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ATI CMS Pack 2025–2026 | All 9 Subjects in One: Pharmacology,
Med-Surg, OB, Pediatrics, Mental Health, Leadership, Community
Health, Nutrition, Fundamentals | 200 NCLEX Questions with
Rationales | A+ Guaranteed
1. (Pharmacology)
A nurse is administering digoxin to a client with heart failure. Before giving the
dose, the nurse reviews the client’s vital signs and notes a heart rate of 56 bpm. The
client also reports nausea and visual disturbances. Which of the following actions
should the nurse take first?
A. Administer the medication with food
B. Document the findings and reassess in 30 minutes
C. Hold the medication and notify the provider
D. Provide the client with antiemetics
Correct Answer: C. Hold the medication and notify the provider
Rationale: A heart rate below 60 bpm in adults is a contraindication for digoxin
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administration. Nausea and visual disturbances (halos) are signs of digoxin
toxicity. The nurse should withhold the dose and notify the provider for further
evaluation.
2. (Med-Surg)
A nurse is caring for a client admitted with diabetic ketoacidosis (DKA). The
client's potassium is 2.9 mEq/L. Which intervention should the nurse anticipate
before administering insulin?
A. Administer IV insulin
B. Replace potassium intravenously
C. Give sodium bicarbonate
D. Encourage oral potassium-rich foods
Correct Answer: B. Replace potassium intravenously
Rationale: Insulin drives potassium into cells, which can worsen hypokalemia.
Replacing potassium first is crucial to prevent cardiac arrhythmias and other life-
threatening complications.
3. (OB/Maternal Newborn)
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A nurse is assessing a client at 37 weeks’ gestation who presents with sudden
vaginal bleeding and reports no pain. The fetal heart rate is within normal limits.
Which condition should the nurse suspect?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Preterm labor
Correct Answer: B. Placenta previa
Rationale: Placenta previa typically presents with painless vaginal bleeding in late
pregnancy. The absence of pain helps differentiate it from placental abruption,
which is painful.
4. (Pediatrics)
A nurse is preparing to administer a routine immunization to a 4-month-old infant.
Which vaccine should the nurse anticipate giving at this visit?
A. MMR
B. DTaP
C. Varicella
D. Hepatitis A
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Correct Answer: B. DTaP
Rationale: The DTaP vaccine is given at 2, 4, and 6 months of age. MMR and
varicella are given after 12 months. Hep A starts at 1 year.
5. (Mental Health)
A client with schizophrenia is experiencing command hallucinations to harm
others. What is the nurse’s priority action?
A. Ask the client directly what the voices are saying
B. Provide diversion activities
C. Administer PRN antipsychotics
D. Place the client in restraints
Correct Answer: A. Ask the client directly what the voices are saying
Rationale: Safety is the priority. The nurse must assess the content of
hallucinations to determine if there is a risk of harm to self or others.
6. (Leadership)
A nurse manager notices that staff are frequently missing documentation deadlines.
Which of the following is the best leadership strategy to improve performance?
ATI CMS Pack 2025–2026 | All 9 Subjects in One: Pharmacology,
Med-Surg, OB, Pediatrics, Mental Health, Leadership, Community
Health, Nutrition, Fundamentals | 200 NCLEX Questions with
Rationales | A+ Guaranteed
1. (Pharmacology)
A nurse is administering digoxin to a client with heart failure. Before giving the
dose, the nurse reviews the client’s vital signs and notes a heart rate of 56 bpm. The
client also reports nausea and visual disturbances. Which of the following actions
should the nurse take first?
A. Administer the medication with food
B. Document the findings and reassess in 30 minutes
C. Hold the medication and notify the provider
D. Provide the client with antiemetics
Correct Answer: C. Hold the medication and notify the provider
Rationale: A heart rate below 60 bpm in adults is a contraindication for digoxin
, 2
administration. Nausea and visual disturbances (halos) are signs of digoxin
toxicity. The nurse should withhold the dose and notify the provider for further
evaluation.
2. (Med-Surg)
A nurse is caring for a client admitted with diabetic ketoacidosis (DKA). The
client's potassium is 2.9 mEq/L. Which intervention should the nurse anticipate
before administering insulin?
A. Administer IV insulin
B. Replace potassium intravenously
C. Give sodium bicarbonate
D. Encourage oral potassium-rich foods
Correct Answer: B. Replace potassium intravenously
Rationale: Insulin drives potassium into cells, which can worsen hypokalemia.
Replacing potassium first is crucial to prevent cardiac arrhythmias and other life-
threatening complications.
3. (OB/Maternal Newborn)
, 3
A nurse is assessing a client at 37 weeks’ gestation who presents with sudden
vaginal bleeding and reports no pain. The fetal heart rate is within normal limits.
Which condition should the nurse suspect?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Preterm labor
Correct Answer: B. Placenta previa
Rationale: Placenta previa typically presents with painless vaginal bleeding in late
pregnancy. The absence of pain helps differentiate it from placental abruption,
which is painful.
4. (Pediatrics)
A nurse is preparing to administer a routine immunization to a 4-month-old infant.
Which vaccine should the nurse anticipate giving at this visit?
A. MMR
B. DTaP
C. Varicella
D. Hepatitis A
, 4
Correct Answer: B. DTaP
Rationale: The DTaP vaccine is given at 2, 4, and 6 months of age. MMR and
varicella are given after 12 months. Hep A starts at 1 year.
5. (Mental Health)
A client with schizophrenia is experiencing command hallucinations to harm
others. What is the nurse’s priority action?
A. Ask the client directly what the voices are saying
B. Provide diversion activities
C. Administer PRN antipsychotics
D. Place the client in restraints
Correct Answer: A. Ask the client directly what the voices are saying
Rationale: Safety is the priority. The nurse must assess the content of
hallucinations to determine if there is a risk of harm to self or others.
6. (Leadership)
A nurse manager notices that staff are frequently missing documentation deadlines.
Which of the following is the best leadership strategy to improve performance?
