ATI & NCLEX REVIEW/ TEST 1
A charge nurse is assigning rooms for the clients to be admitted to the unit. To prevent
falls, which of the following clients should the nurse assign to the room closet to the
nurses' station?
A. A middle adult who is postoperative following laparoscopic cholecystectomy.
B. A middle adult who requires telemetry for a possible myocardial infarction
C. A young adult who is postoperative following an open reduction internal fixation of
the ankle
D. An older adult who is postoperative following a below the knee amputation. - ansD.
An older adult who is postoperative following a below the knee amputation.
A client has been diagnosed with a terminal illness and is crying. What statement made
by the nurse is a barrier for further communication?
A. Everything will be okay. It out of your hands.
B. I am here if you would like to talk
C. Is there anything that i can do for you or questions that I can answer.
D.This must be difficult for you - ansA. Everything will be okay. Its out of your hands.
A client has been involved in a motor vehicle crash and has multiple injuries. What
guiding principle of Florence Nightingale would assist this client's recuperation and
health maintenance? Select all that apply.
A. Clean air and water
B. Cleanliness
C. Blood administration
D. Light
E. Efficient drainage - ansClean air and water
Cleanliness
Light
Efficient Drainage
A client is admitted to the acute care facility with a suspected case of malaria. What
question is priority?
A. Have you had unprotected sex?
B. Have you recently traveled out of the country?
C. What medications are you taking?
D. Do you take any street drugs? - ansB. Have you recently traveled outside of the
country
,A client is going to have a surgical procedure. What intervention provided by the nurse
can help the client feel safe and aid in postoperative recovery?
A. Explain the procedure before surgery
B. Inform the client that they will be alright
C. Call a family member prior to the client entering the surgical suite
D. Make sure all insurance information has been obtained. - ansA. Explain the
procedure before surgery
A client is having abdominal pain. What open-ended statement can the nurse use to find
out more about the clients condition?
A. Tell me more about how you feel
B. Rate your pain on a scale of 1 to 10
C. Point with one finger where your pain is located
D. What medication are you taking? - ansA. Tell me more about how you feel?
A client is suspected to be infected with methicillin-resistant Staphylococcus aureus
(MRSA) in a sacral wound. What precautions should the nurse be sure are followed
during wound care?
A. Droplet
B. Contact
C. Airborne
D. Standard - ansB. Contact
A client no longer requires care in the coronary intensive care unit after coronary artery
bypass graft surgery. Where should the nure prepare to transfer the client?
A. Sub-acute or Step-down unit
B. Skilled care unit
C. Medical Floor
D. Long-Term care - ansA. Sub-acute or Step-down unit
A client that is home bound requires long-term intravenous antibiotic therapy. The
insurance company refuses to keep the client in the hospital during this treatment
regimen. What services would best meet the needs of the client?
A. Hospice
B. Respite Care
C. Home healthcare
D. Telehealth - ansC. home healthcare
,A client with diabetes asks the nurse, "If i can't do heavy exercise, what's the point in
exercising?" What response by the nurse can encourage the client to perform moderate
exercise? Select all that apply.
A. It will prevent the use of insulin.
B. It will prevent cancer.
C. It will enhance energy levels.
D. It will reduce stress.
E. It will provide relaxation. - ansIt will enhance energy levels
It will reduce stress
It will provide relaxation
A high school student interested in becoming a nurse asks the nursing instructor what
the role of the LPN/LVN is. What is the BEST response by the instructor?
A. The LPN/LVN provides bedside car.
B. The LPN/LVN develops the plan of care for clients.
C. The LPN/LVN performs wound care.
D. The LPN/LVN supervises registered nurses (RNs).
E. The LPN/LVN administration prescribed medications to clients. - ansA. The LPN/LVN
provides bedside care.
A muslim-arab female client is in the clinic for a gynecologic procedure. The client does
not directly look at the nurse or physician in the eye when speaking. What does the
nurse interpret this behavior to mean?
A. The client does not trust the caregivers
B. The client is demonstrating modesty
C. The client believes she has a sexually transmitted infection
D. The client has been sexually abused. - ansB. The client is demonstrating modesty.
A nurse caring for a 20 year old client who is sexually active and has come to college
health clinic for a first time check up. Which of the following interventions should the
nurse perform first to determine the clients need for health promotion and disease?
