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ACTUAL ATI COMPREHENSIVE PREDICTOR RETAKE EXAM 2023
WITH ALL 180 QUESTIONS AND CORRECT VERIFIED ANSWERS
WITH RATIONALES/ ATI COMPREHENSIVE PREDICTOR RETAKE
EXAM 2023-2024/ GUARANTEED A (BRAND NEW DEC 2023!!)
A nurse is preparing to admit a 6-year-old with varicella to the pediatric unit.Which of the following actions should the nurse take? A. Assess the child for Koplik spots. B. Assign the child to a negative air pressure room. C. Use droplet precautions when caring for the child. D. Administer aspirin to the child for fever. - ANSWER-Use droplet precautions when caring for the child. Using droplet precautions when caring for the child is appropriate because varicella is highly contagious and spreads through respiratory droplets. Droplet precautions involve wearing a mask and maintaining a safe distance from the infected individual, which helps prevent the spread of the virus to others. An older client with a history of heart failure is admitted with influenza and requests assistance to sit up in bed to eat lunch. The nurse observes the unlicensed assistive personnel (UAP) wearing a gown and gloves to assist the client. Which action should the nurse take? A. Instruct the UAP to notify the nurse of any changes in the client's respiratory status. B. Remind the UAP to apply a fitted respirator mask before entering the client's room. C. Assign the UAP to provide care for another client and assume full care of the client.
D. Review the need for the UAP to wear a face mask while in close contact with the client. - ANSWER-Review the need for the UAP to wear a face mask while in close contact with the client. A nurse is assessing a 5-year-old child who has diabetes insipidus and is receiving desmopressin.Which of the following findings should the nurse identify as an indication that the medication is effective? A. Heart rate 140/min. B. Cessation of nocturnal enuresis. C. Capillary refill 3 seconds. D. Absence of hypoglycemic episodes. - ANSWER-Cessation of nocturnal enuresis. Cessation of nocturnal enuresis (bedwetting) is a significant indication that desmopressin, an antidiuretic hormone, is effective. One of the main symptoms of diabetes insipidus is excessive urination, including during the night, leading to bedwetting. When desmopressin effectively reduces urine production, patients often experience improvement in these symptoms, including the cessation of nocturnal enuresis. A nurse is assessing a client who has a chest tube with a water seal drainage system.Upon assessment, the nurse notes tidaling in the water seal.Which of the following is an explanation for the tidaling? A. The lung has re-expanded. B. There is a loop of tubing below the drainage system. C. The system is working properly. D. The tubing is partially obstructed by clots. - ANSWER-There is a loop of tubing below the drainage system
D. Initiate seizure precautions for the client. - ANSWER-Initiate seizure precautions for the client. This is the correct answer. Initiating seizure precautions is crucial in this situation because benzodiazepine overdose can lead to seizures, especially during the recovery phase as the drug's effects wear off. Implementing seizure precautions, such as padding the siderails and ensuring a safe environment, helps prevent injury during a seizure episode. A nurse is providing discharge instructions to a client who has a new prescription for haloperidol.Which of the following adverse effects should the nurse instruct the client to report to the provider? A. Weight gain. B. Dry mouth. C. Shuffling gait. D. Sedation. - ANSWER-Shuffling gait. This is the correct answer. Shuffling gait, or parkinsonism, is an extrapyramidal symptom associated with the use of antipsychotic medications like haloperidol. It is a movement disorder characterized by a shuffling walk, rigidity, and tremors. Recognizing and reporting this symptom promptly is crucial, as it may indicate the development of a serious neurological condition called tardive dyskinesia. A nurse is caring for an adolescent client who has cystic fibrosis.Which of the following actions should the nurse instruct the client to take prior to initiating postural drainage? A. Eat a meal. B. Take pancrelipase.
