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Free ATI Predator Questions
A nurse on a mental health unit is caring for a client who is in wrist restraints following a violent outburst. Which of the following actions should the nurse take?
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Document observations of the client every 15 min
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Obtain a new prescription for restraints every 48 hr
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Secure the restraints to the side rail
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Tie the restraints with a tight knot
Explanation
Correct Answer: (A) Document observations of the client every 15 min
When a client is in restraints, the nurse is required to monitor and document the client's status every 15 minutes. This includes circulation, skin integrity, range of motion, nutrition, hydration, and the client's psychological status. This ensures client safety and complies with legal and facility standards for restraint use.
Why Other Options are Incorrect:
B. Obtain a new prescription for restraints every 48 hr — Restraint prescriptions must be renewed every 24 hours, not every 48 hours. Allowing restraints to continue for 48 hours without a new order violates legal and safety standards.
C. Secure the restraints to the side rail — Restraints should never be secured to the side rail as lowering the side rail could cause injury to the client. Restraints must be secured to the bed frame.
D. Tie the restraints with a tight knot — Restraints should be tied using a quick-release knot to allow for rapid removal in an emergency. A tight knot could delay removal and compromise client safety.
A nurse is receiving a telephone prescription from a client's provider. Which of the following actions should the nurse take? (Select all that apply.)
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Ask the provider to spell out the name of the medication
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Record the date and time of the telephone prescription
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Request that the provider confirm the read-back of the prescription
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Withhold the medication until the provider signs the prescription
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Instruct another nurse to record the prescription in the medical record
Explanation
Correct Answers: (A), (B), and (C)
A. Ask the provider to spell out the name of the medication — Asking the provider to spell the medication name prevents errors caused by similar-sounding drug names and ensures accurate transcription of the prescription.
B. Record the date and time of the telephone prescription — Documentation of the date and time is a legal requirement for telephone prescriptions and ensures an accurate and complete medical record.
C. Request that the provider confirm the read-back of the prescription — Reading back the prescription to the provider and having them confirm its accuracy is a required safety practice that reduces the risk of transcription errors and medication mistakes.
Why Other Options are Incorrect:
D. Withhold the medication until the provider signs the prescription — Telephone prescriptions are legally valid and can be administered before the provider's signature is obtained. The provider is typically required to sign the prescription within 24 to 48 hours per facility policy, but withholding the medication could harm the client.
E. Instruct another nurse to record the prescription in the medical record — The nurse who receives the telephone prescription is responsible for documenting it in the medical record. Delegating this task to another nurse who was not present during the call is inappropriate and could lead to documentation errors.
A nurse is discussing risk factors for child maltreatment with a newly licensed nurse. Which of the following examples should the nurse include?
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A child who was conceived by in vitro fertilization
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A toddler who has atopic dermatitis
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A school-age child who has cerebral palsy
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An only child
Explanation
Correct Answer: (C) A school-age child who has cerebral palsy
Children with physical or developmental disabilities, such as cerebral palsy, are at significantly higher risk for maltreatment. Caregiving for a child with a disability can be physically and emotionally demanding, and the child may be less able to report or escape abuse. Disability is a well-established risk factor for child maltreatment recognized in nursing and public health literature.
Why the other options are incorrect:
A. A child who was conceived by in vitro fertilization Conception through in vitro fertilization is not a recognized risk factor for child maltreatment. The method of conception does not increase the likelihood of abuse or neglect.
B. A toddler who has atopic dermatitis Atopic dermatitis is a common chronic skin condition in children. While chronic illness can add caregiver stress, atopic dermatitis alone is not identified as a significant risk factor for child maltreatment compared to physical or cognitive disabilities.
D. An only child Being an only child is not a risk factor for maltreatment. In fact, having fewer children in the home may reduce caregiver stress and the risk of maltreatment rather than increase it.
A nurse is caring for a client who suddenly develops chest pain and dyspnea. Which of the following actions should the nurse take first?
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Obtain the client's ABG levels
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Place the client on bedrest
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Prepare the client for a ventilation-perfusion scan
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Elevate the head of the client's bed
Explanation
The first action the nurse should take is to elevate the head of the client's bed. When a client suddenly develops chest pain and dyspnea, elevating the head of the bed to a high Fowler's position of 45 to 90 degrees is the immediate priority as it uses gravity to facilitate chest expansion, reduces the work of breathing, improves lung ventilation, and maximizes oxygenation. This intervention can be performed instantly without a physician's order and directly addresses the client's respiratory distress.
Why the other options are incorrect:
A. Obtain the client's ABG levels — Arterial blood gas collection is an important diagnostic step but requires a physician's order and takes time to obtain and process. The nurse must first address the client's immediate respiratory distress by positioning before pursuing diagnostic testing.
B. Place the client on bedrest — While limiting physical activity is appropriate for a client with chest pain and dyspnea, simply placing the client on bedrest without elevating the head of the bed does not actively address the respiratory distress. Positioning in high Fowler's is a more specific and effective immediate intervention.
C. Prepare the client for a ventilation-perfusion scan — A ventilation-perfusion scan is a diagnostic procedure used to detect pulmonary embolism and requires a physician's order and transport to the radiology department. This is not an immediate nursing action and cannot be done before stabilizing the client's respiratory status.
