ATI RN Fundamentals Practice Tests A & B
A nurse is caring for a client who reports pain. When documenting the quality of the client's pain on an
initial pain assessment, the nurse should record which of the following client statements?
"I am having mild pain"
"The pain is like a dull ache in my stomach"
"I notice that the pain gets worse after I eat"
"The pain makes me feel nauseous" - (correct Answer) - "The pain is like a dull ache in my stomach"
A client in non ambulatory notifies the nurse that his trash can is on fire. After the nurse confirms the
presence of the fire, which of the following actions should the nurse take next?
Activate the emergency fire alarm
Extinguish the fire
Evacuate the client
Confine the fire - (correct Answer) - Evacuate the client
A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the
past 3 days. Which of the following findings should the nurse expect?
Neck vein distention
Urine specific gravity 1.010
Rapid Heart rate
Blood pressure 144/82 mmHg - (correct Answer) - Rapid heart rate
A nurse has accepted a verbal prescription for "thee tenths of a milligram of levothyroxine IV stat" for a
client who has myxedema coma. How should the nurse transcribe the dosage of this medication in the
client's medical record?
.3 mg
0.3 mg
0.30 mg
3/10 mg - (correct Answer) - 0.3 mg
,A nurse is preparing a heparin infusion for a client who was admitted to the facility with deep vein
thrombosis. The prescription reads: 25,000 units of heparin in 0.9% sodium chloride 250 ml to infuse at
800 units/hour. At what rate should the nurse set the infusion pump? - (correct Answer) - 8 ml/hour
A nurse is caring for a client who has a prescription for wound irrigation. Which of the following actions
should the nurse take?
Wear sterile gloves when removing the old dressing
Warm the irrigation solution to 40.5 C (105 F)
Cleanse the wound from the center outward
Use a 20 ml syringe to irrigate the wound - (correct Answer) - Cleanse the wound from the center
outward
A nurse is caring for a client who is receiving fluid through a peripheral IV catheter. Which of the
following findings at the IV site should the nurse identify as indicating infiltration?
Purulent exudate
Warmth
Skin blanching
Bleeding - (correct Answer) - Skin blanching
A nurse is teaching a client whose left leg is in a cast about using crutches. Which of the following
statements should the nurse identify as an indication that the client understands the teaching?
"When descending the stairs, I will first shift my weight to my right leg"
"I should place my crutches 12 inches in front and to the side of each foot"
"As I sit down, I will hold one crutch in each hand"
"I will make sure the shoulder rests are snug against my armpits" - (correct Answer) - "When descending
the stairs, I will first shift my weight to my right leg"
A nurse is caring for a client who has an NG tube and is receiving intermittent feedings through an open
system. Which of the following actions should the nurse take first?
Rinse the feeding back with water between feedings
Tell the client to keep the head of the bed elevated at least 30 degrees
Make sure the enteral formula is at room temperature
, Wipe the top of the formula can with alcohol - (correct Answer) - Tell the client to keep the head of the
bed elevated at least 30 degrees
A nurse is reviewing a client's medication prescription that reads, "digoxin 0.25 by mouth every day".
Which of the following components of the prescription should the nurse verify with the provider?
Medication name
Route of administration
Medication dose
Frequency of administration - (correct Answer) - Medication dose
A nurse is caring for a client who has recently started using a behind the ear hearing aid. Which of the
following statements should the nurse identify as an indication that the client understands the use of
this assistive device?
"This type of hearing aid does not allow for fine tuning of volume"
"I shouldn't have trouble keeping the hearing aid in place during exercise"
"I expect to hear a whistling sound when I first insert the hearing aid"
"I will be sure to remove my hearing aid before taking a shower" - (correct Answer) - "I will be sure to
remove my hearing aid before taking a shower"
A nurse enters a client's room and finds her on the floor. The client's roommate reports that the client
was trying to get out of bed and fell over the side rail onto the floor. Which of the following statements
should the nurse document about this incident?
"Incident report completed"
"Client climbed over the side rails"
"Client found lying on the floor"
"Client was trying to get out of bed" - (correct Answer) - "Client found lying on the floor"
A nurse on a medical unit is preparing to discharge a client to home. Which of the following actions
should the nurse take as part of the medication reconciliation process?
Seal unused medications from the facility in a plastic bag
Evaluate the client's ability to self administer medications
Report an identified discrepancy to The Joint Commission
A nurse is caring for a client who reports pain. When documenting the quality of the client's pain on an
initial pain assessment, the nurse should record which of the following client statements?
