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ATI Leadership Proctored Exam 2019
1. The nurse is providing pre-operative teaching to the anxious patient, who doesn't seem to be learning. What need must the nurse help this patient meet before continuing to teach?
- A. Self-esteem
- B. Love and belonging
- C. Safety
- D. Self-actualization
Correct answer: C
Rationale: The correct answer is C: Safety. Before effective learning can occur, the patient's safety needs must be addressed. When patients feel safe and secure, they are better able to focus on receiving and processing information. Ensuring the patient's safety is a fundamental step in providing care and support, especially in a pre-operative setting where anxiety and concerns about the procedure may be high. Choices A, B, and D are incorrect because while self-esteem, love and belonging, and self-actualization are important needs, the immediate priority in this scenario is addressing the patient's safety concerns to create a conducive environment for learning.
2. What is the primary focus of the Integrated Management of Childhood Illness (IMCI) strategy?
- A. Hospital-based care
- B. Curative care only
- C. Prevention and treatment of childhood illnesses
- D. Surgical interventions
Correct answer: C
Rationale: The primary focus of the Integrated Management of Childhood Illness (IMCI) strategy is the prevention and treatment of major childhood illnesses. The IMCI strategy aims to reduce child mortality and morbidity by emphasizing a holistic approach that includes preventive measures along with curative interventions.
3. When reinforcing teaching with a group of new parents about proper techniques for bottle feeding, which of the following instructions should be provided?
- A. Burp the newborn at the end of the feeding
- B. Hold the newborn close in a supine position
- C. Keep the nipple full of formula throughout the feeding
- D. Refrigerate any unused formula
Correct answer: C
Rationale: The correct technique for bottle feeding includes keeping the nipple full of formula throughout the feeding to prevent air from entering the baby's stomach. This helps reduce the risk of the baby swallowing air, which can lead to discomfort and colic. Therefore, maintaining a full nipple during feeding is essential for the baby's comfort and digestion. Option A is incorrect as burping should be done during the feeding to prevent excessive air intake. Option B is incorrect as the baby should be held semi-upright, not in a supine position, to reduce the risk of choking and ear infections. Option D is irrelevant to the feeding process and does not contribute to the baby's well-being.
4. A client is 1 hour postpartum and the nurse observes a large amount of lochia rubra and several small clots on the client's perineal pad. The fundus is midline and firm at the umbilicus. Which of the following actions should the nurse take?
- A. Notify the healthcare provider.
- B. Increase the frequency of fundal massage.
- C. Encourage the client to empty their bladder.
- D. Document the findings and continue to monitor the client.
Correct answer: D
Rationale: In the postpartum period, the presence of lochia rubra and small clots along with a firm, midline fundus at the umbilicus is considered normal. In this situation, the appropriate action is to document the findings and continue to monitor the client. Changes in the amount and character of lochia, deviation of the fundus from the midline, or fundal height above or below the expected level may indicate a need for further intervention. Encouraging bladder emptying is important but not the priority in this scenario. Notify the healthcare provider if there are signs of abnormal postpartum bleeding or fundal abnormalities. Therefore, choice D is the correct answer. Choices A, B, and C are incorrect because at this stage, there are no signs of abnormality that require immediate notification of the healthcare provider, increased frequency of fundal massage, or immediate bladder emptying.
5. A patient with obsessive-compulsive disorder (OCD) is prescribed fluvoxamine. What is a common side effect of this medication?
- A. Increased appetite
- B. Dry mouth
- C. Weight gain
- D. Nausea
Correct answer: D
Rationale: Nausea is a common side effect of fluvoxamine, a selective serotonin reuptake inhibitor (SSRI) commonly used in the treatment of OCD. Patients should be advised to monitor and report any gastrointestinal disturbances, including nausea, to their healthcare provider.
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