ATI Exam 5 practice test

A nurse is caring for a client who has HF and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose?

0.5 tablets

A nurse is teaching a client about how to use her new hearing aids. Which of the following statements should the nurse identify as an indication that the client needs further instruction?

"I will clean the hearing aids with alcohol wipes."

A nurse manager is providing an inservice program about delegation to AP with staff nurses on the unit. Which of the following statements by a staff nurse indicates an understanding of the teaching?

"The nurse should consider the AP's level of experience when making delegation decisions."

A nurse at an extended-care facility is instructing a class of AP's about the use of assistive devices during ambulation. Which of the following should the nurse give the AP's about the clients' use of a cane?

"When the client moves, he should move the can forward first."

A nurse is preparing to administer morphine sulfate 2 mg IV bolus. Available is morphine sulfate 10 mg/dL. How many ML should the nurse administer per dose?

0.2 mL

A nurse is preparing to administer 250 mg of an antibiotic IM. Available is 3g/5 mL. How many ML should the nurse administer per dose?

0.4 mL

A nurse is caring for an adolescent client who has pneumonia and a prescription for cefpodoxime 5 mg/kg PO every 12 hr for 5 days. The client weighs 88 lb. How many mg should the nurse administer per dose?

200 mg.

A nurse is preparing to administer Ringer's Lactate 500 mL IV bolus to infuse over 3 hr. The drop factor of the manual IV tubing is 20 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?

56 gtt/min

A nurse is completing an 8 hr I&O record for a client who consumed 4 oz juice, 6 oz hot tea, 100 mL ice chips, an IV bolus of 150 mL, and 8 oz broth. The nurse should record how many mL of intake on the client's record?

740 mL

A nurse in the med-surg unit is assigning client care to a nurse who is floating from the PACU. The nurse should recognize that the float nurse is most qualified to care for which of the following clients?

A client who is postop following a lobectomy and has a chest tube.

A nurse is caring for a client who is in the immediate postop period following a partial laryngectomy. Which of the following parameters should the nurse assess first?

Airway patency.

A charge nurse is making client care assignments. Which of the following tasks should the nurse delegate to AP?

Bathe a client who had an amputation 2 days ago. Assist a client to ambulate using a gait belt. Feed a client who had a stroke 3 months ago.

A client is starting celecoxib to treat osteoarthritis. The nurse should instruct the client to watch for and report which of the following adverse effects?

Black, tarry stools.

A nurse is helping an older adult client ambulate in the hallway for the first time since admission. The client has brought her standard walker from home. To ensure proper use of the walker and the safety of the client, which of the following actions should the nurse take?

Check that the client lifts the walker and then places it down in front of her.

A nurse is assessing a client who is experiencing complications due to immobility. Which of the following findings should the nurse expect?

Contractures of the extremities. Crackles in the lungs. Pressure ulcers.

A nurse is assessing a client 1 day postop following abdominal surgery. Suddenly the client reports a pulling sensation and pain in his surgical incision. Which of the following actions should the nurse take?

Cover the area with saline soaked sterile dressings.

A nurse is caring for a client who has bilateral eye patches in place following an injury. When the client's food tray arrives, which of the following interventions should the nurse take to promote independence in eating?

Describe the client the location of the food on the tray.

A nurse is preparing to transfer a client from a bed to a chair. Which of the following actions should the nurse take first?

Determine if the client can bear weight.

A nurse is admitting a client who has a partial hearing loss. Which of the following is the priority action by the nurse?

Determine if the client uses hearing aids.

A nurse is caring for a group of clients. She plans to delegate obtaining morning vital signs to an AP on her team. Which of the following actions should the nurse plan to take?

Determine the time frame the AP should report the results.

A nurse is caring for an older adult client who has had surgery for an intestinal obstruction and has an NG tube to wall suction. Which of the following interventions should the nurse include in the client's postop plan of care?

Discontinue suction when assessing for peristalsis. Irrigate the NG tube with 0.9% sodium chloride irrigation solution. Place sequential compression devices on the bilateral lower extremities. Reposition the client from side to side every 2 hr.

A nurse is caring for a client who is scheduled to have surgery. In preparing the client for surgery, which of the following actions is considered outside the nurse's responsibilities?

Explaining the operative procedure, risks, and benefits.

A nurse is assessing a client who is postop and has anemia due to excess blood loss following surgery. Which of the following findings should the nurse expect?

Fatigue.

A nurse is assisting an older adult client who sometimes loses her balance while walking. Which of the following devices should the nurse use when helping the client ambulate?

