NUR SURGICAL NATI_Comprehensive_Practice_Test_B 2021-2022.
NSG 4060 Comprehensive ATI Practice B
A nurse is assessing a client who received 2 units of packed RBCs 48 hrs ago. Which
of the following findings should indicate to the nurse that the therapy has been
effective?
Hemoglobin 14.9 g/dL
The nurse should identify that packed RBCs a re administered to clients who
have a decreased level of hemoglobin or hematocrit. This h emoglobin level
is within the expected reference range of 14 to 18 g/dL for males and 12 to
16 g/dL for females, indicating the therapy has been effective.
A nurse working in a n emergency department is triaging four clients. Which of the
following clients should the nurse recommend for treatment first?
A middle adult client who has unstable vital signs.
Using the stable vs unstable approach t o client care, the nurse should
recommend priority treatment for the client who has u nstable vital signs
because this client requires immediate treatment to reduce the risk of
further injury o r possible death.
A nurse is caring for a c lient who has fluid volume overload. Which of the following
tasks should the nurse delegate t o the CNA?
Measure the client’s daily weight
It is within the CNAs range of function to measure a client’s daily weight, so
the nurse should delegate this task to them.
A nurse is preparing t o administer mannitol 0.2g/kg IV bolus over 5 min as a test
dose to a client who has severe oliguria. The client weighs 198lb. What is t he
amount in grams the nurse should administer?
18 g
A nurse is conduction a physical examination for an adolescent and is assessing
the range of motion of the legs. W hich of the following images indicates the
adolescent is abducting the hip joint?
In the correct image, the adolescent is abduction the hip joint by moving the
leg away from the midline of the body.
A nurse is caring for a c lient who has hyperthyroidism. Which of the following
findings should the nurse expect?
Tremors
Tremors are a manifestation of hyperthyroidism, along with tachycardia,
diaphoresis, weight loss, insomnia, and exophthalmia.
,NUR SURGICAL NATI_Comprehensive_Practice_Test_B 2021-2022.
A nurse is assessing a school-aged child who has bacterial meningitis. Which of the
following findings should the n urse expect?
Nuchal rigidity
This is a manifestation of bacterial meningitis.
A nurse is assessing a newborn’s heart rate. Which of the following actions should
the nurse take?
Auscultate the apical pulse at least 1 min.
The nurse should auscultate the apical pulse to obtain an accurate
assessment of heart rate and rhythm. Auscultation of a newborn’s heart
sounds can be difficult because of the rapid rate and the transmission of
respiratory sounds.
A nurse is preparing t o assist with a thoracentesis for a client who has pleurisy.
The nurse should plan to perform which of the following actions?
Instruct the client to avoid coughing during the procedure.
It is important for the nurse to remind the client to avoid coughing and to lie
still during a thoracentesis to avoid puncturing the pleura.
A nurse in the ED is a ssessing a preschooler who has a facial laceration. The nurse
should identify which of the f ollowing findings as a potential indication of child
sexual abuse?
The child exhibits discomfort while walking.
The nurse should identify this finding as a potential indication of child sexual
abuse.
A nurse is preparing t o teach about dietary management to a client who has
Crohn’s disease and an enteroenteric f istula. Which of the following nutrients
should the nurse instruct the client to decrease in their d iet?
Fiber
The nurse should instruct the client to consume a low-fiber diet to reduce
diarrhea and inflammation.
A nurse is caring for a c lient who has a prescription for a continuous passive
motion (CPM) machine following a total knee arthroplasty. Which of the following
actions should the nurse take?
Turn off the CPM machine during
mealtime. This promotes client comfort
and dietary intake.
A nurse is preparing t o initiate IV access for an older adult client. Which of the
following sites should the nurse select when initiating the IV for the client?
,NUR SURGICAL NATI_Comprehensive_Practice_Test_B 2021-2022.
Radial vein of the inner arm.
This site will have adequate subcutaneous t issue.
