ATI Comprehensive/ NCLEX
Review with correct answers
2025/2026
Endometiral infection usually occurs - correct answerswith a prolonged rupture of membranes,
not vacuum-assisted births.
Intenstinal gas is a common side effect of - correct answersclients following a cesarean birth
Cervical lacerations are common complications from - correct answersvacuum-assisted birth are
rare but can include perineal, vaginal, or cervical lacerations
When a client is experiencing a wound evisceration... - correct answersthe nurse should initially
stay with the client and call for help. Next, the nurse should place saline-soaked gauze on the
exposed bowels to keep the internal organs moist. The nurse should then place the client in a
supine position with his hips and knees bent to relieve pressure from the open wound. Last, the
nurse should take the client's vital signs to assess for changes in hemodynamics.
Valproic acid can cause - correct answershepatic toxicity
continuous passive motion (CPM) machine - correct answersTurn of the CPM machine during
meals to promote comfort and dietary intake.
-The affected extremity should maintain neutral alignment.
,Heparin - correct answersis an anticoagulant that inhibits the conversation of prothrombin to
thrombin. Patients on an anticoagulant drug such as heparin are at an increased risk of
bleeding.
-Signs of bleeding: ecchymoses, tarry stools, mucosal bleeding, and pink/ red-tinged urine.
Correct method for walking upstairs with crutches - correct answers1. Hold to rail with one hand
and crutches with the other hand.
2. Push down on the stair rail and the crutches and step up with the "unaffected" leg.
3. If not allowed to place weight on the "affected" leg, hop up with the "unaffected" leg.
4. Bring the "affected" leg and the crutches up beside the "unaffected" leg.
5.Remember, the "unaffected" leg goes up first and the crutches move with the "affected" leg.
Droplet precautions - correct answersDROPLET: "SPIDERMAn"
-Sepsis
-Scarlet Fever
-Strep
-Pertussis
-Pneumonia
-Parvovirus
-Influenza
-Diphtheria
-Epiglottitis
-Rubella
-Mumps
,-Adenovirus
Management: Private room/mask
-A private room a rom with other clients with the same infectious disease.
-Masks for providers and visitors
Airborne precautions: - correct answersAIRBORNE: "My Chicken Hez TB"
-Measles
-Chicken pox
-Herpes zoster
-TB
Management: neg. pressure room, private room, mask, n-95 for TB.
-A private room
-Masks or respiratory protection devices for caregivers and visitors.
-An N95 or high-efficiency particulate air (HEPA) respirator is used if the client is known or
suspected to have TB.
-Negative pressure airflow exchange in the room of at least six exchanges per hour.
Contact precautions - correct answersCONTACT: "MRS WEE"
-MRSA
-RSV
, -Skin infections (herpes zoster, cutaneous diphtheria, impetigo, pediculosis, scabies, and staph)
-Wound infections
-Enteric infections (C-Diff)
-Eye infections (conjunctivitis)
Management: gown, gloves, goggles, private room
VRSA - contact and airborne precautions (private room, door closed, negative pressure)
-A private room or a room with other clients with the same infection.
-Gloves and gowns worn by the caregivers and visitors.
Stage I pressure ulcer - correct answersIntact skin with an area of persistent, nonblanchable
redness, typically over a bony prominence, that may feel warmer or cooler than the adjacent
tissue. The tissue is swollen and has congestion, with possible discomfort at the site. With
darker skin tones, the ulcer may appear blue or purple.
Stage II pressure ulcer - correct answersPartial-thickness skin loss involving the epidermis and
the dermis. The ulcer is visible and superficial and may appear as an abrasion, blister, or shallow
crater. Edema persists, and the ulcer may become infected, possibly with pain and scant
drainage.
Stage III pressure ulcer - correct answersFull-thickness tissue loss with damage to or necrosis of
subcutaneous tissue. The ulcer may extend down to, but not through, underlying fascia. The
ulcer appears as a deep crater with or without undermining of adjacent tissue and without
exposed muscle or bone. Drainage and infection are common.
