Review ATI PN management 2023 III

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ATI PN management 2023 III

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Total Questions : 58

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Question 1:

A nurse observes that a client is receiving medication through an infusion pump that the nurse has not been trained to use.

Which of the following is the most appropriate action for the nurse to take?

A. Continue administering the medication and observe the client for adverse reactions. B. Notify the charge nurse and request the client to be reassigned to another nurse. C. Refer to the manufacturer’s guidelines and proceed to use the infusion pump. D. Allow another nurse to demonstrate the use of the infusion pump and then take over.

Answer and Explanation

Choice A:

Continuing to administer the medication and observing the client for adverse reactions is inappropriate in this scenario. Lack of training on the infusion pump poses a risk of medication errors, which could lead to patient harm. Proper operation of medical devices requires adequate training and understanding to ensure safety and effectiveness. Observing adverse reactions does not prevent potential errors during administration.

Choice B:

Notifying the charge nurse and requesting the client to be reassigned to another nurse is the correct action. Nurses must prioritize patient safety and act within their scope of competence. Communicating the lack of training ensures that the task is reassigned to a qualified nurse who can safely and accurately operate the infusion pump, minimizing risks associated with improper use.

Choice C:

Referring to the manufacturer's guidelines and proceeding to use the infusion pump is not the best approach. While guidelines provide technical instructions, nurses need hands-on training to fully understand and safely operate medical devices. Misinterpretation of the guidelines or insufficient familiarity with the pump's mechanisms can lead to errors, compromising patient safety.

Choice D:

Allowing another nurse to demonstrate the use of the infusion pump and then taking over may seem reasonable but is not ideal in this case. Demonstration alone cannot guarantee adequate competence, as proper training includes practice and assessment. The immediate priority is to ensure safe medication administration, which requires a trained and experienced nurse to handle the infusion pump directly.

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Question 2:

The nurse should recognize that floating to the adult medical-surgical unit has placed them at legal risk for:

A. Leaving their assignment on the pediatric unit before completing their duties. B. Being assigned equipment they have not been validated on. C. Refusing to take the assignment in the neonatal intensive care unit. D. Performing procedures outside their scope of practice.

Answer and Explanation

Choice A:

Assignment abandonment involves leaving patients without care, which isn’t the nurse’s action here. The nurse stayed responsible and notified the charge nurse about equipment unfamiliarity to maintain ethical and safe practice standards.

Choice B:

Legal risks arise when a nurse uses medical equipment without validation, breaching competency and risking harm. Standards by regulatory bodies like the Joint Commission highlight the need for appropriate training, ensuring safe, error-free patient care.

Choice C:

Refusal of neonatal assignments does not connect to the case's circumstances. The legal concerns stem from equipment unfamiliarity, not from declining to work in specific units, which falls under staffing policies rather than individual liability.

Choice D:

Scope-of-practice violations occur when nurses exceed their authorized duties, but this doesn’t apply. The central issue involves patient safety risks due to equipment use beyond competence, aligning more closely with training and validation requirements.

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Question 3:

A nurse is observing an assistive personnel (AP) providing care to a group of clients.
Which of the following actions by the AP requires intervention by the nurse?

A. Removing gloves before leaving an isolation room. B. Instructing a client to look down at their feet when being assisted to ambulate. C. Filling a basin with water at 40° C (104° F) when providing foot care. D. Applying water-soluble lubricant to the nares of a client who is receiving oxygen.

Answer and Explanation

Choice A:

Removing gloves outside an isolation room increases contamination risk by allowing pathogens to spread to other surfaces or areas. Standard precautions require immediate disposal of gloves inside isolation rooms to maintain strict infection control measures.

Choice B:

Encouraging clients to look down during ambulation aids balance and reduces fall risks. This recommendation follows safety guidelines and does not indicate incorrect AP behavior requiring intervention or correction by the nurse.

Choice C:

Maintaining a water temperature of 40° C (104° F) aligns with best practices for foot care, ensuring comfort and preventing skin damage. It does not necessitate intervention since this is a safe and appropriate nursing action.

Choice D:

Applying water-soluble lubricant to the nares reduces dryness from oxygen therapy, improving patient comfort. This practice aligns with evidence-based guidelines for oxygen care and does not warrant nurse intervention as it enhances client outcomes.

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Question 4:

A nurse in a provider's office is responding to a newly licensed nurse about the Controlled Substance Act.
The nurse should state that morphine is categorized as which of the following?

