ATI Final Exam Review Questions with
correct answers
A ||nurse ||is ||teaching ||a ||client ||and ||his ||family ||how ||to ||care ||for ||the ||client's ||tracheostomy ||at ||
home. ||Which ||of ||the ||following ||instructions ||is ||appropriate ||for ||the ||client ||and ||family?
1. ||Remove ||the ||outer ||cannula ||cautiously ||for ||routine ||cleaning.
2. ||Use ||tracheostomy ||covers ||when ||outdoors.
3. ||Use ||sterile ||technique ||when ||performing ||tracheostomy ||care ||at ||home.
4. ||Cleanse ||irritated ||skin ||with ||full-strength ||hydrogen ||peroxide. ||- ||VERIFIED ||ANSWER✔✔-2. ||Use ||
tracheostomy ||covers ||when ||outdoors.
A ||nurse ||is ||giving ||an ||end-of-shift ||report ||about ||a ||client ||admitted ||earlier ||that ||day ||with ||
pneumonia. ||Which ||of ||the ||following ||pieces ||of ||information ||is ||most ||essential ||to ||provide?
1. ||Admitting ||diagnosis
2. ||Diagnostic ||test ||results
3. ||Body ||temperature
4. ||Breath ||sounds ||- ||VERIFIED ||ANSWER✔✔-4. ||Breath ||sounds
**ABCs**
A ||nurse ||is ||checking ||blood ||pressures ||at ||a ||community ||health ||screening. ||Which ||of ||the ||following ||
clients ||is ||at ||high ||risk ||for ||primary ||hypertension?
1. ||A ||client ||who ||is ||pregnant
2. ||A ||client ||who ||has ||an ||elevated ||LDL
3. ||A ||client ||who ||takes ||oral ||contraceptives
4. ||A ||client ||who ||has ||kidney ||disease ||- ||VERIFIED ||ANSWER✔✔-2. ||A ||client ||who ||has ||an ||elevated ||
LDL
,A ||nurse ||is ||planning ||care ||for ||a ||client ||who ||has ||had ||a ||stroke ||resulting ||in ||aphasia ||and ||dysphagia.
||Which ||of ||the ||following ||tasks ||should ||the ||nurse ||assign ||to ||an ||AP? ||(Select ||all ||that ||apply.)
- ||Assist ||the ||client ||with ||a ||partial ||bed ||bath.
- ||Measure ||the ||client's ||BP ||after ||the ||nurse ||administers ||an ||antihypertensive ||medication.
- ||Test ||the ||client's ||swallowing ||ability ||by ||providing ||thickened ||liquids.
- ||Use ||a ||communication ||board ||to ||ask ||what ||the ||client ||wants ||for ||lunch.
- ||Irrigate ||the ||client's ||indwelling ||urinary ||catheter. ||- ||VERIFIED ||ANSWER✔✔-- ||Assist ||the ||client ||
with ||a ||partial ||bed ||bath.
- ||Measure ||the ||client's ||BP ||after ||the ||nurse ||administers ||an ||antihypertensive ||medication.
- ||Use ||a ||communication ||board ||to ||ask ||what ||the ||client ||wants ||for ||lunch.
A ||nurse ||is ||caring ||for ||a ||client ||who ||is ||combative ||in ||the ||emergency ||department. ||The ||provider ||
orders ||wrist ||restraints ||after ||the ||client ||attempts ||to ||assault ||the ||admitting ||nurse. ||Which ||of ||the ||
following ||actions ||is ||appropriate ||for ||the ||nurse ||to ||take?
1. ||Tie ||restraints ||to ||the ||lower ||edge ||of ||the ||side ||rail.
2. ||Remove ||each ||restraint ||one ||at ||a ||time ||every ||2 ||hr.
3. ||Ensure ||3 ||finger-widths ||of ||space ||between ||the ||restraint ||and ||the ||client's ||wrist.
4. ||Use ||a ||square ||knot ||to ||securely ||tie ||the ||restraints ||to ||the ||bed. ||- ||VERIFIED ||ANSWER✔✔-2. ||
Remove ||each ||restraint ||one ||at ||a ||time ||every ||2 ||hr.
**To ||perform ||ROM ||exercises ||and ||neurovascular ||checks**
A ||nurse ||is ||preparing ||to ||administer ||morphine ||4 ||mg ||IV ||bolus ||to ||a ||client. ||Available ||is ||morphine ||
5mg/mL. ||Which ||of ||the ||following ||is ||an ||appropriate ||nursing ||intervention?
