A nurse is caring for a client who is receiving total parenteral nutrition (TPN) solution by continuous
IV infusion at 60 mL/hr. The nurse discovers the infusion pump has stopped working. Which of the
following actions should the nurse take while waiting for a new infusion pump?
Administer the TPN solution at the same rate using manual drip tubing.
Offer the client oral fluids in place of the TPN solution.
Infuse 0.9% sodium chloride solution using manual drip tubing at 30 mL/hr.
Provide dextrose 10% in water solution using manual drip tubing at 60 mL/hr.
Provide dextrose 10% in water solution using manual drip tubing at 60 mL/hr.
The nurse should use an infusion pump when administering TPN solution to ensure accurate dosage
and should taper the infusion rate before discontinuing the solution to prevent hypoglycemia. If the
nurse is unable to continue the TPN infusion by infusion pump, the nurse should use manual drip
tubing to infuse dextrose 10% in water at the same rate as the TPN solution.
---
The nurse should administer the TPN solution using an infusion pump to deliver it at a controlled rate
and reduce the risk of hyperglycemia.
The nurse should continue to provide fluids by IV infusion to a client who has been receiving a
continuous TPN infusion to prevent rebound hypoglycemia.
The nurse should infuse an IV solution that will maintain adequate blood glucose levels to reduce the
risk for hypoglycemia.
A home health nurse is providing teaching about infection prevention to a client who has cancer and
is receiving chemotherapy. Which of the following statements by the client indicates an
understanding of the teaching?
A+ TEST BANK 1
, ATI RN VATI COMPREHENSIVE EXAM
2025
"I will leave my drinking water out of my refrigerator for at least 1 hour so it will be room
temperature."
"I will clean my toothbrush in my dishwasher once each month."
"I will take my temperature once each week and let my doctor know if it is high."
"I will walk for short distances throughout the day."
"I will walk for short distances throughout the day."
The client should ambulate for short distances as tolerated throughout the day. This will help to
reduce pulmonary stasis and prevent the development of respiratory infections.
---
Consuming water, or other liquids, that have been standing at room temperature for longer than 1 hr
increases the client's risk for infection due to contamination with bacteria.
Clients can reduce the risk for oral infections by cleaning their toothbrushes in a dishwasher once per
week. This reduces the risk for transmission of bacteria from the toothbrush to the oral cavity.
The client should take their temperature once each day to monitor for infection and notify the
provider if the temperature is greater than 37.8° C (100° F). Early intervention for an infection will
increase the likelihood of the client's recovery.
A nurse is reviewing the medical record of a client who has schizophrenia and is to start taking
clozapine. Which of the following findings should the nurse identify as a contraindication for the
client to receive clozapine?
BP 150/87 mm Hg
WBC count 2,800/mm3
Auditory hallucinations
Nausea
WBC count 2,800/mm3
Clozapine can cause agranulocytosis, which can be life-threatening. Therefore, a WBC count of less
than 3,000/mm3 is a contraindication for the client to receive clozapine. The nurse should withhold
the medication and notify the provider of the client's WBC count.
---
Hypertension is not a contraindication for the client to receive clozapine; however, the nurse should
monitor the client for hypotension, especially when moving from a lying or sitting position to
standing.
Auditory hallucinations are a positive manifestation of psychosis and are not a contraindication for
the client to receive clozapine.
Nausea is not a contraindication for the client to receive clozapine. The client can take clozapine with
food to minimize gastrointestinal upset.
A+ TEST BANK 2
, ATI RN VATI COMPREHENSIVE EXAM
2025
A nurse manager is reviewing unit records and discovers that client falls occur most frequently
during the hours of 0530 and 0730. Which of the following actions should the nurse take when
conducting a root cause analysis?
Investigate environmental factors that might be contributing to client injury during these hours.
Review the performance evaluations of nurses who work during these hours.
Implement a plan to transition from team nursing to primary care nursing during these hours.
Discuss a plan with the providers to reduce the use of barbiturate sedatives prior to these hours.
Investigate environmental factors that might be contributing to client injury during these hours.
