ATI COMPREHENSIVE RETAKE ,PN , RN
WITH NGN PASS A+
1. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A. A client 2 days post-appendectomy requesting pain medication
B. A client with COPD reporting increased shortness of breath and a new productive cough
C. A client scheduled for discharge in 1 hour who needs teaching
D. A client requesting assistance to ambulate to the bathroom
CORRECT: B
RATIONALE: Using Maslow's hierarchy and ABC (Airway, Breathing, Circulation) priority-
setting, the COPD client with worsening shortness of breath and new productive cough indicates
a potential respiratory infection or exacerbation — an immediate threat to breathing. Pain (A) is
important but not life-threatening. Discharge teaching (C) and ambulation (D) are lower
priorities. The nurse assesses the most unstable client first.
2. A nurse is delegating tasks to an LPN and a UAP. Which task is appropriate for the nurse to
delegate to the UAP?
A. Administering a tube feeding
B. Obtaining vital signs on a stable client
C. Teaching a client about a new medication
D. Performing an initial admission assessment
CORRECT: B
RATIONALE: UAPs can perform tasks that do not require nursing judgment, such as
obtaining vital signs on stable clients, bathing, ambulating, and feeding. Medication
administration and tube feedings (A) are LPN/RN scope depending on state and facility policy.
Teaching (C) and assessment (D) are RN responsibilities and cannot be delegated.
3. A nurse is reviewing informed consent with a client. Which statement by the client
indicates understanding?
,A. "The doctor will explain the risks, and then I can sign."
B. "The nurse will tell me everything about the procedure before I sign."
C. "I can withdraw my consent at any time, even after signing."
D. "Signing the consent means I cannot change my mind."
CORRECT: C
RATIONALE: Informed consent is an ongoing process and the client has the right to
withdraw consent at any time. The provider — not the nurse — is responsible for explaining the
procedure, risks, and benefits (A, B). The nurse witnesses the signature and clarifies that the
client understands. Consent is not irreversible (D).
4. A nurse is preparing to administer medications and notes an order that is illegible. What is
the nurse's BEST action?
A. Ask another nurse to interpret the order
B. Call the prescribing provider to clarify the order
C. Administer the medication that seems most likely
D. Hold the medication and document the omission
CORRECT: B
RATIONALE: Illegible or unclear orders must be clarified with the prescriber. Guessing (C) or
asking a colleague to interpret (A) risks a medication error. Simply holding the medication
without clarification (D) delays necessary treatment and does not resolve the order.
5. A nurse is caring for a client who speaks limited English. Which action should the nurse take
to ensure informed consent?
A. Ask the client's adult child to interpret
B. Use a certified medical interpreter
C. Have the client sign the consent in English only
D. Use hand gestures to explain the procedure
CORRECT: B
RATIONALE: A certified medical interpreter ensures accurate communication and protects
the client's rights. Family members — especially minors or adult children — should not interpret
for consent (A) due to potential bias, errors, and confidentiality concerns. Hand gestures (D) are
inadequate for informed consent.
,6. A nurse is acting as a client advocate. Which action BEST demonstrates advocacy?
A. Documenting the client's vital signs accurately
B. Speaking up when the client's wishes conflict with the care plan
C. Administering pain medication as ordered
D. Completing the client's discharge checklist
CORRECT: B
RATIONALE: Advocacy means protecting and supporting the client's rights, wishes, and best
interests — including voicing concerns when the plan conflicts with the client's values.
Documentation (A) and medication administration (C) are core nursing tasks but not examples
of advocacy per se.
7. A nurse receives a report on four clients. Which client should the nurse see FIRST?
A. A client with a new onset of confusion and a BP of 88/50
B. A client requesting a sleeping pill
C. A client with a scheduled dressing change
D. A client who is NPO and asking when they can eat
CORRECT: A
RATIONALE: New confusion with hypotension suggests decreased cerebral perfusion
(possible sepsis, hemorrhage, or shock) — a life-threatening emergency. The other clients are
stable with non-urgent needs.
8. A nurse is teaching a newly licensed nurse about client confidentiality. Which statement
indicates the new nurse understands?
A. "I can discuss clients in the elevator if no one else is around."
B. "I should only share client information with the healthcare team involved in care."
C. "I can post client updates on social media if I don't use their name."
D. "I can share information with my family since they don't know the client."
CORRECT: B
, RATIONALE: HIPAA requires sharing protected health information only on a need-to-know
basis with the care team. Elevators (A), social media even without names (C), and family
members not involved in care (D) are all confidentiality breaches.
9. A nurse is prioritizing care using the nursing process. Which step occurs FIRST?
A. Planning
B. Assessment
C. Implementation
D. Evaluation
CORRECT: B
RATIONALE: The nursing process begins with assessment — gathering subjective and
objective data. Planning (A), implementation (C), and evaluation (D) follow. Assessment is the
foundation for all subsequent steps.
10. A nurse is caring for a client who is scheduled for surgery and has an advance directive.
Which action should the nurse take?
A. Place the advance directive in the chart and inform the surgical team
B. Ignore the advance directive since the client is competent
C. Ask the family to make all decisions
D. Discard the advance directive after surgery
CORRECT: A
RATIONALE: Advance directives must be documented in the medical record and
communicated to the care team. A competent client can still voice their own wishes (B is
incorrect), and family does not automatically make decisions (C). The directive remains valid (D).
11. A nurse is reviewing a client's medication administration record and notices a duplicate
order. What is the priority action?
