505 ATI Final Test bank with Correct
Answers for A+ Score 2025
⫸ A charge nurse is observing a newly hired nurse prepare a sterile field. Which of the
following indicates to the charge nurse that the sterile field is contaminated? ✓ Answer:
Sterile field is opened on a wet surface.
*Opening a sterile field on a wet surface contaminates it because capillary action can wick
bacteria through the dressing.
⫸ A nurse is caring for a client who has dementia. Which of the following interventions
should the nurse take to minimize the risk for injury to this client? ✓ Answer: Use a bed exit
alarm system
⫸ A nurse is implementing a plan of care for an older adult client who is at risk for falls.
Which of the following is an appropriate nursing action? ✓ Answer: Implement a regular
toileting schedule.
*The nurse should toilet the client every 1 to 3 hr to reduce the risk of falls due to the client
ambulating to the bathroom without assistance.
⫸ A nurse is caring for a client with an order for 5 units of Regular insulin and 10 units of
NPH insulin to be mixed together and administered subcutaneously. List the correct order
of steps for this procedure. (Move the steps into the box on the right, placing them in the
selected order of performance. All steps must be used.) ✓ Answer: 1) Inject 10 units of air
into the bottle of NPH insulin
2) Inject 5 units of air into the bottle of Regular insulin
3) Withdraw the correct dose of Regular insulin from the bottle
4) Withdraw the correct dose of NPH insulin from the bottle
,⫸ A nurse is completing an admission assessment of an older adult client. Which of the
following findings is a potential indication of abuse? ✓ Answer: Presence of bruises on the
arms in various stages of healing
⫸ A nurse is educating a family member of a client who is immobile about how to prevent
back injury associated with moving the client up in bed. Which of the following statements
by the family member should indicate to the nurse that he understands the teaching? ✓
Answer: "I will leverage my weight against my wife and shift it as I move her."
⫸ A nurse on an oncology unit is caring for a client who has tears in his eyes and states,
"The doctor just told me that I don't have long to live." Which of the following is an
appropriate response by the nurse? ✓ Answer: "Tell me more about how you're feeling."
⫸ Which of the following techniques should the nurse use when performing nasotracheal
suctioning for a client? ✓ Answer: Apply intermittent suction when withdrawing the
catheter.
_______________________________________
-Insert while pt is inhaling
-Discard after use
-Hold with dominant hand with sterile glove
⫸ A nurse is assisting a client with range-of-motion exercises of the neck. Which of the
following should the nurse suggest to promote neck rotation? ✓ Answer: Move her head
from side to side
⫸ A nurse in a long-term care facility is planning to perform hygiene care for a new
resident. Which of the following assessment questions is the nurse's priority before
beginning this procedure? ✓ Answer: "Are you able to help with your hygiene care?"
,⫸ A nurse is caring for a client following an acute myocardial infarction. The client is
concerned that providing self-care will be difficult due to extreme fatigue. Which of the
following strategies should the nurse implement to promote the client's independence? ✓
Answer: Instruct the client to focus on gradually resuming self-care tasks.
⫸ A nurse is transcribing new prescriptions for a client. Which of the following
prescriptions is accurately transcribed by the nurse? ✓ Answer: Morphine 4 mg IV bolus
every 2 hr PRN for incisional pain
⫸ A nurse is reviewing the medical records for a client who has a pressure ulcer. Which of
the following is an expected finding? ✓ Answer: Serum albumin level of 3 g/dL
*A serum albumin level below 3 g/dL indicates protein deficiency, putting the client at risk
for pressure ulcer formation and poor wound healing.
⫸ A nurse is caring for a client who needs a 24-hr urine collection initiated. Which of the
following client statements indicates an understanding of the procedure? ✓ Answer: "I
flushed what I urinated at 7 a.m. and have saved all urine since."
*For a 24-hr urine collection, the client should discard the first voiding and save all
subsequent voidings.
______________________________________
-Collect urine that is free of feces
-Place urine in container immediately and keep on ice or in fridge
⫸ A nurse is caring for a client who has an NG tube that is irrigated every 8 hr. Which of the
following should be used to irrigate the tube in order to maintain fluid and electrolyte
balance? ✓ Answer: 0.9% sodium chloride
, ⫸ A nurse is caring for a client who is refusing a scheduled blood transfusion for religious
reasons. The client's partner wants the client to have the blood transfusion. Which of the
following actions should the nurse take? ✓ Answer: Withhold the scheduled blood
transfusion.
⫸ A nurse is preparing to obtain a lower extremity blood pressure from a client and no
longer palpates the popliteal pulse after 92 mm Hg. Which of the following images displays
the appropriate mm Hg to which the nurse should inflate the cuff when obtaining the blood
pressure? ✓ Answer: For accurate blood pressure measurement, the nurse should inflate
the cuff 30 mm Hg beyond the last measurement on the manometer at which she was able
to palpate a pulse.
⫸ A nurse is obtaining a health history from a client who has hearing loss. Which of the
following actions by the nurse is appropriate? ✓ Answer: Rephrase rather than repeat
misunderstood information.
⫸ A nurse is performing a Romberg's test during the physical assessment of a client.
Which of the following techniques should the nurse use? ✓ Answer: Have the client stand
with arms at side and feet together.
⫸ A nurse is planning care of an adolescent who is postoperative following a lumbar
laminectomy. Which of the following interventions should the nurse include in the plan of
care? ✓ Answer: Allow the adolescent to make decisions regarding his daily routine.
⫸ A nurse is caring for a client who has taken in 2,600 mL of fluids in 24 hr. Which of the
following is an expected output for the client? ✓ Answer: 2,500 mL
*The client's output should approximate the daily fluid intake. Therefore, an output close to
2,600 mL is expected.