A. Measure vital signs
B. Encourage HIV screening.
C. Determine risk factors
D. Instruct client to use condom - ansC. Determine Risk Factors
The first action of the nurse is the assessment. Talk with the client to first to determine
what risk factors the client might have before initiating the appropriate health promotion
and disease prevention.
A nurse caring for a client who has a history of falls. Which of the following actions is the
nurse's priority?
, A. Complete fall risk assessment
B. Educate the client and family about fall risks
C. Eliminate safety hazards from the client's environment
D. Make sure the client uses assistive aids in his possession. - ansA. Complete fall risk
assessment.
A nurse caring for a client who is a Jehovah's Witness and is scheduled for surgery as a
result of a motor vehicle crash. The surgeon tells the client that a blood transfusion is
essential. The client tells the nurse based on his religious values and mandates, he
cannot receive a blood transfusion. Which of the following responses should the nurse
make?
A."I believe in this case you should really make an exception and accept the blood
transfusion."
B. "I know your family would approve of your decision to have a blood transfusion."
C. " Why does your religion mandate that you cannot receive any blood transfusions."
D."Let's discuss the necessity for a blood transfusion with your religious and spiritual
leaders and come to a reasonable solution." - ansD. "Lets discuss the necessity for a
blood transfusion with your religious and spiritual leaders and come to a reasonable
solution."
A nurse caring for a competent adult client who tells the nurse that the he is thinking
about leaving the hospital against medical advice. The nurse believes that this is not in
the client's best interest, so she prepares to administer a PRN sedative medication that
the client has not requested along with his usual medication. Which of the following
types of tort is the nurse about to commit?
A. Assault
B. False Imprisonment
C. Negligence
D. Breech of confidentiality - ansB. False Imprisonment.
Medication was given with patients consent, it was used as a chemical restraint.
A nurse discovers that a neighbor is a client on the unit in which the nurse works
although the nurse is not assigned to care for that client. The nurse accesses the
electronic medical record (EMR) to find out what the client's diagnosis is. What action
may clients take if they are aware of this type of incident?
A. Report the incident as a HIPPA violation
B. Sue the nurse for libel
C. Sue the nurse for negligence
D. Report the nurse for defamation. - ansA. Report the incident as a HIPPA violation
A charge nurse is assigning rooms for the clients to be admitted to the unit. To prevent
falls, which of the following clients should the nurse assign to the room closet to the
nurses' station?
A. A middle adult who is postoperative following laparoscopic cholecystectomy.
B. A middle adult who requires telemetry for a possible myocardial infarction
C. A young adult who is postoperative following an open reduction internal fixation of
the ankle
D. An older adult who is postoperative following a below the knee amputation. - ansD.
An older adult who is postoperative following a below the knee amputation.
A client has been diagnosed with a terminal illness and is crying. What statement made
by the nurse is a barrier for further communication?
A. Everything will be okay. It out of your hands.
B. I am here if you would like to talk
C. Is there anything that i can do for you or questions that I can answer.
D.This must be difficult for you - ansA. Everything will be okay. Its out of your hands.
A client has been involved in a motor vehicle crash and has multiple injuries. What
guiding principle of Florence Nightingale would assist this client's recuperation and
health maintenance? Select all that apply.
A. Clean air and water
B. Cleanliness
C. Blood administration
D. Light
E. Efficient drainage - ansClean air and water
Cleanliness
Light
Efficient Drainage
A client is admitted to the acute care facility with a suspected case of malaria. What
question is priority?
A. Have you had unprotected sex?
B. Have you recently traveled out of the country?
C. What medications are you taking?
D. Do you take any street drugs? - ansB. Have you recently traveled outside of the
country
,A client is going to have a surgical procedure. What intervention provided by the nurse
can help the client feel safe and aid in postoperative recovery?
A. Explain the procedure before surgery
B. Inform the client that they will be alright
C. Call a family member prior to the client entering the surgical suite
D. Make sure all insurance information has been obtained. - ansA. Explain the
procedure before surgery
A client is having abdominal pain. What open-ended statement can the nurse use to find
out more about the clients condition?
A. Tell me more about how you feel
B. Rate your pain on a scale of 1 to 10
C. Point with one finger where your pain is located
D. What medication are you taking? - ansA. Tell me more about how you feel?
A client is suspected to be infected with methicillin-resistant Staphylococcus aureus
(MRSA) in a sacral wound. What precautions should the nurse be sure are followed
during wound care?
