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ATI RN Comprehensive Predictor 2025; With Complete 180 Questions, Correct Answers, Exams of Nursing

West Virginia University (WVU)Nursing

ATI RN Comprehensive Predictor 2025; With Complete 180 Questions, Correct Answers and Rationale| Verified| Assured A+ Score Guide

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ATI RN Comprehensive Predictor 2025; With Complete

180 Questions, Correct Answers and Rationale| Verified|

Assured A+ Score Guide

1. A nurse is assessing a client who is postoperative following abdominal surgery and has an in-

dwelling urinary catheter that is draining dark yellow urine at 25 ml/hr. Which of the following

interventions should the nurse anticipate?

A. Clamp the catheter tubing for 30 min

B. Initiate continuous bladder irrigation

C. Obtain a urine specimen for culture and sensitivity

D. Administer a fluid bolus

Correct Ans: D.

Rationale: A urinary output of 25 ml/hr is below the expected range of 30-60 ml/hr for an adult.

This low output may indicate dehydration or inadequate fluid intake. Administering a fluid bolus

is an appropriate intervention to increase urinary output. Clamping the catheter (A) could lead to

complications such as bladder distension or infection, while initiating continuous bladder

irrigation (B) is typically used when there is a concern for clot obstruction, not low urine output.

Obtaining a urine culture (C) is not indicated unless there are signs of infection such as fever or

dysuria.

2. A nurse is caring for a client who has experienced a stillbirth. Which of the following actions

should the nurse take during the initial grieving process?

A. Avoid talking to the client about the newborn

B. Discourage the client from allowing friends to see the newborn

C. Offer to take pictures of the newborn for the client

D. Assure the client that she can have additional children

Correct Ans: C.

Rationale: Grieving parents may find comfort in having tangible memories of their stillborn

child. Offering to take pictures (C) is a compassionate way to support them in their grieving

process. Avoiding discussion of the newborn (A) may hinder the grieving process. Discouraging

friends from seeing the newborn (B) is not therapeutic; the client should be allowed to make that

decision. Telling the client that they can have additional children (D) may invalidate the grief

they are experiencing and is not helpful during the initial grieving phase.

Partial preview of the text

Download ATI RN Comprehensive Predictor 2025; With Complete 180 Questions, Correct Answers and more Exams Nursing in PDF only on Docsity!

ATI RN Comprehensive Predictor 2025; With Complete

180 Questions, Correct Answers and Rationale| Verified|

Assured A+ Score Guide

A nurse is assessing a client who is postoperative following abdominal surgery and has an in- dwelling urinary catheter that is draining dark yellow urine at 25 ml/hr. Which of the following interventions should the nurse anticipate? A. Clamp the catheter tubing for 30 min B. Initiate continuous bladder irrigation C. Obtain a urine specimen for culture and sensitivity D. Administer a fluid bolus Correct Ans: D. Rationale: A urinary output of 25 ml/hr is below the expected range of 30-60 ml/hr for an adult. This low output may indicate dehydration or inadequate fluid intake. Administering a fluid bolus is an appropriate intervention to increase urinary output. Clamping the catheter (A) could lead to complications such as bladder distension or infection, while initiating continuous bladder irrigation (B) is typically used when there is a concern for clot obstruction, not low urine output. Obtaining a urine culture (C) is not indicated unless there are signs of infection such as fever or dysuria.
A nurse is caring for a client who has experienced a stillbirth. Which of the following actions should the nurse take during the initial grieving process? A. Avoid talking to the client about the newborn B. Discourage the client from allowing friends to see the newborn C. Offer to take pictures of the newborn for the client D. Assure the client that she can have additional children Correct Ans: C. Rationale: Grieving parents may find comfort in having tangible memories of their stillborn child. Offering to take pictures (C) is a compassionate way to support them in their grieving process. Avoiding discussion of the newborn (A) may hinder the grieving process. Discouraging friends from seeing the newborn (B) is not therapeutic; the client should be allowed to make that decision. Telling the client that they can have additional children (D) may invalidate the grief they are experiencing and is not helpful during the initial grieving phase.