1. ||Return ||the ||unused ||medication ||to ||the ||automatic ||dispensing ||system.
2. ||Keep ||the ||remaining ||medication ||at ||the ||client's ||bedside ||for ||later ||use.
3. ||Have ||a ||second ||nurse ||witness ||the ||disposal ||of ||remaining ||medication.
4. ||Lock ||remaining ||medication ||in ||secure ||cabinet. ||- ||VERIFIED ||ANSWER✔✔-3. ||Have ||a ||second ||
nurse ||witness ||the ||disposal ||of ||remaining ||medication.
A ||nurse ||is ||caring ||for ||a ||client ||who ||asks ||about ||the ||purpose ||of ||advance ||directives. ||Which ||of ||the
||following ||is ||an ||appropriate ||response ||by ||the ||nurse?
,1. ||"It ||allows ||the ||court ||to ||overrule ||an ||adult ||client's ||refusal ||of ||medical ||treatment."
2. ||"It ||permits ||a ||client ||to ||withhold ||medical ||information ||from ||health ||care ||personnel."
3. ||"It ||indicates ||the ||form ||of ||treatment ||a ||client ||is ||willing ||to ||accept ||in ||the ||event ||of ||a ||serious ||
illness."
4. ||"It ||allows ||health ||care ||personnel ||in ||the ||emergency ||department ||to ||stabilize ||a ||client's ||
condition." ||- ||VERIFIED ||ANSWER✔✔-3. ||"It ||indicates ||the ||form ||of ||treatment ||a ||client ||is ||willing ||to ||
accept ||in ||the ||event ||of ||a ||serious ||illness."
A ||nurse ||finds ||a ||client ||on ||the ||floor ||upon ||entering ||the ||client's ||room. ||The ||roommate ||reports ||
that ||the ||client ||was ||trying ||to ||get ||out ||of ||bed ||and ||fell ||over ||the ||bedrail ||onto ||the ||floor. ||Which ||
of ||the ||following ||is ||correct ||documentation ||of ||this ||incident?
1. ||Incident ||report ||completed.
2. ||Client ||climbed ||over ||the ||bedrails.
3. ||Client ||found ||lying ||on ||floor.
4. ||Client ||was ||trying ||to ||get ||out ||of ||bed. ||- ||VERIFIED ||ANSWER✔✔-3. ||Client ||found ||lying ||on ||floor.
**remember, ||be ||Objective ||in ||documentation**
A ||client ||who ||is ||postoperative ||is ||verbalizing ||pain ||as ||a ||2 ||on ||a ||pain ||scale ||of ||0 ||to ||10. ||The ||nurse
||understands ||that ||the ||preoperative ||teaching ||regarding ||pain ||control ||has ||been ||effective ||when ||
the ||client ||states ||which ||of ||the ||following?
1. ||"I ||think ||I ||should ||take ||my ||pain ||medication ||more ||often, ||since ||it ||is ||not ||controlling ||my ||pain."
2. ||"Breathing ||faster ||will ||help ||me ||keep ||my ||mind ||off ||of ||the ||pain."
3. ||"It ||may ||help ||me ||to ||listen ||to ||music ||while ||I'm ||lying ||in ||bed."
4. ||"I ||don't ||want ||to ||walk ||today, ||because ||I'm ||experiencing ||some ||pain." ||- ||VERIFIED ||ANSWER✔✔-
3. ||"It ||may ||help ||me ||to ||listen ||to ||music ||while ||I'm ||lying ||in ||bed."
**nonpharmacological ||intervention ||to ||pain**
A ||client ||demonstrates ||anger ||when ||the ||nurse ||does ||not ||respond ||within ||5 ||min ||of ||ringing ||for ||the
||nurse. ||Which ||of ||the ||following ||is ||an ||appropriate ||response ||by ||the ||nurse?
, 1. ||"I'm ||sorry, ||but ||another ||client ||needed ||my ||attention."
2. ||"I ||arrived ||as ||soon ||as ||I ||could. ||What ||can ||I ||do ||for ||you?"
3. ||"It ||must ||be ||frustrating. ||I ||have ||a ||few ||minutes ||now."