Answers for A+ Score 2025
⫸ A charge nurse is observing a newly hired nurse prepare a sterile field. Which of the
following indicates to the charge nurse that the sterile field is contaminated? ✓ Answer:
Sterile field is opened on a wet surface.
*Opening a sterile field on a wet surface contaminates it because capillary action can wick
bacteria through the dressing.
⫸ A nurse is caring for a client who has dementia. Which of the following interventions
should the nurse take to minimize the risk for injury to this client? ✓ Answer: Use a bed exit
alarm system
⫸ A nurse is implementing a plan of care for an older adult client who is at risk for falls.
Which of the following is an appropriate nursing action? ✓ Answer: Implement a regular
toileting schedule.
*The nurse should toilet the client every 1 to 3 hr to reduce the risk of falls due to the client
ambulating to the bathroom without assistance.
⫸ A nurse is caring for a client with an order for 5 units of Regular insulin and 10 units of
NPH insulin to be mixed together and administered subcutaneously. List the correct order
of steps for this procedure. (Move the steps into the box on the right, placing them in the
selected order of performance. All steps must be used.) ✓ Answer: 1) Inject 10 units of air
into the bottle of NPH insulin
2) Inject 5 units of air into the bottle of Regular insulin
3) Withdraw the correct dose of Regular insulin from the bottle
4) Withdraw the correct dose of NPH insulin from the bottle
,⫸ A nurse is completing an admission assessment of an older adult client. Which of the
following findings is a potential indication of abuse? ✓ Answer: Presence of bruises on the
arms in various stages of healing
⫸ A nurse is educating a family member of a client who is immobile about how to prevent
back injury associated with moving the client up in bed. Which of the following statements
by the family member should indicate to the nurse that he understands the teaching? ✓
Answer: "I will leverage my weight against my wife and shift it as I move her."
⫸ A nurse on an oncology unit is caring for a client who has tears in his eyes and states,
"The doctor just told me that I don't have long to live." Which of the following is an
appropriate response by the nurse? ✓ Answer: "Tell me more about how you're feeling."
⫸ Which of the following techniques should the nurse use when performing nasotracheal
suctioning for a client? ✓ Answer: Apply intermittent suction when withdrawing the
catheter.
_______________________________________
-Insert while pt is inhaling
-Discard after use
-Hold with dominant hand with sterile glove
⫸ A nurse is assisting a client with range-of-motion exercises of the neck. Which of the
following should the nurse suggest to promote neck rotation? ✓ Answer: Move her head
from side to side
⫸ A nurse in a long-term care facility is planning to perform hygiene care for a new
resident. Which of the following assessment questions is the nurse's priority before
beginning this procedure? ✓ Answer: "Are you able to help with your hygiene care?"
,⫸ A nurse is caring for a client following an acute myocardial infarction. The client is
concerned that providing self-care will be difficult due to extreme fatigue. Which of the
following strategies should the nurse implement to promote the client's independence? ✓
Answer: Instruct the client to focus on gradually resuming self-care tasks.
⫸ A nurse is transcribing new prescriptions for a client. Which of the following
prescriptions is accurately transcribed by the nurse? ✓ Answer: Morphine 4 mg IV bolus
every 2 hr PRN for incisional pain
⫸ A nurse is reviewing the medical records for a client who has a pressure ulcer. Which of
the following is an expected finding? ✓ Answer: Serum albumin level of 3 g/dL
*A serum albumin level below 3 g/dL indicates protein deficiency, putting the client at risk
for pressure ulcer formation and poor wound healing.
⫸ A nurse is caring for a client who needs a 24-hr urine collection initiated. Which of the
following client statements indicates an understanding of the procedure? ✓ Answer: "I
flushed what I urinated at 7 a.m. and have saved all urine since."
*For a 24-hr urine collection, the client should discard the first voiding and save all
subsequent voidings.
______________________________________
-Collect urine that is free of feces
-Place urine in container immediately and keep on ice or in fridge
⫸ A nurse is caring for a client who has an NG tube that is irrigated every 8 hr. Which of the
following should be used to irrigate the tube in order to maintain fluid and electrolyte
balance? ✓ Answer: 0.9% sodium chloride
, ⫸ A nurse is caring for a client who is refusing a scheduled blood transfusion for religious
reasons. The client's partner wants the client to have the blood transfusion. Which of the
following actions should the nurse take? ✓ Answer: Withhold the scheduled blood
transfusion.
⫸ A nurse is preparing to obtain a lower extremity blood pressure from a client and no
longer palpates the popliteal pulse after 92 mm Hg. Which of the following images displays
the appropriate mm Hg to which the nurse should inflate the cuff when obtaining the blood
pressure? ✓ Answer: For accurate blood pressure measurement, the nurse should inflate
the cuff 30 mm Hg beyond the last measurement on the manometer at which she was able
to palpate a pulse.
⫸ A nurse is obtaining a health history from a client who has hearing loss. Which of the
following actions by the nurse is appropriate? ✓ Answer: Rephrase rather than repeat
misunderstood information.
⫸ A nurse is performing a Romberg's test during the physical assessment of a client.
Which of the following techniques should the nurse use? ✓ Answer: Have the client stand
with arms at side and feet together.
⫸ A nurse is planning care of an adolescent who is postoperative following a lumbar
laminectomy. Which of the following interventions should the nurse include in the plan of
care? ✓ Answer: Allow the adolescent to make decisions regarding his daily routine.
⫸ A nurse is caring for a client who has taken in 2,600 mL of fluids in 24 hr. Which of the
following is an expected output for the client? ✓ Answer: 2,500 mL
*The client's output should approximate the daily fluid intake. Therefore, an output close to
2,600 mL is expected.
