ATI RN CONCEPT-BASED ASSESSMENT LEVEL 3 B
PROCTORED EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS 100% CORRECT
Question 1
A client who is dehydrated is experiencing orthostatic hypotension. The nurse should understand
that the underlying cause of this condition is:
A) An increase in blood volume
B) A decrease in circulating fluid volume
C) Vasoconstriction of peripheral blood vessels
D) An increase in cardiac output
Correct Answer: B) A decrease in circulating fluid volume
Rationale: Orthostatic hypotension is a drop in blood pressure upon standing. In a
dehydrated client, a fluid volume deficit (hypovolemia) leads to a decrease in the total
circulating blood volume. The body is unable to adequately constrict the blood vessels to
compensate for the position change, resulting in a drop in blood pressure.
Question 2
A nurse is assessing the developmental milestones of a 9-month-old infant. Which of the
following gross motor skills should the nurse expect the infant to be able to perform?
A) Roll from back to front
B) Pull up to a standing position
C) Sit unsupported for up to 10 minutes
D) Walk while holding onto furniture
Correct Answer: C) Sit unsupported for up to 10 minutes
Rationale: By 9 months of age, an infant should have developed the trunk and neck
strength to sit upright without support for an extended period, typically around 10
minutes. Pulling to a stand (B) and cruising (D) are milestones expected closer to 10-12
months. Rolling over (A) is an earlier milestone, typically achieved by 6 months.
Question 3
A nurse is teaching a client who has chronic stress about a technique that uses audio and visual
signals to help gain control over autonomic functions like muscle tension and heart rate. The
nurse is describing which of the following?
A) Biofeedback
B) Guided imagery
C) Progressive muscle relaxation
D) Therapeutic touch
Correct Answer: A) Biofeedback
Rationale: Biofeedback is a mind-body technique that involves using electronic sensors to
receive information (feedback) about the body (bio). This feedback helps the client learn to
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make subtle changes in their body, such as relaxing certain muscles, to achieve desired
results like reduced pain or stress.
Question 4
A nurse is preparing to administer phenytoin IV bolus to a client who is actively seizing. The
nurse should administer the medication at a rate no greater than 50 mg/min to prevent which of
the following adverse effects?
A) Hypertensive crisis
B) Tachycardia and palpitations
C) Hypotension and bradycardia
D) Respiratory depression
Correct Answer: C) Hypotension and bradycardia
Rationale: Rapid intravenous administration of phenytoin can cause severe cardiovascular
collapse, characterized by profound hypotension and bradycardia. To ensure client safety,
the infusion rate must not exceed 50 mg/min for adults.
Question 5
A nurse is assessing a client with a new diagnosis of Parkinson's disease. Which of the following
manifestations should the nurse expect?
A) Intention tremors and hyperkinesia
B) Bradykinesia and resting tremors
C) Hyperreflexia and spasticity
D) Ptosis and diplopia
Correct Answer: B) Bradykinesia and resting tremors
Rationale: Parkinson's disease is characterized by four cardinal motor symptoms: a resting
tremor (often "pill-rolling"), rigidity (stiffness), bradykinesia (slowness of movement), and
postural instability. Bradykinesia can make initiating movements and performing routine
tasks very difficult.
Question 6
A client is diagnosed with Non-Hodgkin's lymphoma. The nurse should explain to the client that
this type of cancer is characterized by:
A) Its systemic spread from one lymph node group to the next.
B) The presence of Reed-Sternberg cells on biopsy.
C) Its erratic spread through the lymphatic system and to other organs.
D) Painful, swollen lymph nodes in the cervical area only.
Correct Answer: C) Its erratic spread through the lymphatic system and to other organs.
Rationale: Unlike Hodgkin's lymphoma, which typically spreads in an orderly, contiguous
fashion, Non-Hodgkin's lymphoma is characterized by its non-contiguous or erratic
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pattern of spread. It can arise in any lymph node and spread to distant sites and organs
early in the disease course. Lymph nodes are typically painless.
Question 7
A nurse is providing education to a client with a new prescription for a diaphragm. Which of the
following statements by the client indicates an understanding of the teaching?
A) "I must remove the diaphragm within 4 hours after intercourse."
B) "I should be refitted if I gain or lose 5 pounds."
C) "I need to apply about two teaspoons of spermicide to the dome before insertion."
D) "I can insert the diaphragm up to 12 hours before having intercourse."
Correct Answer: C) "I need to apply about two teaspoons of spermicide to the dome before
insertion."
Rationale: The diaphragm must be used with spermicide to be effective. The client should
apply about 10 mL (2 tsp) of spermicidal jelly to the dome and around the rim. The
diaphragm must remain in place for at least 6 hours after intercourse (A), and a refit is
needed for a weight fluctuation of 20% (B).
