horizontal violence may be observed among staff interactions and causes stress among staff to minimize stress associated with such interactions nurses

ATI RN

ATI Leadership Proctored Exam

1. Horizontal violence may be observed among staff interactions and causes stress among staff. To minimize stress associated with such interactions, nurses can: (Select all that apply.)

A. Encourage venting as a way to express feelings.
B. Take control of the situation by being assertive.
C. Ignore staff who are volatile.
D. Avoid interactions with angry staff.

Correct answer: B

Rationale: To minimize stress associated with horizontal violence among staff interactions, nurses should take control of the situation by being assertive. Being assertive allows nurses to address the issues causing stress in a constructive and professional manner. Encouraging venting without addressing the underlying problems may not resolve the situation effectively. Ignoring staff who are volatile can escalate the issue further, and avoiding interactions with angry staff does not address the root cause of the problem. Therefore, being assertive and addressing the situation directly is the most effective approach to minimize stress and promote a healthy work environment.

2. An RN’s client with terminal pancreatic cancer asks questions about a do not resuscitate order. Which of the following statements should be included in the RN’s teaching to the client?

A. When a heart ceases to beat, the client is pronounced clinically dead.
B. Physicians must write do not resuscitate (DNR) orders.
C. A DNR order can be written after the health-care provider has discussed it with the client and family.
D. A DNR requires a court decision.

Correct answer: C

Rationale: A DNR order can be written after the health-care provider has discussed it with the client and family.

3. After change-of-shift report, which patient should the nurse assess first?

A. 19-year-old with type 1 diabetes who was admitted with possible dawn phenomenon
B. 35-year-old with type 1 diabetes whose most recent blood glucose reading was 230 mg/dL
C. 60-year-old with hyperosmolar hyperglycemic syndrome who has poor skin turgor and dry oral mucosa
D. 68-year-old with type 2 diabetes who has severe peripheral neuropathy and complains of burning foot pain

Correct answer: C

Rationale: The patient with hyperosmolar hyperglycemic syndrome who presents with poor skin turgor and dry oral mucosa requires immediate attention. These signs indicate severe dehydration and potential electrolyte imbalances, which can lead to serious complications. Assessing this patient first allows for prompt intervention and monitoring to stabilize their condition. Choice A is less urgent as the patient has possible dawn phenomenon, which is a common early-morning rise in blood glucose levels. Choice B, with a blood glucose reading of 230 mg/dL, indicates hyperglycemia but does not present with signs of severe dehydration like the patient in choice C. Choice D, with peripheral neuropathy and foot pain, is important but not as urgent as addressing severe dehydration and electrolyte imbalances in the patient with hyperosmolar hyperglycemic syndrome.

4. A nurse on a medical-surgical unit is caring for a client who has a new prescription for wrist restraints. Which of the following actions should the nurse take?

A. Pad the client's wrists before applying the restraints.
B. Evaluate the client's circulation every 8 hours after application.
C. Secure the restraint ties to the bed's side rails.
D. Remove the restraints every 4 hours to evaluate the client's status.

Correct answer: C

Rationale: When applying wrist restraints, it is crucial to secure the restraint ties to the bed's side rails to ensure the client's safety and prevent injury. Padding the client's wrists (Choice A) is not a standard practice and may compromise the effectiveness of the restraints. Evaluating the client's circulation (Choice B) is important but should be done more frequently than every 8 hours to ensure prompt detection of any circulation issues. Removing the restraints every 4 hours (Choice D) is unnecessary and may increase the risk of injury or agitation in the client.