A. Droplet
B. Contact
C. Airborne
D. Standard - ansB. Contact
A client no longer requires care in the coronary intensive care unit after coronary artery
bypass graft surgery. Where should the nure prepare to transfer the client?
A. Sub-acute or Step-down unit
B. Skilled care unit
C. Medical Floor
D. Long-Term care - ansA. Sub-acute or Step-down unit
A client that is home bound requires long-term intravenous antibiotic therapy. The
insurance company refuses to keep the client in the hospital during this treatment
regimen. What services would best meet the needs of the client?
A. Hospice
B. Respite Care
C. Home healthcare
D. Telehealth - ansC. home healthcare
,A client with diabetes asks the nurse, "If i can't do heavy exercise, what's the point in
exercising?" What response by the nurse can encourage the client to perform moderate
exercise? Select all that apply.
A. It will prevent the use of insulin.
B. It will prevent cancer.
C. It will enhance energy levels.
D. It will reduce stress.
E. It will provide relaxation. - ansIt will enhance energy levels
It will reduce stress
It will provide relaxation
A high school student interested in becoming a nurse asks the nursing instructor what
the role of the LPN/LVN is. What is the BEST response by the instructor?
A. The LPN/LVN provides bedside car.
B. The LPN/LVN develops the plan of care for clients.
C. The LPN/LVN performs wound care.
D. The LPN/LVN supervises registered nurses (RNs).
E. The LPN/LVN administration prescribed medications to clients. - ansA. The LPN/LVN
provides bedside care.
A muslim-arab female client is in the clinic for a gynecologic procedure. The client does
not directly look at the nurse or physician in the eye when speaking. What does the
nurse interpret this behavior to mean?
A. The client does not trust the caregivers
B. The client is demonstrating modesty
C. The client believes she has a sexually transmitted infection
D. The client has been sexually abused. - ansB. The client is demonstrating modesty.
A nurse caring for a 20 year old client who is sexually active and has come to college
health clinic for a first time check up. Which of the following interventions should the
nurse perform first to determine the clients need for health promotion and disease?
A. Measure vital signs
B. Encourage HIV screening.
C. Determine risk factors
D. Instruct client to use condom - ansC. Determine Risk Factors
The first action of the nurse is the assessment. Talk with the client to first to determine
what risk factors the client might have before initiating the appropriate health promotion
and disease prevention.
A nurse caring for a client who has a history of falls. Which of the following actions is the
nurse's priority?
, A. Complete fall risk assessment
B. Educate the client and family about fall risks
C. Eliminate safety hazards from the client's environment
D. Make sure the client uses assistive aids in his possession. - ansA. Complete fall risk
assessment.
A nurse caring for a client who is a Jehovah's Witness and is scheduled for surgery as a
result of a motor vehicle crash. The surgeon tells the client that a blood transfusion is
essential. The client tells the nurse based on his religious values and mandates, he
cannot receive a blood transfusion. Which of the following responses should the nurse
make?
A."I believe in this case you should really make an exception and accept the blood
transfusion."
B. "I know your family would approve of your decision to have a blood transfusion."
C. " Why does your religion mandate that you cannot receive any blood transfusions."
D."Let's discuss the necessity for a blood transfusion with your religious and spiritual
leaders and come to a reasonable solution." - ansD. "Lets discuss the necessity for a
blood transfusion with your religious and spiritual leaders and come to a reasonable
solution."
A nurse caring for a competent adult client who tells the nurse that the he is thinking
about leaving the hospital against medical advice. The nurse believes that this is not in
the client's best interest, so she prepares to administer a PRN sedative medication that
the client has not requested along with his usual medication. Which of the following
types of tort is the nurse about to commit?
A. Assault
B. False Imprisonment
C. Negligence
D. Breech of confidentiality - ansB. False Imprisonment.
Medication was given with patients consent, it was used as a chemical restraint.
A nurse discovers that a neighbor is a client on the unit in which the nurse works
although the nurse is not assigned to care for that client. The nurse accesses the
electronic medical record (EMR) to find out what the client's diagnosis is. What action
may clients take if they are aware of this type of incident?
A. Report the incident as a HIPPA violation
B. Sue the nurse for libel
C. Sue the nurse for negligence
D. Report the nurse for defamation. - ansA. Report the incident as a HIPPA violation
