ATI Nursing Practice Questions –
Retake Exam Prep/ Updated 2025
Version
A nurse working in a provider's office is reinforcing teaching with a client who is 14
weeks of gestation. The nurse should instruct the client to immediately notify the
provider if she experiences which of the following?
A. facial edema
b. urinary frequency
c. acid indigestion
d. breast leakage - ANSWER -Facial edema
rationale: facial edema is an indication of pregnancy-induced hypertension and
should be reported immediately to the provider.
A nurse is caring for a client who is receiving parenteral nutrition through a
nontunneled central venous catheter and reports hearing a gurgling sound on the
side of the catheter. The nurse suspects the catheter has migrated to the jugular
vein. Which of the following actions should the nurse take first?
A. Notify the provider
B. Obtain a chest x-ray
C. Flush the catheter.
D. Stop the infusion. - ANSWER -Stop the infusion
Rationale: This prevents further damage to vessel and minimizes any additional
harm to the client
A nurse is caring for a client who was admitted for acute alcohol delirium withdrawal
2 days ago. Which of the following findings is associated with this diagnosis?
A. Increased appetite
B. Elevated Temperature
C. Bradycardia
D. Drowsiness - ANSWER -Elevated Temperature
Rationale: The content of this question emphasizes the concept of client-centered
care through identifying findings associated with a client's diagnosis. Client-centered
care focuses on the client and emphasizes the client's cultural, ethnic, and social
values. The identification of expected and unexpected findings associated with a
client's diagnosis assists the nurse to distinguish possible unrelated complications
the client might be experiencing, which indicates the need for further investigation.
The specific focus on the client enhances the provision of safe, quality nursing care.
An elevated temperature is a finding associated with acute alcohol delirium.
,A nurse is reinforcing teaching with a caregiver who has aphasia. The nurse should
include which of the following communication strategies in the teaching?
A. Cue the client by providing picture cards that portray common needs.
B. Increase the volume of the voice when speaking to a client.
C. Encourage the client to limit hand gestures when communicating.
D. Vary the use of phrases and terminology in discussions. - ANSWER -Cue the
client by providing picture cards that portray common needs.
Rationale: Using picture cards enhances communication. The nurse should include
this communication strategy in the teaching.
A nurse is caring for a client who has a urinary tract infection and is prescribed
ciprofloxacin (Cipro). The client exhibits urticaria and angioedema following
administration of the medication. Which of the following is the first action the nurse
should take?
A. Administer epinephrine (Adrenaline)
B. Elevate the lower extremities
C. Determine respiratory status
D. Apply oxygen via non-rebreather mask. - ANSWER -Determine respiratory status
Rationale: The client is experiencing angioedema indicating a possible anaphylactic
reaction, which is life-threatening; therefore, the nurse should first determine the
client's respiratory status.
A nurse working in a hospice facility is talking to a client's son who is distressed
because his mother cries frequently and says she wants to die. Which of the
following responses by the nurse is appropriate?
A. "I know this must be difficult, but your mother will calm down soon."
B. "Lets discuss some strategies you can use when this happens again."
C. Individuals near death are ready to let go toward the end."
D. "Have you determined why she is crying and saying she is ready to die?" -
ANSWER -" Let's discuss some strategies you can use when this happens again."
Rationale: This response by the nurse offers to provide information, which can
reduce anxiety and enhance decision making. This response creates a safe
environment, fosters trust and respect, and is appropriate.
A nurse is caring for a client who had cerebrovascular accident 2 days ago. Which of
the following is the first sign of increased intracranial pressure (ICP)?
A. pupil dilation
B. Ataxia
C. Lethargy
D Bradycardia - ANSWER -Lethargy
, rationale: Lethargy occurs when pressure is placed on the reticular activating system
within the brainstem. Along with other indicators of a change in level of
consciousness, such as restlessness, irritability, and disorientation. Lethargy is the
first sign of increased ICP.
A nurse is caring for a client who has an acid-base imbalance. For which of the
following manifestations is metabolic alkalosis a possible complications?
A. Hyperkalemia
B. Severe diarrhea
C. Atelectasis
D. Excessive vomiting - ANSWER -Excessive vomiting
rationale: Metabolic alkalosis is a potential complication of excessive vomiting
because of loss of acid from the body.
A nurse is caring for neonate who was delivered at 30 weeks of gestation after his
mother received two injections of betamethasone (Celestone). because of
administration of betamethasone to the client's mother, the nurse should monitor the
neonate for which of the following effects?
A. Tachycardia
B. Sternal retractions
C. Hypoglycemia
D. Hypothermia - ANSWER -hypoglycemia
rationale: Betamethasone is a glucocorticoid used in the prevention of respiratory
distress syndrome in premature infants. Betamethasone causes hyperglycemia in
the mother, which predisposes the neonate to hypoglycemia in the first hours after
delivery.
A nurse is reinforcing teaching about client consent to treatment with a group of
newly licensed nurses. Which of the following statements by a newly licensed nurse
indicates a need for further teaching?
A. "It is necessary to have written consent for invasive procedures"
B. "Implied consent is appropriate for some aspects of nursing care"
C. It is the responsibility of the provider to obtain express consent"
D. "Informed consent should be obtained separately for each surgical procedure" -
ANSWER -" It is the responsibility of the provider to obtain express consent"
rationale: Nurses frequently obtain express consent by witnessing a client sign a
consent form after ensuring the client has received and understands necessary
information regarding the procedure. This is not an appropriate statement by a newly
licensed nurse and requires further teaching.
A nurse is caring for an adult client who has attempted suicide. The client tells the
nurse he is calling his family to come pick him up. Which of the following actions by
the nurse is appropriate when the client insists on leaving the facility against medical
advice?