When conducting a root cause analysis, the nurse should look at the factors that could possibly lead
to the clients' falls. This can include environmental factors that might be causing the problem.
---
When conducting a root cause analysis, the nurse does not look at the individual performance of
staff members.
When conducting a root cause analysis, the nurse should focus on identifying the cause of a problem,
not potential solutions to the problem.
When conducting a root cause analysis, the nurse should focus on identifying the cause of a problem,
not potential solutions to the problem.
A nurse in the delivery room is caring for a newborn immediately after birth. Which of the following
actions should the nurse take first?
Dry the newborn.
Assign the first Apgar score to the newborn.
Place an identification bracelet on the newborn.
Obtain the newborn's weight.
Dry the newborn.
The greatest risk to the newborn is cold stress. Therefore, the first action the nurse should take is to
dry the newborn.
---
The Apgar score is an important assessment for determining the newborn's adjustment to
extrauterine life. However, this is not the first action the nurse should take.
Placing an identification bracelet on the newborn is an important safety measure. However, this is
not the first action the nurse should take.
Obtaining the newborn's weight is important to help determine the health status of the newborn.
However, this is not the first action the nurse should take.
A+ TEST BANK 3
, ATI RN VATI COMPREHENSIVE EXAM
a4 a4 a4 a4
2025
Obtaininga4thea4newborn'sa4weighta4isa4importanta4toa4helpa4determinea4thea4healtha4statusa4o
fa4thea4newborn.a4However,a4thisa4isa4nota4thea4firsta4actiona4thea4nursea4shoulda4take.a4https:/
/nextgen.atitesting.com/student/images/rn_ca_2013_formb_4b-193.jpg
A
Thea4nursea4shoulda4recognizea4thata4enoxaparina4isa4administereda4intoa4thea4subcutaneousa4tissu
e,a4specificallya4ina4thea4periumbilicala4area.
---
Thea4nursea4shoulda4identifya4thisa4asa4thea4deltoida4site,a4useda4fora4intramusculara4injections.
Thea4nursea4shoulda4identifya4thisa4asa4thea4ventrogluteala4site,a4useda4fora4intramusculara4in
jections.a4Althougha4thea4nursea4cana4usea4thea4anteriora4thigha4fora4aa4subcutaneousa4injecti
on,a4enoxaparina4musta4bea4administereda4ina4aa4differenta4area.
Aa4nursea4isa4caringa4fora4aa4clienta4whoa4hasa4aa4potassiuma4levela4ofa43a4mEq/L.a4Fora4whicha4ofa4the
a4followinga4manifestationsa4shoulda4thea4nursea4monitor?
Increaseda4bowela4sounds
Dry,a4stickya4mucousa4membranesa4Decr
easeda4deepa4tendona4reflexesa4Numbn
essa4anda4tinglinga4ofa4thea4extremities
Decreaseda4deepa4tendona4reflexes
Aa4clienta4whoa4hasa4hypokalemiaa4cana4havea4musclea4weaknessa4anda4decreaseda4deepa4tendona4refl
exes.
---
Aa4clienta4whoa4hasa4hypokalemiaa4isa4likelya4toa4havea4hypoactivea4bowela4soundsa4duea4toa4decr
easeda4gastrointestinala4mobility.
Aa4clienta4whoa4hasa4hypernatremiaa4isa4likelya4toa4havea4dry,a4stickya4mucousa4membranes.
Aa4clienta4whoa4hasa4hypocalcemiaa4isa4likelya4toa4havea4numbnessa4anda4tinglinga4ofa4thea4extre
mitiesa4anda4arounda4thea4mouth.
Aa4nursea4isa4assessinga4aa4clienta4whoa4hasa4aa4stagea4IIa4pressurea4injury.a4Whicha4ofa4thea4followinga
4wounda4characteristicsa4shoulda4thea4nursea4expect?
Musclea4damage
Partial-
thicknessa4skina4lossa4Visib
lea4subcutaneousa4tissuea4
Tendona4exposure
Partial-thicknessa4skina4loss
Thea4nursea4shoulda4expecta4toa4seea4partial-
thicknessa4skina4lossa4ora4blistera4formationa4ina4aa4clienta4whoa4hasa4a
4
A+a4TESTa4BANK
IV infusion at 60 mL/hr. The nurse discovers the infusion pump has stopped working. Which of the
following actions should the nurse take while waiting for a new infusion pump?