Stage IV pressure ulcer - correct answersFull-thickness tissue loss with destruction, tissue
necrosis, or damage to muscle, bone, or supporting structures. There may be sinus tracts, deep
Review with correct answers
2025/2026
Endometiral infection usually occurs - correct answerswith a prolonged rupture of membranes,
not vacuum-assisted births.
Intenstinal gas is a common side effect of - correct answersclients following a cesarean birth
Cervical lacerations are common complications from - correct answersvacuum-assisted birth are
rare but can include perineal, vaginal, or cervical lacerations
When a client is experiencing a wound evisceration... - correct answersthe nurse should initially
stay with the client and call for help. Next, the nurse should place saline-soaked gauze on the
exposed bowels to keep the internal organs moist. The nurse should then place the client in a
supine position with his hips and knees bent to relieve pressure from the open wound. Last, the
nurse should take the client's vital signs to assess for changes in hemodynamics.
Valproic acid can cause - correct answershepatic toxicity
continuous passive motion (CPM) machine - correct answersTurn of the CPM machine during
meals to promote comfort and dietary intake.
-The affected extremity should maintain neutral alignment.
,Heparin - correct answersis an anticoagulant that inhibits the conversation of prothrombin to
thrombin. Patients on an anticoagulant drug such as heparin are at an increased risk of
bleeding.
-Signs of bleeding: ecchymoses, tarry stools, mucosal bleeding, and pink/ red-tinged urine.
Correct method for walking upstairs with crutches - correct answers1. Hold to rail with one hand
and crutches with the other hand.
2. Push down on the stair rail and the crutches and step up with the "unaffected" leg.
3. If not allowed to place weight on the "affected" leg, hop up with the "unaffected" leg.
4. Bring the "affected" leg and the crutches up beside the "unaffected" leg.
5.Remember, the "unaffected" leg goes up first and the crutches move with the "affected" leg.
Droplet precautions - correct answersDROPLET: "SPIDERMAn"
-Sepsis
-Scarlet Fever
-Strep
-Pertussis
-Pneumonia
-Parvovirus
-Influenza
-Diphtheria
-Epiglottitis
-Rubella
-Mumps
,-Adenovirus
Management: Private room/mask
-A private room a rom with other clients with the same infectious disease.
-Masks for providers and visitors
Airborne precautions: - correct answersAIRBORNE: "My Chicken Hez TB"
-Measles
-Chicken pox
-Herpes zoster
-TB
Management: neg. pressure room, private room, mask, n-95 for TB.
-A private room
-Masks or respiratory protection devices for caregivers and visitors.
-An N95 or high-efficiency particulate air (HEPA) respirator is used if the client is known or
suspected to have TB.
-Negative pressure airflow exchange in the room of at least six exchanges per hour.
Contact precautions - correct answersCONTACT: "MRS WEE"
-MRSA
-RSV
, -Skin infections (herpes zoster, cutaneous diphtheria, impetigo, pediculosis, scabies, and staph)
-Wound infections
-Enteric infections (C-Diff)
-Eye infections (conjunctivitis)
Management: gown, gloves, goggles, private room
VRSA - contact and airborne precautions (private room, door closed, negative pressure)
-A private room or a room with other clients with the same infection.
-Gloves and gowns worn by the caregivers and visitors.
Stage I pressure ulcer - correct answersIntact skin with an area of persistent, nonblanchable
redness, typically over a bony prominence, that may feel warmer or cooler than the adjacent
tissue. The tissue is swollen and has congestion, with possible discomfort at the site. With
darker skin tones, the ulcer may appear blue or purple.
Stage II pressure ulcer - correct answersPartial-thickness skin loss involving the epidermis and
the dermis. The ulcer is visible and superficial and may appear as an abrasion, blister, or shallow
crater. Edema persists, and the ulcer may become infected, possibly with pain and scant
drainage.
Stage III pressure ulcer - correct answersFull-thickness tissue loss with damage to or necrosis of
subcutaneous tissue. The ulcer may extend down to, but not through, underlying fascia. The
ulcer appears as a deep crater with or without undermining of adjacent tissue and without
exposed muscle or bone. Drainage and infection are common.
Stage IV pressure ulcer - correct answersFull-thickness tissue loss with destruction, tissue
necrosis, or damage to muscle, bone, or supporting structures. There may be sinus tracts, deep