A nurse is caring for a client who has a major burn injury. Which of the following actions is the nurse’s priority to prevent wound infection? A. Use sterile dressings for wound care B. Apply topical antibiotics to the client’s wounds C. Place the client in protective isolation D. Maintain consistent hand washing by staff Correct Ans: D. Rationale: Hand hygiene is the most effective way to prevent infection. The nurse should ensure that hand hygiene is consistently maintained by all healthcare staff (D). While sterile dressings (A) and topical antibiotics (B) are important, they cannot replace the foundational importance of proper hand hygiene. Placing the client in protective isolation (C) is not necessary unless the client has an immune deficiency, which is not specified in the scenario.
A nurse is speaking with the caregiver of a client who has Alzheimer’s disease. The caregiver states, “Providing constant care is very stressful and is affecting all areas of my life.” Which of the following actions should the nurse take? A. Discuss methods of how to communicate with the client about problem-solving behaviors. B. Suggest that the caregiver seek a prescription for an antipsychotic medication for the client. C. Assist the caregiver to arrange a daycare program for the client. D. Recommend allowing the client to have time alone in their room throughout the day. Correct Ans: C. Rationale: A daycare program (C) can offer the caregiver relief from the constant demands of caregiving, allowing them time to rest and recharge. While communication techniques (A) may be helpful, they do not address the caregiver’s stress directly. Suggesting antipsychotic medications (B) should be a last resort after considering other less invasive options. Allowing the client to be alone (D) could increase safety concerns, especially in someone with Alzheimer’s disease.
A nurse is caring for a client who is 1 hour postpartum and unable to urinate. Which of the following actions should the nurse take? A. Administer a benzodiazepine B. Perform a fundal massage

Rationale: Betamethasone is a corticosteroid used to promote fetal lung maturity in preterm labor. One of its side effects is hyperglycemia (A) because corticosteroids can increase blood sugar levels. Uterine contractions (B) are a sign of preterm labor, not a side effect of the medication. Proteinuria (C) and hypotension (D) are not typical side effects of betamethasone.

A nurse is preparing to obtain a blood sample from a client who has a central venous catheter. Which of the following actions should the nurse take? (SATA) A. Apply a tourniquet above the catheter insertion site. B. Access the catheter using a large bore needle. C. Aspirate for blood return to access catheter patency. D. Flush the catheter with 0.9% sodium chloride. E. Apply force when resistance is met while flushing the catheter. Correct Ans/s: C, D. Rationale: To ensure the central venous catheter is patent and functioning properly, the nurse should aspirate for blood return (C) and flush with 0.9% sodium chloride (D) before drawing a blood sample. Applying a tourniquet (A) can impede blood flow and should not be used near the insertion site of a central line. Using a large bore needle (B) is not necessary for blood collection from a central venous catheter, and applying force (E) is dangerous as it could cause catheter damage or dislodgement.
A nurse is preparing to perform a dressing change on a preschooler. Which of the following actions should the nurse take to prepare the child for the procedure? A. Explain in simple terms how the procedure will affect the child. B. Ask the parents to wait outside the room during the procedure. C. Limit teaching sessions about the procedure to 20 min. D. Instruct the child in deep-breathing methods prior to the procedure. Correct Ans: A. Rationale: Explaining the procedure in simple terms (A) helps the child understand what is happening, reducing anxiety and promoting cooperation. Asking the parents to wait outside (B) can cause distress for a preschooler who may feel more secure with their parents present. Limiting teaching time (C) may not be necessary; it’s more important to provide clear, age- appropriate explanations. Instructing the child in deep-breathing (D) is appropriate, but not the most essential first step in preparation.

