ATI Remediation Question Bank Practice Exam PDF | Questions, Answers,
and Detailed Rationales | Comprehensive Nursing Review for ATI and
NCLEX Preparation | Medical-Surgical Nursing, Pharmacology, Pediatrics,
Maternal-Newborn, Mental Health Nursing, Infection Control, Patient
Safety, Clinical Judgment, and Evidence-Based Nursing Interventions |
Complete ATI Remediation Study and Practice Guide
Question 1: A nurse is preparing to administer insulin aspart to a client with type 1 diabetes
mellitus. Which action should the nurse take first?
A. Check the client's blood glucose level
B. Verify the insulin order with another nurse
C. Assess the client for signs of hypoglycemia
D. Cleanse the injection site with alcohol
CORRECT ANSWER: A. Check the client's blood glucose level
RATIONALE: Before administering rapid-acting insulin such as insulin aspart, the nurse
must first check the client's current blood glucose level to determine the appropriate dose and
prevent hypoglycemia. While verifying orders and assessing for symptoms are important, the
immediate prerequisite for safe insulin administration is knowing the current glucose value to
guide dosing per protocol.
Question 2: A client is receiving morphine via patient-controlled analgesia (PCA)
postoperatively. Which assessment finding requires immediate nursing intervention?
A. Respiratory rate of 10 breaths per minute
B. Pain rating of 3 on a 0–10 scale
C. Sedation score of 2 on a 1–5 scale
D. Blood pressure of 110/70 mm Hg
CORRECT ANSWER: A. Respiratory rate of 10 breaths per minute
RATIONALE: Opioids like morphine can cause respiratory depression, a life-threatening
complication. A respiratory rate below 12 breaths per minute in an adult is a critical finding
requiring immediate intervention, such as stimulating the client, administering naloxone per
protocol, and notifying the provider. The other findings are within expected parameters for a
postoperative client on PCA.
Question 3: Which intervention should a nurse prioritize for a client with a newly applied
cast on the right leg?
A. Elevate the extremity on pillows
B. Apply warm compresses to the cast
C. Encourage ambulation within 1 hour
D. Assess capillary refill every 4 hours
CORRECT ANSWER: A. Elevate the extremity on pillows
RATIONALE: Elevation of a newly casted extremity promotes venous return and reduces
swelling, which helps prevent compartment syndrome. Warm compresses can increase
swelling and are contraindicated initially. Ambulation timing depends on provider orders and
,cast type. While neurovascular assessments are essential, elevation is the priority immediate
intervention to mitigate complications.
Question 4: A nurse is teaching a client about warfarin therapy. Which statement by the
client indicates understanding?
A. "I will take my warfarin with a full glass of grapefruit juice."
B. "I will use a soft-bristled toothbrush to prevent gum bleeding."
C. "I will increase my intake of leafy green vegetables to boost effectiveness."
D. "I will stop taking warfarin if I notice bruising."
CORRECT ANSWER: B. "I will use a soft-bristled toothbrush to prevent gum bleeding."
RATIONALE: Warfarin increases bleeding risk; using a soft-bristled toothbrush minimizes
trauma to oral mucosa and reduces bleeding risk. Grapefruit juice interferes with warfarin
metabolism. Leafy green vegetables are high in vitamin K, which antagonizes warfarin and
should be consumed consistently, not increased abruptly. Clients should never stop
anticoagulants without provider guidance.
Question 5: A client with heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Blood urea nitrogen
D. Hemoglobin A1c
CORRECT ANSWER: B. Serum potassium
RATIONALE: Furosemide is a loop diuretic that promotes potassium excretion, placing
the client at high risk for hypokalemia, which can cause dangerous cardiac dysrhythmias. While
sodium and BUN may also be affected, potassium requires the most vigilant monitoring.
Hemoglobin A1c relates to long-term glucose control and is not directly impacted by
furosemide.
Question 6: Which action by a nurse demonstrates proper technique when administering
an intramuscular injection using the Z-track method?
A. Massaging the injection site after needle withdrawal
B. Pulling the skin laterally before inserting the needle
C. Using a 1-inch needle for all adult clients
D. Injecting the medication rapidly over 2 seconds
CORRECT ANSWER: B. Pulling the skin laterally before inserting the needle
RATIONALE: The Z-track technique involves displacing the skin laterally before needle
insertion to seal the medication in the muscle and prevent leakage into subcutaneous tissue,
reducing irritation and staining. Massaging the site is contraindicated as it can force medication
into subcutaneous layers. Needle length varies by client body habitus, and medications should
be injected slowly (over 5–10 seconds) to minimize discomfort.