Question 8
A client complains of breast pain and tenderness that worsens before her menstrual period. On
palpation, the nurse notes multiple soft, movable lumps in the upper outer quadrant of both
breasts. These findings are characteristic of:
A) Intraductal papilloma
B) Ductal ectasia
C) Fibrocystic breast condition
D) Breast cancer
Correct Answer: C) Fibrocystic breast condition
Rationale: Fibrocystic breast condition is a benign disorder characterized by the presence
of fibrotic tissue and cysts that cause breast pain, tenderness, and palpable lumps. These
symptoms often fluctuate with the menstrual cycle and are typically found in the upper
outer quadrants.
Question 9
A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). The nurse
notes that the client's fingertips are enlarged and the nails have a curved, bulbous appearance.
The nurse should document this finding as:
A) Peripheral cyanosis
B) Digital clubbing
C) Tophi
D) Swan neck deformity
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Correct Answer: B) Digital clubbing
Rationale: Digital clubbing is a physical sign characterized by the painless enlargement of
the terminal phalanges of the fingers and toes. It is caused by chronic tissue hypoxia
(decreased arterial oxygen levels), which is a hallmark of advanced COPD.
Question 10
A nurse is assessing a client with a long history of chronic gout. The nurse notes a hard, painless
nodule on the side of the client's first toe. The nurse should identify this finding as:
A) A Swan neck deformity
B) A flexion contracture
C) Tophi
D) A Heberden's node
Correct Answer: C) Tophi
Rationale: Tophi are deposits of monosodium urate crystals that occur in patients with
chronic, untreated gout. They appear as hard, painless nodules, most commonly on the
joints of the hands and feet, particularly the great toe. They can sometimes break open and
discharge a chalky white material.
Question 11
A nurse is caring for a client with diverticulitis who has been on a clear liquid diet and is now
advancing to a solid diet. Which of the following food choices is the best source of fiber to
recommend?
A) White rice
B) A banana
C) Scrambled eggs
D) Canned peaches
Correct Answer: B) A banana
Rationale: After the acute inflammation of diverticulitis resolves, the diet should be
advanced to be high in fiber to promote regular bowel movements and prevent future
episodes. A banana is a good source of soluble fiber, providing approximately 3.1 grams,
which helps to add bulk to the stool.
Question 12
A nurse is reviewing the health history of a client. The nurse should identify that the use of
which of the following can increase a client's risk for a stroke?
A) Statin medications
B) Oral contraceptives
C) Daily low-dose aspirin
D) Angiotensin-converting enzyme (ACE) inhibitors
PROCTORED EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS 100% CORRECT
Question 1
A client who is dehydrated is experiencing orthostatic hypotension. The nurse should understand
that the underlying cause of this condition is:
A) An increase in blood volume
B) A decrease in circulating fluid volume
C) Vasoconstriction of peripheral blood vessels
D) An increase in cardiac output
Correct Answer: B) A decrease in circulating fluid volume
Rationale: Orthostatic hypotension is a drop in blood pressure upon standing. In a
dehydrated client, a fluid volume deficit (hypovolemia) leads to a decrease in the total
circulating blood volume. The body is unable to adequately constrict the blood vessels to
compensate for the position change, resulting in a drop in blood pressure.
Question 2
A nurse is assessing the developmental milestones of a 9-month-old infant. Which of the
following gross motor skills should the nurse expect the infant to be able to perform?
A) Roll from back to front
B) Pull up to a standing position
C) Sit unsupported for up to 10 minutes
D) Walk while holding onto furniture
Correct Answer: C) Sit unsupported for up to 10 minutes
Rationale: By 9 months of age, an infant should have developed the trunk and neck
strength to sit upright without support for an extended period, typically around 10
minutes. Pulling to a stand (B) and cruising (D) are milestones expected closer to 10-12
months. Rolling over (A) is an earlier milestone, typically achieved by 6 months.
Question 3
A nurse is teaching a client who has chronic stress about a technique that uses audio and visual
signals to help gain control over autonomic functions like muscle tension and heart rate. The
nurse is describing which of the following?
A) Biofeedback
B) Guided imagery
C) Progressive muscle relaxation
D) Therapeutic touch
Correct Answer: A) Biofeedback
Rationale: Biofeedback is a mind-body technique that involves using electronic sensors to
receive information (feedback) about the body (bio). This feedback helps the client learn to
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make subtle changes in their body, such as relaxing certain muscles, to achieve desired
results like reduced pain or stress.
Question 4
A nurse is preparing to administer phenytoin IV bolus to a client who is actively seizing. The
nurse should administer the medication at a rate no greater than 50 mg/min to prevent which of
the following adverse effects?
A) Hypertensive crisis
B) Tachycardia and palpitations
C) Hypotension and bradycardia
D) Respiratory depression
Correct Answer: C) Hypotension and bradycardia
Rationale: Rapid intravenous administration of phenytoin can cause severe cardiovascular
collapse, characterized by profound hypotension and bradycardia. To ensure client safety,
the infusion rate must not exceed 50 mg/min for adults.