C. Use an albuterol inhaler. D. Complete oral hygiene. - ANSWER-Complete oral hygiene. A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing.Which of the following examples should the nurse include in the teaching as an example of malpractice? A. Administering potassium via IV bolus. B. Leaving a nasogastric tube clamped after administering oral medication. C. Placing a yellow bracelet on a client who is at risk for falls. D. Documenting communication with a provider in the progress notes of the client's medical record. - ANSWER-Administering potassium via IV bolus. A nurse is performing a neurological examination on a client as part of a complete physical assessment.The nurse should identify that cranial nerve XI is intact when the client performs which of the following actions? A. Sticks his tongue out. B. Frowns symmetrically. C. Identifies a sour taste. D. Shrugs his shoulders. - ANSWER-Shrugs his shoulders. A nurse is planning care for a client who is receiving continuous enteral tube feedings through an open system.Which of the following interventions should the nurse include in the plan of care? A. Maintain bed elevation at 20 degrees. B. Flush the tubing with 30 mL of water every 4 hr.
Regular assessment and reevaluation of the client's need for restraint are important to prevent potential complications and to ensure the client's safety and comfort. This includes releasing the restraint at least every 4 hours and conducting a thorough assessment to determine if continued use is necessary. A nurse is assessing a client who has a possible right pneumothorax.Which of the following findings should the nurse expect? A. Paradoxical chest movement. B. Reduced right-sided breath sounds. C. High-pitched stridor. D. Intercostal retractions. - ANSWER-Reduced right-sided breath sounds. Reduced right-sided breath sounds are a common finding in right pneumothorax. Air in the pleural space can cause lung collapse, leading to decreased or absent breath sounds on the affected side. A nurse is implementing seizure precautions for a client who has had a tonic-clonic seizure.Which of the following interventions should the nurse include in the plan of care? A. Provide a tracheostomy tray at the bedside. B. Place the client in a supine position. C. Place a plastic tongue depressor at the client's bedside. D. Insert an IV saline lock. - ANSWER-Insert an IV saline lock. Inserting an IV saline lock is a relevant intervention for seizure precautions. It allows for prompt administration of medications or fluids if necessary. Establishing
IV access is important, especially if antiepileptic medications need to be administered to control seizures. A nurse is admitting a client to a medical-surgical unit.When performing medication reconciliation for the client, which of the following actions should the nurse take? A. Include any adverse effects of the medications the client might develop. B. Compare new prescriptions with the list of medications the client reports. C. Exclude nutritional supplements from the list of medications the client reports. D. Encourage the client to make his own list after he returns to his home. - ANSWER-B. Compare new prescriptions with the list of medications the client reports. Comparing new prescriptions with the list of medications the client reports is the correct approach to medication reconciliation. This helps identify discrepancies, ensuring that the client's current medications are accurately documented and preventing medication errors. A nurse is reviewing the medical history of a client who asks about the use of warfarin.The nurse should identify which of the following findings as a contraindication for the administration of this medication? A. Recent myocardial infarction. B. Recent eye surgery. C. Thrombophlebitis. D. Breast cancer. - ANSWER-Recent eye surgery.
Placing locks at the tops of exterior doors is essential for the safety of clients with Alzheimer's disease. Alzheimer's patients often have a tendency to wander and may become disoriented, putting them at risk of getting lost or injured outside the home. Proper locks can prevent them from leaving the house unsupervised. A charge nurse on a medical-surgical unit is assisting with the emergency response plan following an external disaster in the community.In anticipation of multiple client admissions, which of the following current clients should the nurse recommend for early discharge? A. A client who is receiving heparin for deep-vein thrombosis. B. A client who is 1 day postoperative following a vertebroplasty. C. A client who has cancer and a sealed implant for radiation therapy. D. A client who has COPD and a respiratory rate of 44/min. - ANSWER-A client who is 1 day postoperative following a vertebroplasty. In the context of an emergency response plan following an external disaster and the need to create bed space for potential admissions, the nurse should consider early discharge for clients who are stable and whose discharge will not compromise their safety or health. Based on the given options, the most appropriate candidate for early discharge would be: A client who is 1 day postoperative following a vertebroplasty. Clients who are one day postoperative after a vertebroplasty are typically recovering from a relatively minor procedure and may be stable for discharge if their condition remains uncomplicated. A nurse is caring for a client who has a placenta previa.Which of the following findings should the nurse expect?