,Question 7: A nurse is caring for a client with a chest tube connected to a water-seal
drainage system. Which finding indicates the system is functioning correctly?
A. Continuous bubbling in the water-seal chamber
B. Tidaling in the water-seal chamber with respiration
C. Drainage of 200 mL of bright red blood per hour
D. Absence of fluctuation in the suction control chamber
CORRECT ANSWER: B. Tidaling in the water-seal chamber with respiration
RATIONALE: Tidaling (fluctuation of fluid level with inspiration and expiration) in the
water-seal chamber indicates the chest tube is patent and responding to intrapleural pressure
changes, which is expected. Continuous bubbling suggests an air leak. Drainage exceeding 100
mL/hour of bright red blood may indicate hemorrhage. The suction control chamber should
have gentle, continuous bubbling if wall suction is applied.
Question 8: Which assessment finding in a client with preeclampsia requires immediate
notification of the provider?
A. Blood pressure of 148/92 mm Hg
B. 1+ proteinuria on dipstick
C. Report of a persistent headache
D. 2+ deep tendon reflexes
CORRECT ANSWER: C. Report of a persistent headache
RATIONALE: A persistent headache in preeclampsia may indicate cerebral edema or
impending eclampsia, requiring urgent intervention. While elevated BP and proteinuria define
preeclampsia, they are expected findings being monitored. Hyperreflexia (3+ or 4+) is more
concerning than 2+. Headache is a red-flag symptom signaling possible progression to severe
features.
Question 9: A nurse is preparing to administer a blood transfusion. Which step is essential
to prevent a transfusion reaction?
A. Administer the blood with 5% dextrose solution
B. Verify the blood product with another registered nurse
C. Warm the blood unit in a microwave before infusion
D. Infuse the blood over 1 hour regardless of volume
CORRECT ANSWER: B. Verify the blood product with another registered nurse
RATIONALE: Dual verification of the blood product, client identity, and compatibility by
two licensed nurses is a critical safety step to prevent fatal hemolytic reactions. Blood must be
administered with normal saline only; dextrose causes hemolysis. Blood should never be
microwaved, as it damages cells. Infusion time depends on volume and client tolerance,
typically 2–4 hours per unit.
Question 10: Which intervention should a nurse implement first for a client experiencing
an acute asthma attack?
, A. Administer a prescribed short-acting beta-agonist via nebulizer
B. Obtain a peak expiratory flow reading
C. Place the client in a supine position
D. Apply oxygen at 2 L/min via nasal cannula
CORRECT ANSWER: A. Administer a prescribed short-acting beta-agonist via nebulizer
RATIONALE: During an acute asthma exacerbation, the priority is rapid bronchodilation to
relieve airway obstruction. Short-acting beta-agonists (e.g., albuterol) are first-line therapy.
While oxygen and assessment are important, delaying bronchodilator administration worsens
outcomes. The client should be positioned upright, not supine, to maximize lung expansion.
Question 11: A client with chronic kidney disease has a serum potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering?
A. Sodium polystyrene sulfonate
B. Epoetin alfa
C. Calcium carbonate
D. Furosemide
CORRECT ANSWER: A. Sodium polystyrene sulfonate
RATIONALE: Sodium polystyrene sulfonate (Kayexalate) is a potassium-binding resin
used to treat hyperkalemia, a life-threatening complication of chronic kidney disease. Epoetin
alfa stimulates red blood cell production for anemia. Calcium carbonate manages
hyperphosphatemia. Furosemide may promote potassium excretion but is less effective in
advanced CKD and not first-line for severe hyperkalemia.
Question 12: Which finding should a nurse recognize as a sign of effective breastfeeding in
a newborn?
A. The infant feeds every 4 hours
B. The mother reports no nipple pain
C. The infant has 6–8 wet diapers per day after day 5
D. The infant falls asleep within 2 minutes of latching
CORRECT ANSWER: C. The infant has 6–8 wet diapers per day after day 5
RATIONALE: Adequate urine output (6–8 wet diapers/day after the first week) indicates
sufficient milk intake and hydration. Newborns should feed 8–12 times per 24 hours, not every 4
hours. Absence of pain is ideal but not a direct measure of infant intake. Falling asleep quickly
may indicate fatigue or poor latch, not effective feeding.
Question 13: A nurse is caring for a client with a closed head injury. Which assessment
finding is most indicative of increasing intracranial pressure?