4. ||"We ||had ||an ||emergency ||on ||the ||unit, ||but ||now ||I'm ||here." ||- ||VERIFIED ||ANSWER✔✔-3. ||"It ||must
||be ||frustrating. ||I ||have ||a ||few ||minutes ||now."
**therapeutic ||by ||acknowledging ||client's ||feelings**
A ||nurse ||is ||admitting ||a ||client ||who ||is ||having ||an ||exacerbation ||of ||heart ||failure. ||In ||planning ||this ||
client's ||care, ||when ||should ||the ||nurse ||initiate ||discharge ||planning?
1. ||During ||the ||admission ||process
2. ||As ||soon ||as ||the ||client's ||condition ||is ||stable
3. ||During ||the ||initial ||team ||conference
4. ||After ||consulting ||with ||the ||client's ||family ||- ||VERIFIED ||ANSWER✔✔-1. ||During ||the ||admission ||
process
**discharge ||planning ||starts ||at ||admission ||(patient ||needs ||for ||during ||and ||after ||hospital)**
A ||nurse ||manager ||is ||overseeing ||the ||care ||of ||a ||unit. ||Which ||of ||the ||following ||should ||the ||nurse ||
manager ||identify ||as ||a ||violation ||of ||HIPPA ||guidelines?
1. ||The ||assigned ||nurse ||reviews ||the ||medical ||chart ||with ||a ||nursing ||student.
2. ||A ||nursing ||student ||discusses ||a ||client's ||status ||with ||the ||assigned ||nurse ||at ||the ||bedside.
3. ||The ||assigned ||nurse ||returns ||a ||call ||to ||a ||client's ||Power ||of ||Attorney ||to ||discuss ||the ||client's ||
care.
4. ||A ||nursing ||student ||consults ||a ||former ||classmate ||to ||assist ||with ||her ||documentation. ||- ||VERIFIED
||ANSWER✔✔-4. ||A ||nursing ||student ||consults ||a ||former ||classmate ||to ||assist ||with ||her ||
documentation.
**only ||those ||in ||direct ||care**
A ||nurse ||is ||teaching ||a ||client ||about ||self-administering ||NPH ||insulin. ||Which ||of ||the ||following ||
actions ||by ||the ||client ||indicates ||a ||need ||for ||further ||teaching?
correct answers
A ||nurse ||is ||teaching ||a ||client ||and ||his ||family ||how ||to ||care ||for ||the ||client's ||tracheostomy ||at ||
home. ||Which ||of ||the ||following ||instructions ||is ||appropriate ||for ||the ||client ||and ||family?
1. ||Remove ||the ||outer ||cannula ||cautiously ||for ||routine ||cleaning.
2. ||Use ||tracheostomy ||covers ||when ||outdoors.
3. ||Use ||sterile ||technique ||when ||performing ||tracheostomy ||care ||at ||home.
4. ||Cleanse ||irritated ||skin ||with ||full-strength ||hydrogen ||peroxide. ||- ||VERIFIED ||ANSWER✔✔-2. ||Use ||
tracheostomy ||covers ||when ||outdoors.
A ||nurse ||is ||giving ||an ||end-of-shift ||report ||about ||a ||client ||admitted ||earlier ||that ||day ||with ||
pneumonia. ||Which ||of ||the ||following ||pieces ||of ||information ||is ||most ||essential ||to ||provide?
1. ||Admitting ||diagnosis
2. ||Diagnostic ||test ||results
3. ||Body ||temperature
4. ||Breath ||sounds ||- ||VERIFIED ||ANSWER✔✔-4. ||Breath ||sounds
**ABCs**
A ||nurse ||is ||checking ||blood ||pressures ||at ||a ||community ||health ||screening. ||Which ||of ||the ||following ||
clients ||is ||at ||high ||risk ||for ||primary ||hypertension?
1. ||A ||client ||who ||is ||pregnant
2. ||A ||client ||who ||has ||an ||elevated ||LDL
3. ||A ||client ||who ||takes ||oral ||contraceptives
4. ||A ||client ||who ||has ||kidney ||disease ||- ||VERIFIED ||ANSWER✔✔-2. ||A ||client ||who ||has ||an ||elevated ||
LDL
,A ||nurse ||is ||planning ||care ||for ||a ||client ||who ||has ||had ||a ||stroke ||resulting ||in ||aphasia ||and ||dysphagia.
||Which ||of ||the ||following ||tasks ||should ||the ||nurse ||assign ||to ||an ||AP? ||(Select ||all ||that ||apply.)