A. assign a security guard to stay at the client's door.
Retake Exam Prep/ Updated 2025
Version
A nurse working in a provider's office is reinforcing teaching with a client who is 14
weeks of gestation. The nurse should instruct the client to immediately notify the
provider if she experiences which of the following?
A. facial edema
b. urinary frequency
c. acid indigestion
d. breast leakage - ANSWER -Facial edema
rationale: facial edema is an indication of pregnancy-induced hypertension and
should be reported immediately to the provider.
A nurse is caring for a client who is receiving parenteral nutrition through a
nontunneled central venous catheter and reports hearing a gurgling sound on the
side of the catheter. The nurse suspects the catheter has migrated to the jugular
vein. Which of the following actions should the nurse take first?
A. Notify the provider
B. Obtain a chest x-ray
C. Flush the catheter.
D. Stop the infusion. - ANSWER -Stop the infusion
Rationale: This prevents further damage to vessel and minimizes any additional
harm to the client
A nurse is caring for a client who was admitted for acute alcohol delirium withdrawal
2 days ago. Which of the following findings is associated with this diagnosis?
A. Increased appetite
B. Elevated Temperature
C. Bradycardia
D. Drowsiness - ANSWER -Elevated Temperature
Rationale: The content of this question emphasizes the concept of client-centered
care through identifying findings associated with a client's diagnosis. Client-centered
care focuses on the client and emphasizes the client's cultural, ethnic, and social
values. The identification of expected and unexpected findings associated with a
client's diagnosis assists the nurse to distinguish possible unrelated complications
the client might be experiencing, which indicates the need for further investigation.
The specific focus on the client enhances the provision of safe, quality nursing care.
An elevated temperature is a finding associated with acute alcohol delirium.
,A nurse is reinforcing teaching with a caregiver who has aphasia. The nurse should
include which of the following communication strategies in the teaching?
A. Cue the client by providing picture cards that portray common needs.
B. Increase the volume of the voice when speaking to a client.
C. Encourage the client to limit hand gestures when communicating.
D. Vary the use of phrases and terminology in discussions. - ANSWER -Cue the
client by providing picture cards that portray common needs.
Rationale: Using picture cards enhances communication. The nurse should include
this communication strategy in the teaching.
A nurse is caring for a client who has a urinary tract infection and is prescribed
ciprofloxacin (Cipro). The client exhibits urticaria and angioedema following
administration of the medication. Which of the following is the first action the nurse
should take?
A. Administer epinephrine (Adrenaline)
B. Elevate the lower extremities
C. Determine respiratory status
D. Apply oxygen via non-rebreather mask. - ANSWER -Determine respiratory status
Rationale: The client is experiencing angioedema indicating a possible anaphylactic
reaction, which is life-threatening; therefore, the nurse should first determine the
client's respiratory status.
A nurse working in a hospice facility is talking to a client's son who is distressed
because his mother cries frequently and says she wants to die. Which of the
following responses by the nurse is appropriate?
A. "I know this must be difficult, but your mother will calm down soon."
B. "Lets discuss some strategies you can use when this happens again."
C. Individuals near death are ready to let go toward the end."
D. "Have you determined why she is crying and saying she is ready to die?" -
ANSWER -" Let's discuss some strategies you can use when this happens again."
Rationale: This response by the nurse offers to provide information, which can
reduce anxiety and enhance decision making. This response creates a safe
environment, fosters trust and respect, and is appropriate.
A nurse is caring for a client who had cerebrovascular accident 2 days ago. Which of
the following is the first sign of increased intracranial pressure (ICP)?
A. pupil dilation
B. Ataxia
C. Lethargy
D Bradycardia - ANSWER -Lethargy
, rationale: Lethargy occurs when pressure is placed on the reticular activating system
within the brainstem. Along with other indicators of a change in level of
consciousness, such as restlessness, irritability, and disorientation. Lethargy is the
first sign of increased ICP.
A nurse is caring for a client who has an acid-base imbalance. For which of the
following manifestations is metabolic alkalosis a possible complications?
A. Hyperkalemia
B. Severe diarrhea
C. Atelectasis
D. Excessive vomiting - ANSWER -Excessive vomiting
rationale: Metabolic alkalosis is a potential complication of excessive vomiting
because of loss of acid from the body.
A nurse is caring for neonate who was delivered at 30 weeks of gestation after his
mother received two injections of betamethasone (Celestone). because of
administration of betamethasone to the client's mother, the nurse should monitor the
neonate for which of the following effects?
A. Tachycardia
B. Sternal retractions
C. Hypoglycemia
D. Hypothermia - ANSWER -hypoglycemia
rationale: Betamethasone is a glucocorticoid used in the prevention of respiratory
distress syndrome in premature infants. Betamethasone causes hyperglycemia in
the mother, which predisposes the neonate to hypoglycemia in the first hours after
delivery.
A nurse is reinforcing teaching about client consent to treatment with a group of
newly licensed nurses. Which of the following statements by a newly licensed nurse
indicates a need for further teaching?
A. "It is necessary to have written consent for invasive procedures"
B. "Implied consent is appropriate for some aspects of nursing care"
C. It is the responsibility of the provider to obtain express consent"
D. "Informed consent should be obtained separately for each surgical procedure" -
ANSWER -" It is the responsibility of the provider to obtain express consent"
rationale: Nurses frequently obtain express consent by witnessing a client sign a
consent form after ensuring the client has received and understands necessary
information regarding the procedure. This is not an appropriate statement by a newly
licensed nurse and requires further teaching.
A nurse is caring for an adult client who has attempted suicide. The client tells the
nurse he is calling his family to come pick him up. Which of the following actions by
the nurse is appropriate when the client insists on leaving the facility against medical
advice?
A. assign a security guard to stay at the client's door.
