[ATI COMPREHENSIVE RETAKE 2026 WITH NGN] QUESTIONS AND
ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS |
UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
A nurse is assessing a client who has a new diagnosis of heart failure. Which of the following findings should the
nurse expect?
A. Decreased jugular venous pressure
B. Peripheral edema
C. Increased urine output
D. Orthopnea
🟢 Correct Answer: D. Orthopnea
🔴 RATIONALE: Orthopnea (difficulty breathing when lying flat) is a common finding in heart failure due to
pulmonary congestion. Jugular venous pressure is typically elevated, peripheral edema is present but orthopnea
is a classic symptom, and urine output is typically decreased.
,Question 2
A nurse is caring for a client who is receiving a blood transfusion. The client develops chills, fever, and low back
pain. Which of the following actions should the nurse take first?
A. Stop the blood transfusion
B. Notify the healthcare provider
C. Administer diphenhydramine
D. Assess the client's vital signs
🟢 Correct Answer: A. Stop the blood transfusion
🔴 RATIONALE: Chills, fever, and low back pain indicate a hemolytic transfusion reaction. The nurse should stop
the transfusion immediately to prevent further complications. Notifying the provider, assessing vital signs, and
administering medications are secondary actions.
Question 3
A nurse is providing education to a client who has been prescribed warfarin. Which of the following statements
by the client indicates a need for further teaching?
A. "I will take ibuprofen for my headaches."
,B. "I will have my INR checked regularly."
C. "I will wear a medical alert bracelet."
D. "I will avoid eating large amounts of green leafy vegetables."
🟢 Correct Answer: A. "I will take ibuprofen for my headaches."
🔴 RATIONALE: Ibuprofen is an NSAID that increases the risk of bleeding when taken with warfarin and should
be avoided. Regular INR monitoring, wearing a medical alert bracelet, and avoiding large amounts of vitamin K-
rich foods are appropriate.
Question 4
A nurse is caring for a client who has a nasogastric (NG) tube to low intermittent suction. Which of the following
actions should the nurse take to maintain tube patency?
A. Flush the tube with 30 mL of air every 4 hours
B. Irrigate the tube with sterile water as prescribed
C. Clamp the tube for 15 minutes every hour
D. Apply petroleum jelly to the nares
🟢 Correct Answer: B. Irrigate the tube with sterile water as prescribed
, 🔴 RATIONALE: Irrigating the NG tube with sterile water or normal saline as prescribed helps maintain patency.
Flushing with air is not recommended, clamping does not maintain patency, and petroleum jelly is used to
prevent skin breakdown, not patency.
Question 5
A nurse is assessing a client who has a diagnosis of acute appendicitis. Which of the following findings is most
consistent with this condition?
A. Pain in the right upper quadrant
B. Rebound tenderness in the right lower quadrant
C. Pain that is relieved by eating
D. Nausea and vomiting
🟢 Correct Answer: B. Rebound tenderness in the right lower quadrant
🔴 RATIONALE: Rebound tenderness in the right lower quadrant is a classic sign of appendicitis. Pain in the
right upper quadrant suggests gallbladder disease, pain relieved by eating suggests ulcer disease, and nausea
and vomiting are non-specific.
ANSWERS ALREADY GRADED A+. 100% VERIFIED SOLUTIONS |
UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
A nurse is assessing a client who has a new diagnosis of heart failure. Which of the following findings should the
nurse expect?
A. Decreased jugular venous pressure
B. Peripheral edema
C. Increased urine output
D. Orthopnea
🟢 Correct Answer: D. Orthopnea
🔴 RATIONALE: Orthopnea (difficulty breathing when lying flat) is a common finding in heart failure due to
pulmonary congestion. Jugular venous pressure is typically elevated, peripheral edema is present but orthopnea
is a classic symptom, and urine output is typically decreased.
,Question 2
A nurse is caring for a client who is receiving a blood transfusion. The client develops chills, fever, and low back
pain. Which of the following actions should the nurse take first?
A. Stop the blood transfusion
B. Notify the healthcare provider
C. Administer diphenhydramine
D. Assess the client's vital signs
🟢 Correct Answer: A. Stop the blood transfusion
🔴 RATIONALE: Chills, fever, and low back pain indicate a hemolytic transfusion reaction. The nurse should stop
the transfusion immediately to prevent further complications. Notifying the provider, assessing vital signs, and
administering medications are secondary actions.
Question 3
A nurse is providing education to a client who has been prescribed warfarin. Which of the following statements
by the client indicates a need for further teaching?
A. "I will take ibuprofen for my headaches."
,B. "I will have my INR checked regularly."
C. "I will wear a medical alert bracelet."
D. "I will avoid eating large amounts of green leafy vegetables."
🟢 Correct Answer: A. "I will take ibuprofen for my headaches."
🔴 RATIONALE: Ibuprofen is an NSAID that increases the risk of bleeding when taken with warfarin and should
be avoided. Regular INR monitoring, wearing a medical alert bracelet, and avoiding large amounts of vitamin K-
rich foods are appropriate.
Question 4
A nurse is caring for a client who has a nasogastric (NG) tube to low intermittent suction. Which of the following
actions should the nurse take to maintain tube patency?
A. Flush the tube with 30 mL of air every 4 hours
B. Irrigate the tube with sterile water as prescribed
C. Clamp the tube for 15 minutes every hour
D. Apply petroleum jelly to the nares
🟢 Correct Answer: B. Irrigate the tube with sterile water as prescribed
, 🔴 RATIONALE: Irrigating the NG tube with sterile water or normal saline as prescribed helps maintain patency.
Flushing with air is not recommended, clamping does not maintain patency, and petroleum jelly is used to
prevent skin breakdown, not patency.
Question 5
A nurse is assessing a client who has a diagnosis of acute appendicitis. Which of the following findings is most
consistent with this condition?
A. Pain in the right upper quadrant
B. Rebound tenderness in the right lower quadrant
C. Pain that is relieved by eating
D. Nausea and vomiting
🟢 Correct Answer: B. Rebound tenderness in the right lower quadrant
🔴 RATIONALE: Rebound tenderness in the right lower quadrant is a classic sign of appendicitis. Pain in the
right upper quadrant suggests gallbladder disease, pain relieved by eating suggests ulcer disease, and nausea
and vomiting are non-specific.