A. Schedule II. B. Schedule III. C. Schedule IV. D. Schedule V.

Answer and Explanation

Choice A:

Morphine is classified as a Schedule II drug under the Controlled Substance Act. These substances have high abuse potential but accepted medical uses. Strict regulations on prescribing and dispensing help mitigate addiction risks while enabling pain management.

Choice B:

Schedule III drugs have lower abuse potential than Schedule II, such as anabolic steroids. Morphine’s classification reflects greater concern for dependency risks, making this categorization inaccurate given its pharmacological profile and misuse statistics.

Choice C:

Schedule IV substances, like benzodiazepines, pose even lower dependency risks. Morphine’s high potential for abuse makes it inappropriate to group with these drugs, highlighting its place in the more tightly regulated Schedule II category.

Choice D:

Schedule V includes medications with the least potential for abuse, like cough preparations containing small amounts of codeine. Morphine’s analgesic potency and risk profile far exceed those of Schedule V drugs, underscoring the inaccuracy of this classification.

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Question 5:

A nurse in a long-term care facility is reinforcing teaching with a newly licensed nurse about chemotherapy-induced nausea.
Which of the following food selections indicates the newly licensed nurse understands the teaching?

A. Soft-serve ice cream. B. Hot tea. C. String cheese. D. Raisin toast.

Answer and Explanation

Choice A:

Soft-serve ice cream contains dairy and sugar, which can worsen nausea for chemotherapy patients. Its high fat content may also contribute to gastrointestinal discomfort, making it an unsuitable food choice for managing nausea.

Choice B:

Hot tea, especially caffeinated varieties, may irritate the gastrointestinal lining and exacerbate nausea. While herbal teas could be soothing, this option does not explicitly align with the dietary recommendations for nausea management.

Choice C:

String cheese offers a protein-rich, low-fat option that is easy on the stomach and unlikely to exacerbate nausea. It aligns with dietary recommendations for managing chemotherapy-induced symptoms due to its mild taste and nutritional benefits.

Choice D:

Raisin toast contains fiber, which can be challenging to digest during nausea episodes, potentially worsening symptoms. Its texture and sweetness may also increase the risk of gastrointestinal upset, making it less suitable than other options. .

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Question 6:

A nurse is assisting with the discharge of a client who is postoperative following a total knee arthroplasty.
The client lives alone and does not have any friends or relatives who live close by. Which of the following actions should the nurse plan to take?

A. Suggest the client consider placement in a long-term care facility. B. Recommend a referral for the client to social services. C. Discuss the implications of the client's discharge with the ethics committee. D. Call the client's provider and suggest delaying discharge.

Answer and Explanation

Choice A:

Suggesting long-term care placement may disregard the client’s autonomy and independence. Postoperative care often emphasizes rehabilitation and support, not institutionalization, unless medically necessary or preferred by the client. Autonomy is vital in discharge planning, aligning with patient-centered care principles.

Choice B:

Referral to social services connects the client with resources like home care or rehabilitation. Social workers can assess unmet needs and coordinate assistance, ensuring a safe discharge. Collaboration improves outcomes in individuals lacking support systems.

Choice C:

Ethics committees address dilemmas with moral implications, like end-of-life care. Discharge planning typically requires clinical and social assessment rather than moral adjudication. Engaging the ethics committee unnecessarily delays support.

Choice D:

Discharge timing is based on clinical readiness and does not hinge solely on the client’s social situation. Suggesting delay may not address unmet needs. Utilizing support resources is more constructive.

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Question 7:

A nurse is caring for a client who states, "I am leaving this hospital because I'm frustrated with my therapy.”. Which of the following actions should the nurse take?

A. Arrange for the client to speak with other clients who are undergoing the same therapy. B. Tell the client that they cannot leave without a discharge prescription from their provider. C. Explain to the client that no additional treatment will be provided if they choose to come back. D. Ask the provider to speak with the client in person regarding their plan of care.

Answer and Explanation

Choice A:

Speaking with other clients may inadvertently breach confidentiality. Additionally, client frustration with therapy often needs individualized attention to explore concerns, address misunderstandings, and rebuild trust.

Choice B:

Telling the client they cannot leave without a discharge prescription could infringe on their right to autonomy. Clients have the right to leave AMA (against medical advice) after understanding associated risks.