A. Spotting. B. Nausea. C. Board-like abdomen. D. Delayed menses. - ANSWER-A. Spotting. Spotting is a common finding in placenta previa. It occurs due to the abnormal implantation of the placenta over or near the cervical os, leading to vaginal bleeding. This bleeding can range from mild spotting to severe hemorrhage and is a significant sign of placenta previa. A nurse is caring for a client who has an implanted venous access port.Which of the following should the nurse use to access the port? A. An angiocatheter. B. A 25-gauge needle. C. A butterfly needle. D. A noncoring needle. - ANSWER-A noncoring needle. A noncoring needle, also known as a Huber needle, is the correct choice for accessing an implanted venous access port. Noncoring needles have a specially designed tip that creates a smaller puncture hole, reducing damage to the port membrane and minimizing patient discomfort. They are specifically designed for accessing ports and are the standard choice for this procedure. A nurse is planning care for a client who is scheduled to receive a transfusion of packed RBCs.Which of the following actions should the nurse plan to take? A. Store the unit of blood at room temperature for 1 hr prior to the infusion.
A. Diazepam B. Acetaminophen. C. Ibuprofen. D. Naloxone. - ANSWER-D. Naloxone. Naloxone (Narcan) is the correct choice. Naloxone is an opioid receptor antagonist used to reverse the effects of opioid overdose, including respiratory depression. Given the client's low respiratory rate, naloxone should be administered promptly to counteract the effects of hydromorphone. This is the most appropriate and potentially life-saving intervention for this client. A nurse is planning care for a school-age child who is 4 hr postoperative following appendicitis.Which of the following actions should the nurse include in the plan of care? A. Offer small amounts of clear liquids 6 hr following surgery. B. Apply a warm compress to the operative site once daily. C. Administer analgesics on a scheduled basis for the first 24 hr. D. Give cromolyn nebulized solution every 8 hr. - ANSWER-Administer analgesics on a scheduled basis for the first 24 hr. Administering analgesics on a scheduled basis for the first 24 hours is essential for managing postoperative pain effectively. Pain can interfere with the child's recovery, breathing, and overall well-being. Scheduled pain medications ensure a consistent level of pain relief, allowing the child to rest and recover more comfortably.
A home care nurse is making a follow-up visit with a client who has COPD and is using a compressed oxygen system in his home.Which of the following actions should the nurse take? A. Place the oxygen tank away from curtains or drapes. B. Ensure that the client checks the gauge weekly. C. Store the oxygen tank wrench in a locked cabinet. D. Have the client store smaller tanks under his bed. - ANSWER-Place the oxygen tank away from curtains or drapes. A nurse in an outpatient mental health clinic is assessing an adolescent client.The nurse should expect the adolescent to be in which of the following of Erikson's stages of psychosocial development? A. Trust vs mistrust. B. Intimacy vs isolation. C. Identity vs role confusion. D. Generativity vs self-absorption. - ANSWER-Identity vs role confusion. A nurse is providing preoperative teaching to a client about the administration of morphine via a PCA pump.Which of the following statements by the client indicates an understanding of the teaching? A. "Using this machine increases my risk of overdose." B. "I can get pain medication any time as long as I press the button." C. "My partner can press my pain medication button for me if I am sleeping." D. "I will receive a limited amount of pain medication when I press the button." - ANSWER-B. "I can get pain medication any time as long as I press the button."