Administer the TPN solution at the same rate using manual drip tubing.
Offer the client oral fluids in place of the TPN solution.
Infuse 0.9% sodium chloride solution using manual drip tubing at 30 mL/hr.
Provide dextrose 10% in water solution using manual drip tubing at 60 mL/hr.
Provide dextrose 10% in water solution using manual drip tubing at 60 mL/hr.
The nurse should use an infusion pump when administering TPN solution to ensure accurate dosage
and should taper the infusion rate before discontinuing the solution to prevent hypoglycemia. If the
nurse is unable to continue the TPN infusion by infusion pump, the nurse should use manual drip
tubing to infuse dextrose 10% in water at the same rate as the TPN solution.
---
The nurse should administer the TPN solution using an infusion pump to deliver it at a controlled rate
and reduce the risk of hyperglycemia.
The nurse should continue to provide fluids by IV infusion to a client who has been receiving a
continuous TPN infusion to prevent rebound hypoglycemia.
The nurse should infuse an IV solution that will maintain adequate blood glucose levels to reduce the
risk for hypoglycemia.
A home health nurse is providing teaching about infection prevention to a client who has cancer and
is receiving chemotherapy. Which of the following statements by the client indicates an
understanding of the teaching?
A+ TEST BANK 1
, ATI RN VATI COMPREHENSIVE EXAM
2025
"I will leave my drinking water out of my refrigerator for at least 1 hour so it will be room
temperature."
"I will clean my toothbrush in my dishwasher once each month."
"I will take my temperature once each week and let my doctor know if it is high."
"I will walk for short distances throughout the day."
"I will walk for short distances throughout the day."
The client should ambulate for short distances as tolerated throughout the day. This will help to
reduce pulmonary stasis and prevent the development of respiratory infections.
---
Consuming water, or other liquids, that have been standing at room temperature for longer than 1 hr
increases the client's risk for infection due to contamination with bacteria.
Clients can reduce the risk for oral infections by cleaning their toothbrushes in a dishwasher once per
week. This reduces the risk for transmission of bacteria from the toothbrush to the oral cavity.
The client should take their temperature once each day to monitor for infection and notify the
provider if the temperature is greater than 37.8° C (100° F). Early intervention for an infection will
increase the likelihood of the client's recovery.
A nurse is reviewing the medical record of a client who has schizophrenia and is to start taking
clozapine. Which of the following findings should the nurse identify as a contraindication for the
client to receive clozapine?
BP 150/87 mm Hg
WBC count 2,800/mm3
Auditory hallucinations
Nausea
WBC count 2,800/mm3
Clozapine can cause agranulocytosis, which can be life-threatening. Therefore, a WBC count of less
than 3,000/mm3 is a contraindication for the client to receive clozapine. The nurse should withhold
the medication and notify the provider of the client's WBC count.
---
Hypertension is not a contraindication for the client to receive clozapine; however, the nurse should
monitor the client for hypotension, especially when moving from a lying or sitting position to
standing.
Auditory hallucinations are a positive manifestation of psychosis and are not a contraindication for
the client to receive clozapine.
Nausea is not a contraindication for the client to receive clozapine. The client can take clozapine with
food to minimize gastrointestinal upset.
A+ TEST BANK 2
, ATI RN VATI COMPREHENSIVE EXAM
2025
A nurse manager is reviewing unit records and discovers that client falls occur most frequently
during the hours of 0530 and 0730. Which of the following actions should the nurse take when
conducting a root cause analysis?
Investigate environmental factors that might be contributing to client injury during these hours.
Review the performance evaluations of nurses who work during these hours.
Implement a plan to transition from team nursing to primary care nursing during these hours.
Discuss a plan with the providers to reduce the use of barbiturate sedatives prior to these hours.
Investigate environmental factors that might be contributing to client injury during these hours.
When conducting a root cause analysis, the nurse should look at the factors that could possibly lead
to the clients' falls. This can include environmental factors that might be causing the problem.