A. Administer both medications
B. Clarify the order with the prescribing provider
C. Skip both medications
D. Ask the client which one they usually take
WITH NGN PASS A+
1. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A. A client 2 days post-appendectomy requesting pain medication
B. A client with COPD reporting increased shortness of breath and a new productive cough
C. A client scheduled for discharge in 1 hour who needs teaching
D. A client requesting assistance to ambulate to the bathroom
CORRECT: B
RATIONALE: Using Maslow's hierarchy and ABC (Airway, Breathing, Circulation) priority-
setting, the COPD client with worsening shortness of breath and new productive cough indicates
a potential respiratory infection or exacerbation — an immediate threat to breathing. Pain (A) is
important but not life-threatening. Discharge teaching (C) and ambulation (D) are lower
priorities. The nurse assesses the most unstable client first.
2. A nurse is delegating tasks to an LPN and a UAP. Which task is appropriate for the nurse to
delegate to the UAP?
A. Administering a tube feeding
B. Obtaining vital signs on a stable client
C. Teaching a client about a new medication
D. Performing an initial admission assessment
CORRECT: B
RATIONALE: UAPs can perform tasks that do not require nursing judgment, such as
obtaining vital signs on stable clients, bathing, ambulating, and feeding. Medication
administration and tube feedings (A) are LPN/RN scope depending on state and facility policy.
Teaching (C) and assessment (D) are RN responsibilities and cannot be delegated.
3. A nurse is reviewing informed consent with a client. Which statement by the client
indicates understanding?
,A. "The doctor will explain the risks, and then I can sign."
B. "The nurse will tell me everything about the procedure before I sign."
C. "I can withdraw my consent at any time, even after signing."
D. "Signing the consent means I cannot change my mind."
CORRECT: C
RATIONALE: Informed consent is an ongoing process and the client has the right to
withdraw consent at any time. The provider — not the nurse — is responsible for explaining the
procedure, risks, and benefits (A, B). The nurse witnesses the signature and clarifies that the
client understands. Consent is not irreversible (D).
4. A nurse is preparing to administer medications and notes an order that is illegible. What is
the nurse's BEST action?
A. Ask another nurse to interpret the order
B. Call the prescribing provider to clarify the order
C. Administer the medication that seems most likely
D. Hold the medication and document the omission
CORRECT: B
RATIONALE: Illegible or unclear orders must be clarified with the prescriber. Guessing (C) or
asking a colleague to interpret (A) risks a medication error. Simply holding the medication
without clarification (D) delays necessary treatment and does not resolve the order.
5. A nurse is caring for a client who speaks limited English. Which action should the nurse take
to ensure informed consent?
A. Ask the client's adult child to interpret
B. Use a certified medical interpreter
C. Have the client sign the consent in English only
D. Use hand gestures to explain the procedure
CORRECT: B
RATIONALE: A certified medical interpreter ensures accurate communication and protects
the client's rights. Family members — especially minors or adult children — should not interpret
for consent (A) due to potential bias, errors, and confidentiality concerns. Hand gestures (D) are
inadequate for informed consent.
,6. A nurse is acting as a client advocate. Which action BEST demonstrates advocacy?
A. Documenting the client's vital signs accurately
B. Speaking up when the client's wishes conflict with the care plan
C. Administering pain medication as ordered
D. Completing the client's discharge checklist
CORRECT: B
RATIONALE: Advocacy means protecting and supporting the client's rights, wishes, and best
interests — including voicing concerns when the plan conflicts with the client's values.
Documentation (A) and medication administration (C) are core nursing tasks but not examples
of advocacy per se.
7. A nurse receives a report on four clients. Which client should the nurse see FIRST?
A. A client with a new onset of confusion and a BP of 88/50
B. A client requesting a sleeping pill
C. A client with a scheduled dressing change
D. A client who is NPO and asking when they can eat
CORRECT: A
RATIONALE: New confusion with hypotension suggests decreased cerebral perfusion
(possible sepsis, hemorrhage, or shock) — a life-threatening emergency. The other clients are
stable with non-urgent needs.
8. A nurse is teaching a newly licensed nurse about client confidentiality. Which statement
indicates the new nurse understands?
A. "I can discuss clients in the elevator if no one else is around."
B. "I should only share client information with the healthcare team involved in care."
C. "I can post client updates on social media if I don't use their name."
D. "I can share information with my family since they don't know the client."
CORRECT: B
, RATIONALE: HIPAA requires sharing protected health information only on a need-to-know
basis with the care team. Elevators (A), social media even without names (C), and family
members not involved in care (D) are all confidentiality breaches.
9. A nurse is prioritizing care using the nursing process. Which step occurs FIRST?
A. Planning
B. Assessment
C. Implementation
D. Evaluation
CORRECT: B
RATIONALE: The nursing process begins with assessment — gathering subjective and
objective data. Planning (A), implementation (C), and evaluation (D) follow. Assessment is the
foundation for all subsequent steps.
10. A nurse is caring for a client who is scheduled for surgery and has an advance directive.
Which action should the nurse take?
A. Place the advance directive in the chart and inform the surgical team
B. Ignore the advance directive since the client is competent
C. Ask the family to make all decisions
D. Discard the advance directive after surgery
CORRECT: A
RATIONALE: Advance directives must be documented in the medical record and
communicated to the care team. A competent client can still voice their own wishes (B is
incorrect), and family does not automatically make decisions (C). The directive remains valid (D).
11. A nurse is reviewing a client's medication administration record and notices a duplicate
order. What is the priority action?
A. Administer both medications
B. Clarify the order with the prescribing provider
C. Skip both medications
D. Ask the client which one they usually take
