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1. During a physical assessment of adult clients, which of the following techniques should the nurse use?
- A. Use the Face, Legs, Activity, Cry, and Consolability (FLACC) pain rating scale for a client experiencing pain.
- B. Palpate the client's abdomen before auscultating bowel sounds.
- C. Ensure the bladder of the blood pressure cuff surrounds 80% of the client's arm.
- D. Obtain an apical heart rate by auscultating at the third intercostal space to the left of the sternum.
Correct answer: B
Rationale: When performing a physical assessment, it is essential to palpate the client's abdomen before auscultating bowel sounds. This sequence helps prevent altering bowel sound results due to the pressure applied during palpation. Choice A is incorrect because the FLACC pain rating scale is typically used for nonverbal or pediatric clients, not adults. Choice C is incorrect because the bladder of the blood pressure cuff should surround about 80% of the client's arm circumference, not the bladder of the cuff itself. Choice D is incorrect because to obtain an apical heart rate, auscultation should be done at the fifth intercostal space at the midclavicular line, not at the third intercostal space to the left of the sternum.
2. How can a staff nurse recognize they are experiencing burnout? (EXCEPT)
- A. They are spending more time talking to staff on other units.
- B. Staff is questioning their clinical judgment.
- C. They sleep longer hours, sometimes coming in late to work.
- D. They are drinking alcohol more frequently to relax.
Correct answer: A
Rationale: Recognizing burnout is essential to maintaining quality patient care. Spending more time talking to staff on other units is a common practice and does not necessarily indicate burnout. On the other hand, staff questioning their clinical judgment, sleeping longer hours or coming in late to work, and resorting to alcohol to relax are signs of burnout. These behaviors can impact patient care and indicate the professional is struggling to cope with stressors.
3. Which of the following is an example of an environmental factor that could influence decision-making in nursing?
- A. Personal preferences
- B. Ethical considerations
- C. Availability of resources
- D. All of the above
Correct answer: D
Rationale: The correct answer is D, 'All of the above.' Environmental factors encompass a wide range of influences on decision-making in nursing. Personal preferences can impact how a nurse chooses a course of action, ethical considerations guide decision-making based on moral principles, and the availability of resources determines the options that are feasible. Therefore, all of these factors play a significant role in influencing decision-making in nursing. Choices A, B, and C are incorrect because each of them individually represents a specific environmental factor, whereas the correct answer D acknowledges that all of these factors collectively contribute to influencing decision-making.
4. A nurse manager is considering the variances of the budget. Fewer monies were spent than expected. What type of variance is this?
- A. Unfavorable variance
- B. Favorable variance
- C. Dependent variance
- D. Independent variance
Correct answer: B
Rationale: The correct answer is B, favorable variance. When fewer funds are spent than expected, it indicates efficient budget management, making it a favorable outcome. Choice A, unfavorable variance, is incorrect as it would apply if more money than expected was spent. Choices C and D, dependent variance and independent variance, are unrelated terms in the context of budget variances and do not apply to the situation described.
5. When a nurse observes a fellow nurse preparing an incorrect dose of medication, what is the best action to take?
- A. Ignore the error
- B. Administer the medication anyway
- C. Correct the error without informing the nurse
- D. Report the error to the supervisor immediately
Correct answer: D
Rationale: The best action to take when a nurse observes a fellow nurse preparing an incorrect dose of medication is to report the error to the supervisor immediately. Reporting the error is crucial to ensure patient safety and prevent any potential harm. Ignoring the error (Choice A) is not appropriate as it puts the patient at risk. Administering the medication anyway (Choice B) could harm the patient. Correcting the error without informing the nurse (Choice C) does not address the root cause of the issue, which should be brought to the attention of the supervisor for proper investigation and resolution.
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