"I am having mild pain"
"The pain is like a dull ache in my stomach"
"I notice that the pain gets worse after I eat"
"The pain makes me feel nauseous" - (correct Answer) - "The pain is like a dull ache in my stomach"
A client in non ambulatory notifies the nurse that his trash can is on fire. After the nurse confirms the
presence of the fire, which of the following actions should the nurse take next?
Activate the emergency fire alarm
Extinguish the fire
Evacuate the client
Confine the fire - (correct Answer) - Evacuate the client
A nurse is completing an admission assessment for a client who reports vomiting and diarrhea for the
past 3 days. Which of the following findings should the nurse expect?
Neck vein distention
Urine specific gravity 1.010
Rapid Heart rate
Blood pressure 144/82 mmHg - (correct Answer) - Rapid heart rate
A nurse has accepted a verbal prescription for "thee tenths of a milligram of levothyroxine IV stat" for a
client who has myxedema coma. How should the nurse transcribe the dosage of this medication in the
client's medical record?
.3 mg
0.3 mg
0.30 mg
3/10 mg - (correct Answer) - 0.3 mg
,A nurse is preparing a heparin infusion for a client who was admitted to the facility with deep vein
thrombosis. The prescription reads: 25,000 units of heparin in 0.9% sodium chloride 250 ml to infuse at
800 units/hour. At what rate should the nurse set the infusion pump? - (correct Answer) - 8 ml/hour
A nurse is caring for a client who has a prescription for wound irrigation. Which of the following actions
should the nurse take?
Wear sterile gloves when removing the old dressing
Warm the irrigation solution to 40.5 C (105 F)
Cleanse the wound from the center outward
Use a 20 ml syringe to irrigate the wound - (correct Answer) - Cleanse the wound from the center
outward
A nurse is caring for a client who is receiving fluid through a peripheral IV catheter. Which of the
following findings at the IV site should the nurse identify as indicating infiltration?
Purulent exudate
Warmth
Skin blanching
Bleeding - (correct Answer) - Skin blanching
A nurse is teaching a client whose left leg is in a cast about using crutches. Which of the following
statements should the nurse identify as an indication that the client understands the teaching?
"When descending the stairs, I will first shift my weight to my right leg"
"I should place my crutches 12 inches in front and to the side of each foot"
"As I sit down, I will hold one crutch in each hand"
"I will make sure the shoulder rests are snug against my armpits" - (correct Answer) - "When descending
the stairs, I will first shift my weight to my right leg"
A nurse is caring for a client who has an NG tube and is receiving intermittent feedings through an open
system. Which of the following actions should the nurse take first?
Rinse the feeding back with water between feedings
Tell the client to keep the head of the bed elevated at least 30 degrees
Make sure the enteral formula is at room temperature
, Wipe the top of the formula can with alcohol - (correct Answer) - Tell the client to keep the head of the
bed elevated at least 30 degrees
A nurse is reviewing a client's medication prescription that reads, "digoxin 0.25 by mouth every day".
Which of the following components of the prescription should the nurse verify with the provider?
Medication name
Route of administration
Medication dose
Frequency of administration - (correct Answer) - Medication dose
A nurse is caring for a client who has recently started using a behind the ear hearing aid. Which of the
following statements should the nurse identify as an indication that the client understands the use of
this assistive device?
"This type of hearing aid does not allow for fine tuning of volume"
"I shouldn't have trouble keeping the hearing aid in place during exercise"
"I expect to hear a whistling sound when I first insert the hearing aid"
"I will be sure to remove my hearing aid before taking a shower" - (correct Answer) - "I will be sure to
remove my hearing aid before taking a shower"
A nurse enters a client's room and finds her on the floor. The client's roommate reports that the client
was trying to get out of bed and fell over the side rail onto the floor. Which of the following statements
should the nurse document about this incident?
"Incident report completed"
"Client climbed over the side rails"
"Client found lying on the floor"
"Client was trying to get out of bed" - (correct Answer) - "Client found lying on the floor"
A nurse on a medical unit is preparing to discharge a client to home. Which of the following actions
should the nurse take as part of the medication reconciliation process?
Seal unused medications from the facility in a plastic bag
Evaluate the client's ability to self administer medications
Report an identified discrepancy to The Joint Commission