---
When conducting a root cause analysis, the nurse does not look at the individual performance of
staff members.
When conducting a root cause analysis, the nurse should focus on identifying the cause of a problem,
not potential solutions to the problem.
When conducting a root cause analysis, the nurse should focus on identifying the cause of a problem,
not potential solutions to the problem.
A nurse in the delivery room is caring for a newborn immediately after birth. Which of the following
actions should the nurse take first?
Dry the newborn.
Assign the first Apgar score to the newborn.
Place an identification bracelet on the newborn.
Obtain the newborn's weight.
Dry the newborn.
The greatest risk to the newborn is cold stress. Therefore, the first action the nurse should take is to
dry the newborn.
---
The Apgar score is an important assessment for determining the newborn's adjustment to
extrauterine life. However, this is not the first action the nurse should take.
Placing an identification bracelet on the newborn is an important safety measure. However, this is
not the first action the nurse should take.
Obtaining the newborn's weight is important to help determine the health status of the newborn.
However, this is not the first action the nurse should take.
A+ TEST BANK 3
, ATI RN VATI COMPREHENSIVE EXAM
a4 a4 a4 a4
2025
Obtaininga4thea4newborn'sa4weighta4isa4importanta4toa4helpa4determinea4thea4healtha4statusa4o
fa4thea4newborn.a4However,a4thisa4isa4nota4thea4firsta4actiona4thea4nursea4shoulda4take.a4https:/
/nextgen.atitesting.com/student/images/rn_ca_2013_formb_4b-193.jpg
A
Thea4nursea4shoulda4recognizea4thata4enoxaparina4isa4administereda4intoa4thea4subcutaneousa4tissu
e,a4specificallya4ina4thea4periumbilicala4area.
---
Thea4nursea4shoulda4identifya4thisa4asa4thea4deltoida4site,a4useda4fora4intramusculara4injections.
Thea4nursea4shoulda4identifya4thisa4asa4thea4ventrogluteala4site,a4useda4fora4intramusculara4in
jections.a4Althougha4thea4nursea4cana4usea4thea4anteriora4thigha4fora4aa4subcutaneousa4injecti
on,a4enoxaparina4musta4bea4administereda4ina4aa4differenta4area.
Aa4nursea4isa4caringa4fora4aa4clienta4whoa4hasa4aa4potassiuma4levela4ofa43a4mEq/L.a4Fora4whicha4ofa4the
a4followinga4manifestationsa4shoulda4thea4nursea4monitor?
Increaseda4bowela4sounds
Dry,a4stickya4mucousa4membranesa4Decr
easeda4deepa4tendona4reflexesa4Numbn
essa4anda4tinglinga4ofa4thea4extremities
Decreaseda4deepa4tendona4reflexes
Aa4clienta4whoa4hasa4hypokalemiaa4cana4havea4musclea4weaknessa4anda4decreaseda4deepa4tendona4refl
exes.
---
Aa4clienta4whoa4hasa4hypokalemiaa4isa4likelya4toa4havea4hypoactivea4bowela4soundsa4duea4toa4decr
easeda4gastrointestinala4mobility.
Aa4clienta4whoa4hasa4hypernatremiaa4isa4likelya4toa4havea4dry,a4stickya4mucousa4membranes.
Aa4clienta4whoa4hasa4hypocalcemiaa4isa4likelya4toa4havea4numbnessa4anda4tinglinga4ofa4thea4extre
mitiesa4anda4arounda4thea4mouth.
Aa4nursea4isa4assessinga4aa4clienta4whoa4hasa4aa4stagea4IIa4pressurea4injury.a4Whicha4ofa4thea4followinga
4wounda4characteristicsa4shoulda4thea4nursea4expect?
Musclea4damage
Partial-
thicknessa4skina4lossa4Visib
lea4subcutaneousa4tissuea4
Tendona4exposure
Partial-thicknessa4skina4loss
Thea4nursea4shoulda4expecta4toa4seea4partial-
thicknessa4skina4lossa4ora4blistera4formationa4ina4aa4clienta4whoa4hasa4a
4
A+a4TESTa4BANK