Choice C:

Informing the client that no additional treatment will be provided upon return is coercive and unprofessional. Healthcare professionals must maintain open access to care, even if the client initially refuses recommended therapy.

Choice D:

Having the provider discuss the care plan directly with the client can address misunderstandings about therapy and promote collaboration. This approach respects the client’s autonomy while clarifying potential risks of leaving.

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Question 8:

A nurse is reinforcing teaching with a newly licensed nurse about client confidentiality.
Which of the following information should the nurse include?

A. Conduct change-of-shift report in a designated staff-only area. B. Log assistive personnel into unit computers for documentation purposes. C. Place the client's name on the cover sheet when faxing protected health information. D. Identify clients by room number instead of name in printed materials for student use.

Answer and Explanation

Choice A:

Conducting change-of-shift reports in staff-only areas prevents unauthorized access to sensitive information. This aligns with HIPAA guidelines and ensures confidentiality. It also minimizes the risk of incidental disclosure to unauthorized individuals.

Choice B:

Logging others into unit computers compromises accountability and data security. Proper login ensures that only authorized personnel access confidential information, reducing risks of privacy breaches or documentation errors.

Choice C:

Placing the client’s name on cover sheets violates confidentiality if faxed to unintended recipients. Faxing protected health information requires de-identification or additional safeguards to comply with privacy regulations.

Choice D:

Identifying clients solely by room numbers introduces risks if materials are lost or misused. Although it obscures names, it fails to fully de-identify information. Education should emphasize secure handling of protected data. .

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Question 9:

A nurse is caring for a client who has gone into cardiac arrest.
The client's chart indicates refusal of life-sustaining measures in a living will signed 10 years ago, but a do-not-resuscitate (DNR) prescription has not been written by the provider.
Which of the following actions by the nurse is appropriate?

A. Consult with the client's family regarding resuscitation efforts. B. Comply with the living will and let the client expire naturally. C. Call a code because a DNR prescription has not been written. D. Contact the provider for instructions regarding a DNR.

Answer and Explanation

Choice A:

Consulting with the client’s family would delay critical actions in an emergency. Additionally, family members cannot override the legal documentation of the client's wishes, such as a living will. Ethical guidelines prioritize the client's autonomy, but without a written DNR, the nurse should prioritize immediate life-saving efforts.

Choice B:

A living will outlines patient preferences, but it is not legally enforceable without a corresponding provider’s order. Complying with it without a written DNR could violate legal and professional standards. The nurse must initiate life-saving actions unless explicitly instructed otherwise by the provider.

Choice C:

Without a written DNR, the nurse must take measures to preserve life as per standard resuscitation guidelines. Legal protection applies to actions taken during a cardiac arrest to avoid negligence. This ensures that the client receives immediate care until proper clarification is made.

Choice D:

Contacting the provider during a cardiac arrest introduces a delay, increasing the risk of irreversible damage or death. While it is essential to clarify orders, emergency protocol dictates acting promptly to save the client’s life in the absence of clear documentation.

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Question 10:

A nurse is caring for a 16-year-old client who was in a motor-vehicle crash and needs surgical intervention immediately.
The staff cannot reach either of the client's parents.
The nurse should identify that which of the following is true about obtaining consent?

A. The surgeon should delay surgery until he can obtain informed consent from a parent. B. The client's pediatrician can obtain implied consent. C. The surgeon can obtain informed consent from the client's adult cousin. D. The surgeon can proceed with the surgery by invoking implied consent.

Answer and Explanation

Choice A:

Delaying surgery in an emergency violates the standard of care. When life-saving intervention is necessary, implied consent applies to act in the client’s best interests. Delaying for parental consent increases the risk of harm or mortality.

Choice B:

A pediatrician cannot grant consent in place of the legal guardians. Implied consent applies specifically to urgent situations where the client cannot consent, and the delay to contact a surrogate is not feasible.

Choice C:

A relative other than a parent or legal guardian cannot provide consent unless legally appointed. Emergency situations follow implied consent protocols when legal surrogates are unavailable. Proceeding with life-saving care does not require seeking extended family approval.

Choice D:

Implied consent is a legal principle used in emergencies to authorize necessary treatment when a legal guardian or proxy cannot be reached. This ensures timely intervention to prevent harm, especially for minors unable to consent themselves.

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Total Questions : 58

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ATI PN management 2023 III

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