A. Pupils equal and reactive at 3 mm
B. Systolic blood pressure of 110 mm Hg
C. Decreasing level of consciousness
D. Temperature of 37.2°C (99°F)
CORRECT ANSWER: C. Decreasing level of consciousness
and Detailed Rationales | Comprehensive Nursing Review for ATI and
NCLEX Preparation | Medical-Surgical Nursing, Pharmacology, Pediatrics,
Maternal-Newborn, Mental Health Nursing, Infection Control, Patient
Safety, Clinical Judgment, and Evidence-Based Nursing Interventions |
Complete ATI Remediation Study and Practice Guide
Question 1: A nurse is preparing to administer insulin aspart to a client with type 1 diabetes
mellitus. Which action should the nurse take first?
A. Check the client's blood glucose level
B. Verify the insulin order with another nurse
C. Assess the client for signs of hypoglycemia
D. Cleanse the injection site with alcohol
CORRECT ANSWER: A. Check the client's blood glucose level
RATIONALE: Before administering rapid-acting insulin such as insulin aspart, the nurse
must first check the client's current blood glucose level to determine the appropriate dose and
prevent hypoglycemia. While verifying orders and assessing for symptoms are important, the
immediate prerequisite for safe insulin administration is knowing the current glucose value to
guide dosing per protocol.
Question 2: A client is receiving morphine via patient-controlled analgesia (PCA)
postoperatively. Which assessment finding requires immediate nursing intervention?
A. Respiratory rate of 10 breaths per minute
B. Pain rating of 3 on a 0–10 scale
C. Sedation score of 2 on a 1–5 scale
D. Blood pressure of 110/70 mm Hg
CORRECT ANSWER: A. Respiratory rate of 10 breaths per minute
RATIONALE: Opioids like morphine can cause respiratory depression, a life-threatening
complication. A respiratory rate below 12 breaths per minute in an adult is a critical finding
requiring immediate intervention, such as stimulating the client, administering naloxone per
protocol, and notifying the provider. The other findings are within expected parameters for a
postoperative client on PCA.
Question 3: Which intervention should a nurse prioritize for a client with a newly applied
cast on the right leg?
A. Elevate the extremity on pillows
B. Apply warm compresses to the cast
C. Encourage ambulation within 1 hour
D. Assess capillary refill every 4 hours
CORRECT ANSWER: A. Elevate the extremity on pillows
RATIONALE: Elevation of a newly casted extremity promotes venous return and reduces
swelling, which helps prevent compartment syndrome. Warm compresses can increase
swelling and are contraindicated initially. Ambulation timing depends on provider orders and
,cast type. While neurovascular assessments are essential, elevation is the priority immediate
intervention to mitigate complications.
Question 4: A nurse is teaching a client about warfarin therapy. Which statement by the
client indicates understanding?
A. "I will take my warfarin with a full glass of grapefruit juice."
B. "I will use a soft-bristled toothbrush to prevent gum bleeding."
C. "I will increase my intake of leafy green vegetables to boost effectiveness."
D. "I will stop taking warfarin if I notice bruising."
CORRECT ANSWER: B. "I will use a soft-bristled toothbrush to prevent gum bleeding."
RATIONALE: Warfarin increases bleeding risk; using a soft-bristled toothbrush minimizes
trauma to oral mucosa and reduces bleeding risk. Grapefruit juice interferes with warfarin
metabolism. Leafy green vegetables are high in vitamin K, which antagonizes warfarin and
should be consumed consistently, not increased abruptly. Clients should never stop
anticoagulants without provider guidance.
Question 5: A client with heart failure is prescribed furosemide. Which laboratory value
should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Blood urea nitrogen
D. Hemoglobin A1c
CORRECT ANSWER: B. Serum potassium
RATIONALE: Furosemide is a loop diuretic that promotes potassium excretion, placing
the client at high risk for hypokalemia, which can cause dangerous cardiac dysrhythmias. While
sodium and BUN may also be affected, potassium requires the most vigilant monitoring.
Hemoglobin A1c relates to long-term glucose control and is not directly impacted by
furosemide.
Question 6: Which action by a nurse demonstrates proper technique when administering
an intramuscular injection using the Z-track method?
A. Massaging the injection site after needle withdrawal
B. Pulling the skin laterally before inserting the needle
C. Using a 1-inch needle for all adult clients
D. Injecting the medication rapidly over 2 seconds
CORRECT ANSWER: B. Pulling the skin laterally before inserting the needle
RATIONALE: The Z-track technique involves displacing the skin laterally before needle
insertion to seal the medication in the muscle and prevent leakage into subcutaneous tissue,
reducing irritation and staining. Massaging the site is contraindicated as it can force medication
into subcutaneous layers. Needle length varies by client body habitus, and medications should
be injected slowly (over 5–10 seconds) to minimize discomfort.
