RN ATI LEADERSHIP PROCTORED EXAM 2023 WITH NGN

Which of the following strategies should the committee plan to initiate first? A. Provide an in service on medication administration to all the nurses. Rationale: A recommendation for staff education may be indicated, but this does not assist the committee to identify factors that lead to medication errors. B. Require staff nurses to demonstrate competency by passing a medication administration examination. Rationale: Ensuring competency in medication administration may be indicated, but this does not assist the committee to identify factors that lead to medication errors. C. Review the events leading up to each medication administration error. Rationale: After a sentinel event, the first step the committee should plan to take is to use root cause analysis to identify the underlying cause or causes that led to the medication errors. D. Develop a quality improvement program for nurses involved in medication administration errors. Rationale: Although development of a quality improvement program for nurses involved in medication errors may be indicated, this does not assist the committee to identify factors that lead to medication errors. 9.A charge nurse has access to the facility’s electronic client records. It is appropriate for the charge nurse to share her personal password with whom? A. The nurse manager Rationale: A nurse manager authorized to have access to a computer will have a personal password. B. No one Rationale: Computer passwords cannot be shared with others for any reason. Any facility employee authorized to have access to the database on a computer will have a personal password. C. A nursing student who is completing a preceptorship on the unit Rationale: A nursing student who is authorized to have access to the database on a computer will have a personal password. D. The unit clerk Rationale: A unit clerk authorized to have access to a computer will have a personal password. 10.A nurse on a medical-surgical unit is reconciling a newly admitted client’s medication. The nurse is reviewing the process of medication reconciliation with a newly licensed nurse. The nurse should include which of the following information? A. The American Hospital Association requires accredited facilities to have protocols in place requiring medication reconciliation. Rationale: The Joint Commission requires accredited facilities to have protocols in place requiring medication reconciliation. B. The purpose of medication reconciliation is to prevent adverse medication reactions. Rationale: Medication reconciliation includes reviewing an accurate list of all medications the client is taking and comparing that list to new medications the provider has prescribed. This action decreases the risk of medication interactions and adverse outcomes. C. The nurse who performs medication reconciliation is demonstrating the ethical principal of veracity. Rationale: This action by the nurse does not demonstrate the ethical principal veracity, which means telling the truth. The nurse who performs medication reconciliation is demonstrating the ethical principle beneficence, which means the nurse takes action to promote good, and nonmaleficence, which means the nurse takes action to prevent harm. D. The International Council of Nurses Code of Ethics stipulates that the nurse performs medication reconciliation when a client is admitted to a facility, is transferred to another facility, and when a client is discharged from a facility. Rationale: The International Council of Nurses Code of Ethics stipulates that nurses have a responsibility to promote health and prevent illness, but it does not mandate medication reconciliation. The Institute for Healthcare Improvement recommends the nurse perform medication reconciliation when a client is transferred, and The Joint Commission requires medication reconciliation when a client is admitted and when a client is discharged. 11.A nurse is caring for a client on the medical-surgical unit. The client has been taking warfarin at home and her laboratory values reveal her INR is 3.5. The client states she is checking herself out of the hospital and refuses to wait until her provider can discuss the situation with her. Which of the following actions should the nurse take? A. Tell the client she will not be permitted to leave the facility until she has signed the against medical advice (AMA) form. Rationale: The nurse should attempt to get the client to sign the AMA form because this measure can help to defend the facility if a lawsuit ensues; however, the nurse should not tell the client she will not be permitted to leave the facility because this action could lead to charges of false imprisonment. B. Tell the client if she leaves without a written prescription for discharge, her insurance will not pay for the facility visit. Rationale: This action by the nurse is uncaring and the client could perceive it as a threat. C. Explain the risk the client faces if she leaves the facility. Rationale: The expected reference range for INR while a client is taking warfarin is 2 to 3. The nurse has an obligation to explain to the client that her INR is very high and she is at risk for bleeding. D. Ask the security department to guard the room to the client’s door. Rationale: This action could lead to charges of false imprisonment. 12.A nurse on a medical-surgical unit is planning to delegate tasks to an adult volunteer. Which of the following tasks should the charge nurse avoid assigning to the volunteer? A. Delivering meal trays to clients in their rooms Rationale: Delivering meal trays is an appropriate task to delegate to a volunteer. B. Assisting a client who has difficulty seeing the foods on the tray while eating Rationale: Assisting a client who has a vision deficiency to eat is an appropriate task to delegate to a volunteer. C. Delivering a routine urine specimen to the laboratory Rationale: Delivering a routine urine specimen is an appropriate task for a volunteer. D. Observing a postoperative client who is confused Rationale: A nurse who uses delegation is responsible for delegating tasks to the right person. A volunteer does not have the training to intervene if this client tries to get out of bed or starts pulling at tubes. The observation of this client should be assigned to a member of the nursing staff. 13.An assistive personnel (AP) tells the nurse manager that she observed a nurse on the unit removing a small amount of morphine from syringes prior to administering the medication to clients. Which of the following actions should the nurse manager take first? A. Gather data about the nurse’s work performance and attendance history. Rationale: The first action the nurse should take is to conduct an investigation and determine if the allegations are true. B. Approach the involved nurse to discuss the behavior. Rationale: The nurse should approach the involved nurse to discuss the behavior; however, there is another action the nurse should take first. C. Notify the risk manager. Rationale: The nurse should notify the risk manager; however, there is another action the nurse should take first. D. Refer the nurse to the board of nursing diversion program. Rationale: The nurse should report the incident to the board of nursing if the suspicion of drug diversion is founded; however, there is another action the nurse should take first. 14.A nurse is caring for a client who has severe head injuries and is declared brain dead. The transplant coordinator has spoken with the client’s family about organ donation. The client’s spouse states she is confused and does not know what she should do. Which of the following responses by the nurse is appropriate? A. "There is such a shortage of organs in this country, so I think you should go ahead and consent to donate your spouse’s organs." Rationale: The nurse should avoid giving her personal opinion. B. "What do you think your spouse would have wanted?" Rationale: Federal law requires facilities to have policies and procedures in place about making a request for organ and tissue donation at the time of death. The request is made by an employee, often a social worker, who has advanced training and can request the donations in a caring, sensitive manner. The role of the nurse is to provide emotional support to the family. Family members should consider the deceased person’s wishes when making their decision. C. "Most religions support organ donation, so don’t let that stand in the way." Rationale: While it is true that most religions support organ donation, there is no indication that this is a concern felt by the client’s spouse. D. "Don’t you think you will feel a little better about the situation if you donate your spouse’s organs? "Rationale: The nurse should not provide the client’s spouse with false reassurance.