D. Addressing client needs when providing resources. E. Honoring family requests to withhold medical information. - ANSWER- Promoting health care access. Encouraging clients to seek further information from the provider. Addressing client needs when providing resources. A nurse is assessing a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate 4 hr ago.The nurse notes pink- tinged urine in the drainage bag.Which of the following actions should the nurse take? A. Maintain the irrigation solution rate. B. Replace the indwelling urinary catheter. C. Perform the Credé's maneuver. D. Warm the irrigation solution. - ANSWER-Maintain the irrigation solution rate. Maintaining the irrigation solution rate is appropriate in this situation. Pink-tinged urine in the drainage bag indicates the presence of blood, which is expected after a transurethral resection of the prostate. However, if the bleeding becomes excessive, the healthcare provider should be notified. Adjusting the irrigation solution rate might be necessary based on the provider's orders, but abruptly changing the rate without medical direction could lead to complications. 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. Keep an abduction pillow between the client's legs. 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. Raise the head of the client's bed to a high-Fowler's position. - ANSWER-Keep an abduction pillow between the client's legs. Keeping an abduction pillow between the client's legs is a preventive measure to avoid dislocation of the hip prosthesis. This positioning helps maintain the correct alignment of the hip joint, reducing the risk of dislocation. Abduction pillows are commonly used postoperatively after total hip arthroplasty to support proper hip positioning while the patient is in bed. A nurse enters a client's room and sees a small fire in the client's bathroom.Identify the sequence of steps the nurse should take.(Move the steps into the box on the right, placing them in the order of performance.Use all the steps.) A. Use the unit's fire extinguisher to attempt to put out the fire. B. Close all nearby windows and doors. C. Activate the facility's fire alarm system. D. Transport the client to another area of the nursing unit. - ANSWER- A nurse is caring for a client who has pneumonia and tells the nurse, "I feel like an elephant is sitting on my chest." The client is weak and unable to walk.After the nurse initiates chest pain protocol, which of the following is the priority diagnostic test? A. 12-lead ECG. B. PT and INR. C. Serum potassium.
A. Previous violent behavior. B. Experiencing delusions. C. Male gender. D. A history of being in prison. - ANSWER-Previous violent behavior. Research consistently shows that individuals who have a history of violent behavior are at a higher risk of engaging in future violent acts. This is a significant predictor because past behavior is often indicative of future behavior. Individuals with a history of violence may have difficulty managing anger, frustration, or stress, making them more prone to aggressive tendencies in various situations. A nurse in a long-term care facility is admitting a client who has dementia.Which of the following actions should the nurse take to reduce the risk for client injury? A. Assist the client to the toilet frequently. B. Raise the side rails up when the client is in bed. C. Place the bedside table at the foot of the bed. D. Keep the television on during the night. - ANSWER-Assist the client to the toilet frequently. Clients with dementia often experience difficulties with memory, cognition, and orientation, which can lead to increased risk of falls and injuries, especially when trying to perform activities of daily living such as using the toilet. Assisting the client to the toilet frequently helps prevent accidents and reduces the risk of injury from falls. Timely toileting can also improve the client's comfort and overall quality of life.
A nurse is providing discharge teaching to a client following a total gastrectomy.The nurse should instruct the client about which of the following medications? A. Vitamin B12. B. Ranitidine. C. Vitamin K. D. Metoclopramide. - ANSWER-Vitamin B12. After a total gastrectomy, the client lacks the intrinsic factor necessary for the absorption of vitamin B12 in the terminal ileum. Therefore, vitamin B supplementation is essential to prevent pernicious anemia, a condition caused by vitamin B12 deficiency. The absence of intrinsic factor hinders the absorption of vitamin B12 from dietary sources, making it necessary to provide this vitamin through injections or high-dose oral supplements. Vitamin B12 supplementation is a standard practice following a total gastrectomy. A nurse is caring for a client who is receiving brachytherapy for endometrial cancer.Which of the following actions should the nurse take? A. Place the client's soiled bed linens in a biohazard bag outside the client's room. B. Wear an isolation gown when caring for the client. C. Keep visitors at least 6 feet (1.8 m) away from the client. D. Discard the radioactive source in the client's trash can. - ANSWER-Place the client's soiled bed linens in a biohazard bag outside the client's room. Placing the client's soiled bed linens in a biohazard bag outside the client's room is a correct practice for managing potentially contaminated items. However, it is not specific to the nurse's personal protective equipment (PPE) when caring for the