A nurse is performing wound care for a client who has an abdominal incision. Which of the following techniques should the nurse implement? A. Irrigate the wound using a 10-mL syringe. B. Cleanse the wound starting at the bottom and moving upward. C. Cleanse the insertion site of the drain using a circular motion towards the center. D. Irrigate the wound with a low-pressure flow of solution. Correct Ans: D. Rationale: Wound irrigation should be performed with a low-pressure flow to prevent damage to the tissue (D). A 10-mL syringe (A) is too small for adequate irrigation. The wound should be cleansed from the cleanest area to the dirtiest (B), not upward. Circular motion towards the center (C) is used for drain sites, but the focus for the wound itself should be on proper irrigation techniques.
A nurse on an antepartum unit is prioritizing care for multiple clients. Which of the following clients should the nurse see first? A. A client who is at 36 weeks of gestation and has a biophysical profile score of 8. B. A client who has preeclampsia and reports a persistent headache. C. A client who has pregestational diabetes mellitus and an HbA1c of 6.2%. D. A client who is at 28 weeks of gestation and reports leukorrhea. Correct Ans: B. Rationale: A persistent headache in a client with preeclampsia may be a sign of worsening preeclampsia or impending eclampsia, which can lead to seizures and other life-threatening complications. Therefore, this is the priority concern. A biophysical profile score of 8 (A) is within the normal range, and an HbA1c of 6.2% (C) is an acceptable level for a client with pregestational diabetes. Leukorrhea (D) at 28 weeks is typically normal during pregnancy.
A nurse is caring for a client who is recovering from an amputation of her right arm above the elbow. Which of the following information should the nurse report to the occupational therapist? A. The client’s parent is in a skilled nursing facility. B. The client has two small children at home. C. The client is allergic to penicillin. D. The client lives in a two-story home. Correct Ans: B.

A nurse is providing care for a patient who has depression and is to have electroconvulsive therapy. Which of the following conditions should the nurse identify as increasing the client’s risk for complications? A. Hyperthyroidism B. Renal calculi C. Diabetes mellitus D. Cardiac dysrhythmias Correct Ans: D. Rationale: Electroconvulsive therapy (ECT) can affect the cardiovascular system, particularly in individuals with preexisting cardiac conditions. Cardiac dysrhythmias (D) increase the risk of complications during ECT. While hyperthyroidism (A) and diabetes mellitus (C) can affect overall health, they do not directly increase the risk of complications from ECT. Renal calculi (B) are unrelated to ECT risks.
A nurse is reviewing the laboratory results of a client who has rheumatoid arthritis. Which of the following findings should the nurse report to the provider? A. WBC count 8,000/mm B. Platelets 150,000/mm C. Aspartate aminotransferase 10 units/L D. Erythrocyte sedimentation 75 mm/hr Correct Ans: D. Rationale: An elevated erythrocyte sedimentation rate (ESR) is a common marker of inflammation. An ESR of 75 mm/hr (D) is significantly elevated and indicates active inflammation, which should be reported to the provider. WBC count (A), platelet count (B), and aspartate aminotransferase (C) are within normal ranges and do not require urgent attention in this context.
A nurse is suctioning the airway of a client who is receiving mechanical ventilation via an endotracheal tube. Which of the following findings should the nurse identify as an indication that suctioning has been effective? A. Presence of a productive cough B. Decreased peak inspiratory pressure C. Thinning of mucous secretions D. Flattening of the artificial airway cuff

Correct Ans: B. Rationale: Decreased peak inspiratory pressure (B) indicates that the airway is clearer after suctioning and that the ventilator can function more effectively. A productive cough (A) can be a sign of adequate airway clearance, but it is not necessarily related to suctioning effectiveness. Thinning of mucous secretions (C) may happen as a result of suctioning but is not an indicator of its effectiveness. Flattening of the airway cuff (D) is not a desired effect of suctioning and could be harmful.

