2026 ATI RN Comprehensive Online Practice A 2026 UPDATE
1. A nurse is caring for a client who is receiving lithium carbonate to treat bipolar disorder.
Which of the following findings should the nurse identify as an early indicator of lithium
toxicity?
A. Coarse hand tremors
B. Confusion
C. Lethargy
D. Slurred speech
Answer: D
Rationale: Slurred speech is an early sign of lithium toxicity. Other early signs include
nausea, vomiting, diarrhea, and muscle weakness. Coarse tremors and confusion are signs
of advanced toxicity.
2. A nurse is teaching a client who has a new prescription for warfarin. Which of the following
instructions should the nurse include?
A. Increase intake of dark green leafy vegetables.
B. Take aspirin for minor headaches.
C. Use a soft-bristled toothbrush.
D. Expect urine to turn orange.
,Answer: C
Rationale: Warfarin is an anticoagulant, which increases the risk of bleeding. Using a soft-
bristled toothbrush helps prevent gingival bleeding. Leafy greens should be kept
consistent, and aspirin should be avoided.
3. A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. Which of the following findings should the nurse report to the provider?
A. Fluctuation of the water level with respiration
B. Drainage of 50 mL of serosanguineous fluid in 2 hr
C. Continuous bubbling in the water-seal chamber
D. Occasional bubbling in the suction control chamber
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system and must be reported immediately. Tidaling (fluctuation) is a normal finding.
4. A nurse is caring for a client who is in the active phase of labor and has a prescription for
magnesium sulfate. Which of the following findings is a manifestation of magnesium toxicity?
A. Hyperreflexia
B. Increased urine output
C. Respiratory rate 10/min
D. Tachycardia
, Answer: C
Rationale: Magnesium sulfate is a CNS depressant. Signs of toxicity include respiratory
depression (RR < 12/min), loss of deep tendon reflexes, and decreased urine output.
5. A nurse is providing teaching to a client who has heart failure and a new prescription for
digoxin. Which of the following statements by the client indicates an understanding of the
teaching?
A. ‘I will increase my intake of high-fiber foods.’
B. ‘I will take an antacid if the medication causes nausea.’
C. ‘I will take my pulse for 1 minute before taking this medication.’
D. ‘I will stop taking the medicine if I feel dizzy.’
Answer: C
Rationale: The client should check their apical pulse for one full minute and hold the
medication if the heart rate is below 60/min. Nausea is a sign of toxicity and should be
reported, not treated with antacids.
6. A nurse is reviewing the laboratory results of a client who is receiving heparin by
continuous IV infusion. Which of the following results should the nurse report to the
provider?
A. aPTT 70 seconds
B. Hgb 14 g/dL
1. A nurse is caring for a client who is receiving lithium carbonate to treat bipolar disorder.
Which of the following findings should the nurse identify as an early indicator of lithium
toxicity?
A. Coarse hand tremors
B. Confusion
C. Lethargy
D. Slurred speech
Answer: D
Rationale: Slurred speech is an early sign of lithium toxicity. Other early signs include
nausea, vomiting, diarrhea, and muscle weakness. Coarse tremors and confusion are signs
of advanced toxicity.
2. A nurse is teaching a client who has a new prescription for warfarin. Which of the following
instructions should the nurse include?
A. Increase intake of dark green leafy vegetables.
B. Take aspirin for minor headaches.
C. Use a soft-bristled toothbrush.
D. Expect urine to turn orange.
,Answer: C
Rationale: Warfarin is an anticoagulant, which increases the risk of bleeding. Using a soft-
bristled toothbrush helps prevent gingival bleeding. Leafy greens should be kept
consistent, and aspirin should be avoided.
3. A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. Which of the following findings should the nurse report to the provider?
A. Fluctuation of the water level with respiration
B. Drainage of 50 mL of serosanguineous fluid in 2 hr
C. Continuous bubbling in the water-seal chamber
D. Occasional bubbling in the suction control chamber
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak in the
system and must be reported immediately. Tidaling (fluctuation) is a normal finding.
4. A nurse is caring for a client who is in the active phase of labor and has a prescription for
magnesium sulfate. Which of the following findings is a manifestation of magnesium toxicity?
A. Hyperreflexia
B. Increased urine output
C. Respiratory rate 10/min
D. Tachycardia
, Answer: C
Rationale: Magnesium sulfate is a CNS depressant. Signs of toxicity include respiratory
depression (RR < 12/min), loss of deep tendon reflexes, and decreased urine output.
5. A nurse is providing teaching to a client who has heart failure and a new prescription for
digoxin. Which of the following statements by the client indicates an understanding of the
teaching?
A. ‘I will increase my intake of high-fiber foods.’
B. ‘I will take an antacid if the medication causes nausea.’
C. ‘I will take my pulse for 1 minute before taking this medication.’
D. ‘I will stop taking the medicine if I feel dizzy.’
Answer: C
Rationale: The client should check their apical pulse for one full minute and hold the
medication if the heart rate is below 60/min. Nausea is a sign of toxicity and should be
reported, not treated with antacids.
6. A nurse is reviewing the laboratory results of a client who is receiving heparin by
continuous IV infusion. Which of the following results should the nurse report to the
provider?
A. aPTT 70 seconds
B. Hgb 14 g/dL
