ATI RN Leadership Retake 3

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Sample questions from ATI RN Leadership Retake 3

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, which client should the charge nurse assess first?

   • A.A client with diabetes mellitus who has a blood glucose of 248 mg/dL before lunch
   • B.A client with pneumonia who has a temperature of 38.1 C (100.6 F)
   • C.A client with chronic heart failure who has 2+ bilateral ankle edema
   • D.A client 6 hr after a thyroidectomy who reports tingling around the mouth

   Rationale: Perioral tingling after thyroidectomy can indicate hypocalcemia from parathyroid injury, which can progress to tetany and airway compromise. The other findings require follow-up, but chronic edema, a modest fever, and hyperglycemia are less immediately threatening than possible acute hypocalcemia. Prioritize findings that signal a rapidly worsening threat to airway, breathing, or circulation.

2. 2.During a home visit, the RN is planning care for a client recovering from a stroke who has right-sided weakness. Which tasks can the RN delegate to an experienced assistive personnel (AP)? Select all that apply.

   • A.Assist the client with bathing after the RN has assessed the client's transfer ability
   • B.Teach the family how to perform range-of-motion exercises
   • C.Report new difficulty swallowing to the RN
   • D.Evaluate the client's progress toward independent dressing
   • E.Develop the client's plan of care for preventing falls
   • F.Measure and record the client's oral intake

   Rationale: An AP may provide routine personal care after the RN assesses safety, measure intake, and report a change such as new swallowing difficulty. Evaluating progress and developing a fall-prevention plan require RN judgment, while teaching the family is an RN responsibility. Delegation transfers a task, not accountability for assessment, teaching, or evaluation.

3. 3.A client scheduled for an elective procedure tells the nurse, 'I still do not understand what the surgeon plans to do.' The consent form is unsigned. Which action should the nurse take?

   • A.Notify the surgeon that the client needs further explanation
   • B.Witness the client's signature after the client says they trust the surgeon
   • C.Ask a family member to explain the procedure to the client
   • D.Explain the procedure in detail and ask the client to sign

   Rationale: The provider performing the procedure is responsible for explaining its nature, risks, benefits, and alternatives and answering the client's questions. The nurse should pause the consent process and notify the surgeon when the client does not understand. A family member cannot substitute for the provider's explanation, and witnessing a signature does not mean the nurse provides informed consent.

4. 4.In the emergency department, a client with a head injury becomes increasingly drowsy and develops unequal pupils. Which action should the charge nurse take first?

   • A.Move the client to a quiet room to reduce stimulation
   • B.Ask the AP to repeat the client's vital signs in 30 minutes
   • C.Notify the provider immediately and ensure the client is assessed without delay
   • D.Document the findings and include them in the next shift report

   Answer and rationale are in the full material.

5. 5.Refer to the client's chart. Which actions should the charge nurse take in response to the client's current status? Select all that apply.

   • A.Prepare to communicate the trend in respiratory rate and oxygen saturation to the provider
   • B.Increase the oxygen flow without an order and leave the client unattended
   • C.Delegate the focused respiratory assessment to the AP
   • D.Wait until the next scheduled vital-sign assessment because the client is already receiving oxygen
   • E.Reassess the client's respiratory status and oxygenation now
   • F.Notify the rapid response team according to facility criteria

   Answer and rationale are in the full material.