A nurse is caring for a client who is in a seclusion room following violent behavior. The client continues to display aggressive behavior. Which of the following actions should the nurse take? A. Stand within 30 cm (1 ft) of the client when speaking with them. B. Express sympathy for the client’s situation. C. Confront the client about his behavior. D. Speak assertively to the client. Correct Ans: D. Rationale: Speaking assertively (D) helps to establish clear boundaries and communicate authority without escalating the situation. Standing too close (A) may increase the client's aggression. Expressing sympathy (B) may be perceived as weak and might not help in maintaining control. Confronting the client (C) can escalate the situation and is generally not a therapeutic response.
A nurse is caring for a client who is immediately postoperative following an adrenalectomy to treat Cushing’s disease. Which of the following actions is the nurse’s priority? A. Reposition the client for comfort every 2 hours B. Observe for any indications of infection C. Document amount and color of the incisional drainage D. Monitor the client’s fluid and electrolyte status. Correct Ans: D. Rationale: The priority concern after an adrenalectomy is monitoring the client’s fluid and electrolyte status, as the body is adjusting to a new balance without excess cortisol. Fluid imbalances, particularly with sodium and potassium, are common after this surgery. Repositioning for comfort (A) and monitoring incisional drainage (C) are important, but they are secondary to managing fluid and electrolytes. Infection (B) is a concern, but fluid and electrolyte imbalances are the immediate postoperative priority.

C. Baked potato chips D. Cheesecake Correct Ans: A. Rationale: Air-popped popcorn (A) is a healthy, low-calorie snack option. It is high in fiber and can be a good source of whole grains. A milkshake made with whole milk (B) is high in fat and sugar, which isn't ideal for a healthy snack. Baked potato chips (C) may be lower in fat compared to regular chips, but they can still be high in sodium. Cheesecake (D) is high in fat and sugar and does not provide essential nutrients for growing children.

A nurse is providing teaching to a client who has a new prescription for enoxaparin. Which of the following medications for pain relief should the nurse include in the teaching that can be taken concurrently with enoxaparin? A. Naproxen sodium B. Ibuprofen C. Acetaminophen D. Aspirin Correct Ans: C. Rationale: Acetaminophen (C) is the preferred pain reliever for clients on enoxaparin because it does not increase the risk of bleeding, unlike nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (A), ibuprofen (B), and aspirin (D), which can interfere with platelet function and increase the risk of bleeding. Enoxaparin is an anticoagulant, so it is important to avoid drugs that can increase bleeding risks.
A nurse is caring for a client who has fibromyalgia and requests pain medication. Which of the following medications should the nurse plan to administer? A. Colchicine B. Lorazepam C. Pregabalin D. Codeine Correct Ans: C. Rationale: Pregabalin (C) is commonly used to treat fibromyalgia pain as it works on the nervous system to reduce pain and improve sleep. Colchicine (A) is used to treat gout, lorazepam (B) is a benzodiazepine used for anxiety, and codeine (D) is an opioid that is not a first-line treatment for fibromyalgia due to the risk of dependence and side effects.

A nurse is caring for a client who has congestive heart failure and is receiving furosemide and digoxin. Which of the following laboratory values indicates that the client is at risk for developing digoxin toxicity? A. Glucose 150 mg/dL B. Magnesium 1.3 mEq/L C. Potassium 3.1 mEq/L D. Sodium 134 mEq/L Correct Ans: C. Rationale: Low potassium (C) levels can increase the risk of digoxin toxicity, as potassium and digoxin have a reciprocal relationship in the heart. Furosemide is a diuretic that can lead to hypokalemia, which puts the client at risk for digoxin toxicity. A magnesium level of 1.3 mEq/L (B) is on the lower end but not as critical in terms of digoxin toxicity. Glucose levels (A) and sodium levels (D) are less directly related to digoxin toxicity.
A nurse is caring for a client who had an embolic stroke and has a prescription for alteplase. Which of the following in the client’s history should the nurse identify as a contraindication for receiving alteplase? A. Hip arthroplasty 1 week ago B. Obstructive lung disease C. Retinal detachment D. Acute kidney failure 6 months ago Correct Ans: A. Rationale: Alteplase is a thrombolytic medication used to dissolve clots in the case of an ischemic stroke. A history of recent surgery, such as hip arthroplasty (A) within one week, increases the risk of bleeding, which is a contraindication for alteplase. Obstructive lung disease (B), retinal detachment (C), and acute kidney failure (D) do not directly contraindicate the use of alteplase for an embolic stroke.
A nurse is providing discharge teaching for a client who has a new implantable cardioverter defibrillator (ICD). Which of the following client statements demonstrates understanding of the teaching? A. “I will soak in the tub rather than showering.” B. “I can hold my cellphone on the same side of my body as the ICD.”

secure, the nurse can move on to controlling the bleeding (D), inserting an IV line (B), and preparing for diagnostic imaging (A). However, airway management takes precedence.