- ||Assist ||the ||client ||with ||a ||partial ||bed ||bath.
- ||Measure ||the ||client's ||BP ||after ||the ||nurse ||administers ||an ||antihypertensive ||medication.
- ||Test ||the ||client's ||swallowing ||ability ||by ||providing ||thickened ||liquids.
- ||Use ||a ||communication ||board ||to ||ask ||what ||the ||client ||wants ||for ||lunch.
- ||Irrigate ||the ||client's ||indwelling ||urinary ||catheter. ||- ||VERIFIED ||ANSWER✔✔-- ||Assist ||the ||client ||
with ||a ||partial ||bed ||bath.
- ||Measure ||the ||client's ||BP ||after ||the ||nurse ||administers ||an ||antihypertensive ||medication.
- ||Use ||a ||communication ||board ||to ||ask ||what ||the ||client ||wants ||for ||lunch.
A ||nurse ||is ||caring ||for ||a ||client ||who ||is ||combative ||in ||the ||emergency ||department. ||The ||provider ||
orders ||wrist ||restraints ||after ||the ||client ||attempts ||to ||assault ||the ||admitting ||nurse. ||Which ||of ||the ||
following ||actions ||is ||appropriate ||for ||the ||nurse ||to ||take?
1. ||Tie ||restraints ||to ||the ||lower ||edge ||of ||the ||side ||rail.
2. ||Remove ||each ||restraint ||one ||at ||a ||time ||every ||2 ||hr.
3. ||Ensure ||3 ||finger-widths ||of ||space ||between ||the ||restraint ||and ||the ||client's ||wrist.
4. ||Use ||a ||square ||knot ||to ||securely ||tie ||the ||restraints ||to ||the ||bed. ||- ||VERIFIED ||ANSWER✔✔-2. ||
Remove ||each ||restraint ||one ||at ||a ||time ||every ||2 ||hr.
**To ||perform ||ROM ||exercises ||and ||neurovascular ||checks**
A ||nurse ||is ||preparing ||to ||administer ||morphine ||4 ||mg ||IV ||bolus ||to ||a ||client. ||Available ||is ||morphine ||
5mg/mL. ||Which ||of ||the ||following ||is ||an ||appropriate ||nursing ||intervention?
1. ||Return ||the ||unused ||medication ||to ||the ||automatic ||dispensing ||system.
2. ||Keep ||the ||remaining ||medication ||at ||the ||client's ||bedside ||for ||later ||use.
3. ||Have ||a ||second ||nurse ||witness ||the ||disposal ||of ||remaining ||medication.
4. ||Lock ||remaining ||medication ||in ||secure ||cabinet. ||- ||VERIFIED ||ANSWER✔✔-3. ||Have ||a ||second ||
nurse ||witness ||the ||disposal ||of ||remaining ||medication.
A ||nurse ||is ||caring ||for ||a ||client ||who ||asks ||about ||the ||purpose ||of ||advance ||directives. ||Which ||of ||the
||following ||is ||an ||appropriate ||response ||by ||the ||nurse?
,1. ||"It ||allows ||the ||court ||to ||overrule ||an ||adult ||client's ||refusal ||of ||medical ||treatment."
2. ||"It ||permits ||a ||client ||to ||withhold ||medical ||information ||from ||health ||care ||personnel."
3. ||"It ||indicates ||the ||form ||of ||treatment ||a ||client ||is ||willing ||to ||accept ||in ||the ||event ||of ||a ||serious ||
illness."
4. ||"It ||allows ||health ||care ||personnel ||in ||the ||emergency ||department ||to ||stabilize ||a ||client's ||
condition." ||- ||VERIFIED ||ANSWER✔✔-3. ||"It ||indicates ||the ||form ||of ||treatment ||a ||client ||is ||willing ||to ||
accept ||in ||the ||event ||of ||a ||serious ||illness."
A ||nurse ||finds ||a ||client ||on ||the ||floor ||upon ||entering ||the ||client's ||room. ||The ||roommate ||reports ||
that ||the ||client ||was ||trying ||to ||get ||out ||of ||bed ||and ||fell ||over ||the ||bedrail ||onto ||the ||floor. ||Which ||
of ||the ||following ||is ||correct ||documentation ||of ||this ||incident?
1. ||Incident ||report ||completed.
