parish nurse?
A. Liaison
B. Pastoral care provider
C. Health educator
D. Personal Health counselor
Answer: A. Liaison
Rationale:
A liaison is a person who establishes and maintains communication between different groups
or individuals. In this scenario, the nurse is connecting the member of the congregation with a
community meal delivery program, acting as a liaison between the two parties.
18. A nurse performing triage during a mass casualty incident should recognize that which of
the following clients should be transported to the hospital first?
A. A client who reports substernal chest pain radiating to the neck
B. A client who has an open fracture of the femur
C. A client who has a 4-inch laceration on the forearm
D. A client who has a penetrating head injury and fixed dilated pupils 19.
Answer: A. A client who reports substernal chest pain radiating to the neck
Rationale:
Substernal chest pain radiating to the neck is a symptom of a potentially life-threatening
condition such as a heart attack. This client should be transported to the hospital first for
further evaluation and treatment to prevent complications.
19. A nurse manager overhears a provider and a staff nurse talking about a client’s diagnosis
in the cafeteria. Which of the following actions should the nurse take first?
A. Provide a staff in-service about client confidentiality
B. Report the incident to the nursing supervisor
C. Remind them that the client info is confidential
D. Fill out an incident report regarding the situation
Answer: C. Remind them that the client info is confidential
Rationale:
The first action should be to address the immediate situation by reminding the individuals of
the importance of maintaining client confidentiality. This can help prevent further breaches of
confidentiality before addressing the issue through education or reporting.
20. A client has a substance use disorder is admitted to the mental health Unit and reports that
he has been depressed lately. When preparing for discharge the next day, the client states:
“It’s Ok. Soon everything will be just fine.” Which of the following is the nurse’s primary
first action?
A. Ask the client if he has considered hurting himself
B. Provide the client with info about Alcoholics Anonymous
C. Encourage the client to participate in physical activities
Answer: A. Ask the client if he has considered hurting himself
Rationale:
The client's statement, "Soon everything will be just fine," coupled with a history of
depression and substance use disorder, raises concern for suicidal ideation. The nurse's
primary action should be to assess the client's risk for self-harm and intervene accordingly to
ensure the client's safety.