A nurse is reviewing the rhythm strip of a client who is experiencing sinus arrhythmia. Which of the following findings should the nurse expect? A. Inconsistent P wave formation. B. Ventricular and atrial rates 120/min C. P-R intervals of 0.30 seconds D. P to QRS ratio 1: Correct Ans: Rationale: In sinus arrhythmia, the rhythm is typically normal with a 1:1 ratio of P waves to QRS complexes (D). The P wave formation (A) should be consistent as it originates from the sinoatrial (SA) node. Sinus arrhythmia involves slight variations in heart rate with breathing, but the rates should not be excessively high (B), and the P-R interval (C) is usually between 0.12- 0.20 seconds, not 0.30 seconds.
A nurse is admitting a client who has dementia to a long-term care facility. The client tells the nurse that she lived in this facility years ago and took care of all the residents by herself. The nurse should document this as which of the following findings? A. Confabulation B. Agnosia C. Projection D. Perseveration Correct Ans: A. Confabulation Rationale: Confabulation (A) involves the creation of false memories or information without the intention to deceive. It is common in clients with dementia who may confuse the present with past events or make up stories. Agnosia (B) refers to the inability to recognize familiar objects or people, projection (C) involves attributing one's own thoughts or feelings to others, and perseveration (D) refers to the repetition of words or actions despite changing circumstances.
A nurse is reviewing home recommendations with a client who is postoperative following knee surgery. Which of the following recommendations should the nurse make?

A. Place a handrail in the entryway of the house. B. Place a towel on the floor outside of the shower. C. Ensure that all area rugs are rubber-backed. D. Wear slippers with cloth soles. Correct Ans: A. Place a handrail in the entryway of the house. Rationale: Placing a handrail (A) in the entryway provides the client with support when entering or exiting the house, which is especially important after knee surgery to prevent falls. A towel on the floor outside of the shower (B) could be a slipping hazard. Area rugs should be removed or secured, not just made rubber-backed (C), to prevent tripping. Slippers with cloth soles (D) could increase the risk of slipping, so shoes with non-slip soles should be worn.

A nurse is caring for a client who is postoperative following total hip arthroplasty. Which of the following actions should the nurse take to prevent dislocation of the prosthesis? A. Raise the head of the client’s bed to a high-fowler’s position. B. Elevate the client’s affected leg on a pillow when in bed. C. Position the client’s knees slightly higher than the hips when up in a chair. D. Keep an abduction pillow between the client’s legs. Correct Ans: D. Keep an abduction pillow between the client’s legs. Rationale: Keeping an abduction pillow (D) between the client’s legs after hip arthroplasty helps maintain the proper positioning of the hip joint and prevents dislocation. Raising the head of the bed to a high-Fowler’s position (A) could increase the risk of hip dislocation by causing excessive flexion. Elevating the leg on a pillow (B) could lead to hip flexion beyond the safe limit. The knees should not be higher than the hips (C) to prevent hip dislocation.
A nurse in a pediatric clinic is teaching a newly hired nurse about the varicella zoster virus. Which of the following information should the nurse include? A. Children who have varicella should be placed on droplet precautions. B. Children who have varicella are contagious 4 days before the first vesicle eruption. C. Children who have varicella are contagious until the vesicles are crusted. D. Children who have varicella should receive the herpes zoster vaccine. Correct Ans: C. Children who have varicella are contagious until the vesicles are crusted. Rationale: Children with varicella (chickenpox) are contagious from 1-2 days before the appearance of the rash until all the vesicles have crusted over (C). Varicella is spread via direct contact and respiratory droplets, not droplet precautions alone (A). Varicella is contagious before

