when a nurse uses criteria such as high risk for falls infection protocols and special communication needs to determine the mix and number of staff ne when a nurse uses criteria such as high risk for falls infection protocols and special communication needs to determine the mix and number of staff ne
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Nursing Elites

ATI LPN

ATI Leadership Proctored Exam 2023

1. When considering factors like high risk for falls, infection protocols, and special communication needs to determine the mix and number of staff needed on a telemetry unit, what is being utilized?

Correct answer: D

Rationale: In this scenario, the nurse is using a Patient Classification System, which helps in determining the appropriate staffing levels based on the acuity and care requirements of the patients in the telemetry unit. By considering factors like high risk for falls, infection protocols, and special communication needs, the nurse can allocate the right mix and number of staff to provide safe and effective care. The other choices are incorrect because diagnostic related groups are used for billing purposes, clinical pathways are standard care plans for specific diagnoses, and case management involves coordinating care and services for patients.

2. A client with liver failure is at an increased risk of bleeding due to the inability to synthesize prothrombin in the liver. What factor most likely contributes to this loss of function?

Correct answer: D

Rationale: The correct answer is D. The liver's inability to use vitamin K is the most likely factor contributing to the loss of prothrombin synthesis in liver failure. Vitamin K is essential for the synthesis of prothrombin, a crucial clotting factor. In liver failure, impaired utilization of vitamin K leads to decreased production of prothrombin, increasing the risk of bleeding in affected individuals.

3. A nurse is assisting with monitoring a client who is in labor and has spontaneous rupture of membranes following a vaginal examination. The provider reports the client's cervix is dilated to 1 cm with an unengaged presenting part. Which of the following actions should the nurse take?

Correct answer: B

Rationale: In this scenario, with the client's cervix dilated to only 1 cm and an unengaged presenting part, the priority action is to apply the external fetal monitor. This allows for continuous monitoring of the fetal heart rate during early labor, which is crucial for assessing fetal well-being. Encouraging the client to bear down is not appropriate at 1 cm dilation, as it may not be effective and can lead to exhaustion. Providing the client with fluids or administering IV fluids may be necessary for hydration, but the immediate concern is monitoring fetal well-being.

4. General guidelines when assessing a 2-year-old child with abdominal pain and adequate perfusion include:

Correct answer: C

Rationale: When assessing a 2-year-old child with abdominal pain and adequate perfusion, it is essential to examine the child in the parent's arms. This approach can help maintain the child's comfort, keep them calm, and increase their cooperation during the assessment. Placing the child supine and palpating the abdomen (Choice A) can be distressing and uncomfortable for the child. Separating the child from the parent (Choice B) may cause additional stress and hinder the examination process. Palpating the painful area first (Choice D) can lead to increased discomfort and resistance from the child.

5. A nurse in a clinic receives a phone call from a client who would like information about pregnancy testing. Which of the following information should the nurse provide to the client?

Correct answer: D

Rationale: For the most accurate results, a home pregnancy test should be done using the first morning urine, which contains the highest concentration of hCG.

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