2. ||Client ||climbed ||over ||the ||bedrails.
3. ||Client ||found ||lying ||on ||floor.
4. ||Client ||was ||trying ||to ||get ||out ||of ||bed. ||- ||VERIFIED ||ANSWER✔✔-3. ||Client ||found ||lying ||on ||floor.
**remember, ||be ||Objective ||in ||documentation**
A ||client ||who ||is ||postoperative ||is ||verbalizing ||pain ||as ||a ||2 ||on ||a ||pain ||scale ||of ||0 ||to ||10. ||The ||nurse
||understands ||that ||the ||preoperative ||teaching ||regarding ||pain ||control ||has ||been ||effective ||when ||
the ||client ||states ||which ||of ||the ||following?
1. ||"I ||think ||I ||should ||take ||my ||pain ||medication ||more ||often, ||since ||it ||is ||not ||controlling ||my ||pain."
2. ||"Breathing ||faster ||will ||help ||me ||keep ||my ||mind ||off ||of ||the ||pain."
3. ||"It ||may ||help ||me ||to ||listen ||to ||music ||while ||I'm ||lying ||in ||bed."
4. ||"I ||don't ||want ||to ||walk ||today, ||because ||I'm ||experiencing ||some ||pain." ||- ||VERIFIED ||ANSWER✔✔-
3. ||"It ||may ||help ||me ||to ||listen ||to ||music ||while ||I'm ||lying ||in ||bed."
**nonpharmacological ||intervention ||to ||pain**
A ||client ||demonstrates ||anger ||when ||the ||nurse ||does ||not ||respond ||within ||5 ||min ||of ||ringing ||for ||the
||nurse. ||Which ||of ||the ||following ||is ||an ||appropriate ||response ||by ||the ||nurse?
, 1. ||"I'm ||sorry, ||but ||another ||client ||needed ||my ||attention."
2. ||"I ||arrived ||as ||soon ||as ||I ||could. ||What ||can ||I ||do ||for ||you?"
3. ||"It ||must ||be ||frustrating. ||I ||have ||a ||few ||minutes ||now."
4. ||"We ||had ||an ||emergency ||on ||the ||unit, ||but ||now ||I'm ||here." ||- ||VERIFIED ||ANSWER✔✔-3. ||"It ||must
||be ||frustrating. ||I ||have ||a ||few ||minutes ||now."
**therapeutic ||by ||acknowledging ||client's ||feelings**
A ||nurse ||is ||admitting ||a ||client ||who ||is ||having ||an ||exacerbation ||of ||heart ||failure. ||In ||planning ||this ||
client's ||care, ||when ||should ||the ||nurse ||initiate ||discharge ||planning?
1. ||During ||the ||admission ||process
2. ||As ||soon ||as ||the ||client's ||condition ||is ||stable
3. ||During ||the ||initial ||team ||conference
4. ||After ||consulting ||with ||the ||client's ||family ||- ||VERIFIED ||ANSWER✔✔-1. ||During ||the ||admission ||
process
**discharge ||planning ||starts ||at ||admission ||(patient ||needs ||for ||during ||and ||after ||hospital)**
A ||nurse ||manager ||is ||overseeing ||the ||care ||of ||a ||unit. ||Which ||of ||the ||following ||should ||the ||nurse ||
manager ||identify ||as ||a ||violation ||of ||HIPPA ||guidelines?
1. ||The ||assigned ||nurse ||reviews ||the ||medical ||chart ||with ||a ||nursing ||student.
2. ||A ||nursing ||student ||discusses ||a ||client's ||status ||with ||the ||assigned ||nurse ||at ||the ||bedside.
3. ||The ||assigned ||nurse ||returns ||a ||call ||to ||a ||client's ||Power ||of ||Attorney ||to ||discuss ||the ||client's ||
care.
4. ||A ||nursing ||student ||consults ||a ||former ||classmate ||to ||assist ||with ||her ||documentation. ||- ||VERIFIED
||ANSWER✔✔-4. ||A ||nursing ||student ||consults ||a ||former ||classmate ||to ||assist ||with ||her ||
documentation.
**only ||those ||in ||direct ||care**
A ||nurse ||is ||teaching ||a ||client ||about ||self-administering ||NPH ||insulin. ||Which ||of ||the ||following ||
actions ||by ||the ||client ||indicates ||a ||need ||for ||further ||teaching?