A. “I can use petroleum jelly as a lubricant with the condom.” B. “I can re-use the condom one time after initial use.” C. “I can use natural-skin condoms to prevent sexually transmitted infections.” D. “I can store the condoms in the drawer of my nightstand.” Correct Ans: D. “I can store the condoms in the drawer of my nightstand.” Rationale: Condoms should be stored in a cool, dry place, and storing them in a drawer (D) is appropriate. Petroleum jelly (A) can degrade latex condoms, so it should not be used with them. Condoms should never be reused (B). Natural-skin condoms (C) do not protect against sexually transmitted infections because they have tiny pores that may allow viruses to pass through.

A nurse is planning care for a client who has a chest tube. Which of the following interventions should the nurse include in the plan? (SATA) A. Maintain the collection chamber above the level of the client’s waist. B. Mark the drainage output on the collection chamber hourly. C. Clamp the chest tube every 2 hours to assess the amount of drainage. D. Add water to the water seal chamber as it evaporates. E. Strip the chest tube vigorously to dislodge blood clots. Correct Ans: B. Mark the drainage output on the collection chamber hourly. D. Add water to the water seal chamber as it evaporates. Rationale: The nurse should mark the drainage output hourly (B) to monitor for changes in drainage. The water seal chamber (D) should be maintained at the correct water level, adding water as necessary to ensure proper functioning. Clamping the chest tube (C) can increase the risk of a tension pneumothorax and should not be routinely done. Stripping the chest tube (E) is not recommended as it can cause injury to the lung tissue. Maintaining the collection chamber below the level of the chest (A) is the correct positioning to prevent backflow, not above the waist.
The nurse is reviewing a medical record of a client who has a prescription for intermittent heat therapy for a foot injury. Which of the following findings should the nurse identify as a contraindication to heat therapy? A. Osteoarthritis B. Peripheral neuropathy C. Abdominal aortic aneurysm D. Phlebitis Correct Ans: C. Abdominal aortic aneurysm

Rationale: Heat therapy should be avoided in clients with an abdominal aortic aneurysm (C) because heat can cause vasodilation, which might rupture the aneurysm. Osteoarthritis (A), peripheral neuropathy (B), and phlebitis (D) are not contraindications for heat therapy, although heat should be applied cautiously to areas with poor sensation (as in peripheral neuropathy).

A charge nurse is recommending postpartum clients for discharge following a local disaster. Which of the following clients should the nurse recommend for discharge first? A. A 15-year-old client who delivered via emergency cesarean birth 1 day ago B. A 42-year-old client who has preeclampsia and a BP of 166/110 mm Hg C. A client who delivered precipitously and has a second-degree perineal laceration D. A client who has received 2 units of RBCs 6 hr ago for a postpartum hemorrhage Correct Ans: C. A client who delivered precipitously and has a second-degree perineal laceration Rationale: The client with a second-degree perineal laceration (C) and no complications is stable and can be discharged first. The 15-year-old client (A) who had an emergency cesarean section needs monitoring for potential complications. The 42-year-old client with preeclampsia (B) and elevated BP needs further evaluation and monitoring before discharge. The client who received blood transfusions (D) for postpartum hemorrhage is also at risk for complications and should be monitored before discharge.
A nurse is providing teaching about crutch safety to a client. Which of the following client actions indicates an understanding of the teaching? A. The client flexes her elbows 10 degrees when supporting weight by using the handgrips. B. The client places the crutches 30 cm (12 in) to the front and side of each foot while standing. C. The client leans on both crutches to support body weight. D. The client keeps her axillae free of pressure. Correct Ans: D. The client keeps her axillae free of pressure. Rationale: The correct technique for using crutches involves keeping the axillae free of pressure to prevent nerve damage or injury. The handgrips should be positioned at a height that allows the client to bend their elbows at about 30 degrees (not 10 degrees) while bearing weight, not placing pressure on the axillae (A). The crutches should be placed about 15 cm (6 inches) to the front and side of the foot (not 30 cm) (B). Leaning on the crutches (C) can cause injury, as the client should primarily support their weight through their hands, not their armpits.