,Question 7: A nurse is caring for a client with a chest tube connected to a water-seal
drainage system. Which finding indicates the system is functioning correctly?
A. Continuous bubbling in the water-seal chamber
B. Tidaling in the water-seal chamber with respiration
C. Drainage of 200 mL of bright red blood per hour
D. Absence of fluctuation in the suction control chamber
CORRECT ANSWER: B. Tidaling in the water-seal chamber with respiration
RATIONALE: Tidaling (fluctuation of fluid level with inspiration and expiration) in the
water-seal chamber indicates the chest tube is patent and responding to intrapleural pressure
changes, which is expected. Continuous bubbling suggests an air leak. Drainage exceeding 100
mL/hour of bright red blood may indicate hemorrhage. The suction control chamber should
have gentle, continuous bubbling if wall suction is applied.
Question 8: Which assessment finding in a client with preeclampsia requires immediate
notification of the provider?
A. Blood pressure of 148/92 mm Hg
B. 1+ proteinuria on dipstick
C. Report of a persistent headache
D. 2+ deep tendon reflexes
CORRECT ANSWER: C. Report of a persistent headache
RATIONALE: A persistent headache in preeclampsia may indicate cerebral edema or
impending eclampsia, requiring urgent intervention. While elevated BP and proteinuria define
preeclampsia, they are expected findings being monitored. Hyperreflexia (3+ or 4+) is more
concerning than 2+. Headache is a red-flag symptom signaling possible progression to severe
features.
Question 9: A nurse is preparing to administer a blood transfusion. Which step is essential
to prevent a transfusion reaction?
A. Administer the blood with 5% dextrose solution
B. Verify the blood product with another registered nurse
C. Warm the blood unit in a microwave before infusion
D. Infuse the blood over 1 hour regardless of volume
CORRECT ANSWER: B. Verify the blood product with another registered nurse
RATIONALE: Dual verification of the blood product, client identity, and compatibility by
two licensed nurses is a critical safety step to prevent fatal hemolytic reactions. Blood must be
administered with normal saline only; dextrose causes hemolysis. Blood should never be
microwaved, as it damages cells. Infusion time depends on volume and client tolerance,
typically 2–4 hours per unit.
Question 10: Which intervention should a nurse implement first for a client experiencing
an acute asthma attack?
, A. Administer a prescribed short-acting beta-agonist via nebulizer
B. Obtain a peak expiratory flow reading
C. Place the client in a supine position
D. Apply oxygen at 2 L/min via nasal cannula
CORRECT ANSWER: A. Administer a prescribed short-acting beta-agonist via nebulizer
RATIONALE: During an acute asthma exacerbation, the priority is rapid bronchodilation to
relieve airway obstruction. Short-acting beta-agonists (e.g., albuterol) are first-line therapy.
While oxygen and assessment are important, delaying bronchodilator administration worsens
outcomes. The client should be positioned upright, not supine, to maximize lung expansion.
Question 11: A client with chronic kidney disease has a serum potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering?
A. Sodium polystyrene sulfonate
B. Epoetin alfa
C. Calcium carbonate
D. Furosemide
CORRECT ANSWER: A. Sodium polystyrene sulfonate
RATIONALE: Sodium polystyrene sulfonate (Kayexalate) is a potassium-binding resin
used to treat hyperkalemia, a life-threatening complication of chronic kidney disease. Epoetin
alfa stimulates red blood cell production for anemia. Calcium carbonate manages
hyperphosphatemia. Furosemide may promote potassium excretion but is less effective in
advanced CKD and not first-line for severe hyperkalemia.
Question 12: Which finding should a nurse recognize as a sign of effective breastfeeding in
a newborn?
A. The infant feeds every 4 hours
B. The mother reports no nipple pain
C. The infant has 6–8 wet diapers per day after day 5
D. The infant falls asleep within 2 minutes of latching
CORRECT ANSWER: C. The infant has 6–8 wet diapers per day after day 5
RATIONALE: Adequate urine output (6–8 wet diapers/day after the first week) indicates
sufficient milk intake and hydration. Newborns should feed 8–12 times per 24 hours, not every 4
hours. Absence of pain is ideal but not a direct measure of infant intake. Falling asleep quickly
may indicate fatigue or poor latch, not effective feeding.
Question 13: A nurse is caring for a client with a closed head injury. Which assessment
finding is most indicative of increasing intracranial pressure?
A. Pupils equal and reactive at 3 mm
B. Systolic blood pressure of 110 mm Hg
C. Decreasing level of consciousness
D. Temperature of 37.2°C (99°F)
CORRECT ANSWER: C. Decreasing level of consciousness