Question 5
A nurse is assessing a client with a new diagnosis of Parkinson's disease. Which of the following
manifestations should the nurse expect?
A) Intention tremors and hyperkinesia
B) Bradykinesia and resting tremors
C) Hyperreflexia and spasticity
D) Ptosis and diplopia
Correct Answer: B) Bradykinesia and resting tremors
Rationale: Parkinson's disease is characterized by four cardinal motor symptoms: a resting
tremor (often "pill-rolling"), rigidity (stiffness), bradykinesia (slowness of movement), and
postural instability. Bradykinesia can make initiating movements and performing routine
tasks very difficult.
Question 6
A client is diagnosed with Non-Hodgkin's lymphoma. The nurse should explain to the client that
this type of cancer is characterized by:
A) Its systemic spread from one lymph node group to the next.
B) The presence of Reed-Sternberg cells on biopsy.
C) Its erratic spread through the lymphatic system and to other organs.
D) Painful, swollen lymph nodes in the cervical area only.
Correct Answer: C) Its erratic spread through the lymphatic system and to other organs.
Rationale: Unlike Hodgkin's lymphoma, which typically spreads in an orderly, contiguous
fashion, Non-Hodgkin's lymphoma is characterized by its non-contiguous or erratic
,[Type here]
pattern of spread. It can arise in any lymph node and spread to distant sites and organs
early in the disease course. Lymph nodes are typically painless.
Question 7
A nurse is providing education to a client with a new prescription for a diaphragm. Which of the
following statements by the client indicates an understanding of the teaching?
A) "I must remove the diaphragm within 4 hours after intercourse."
B) "I should be refitted if I gain or lose 5 pounds."
C) "I need to apply about two teaspoons of spermicide to the dome before insertion."
D) "I can insert the diaphragm up to 12 hours before having intercourse."
Correct Answer: C) "I need to apply about two teaspoons of spermicide to the dome before
insertion."
Rationale: The diaphragm must be used with spermicide to be effective. The client should
apply about 10 mL (2 tsp) of spermicidal jelly to the dome and around the rim. The
diaphragm must remain in place for at least 6 hours after intercourse (A), and a refit is
needed for a weight fluctuation of 20% (B).
Question 8
A client complains of breast pain and tenderness that worsens before her menstrual period. On
palpation, the nurse notes multiple soft, movable lumps in the upper outer quadrant of both
breasts. These findings are characteristic of:
A) Intraductal papilloma
B) Ductal ectasia
C) Fibrocystic breast condition
D) Breast cancer
Correct Answer: C) Fibrocystic breast condition
Rationale: Fibrocystic breast condition is a benign disorder characterized by the presence
of fibrotic tissue and cysts that cause breast pain, tenderness, and palpable lumps. These
symptoms often fluctuate with the menstrual cycle and are typically found in the upper
outer quadrants.
Question 9
A nurse is assessing a client with chronic obstructive pulmonary disease (COPD). The nurse
notes that the client's fingertips are enlarged and the nails have a curved, bulbous appearance.
The nurse should document this finding as:
A) Peripheral cyanosis
B) Digital clubbing
C) Tophi
D) Swan neck deformity
, [Type here]
Correct Answer: B) Digital clubbing
Rationale: Digital clubbing is a physical sign characterized by the painless enlargement of
the terminal phalanges of the fingers and toes. It is caused by chronic tissue hypoxia
(decreased arterial oxygen levels), which is a hallmark of advanced COPD.
Question 10
A nurse is assessing a client with a long history of chronic gout. The nurse notes a hard, painless
nodule on the side of the client's first toe. The nurse should identify this finding as:
A) A Swan neck deformity
B) A flexion contracture
C) Tophi
D) A Heberden's node
Correct Answer: C) Tophi
Rationale: Tophi are deposits of monosodium urate crystals that occur in patients with
chronic, untreated gout. They appear as hard, painless nodules, most commonly on the
joints of the hands and feet, particularly the great toe. They can sometimes break open and
discharge a chalky white material.
Question 11
A nurse is caring for a client with diverticulitis who has been on a clear liquid diet and is now
advancing to a solid diet. Which of the following food choices is the best source of fiber to
recommend?
A) White rice
B) A banana
C) Scrambled eggs
D) Canned peaches
Correct Answer: B) A banana
Rationale: After the acute inflammation of diverticulitis resolves, the diet should be
advanced to be high in fiber to promote regular bowel movements and prevent future
episodes. A banana is a good source of soluble fiber, providing approximately 3.1 grams,
which helps to add bulk to the stool.
Question 12
A nurse is reviewing the health history of a client. The nurse should identify that the use of
which of the following can increase a client's risk for a stroke?
A) Statin medications
B) Oral contraceptives
C) Daily low-dose aspirin
D) Angiotensin-converting enzyme (ACE) inhibitors