Rationale: It is important for nurses to obtain professional liability insurance (C) to protect themselves in case of legal action. Living wills (A) are important but may not always be required prior to treatment. Incident reports (B) are confidential and should never be placed in medical records, as they are not part of the client's legal record. Overestimating acuity (D) to prevent short staffing is not an ethical or professional approach.

A nurse is caring for a client who speaks a language different than the nurse. Which of the following actions should the nurse make? A. Review the facility policy about the use of an interpreter. B. Direct attention toward the interpreter when speaking to the client. C. Request a family member or friend to interpret information to the client. D. Request an interpreter of a different sex from the client. Correct Ans: A. Review the facility policy about the use of an interpreter. Rationale: The nurse should always follow the facility's policy regarding the use of an interpreter (A) to ensure accurate communication and avoid misunderstandings. The nurse should direct their attention to the client, not the interpreter (B). Family members (C) are not recommended as interpreters because they may not translate accurately or impartially. The sex of the interpreter (D) is generally not a requirement unless specified by the client.
A nurse in the emergency department is caring for a client following a motor-vehicle crash. Which of the following findings should the nurse identify as a manifestation of hypovolemic shock? A. Decreased respiratory rate B. Change in level of consciousness C. Increased urine output D. Hyperactive deep-tendon reflexes Correct Ans: B. Change in level of consciousness Rationale: Hypovolemic shock (B) often causes a decrease in perfusion, leading to confusion or a change in the level of consciousness. Decreased respiratory rate (A) is not typical; respiratory rate often increases in shock. Increased urine output (C) is the opposite of what occurs in hypovolemic shock, where urine output tends to decrease. Hyperactive reflexes (D) are not a manifestation of hypovolemic shock.

A nurse is caring for a client following application of a cast. Which of the following actions should the nurse take first? A. Position the casted extremity on a pillow. B. Place an ice pack over the cast. C. Teach the client to keep the cast clean and dry. D. Palpate the pulse distal to the cast. Correct Ans: D. Palpate the pulse distal to the cast. Rationale: The first action the nurse should take is to assess the circulation by palpating the pulse distal to the cast (D). This helps detect any potential circulatory compromise. Positioning the cast on a pillow (A) and placing an ice pack (B) are important but come after assessing the client's circulation. Teaching the client to keep the cast clean and dry (C) is important for later care but is not an immediate priority.
A nurse is performing a gait assessment on a client to evaluate the client’s ability to perform ADLs. Which of the following findings indicates a standard gait? A. The client looks at the floor when walking. B. The client’s shoulders are rounded slightly forward. C. The client’s heels touch the ground before their toes. D. The client’s dominant foot bears more weight. Correct Ans: C. The client’s heels touch the ground before their toes. Rationale: In a normal gait, the heel strikes the ground first (C), followed by the rest of the foot. Looking at the floor (A) or having rounded shoulders (B) are not typical characteristics of a standard gait. The body weight should be distributed evenly (D), not more on the dominant foot.
A nurse on a mental health unit is caring for a client who has suicidal ideation. Which of the following actions should the nurse take? A. Place the client in a group therapy session. B. Avoid discussing suicidal thoughts with the client. C. Give the client a radio to listen to in his room. D. Establish a no-suicide contract with the client. Correct Ans: D. Establish a no-suicide contract with the client. Rationale: Establishing a no-suicide contract (D) is an evidence-based practice to ensure that the client is committed to seeking help if they feel suicidal. Avoiding the topic (B) can cause

ATI RN Comprehensive Predictor 2025; With Complete 180 Questions, Correct Answers, Exams of Nursing

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Download ATI RN Comprehensive Predictor 2025; With Complete 180 Questions, Correct Answers and more Exams Nursing in PDF only on Docsity!

ATI RN Comprehensive Predictor 2025; With Complete

180 Questions, Correct Answers and Rationale| Verified|

Assured A+ Score Guide