, NUR SURGICAL NATI_Comprehensive_Practice_Test_B 2021-2022.
A nurse is developing a client education program a bout osteoporosis for older adult
clients. The nurse should include which of the following variables as a risk factor for
osteoporosis?
Sedentary lifestyle.
This is a risk factor for osteoporosis. The nurse should encourage older adult
clients to engage in weight-bearing exercises because t hey will promote
bone health by increasing calcium and phosphorus levels.
A nurse in an ED is caring for a child who has a fever and fluid-filled vesicles on the
trunk and extremities. Which of t he following interventions should the nurse
identify as the priority?
Initiate transmission-based precautions
When using the urgent vs nonurgent approach to client care, the nurse
should determine that the priority action is to initiate transmission-based
precautions for the child. The child most likely has varicella. Therefore, the
nurse should isolate the child to prevent the spread of the infection.
A nurse is caring for a c lient who has a clogged percutaneous gastrostomy feeding
tube. Which of the following actions should the nurse take first?
Change the position of the client.
When providing client care, the nurse should use the least restrictive
intervention first. Therefore, the nurse should reposition the client to remove
any kinks in the tube, which can lead to clogging. If this method is
unsuccessful, t he nurse should attempt to flush or aspirate the client’s tube to
remove the clog.
A home health care nurse is developing a teaching plan for a client who has a new
ileostomy. Which of the following i nstructions should the nurse include?
Empty the appliance when it is one-third t o one-half full.
The ileostomy pouch should be emptied when it is o ne-third to one-half full
to prevent stool leakage and skin irritation.
A nurse is reviewing the laboratory report of a client who has end-stage kidney
disease and received hemodialysis 24 yr ago. Which of the following lab values
should the nurse report to the provider?
Sodium 148 mEq/L
The nurse should report this sodium level because it is a bove the expected
reference range of 136 to 145 mEq/L, indicating hypernatremia. Clients who
have kidney disease often retain sodium and require sodium-restricted diets.
A nurse is caring for four clients. Which of the following tasks should the nurse
delegate to a CNA?
NSG 4060 Comprehensive ATI Practice B
A nurse is assessing a client who received 2 units of packed RBCs 48 hrs ago. Which
of the following findings should indicate to the nurse that the therapy has been
effective?
Hemoglobin 14.9 g/dL
The nurse should identify that packed RBCs a re administered to clients who
have a decreased level of hemoglobin or hematocrit. This h emoglobin level
is within the expected reference range of 14 to 18 g/dL for males and 12 to
16 g/dL for females, indicating the therapy has been effective.
A nurse working in a n emergency department is triaging four clients. Which of the
following clients should the nurse recommend for treatment first?
A middle adult client who has unstable vital signs.
Using the stable vs unstable approach t o client care, the nurse should
recommend priority treatment for the client who has u nstable vital signs
because this client requires immediate treatment to reduce the risk of
further injury o r possible death.
A nurse is caring for a c lient who has fluid volume overload. Which of the following
tasks should the nurse delegate t o the CNA?
Measure the client’s daily weight
It is within the CNAs range of function to measure a client’s daily weight, so
the nurse should delegate this task to them.
A nurse is preparing t o administer mannitol 0.2g/kg IV bolus over 5 min as a test
dose to a client who has severe oliguria. The client weighs 198lb. What is t he
amount in grams the nurse should administer?
18 g
A nurse is conduction a physical examination for an adolescent and is assessing
the range of motion of the legs. W hich of the following images indicates the
adolescent is abducting the hip joint?
In the correct image, the adolescent is abduction the hip joint by moving the
leg away from the midline of the body.
A nurse is caring for a c lient who has hyperthyroidism. Which of the following
findings should the nurse expect?
Tremors
Tremors are a manifestation of hyperthyroidism, along with tachycardia,
diaphoresis, weight loss, insomnia, and exophthalmia.
,NUR SURGICAL NATI_Comprehensive_Practice_Test_B 2021-2022.