Gait belt

A nurse is caring for a client whose family is in a state of disagreement over the care of their family member. The nurse should report the situation to which of the following facility personnel?

Hospital ethics committee

A nurse is caring for a client who has emphysema and has difficulty with mobility. The client receives home health care and spends most of his day in a reclining chair. Which of the following physiological responses to prolonged immobility should the nurse expect?

Increased calcium excretion.

At the beginning of the shift, an RN is preparing assignments for a LPN and an AP. Which of the following tasks should the nurse assign to the LPN?

Inserting a NG tube for a client.

A nurse is caring for a client who is prescribed bedrest. The plan of care indicates that the client should perform isometric exercises every 2 hr. Which of the following actions should the nurse take as directed by the plan of care?

Instruct the client to tighten muscle groups for a short period, and then relax.

A nurse is assisting with transferring a client from the bed to a wheelchair. Which of the following actions should the nurse take?

Lock the wheels of the bed and the wheelchair.

A nurse is assisting a client during ambulation when the client begins to fall. Which of the following actions should the nurse take?

Lower the client to the floor.

A nurse in an acute care setting is planning care for a group of clients at the beginning of the shift. Which of the following tasks should the nurse assign to the AP?

Monitoring vital signs of a client who had an appendectomy 12 hr ago.

A nurse and an experienced LPN are caring for a group of clients. Which of the following should the nurse delegate to the LPN?

Obtain vital signs from a client who is 6 hours postop. Administer a tap water enema to a client who is preop. Catheterize a client who has not voided in 8 hrs.

A nurse is caring for a client who is postop following an abdominal surgery. Which of the following findings should indicate to the nurse the clients peristalsis is returning?

Passage of flatus.

A nurse on the postpartum unit is caring for a group of client's with an AP. Which of the following tasks should the nurse plan to delegate to the AP?

Provide a sitz bath to a client who has fourth degree laceration and is 2 days postpartum.

A nurse is observing an AP changing the linens on the bed of a client who is immobile. Which of the following actions by the AP should the nurse identify as an indication of the need to intervene?

Reaches over the bed to straighten the fitted sheet.

A nurse is admitting a client who is arriving back to the unit from the PACU following hip arthroplasty. Which of the following tasks should the nurse assign to the AP?

Record the amount of urine in the catheter drainage bag.

A charge nurse is reviewing the list of tasks that have been delegated to the AP by the staff nurse. Which of the following tasks should the charge nurse reassign to a licensed nurse?

Removing and cleaning the cannula of a client who has a new tracheostomy.

A nurse checks with the AP on the unit throughout the shift to determine if they are completing tasks. The nurse is demonstrating which of the following rights of delegation?

Right supervision.

A home health nurse is assessing an older adult client in the home who has decreased vision due to a history of glaucoma. Which of the following findings should the nurse identify as a safety risk?

Scatter rugs are present in the kitchen.

A nurse in a long term care facility is planning care for several clients. Which of the following activities should the nurse delegate to the LPN?

Scheduling a diagnostic study for a client.

When planning delegation of tasks to AP, a nurse considers the five rights of delegation. Which of the following should the nurse consider when using one of the five right of delegation?

The AP has the knowledge and skill to perform the task.

A nurse is preparing to move a client who is only partially able to assist up in bed. Which of the following methods should the nurse plan to use?

Two nurses using a friction reducing device.

A nurse is preparing to transfer a client who has left sided weakness from the bed to a chair. Which of the following actions should the nurse plan to take?

Use a gait belt to stand and pivot the client.

A charge nurse delegates to a LPN the task of changing a clients dressing. Several hours later the client reports the dressing has not been changed. Which of the following actions should the charge nurse take?

Verify the LPN knows how to do a dressing change.

A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make?

Walking briskly.

A nurse is talking with a client who is beginning a program of moderate exercise. The client asks the nurse why warm up exercises are necessary. Which of the following responses should the nurse make?

Warm up exercises reduce the risk of injury.

A nursing is talking with a client who is beginning a program of moderate exercise. The client asks the nurse why warm up exercises are necessary. Which of the following responses should the nurse make?

Warm up exercises reduce the risk of injury.

A nurse is assessing a client who is 48 hr postop following abdominal surgery. Which of the following findings should the nurse report to the provider?

Yellow-green drainage on the surgical incision.

A nurse is assisting a newly licensed nurse with delegating tasks to an AP on the unit. Which of the following statements by the nurse explains the purpose of delegation?

"Delegation permits a designated individual to meet a goal on your behalf."