A nurse is assessing a school-aged child who has bacterial meningitis. Which of the
following findings should the n urse expect?
Nuchal rigidity
This is a manifestation of bacterial meningitis.
A nurse is assessing a newborn’s heart rate. Which of the following actions should
the nurse take?
Auscultate the apical pulse at least 1 min.
The nurse should auscultate the apical pulse to obtain an accurate
assessment of heart rate and rhythm. Auscultation of a newborn’s heart
sounds can be difficult because of the rapid rate and the transmission of
respiratory sounds.
A nurse is preparing t o assist with a thoracentesis for a client who has pleurisy.
The nurse should plan to perform which of the following actions?
Instruct the client to avoid coughing during the procedure.
It is important for the nurse to remind the client to avoid coughing and to lie
still during a thoracentesis to avoid puncturing the pleura.
A nurse in the ED is a ssessing a preschooler who has a facial laceration. The nurse
should identify which of the f ollowing findings as a potential indication of child
sexual abuse?
The child exhibits discomfort while walking.
The nurse should identify this finding as a potential indication of child sexual
abuse.
A nurse is preparing t o teach about dietary management to a client who has
Crohn’s disease and an enteroenteric f istula. Which of the following nutrients
should the nurse instruct the client to decrease in their d iet?
Fiber
The nurse should instruct the client to consume a low-fiber diet to reduce
diarrhea and inflammation.
A nurse is caring for a c lient who has a prescription for a continuous passive
motion (CPM) machine following a total knee arthroplasty. Which of the following
actions should the nurse take?
Turn off the CPM machine during
mealtime. This promotes client comfort
and dietary intake.
A nurse is preparing t o initiate IV access for an older adult client. Which of the
following sites should the nurse select when initiating the IV for the client?
,NUR SURGICAL NATI_Comprehensive_Practice_Test_B 2021-2022.
Radial vein of the inner arm.
This site will have adequate subcutaneous t issue.
, NUR SURGICAL NATI_Comprehensive_Practice_Test_B 2021-2022.
A nurse is developing a client education program a bout osteoporosis for older adult
clients. The nurse should include which of the following variables as a risk factor for
osteoporosis?
Sedentary lifestyle.
This is a risk factor for osteoporosis. The nurse should encourage older adult
clients to engage in weight-bearing exercises because t hey will promote
bone health by increasing calcium and phosphorus levels.
A nurse in an ED is caring for a child who has a fever and fluid-filled vesicles on the
trunk and extremities. Which of t he following interventions should the nurse
identify as the priority?
Initiate transmission-based precautions
When using the urgent vs nonurgent approach to client care, the nurse
should determine that the priority action is to initiate transmission-based
precautions for the child. The child most likely has varicella. Therefore, the
nurse should isolate the child to prevent the spread of the infection.
A nurse is caring for a c lient who has a clogged percutaneous gastrostomy feeding
tube. Which of the following actions should the nurse take first?
Change the position of the client.
When providing client care, the nurse should use the least restrictive
intervention first. Therefore, the nurse should reposition the client to remove
any kinks in the tube, which can lead to clogging. If this method is
unsuccessful, t he nurse should attempt to flush or aspirate the client’s tube to
remove the clog.
A home health care nurse is developing a teaching plan for a client who has a new
ileostomy. Which of the following i nstructions should the nurse include?
Empty the appliance when it is one-third t o one-half full.
The ileostomy pouch should be emptied when it is o ne-third to one-half full
to prevent stool leakage and skin irritation.
A nurse is reviewing the laboratory report of a client who has end-stage kidney
disease and received hemodialysis 24 yr ago. Which of the following lab values
should the nurse report to the provider?
Sodium 148 mEq/L
The nurse should report this sodium level because it is a bove the expected
reference range of 136 to 145 mEq/L, indicating hypernatremia. Clients who
have kidney disease often retain sodium and require sodium-restricted diets.
A nurse is caring for four clients. Which of the following tasks should the nurse
delegate to a CNA?