A nurse is documenting client care in the nurses' notes and notices that a space was left blank. Which of the following actions should the nurse take?
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Draw a horizontal line through the space and sign at the end of the line
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Place the date at the beginning of the space, followed by double lines
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Leave the space as it is within the entry
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Black out the line with a felt-tip pen
Explanation
Correct Answer: (A) Draw a horizontal line through the space and sign at the end of the line
When a blank space is left in nurses' notes, the correct documentation practice is to draw a single horizontal line through the blank space and sign at the end of the line. This prevents anyone from adding unauthorized information into the blank space, maintaining the integrity and legal validity of the medical record.
Why Other Options are Incorrect:
B. Place the date at the beginning of the space, followed by double lines — This is not the correct protocol for handling blank spaces in documentation. Simply placing a date does not prevent unauthorized additions to the record.
C. Leave the space as it is within the entry — Leaving a blank space in medical documentation is incorrect as it creates an opportunity for unauthorized information to be inserted, which could compromise the legal integrity of the medical record.
D. Black out the line with a felt-tip pen — Blacking out any part of a medical record is considered falsification of documentation and is both unethical and illegal. It implies that information is being hidden or altered.
A nurse is assisting with the care of a client in a clinic. A 16-year-old client reports to the clinic with their friend. The client's friend informs the nurse that the client has not been themselves lately. Their parents and a sibling died due to injuries sustained when a tornado moved through their town 1 month ago. The client was the only survivor in their family and witnessed the death of their parents and sibling. At 0910, the client appears anxious but answers questions appropriately for age. They report experiencing nightmares that awaken them at night and startle easily during thunderstorms, but the client states they have always been afraid of thunderstorms. The client states they have been smoking marijuana for about 1 month because it helps clear their mind. Client also states they have no desire to attend school. Based on the information in the client's medical record, which of the following findings require immediate follow-up? Select the 4 findings that require immediate follow-up by the nurse.
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Attends school regularly
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Friend reporting client is not themselves
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Heart rate 99/min
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Blood pressure 122/80 mmHg
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Witnessing the death of their parents and sibling
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Smoking marijuana to clear their mind
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Client experiences nightmares
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Startles easy during thunderstorm
Explanation
Explanation:
Correct Answer: (B) Friend reporting client is not themselves, (E) Witnessing the death of their parents and sibling, (F) Smoking marijuana to clear their mind, (G) Client experiences nightmares
These four findings are consistent with Post-Traumatic Stress Disorder (PTSD) and require immediate follow-up:
B. Friend reporting client is not themselves — A change in personality or behavior noted by someone close to the client is a significant red flag indicating psychological distress requiring immediate assessment.
E. Witnessing the death of their parents and sibling — This is a severe traumatic event that is a direct trigger for PTSD and requires immediate psychological intervention and follow-up.
F. Smoking marijuana to clear their mind — Substance use as a coping mechanism in a minor is a serious concern indicating the client is struggling to manage trauma and requires immediate intervention.
G. Client experiences nightmares — Recurring nightmares are a hallmark symptom of PTSD and indicate the client is re-experiencing the traumatic event, requiring immediate mental health follow-up.
Why Other Options are Incorrect:
A. Attends school regularly — The client actually states they have no desire to attend school, which would be a concern, but regular attendance itself is not a finding requiring follow-up.
C. Heart rate 99/min — While slightly elevated, a heart rate of 99/min is within acceptable limits and not an immediate priority finding.
D. Blood pressure 122/80 mmHg — This is within normal range for a 16-year-old and does not require immediate follow-up.
H. Startles easy during thunderstorm — The client reports having always been afraid of thunderstorms, making this a pre-existing condition rather than a new finding related to the trauma.
A nurse is participating in an interprofessional client care conference for a client who has experienced a stroke. The nurse should identify that which of the following client care issues requires reporting to the interprofessional team?
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The client tells the nurse he prefers a snack before bedtime
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The client requests to perform ADLs later in the day
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The client is unable to grasp eating utensils
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The client requires reinforcement of teaching about the purpose of his medications
Explanation
Correct Answer: (C) The client is unable to grasp eating utensils
The inability to grasp eating utensils following a stroke indicates a significant functional deficit that requires interprofessional collaboration. This finding should be reported to the team as it requires the expertise of occupational therapy to assess fine motor skills, recommend adaptive equipment, and develop a plan to restore or compensate for this lost function.
Why the other options are incorrect:
A. The client tells the nurse he prefers a snack before bedtime — Personal food preferences are a routine nursing care matter that does not require reporting to the entire interprofessional team. The nurse can accommodate this preference independently.
B. The client requests to perform ADLs later in the day — Adjusting the timing of activities of daily living is a routine scheduling matter that the nurse can address independently without involving the interprofessional team.
D. The client requires reinforcement of teaching about the purpose of his medications — Medication teaching reinforcement is within the nurse's scope of practice and does not require escalation to the full interprofessional team unless there are complex issues such as non-compliance or cognitive impairment affecting understanding.
Exhibit 2 – Nurses' Notes Day 1, 1000: Left hip surgical wound warm, appears inflamed, and tender to touch. Thick, yellow discharge noted on dressing. Provider notified. Day 1, 1100: Client states "When am I going home?" The client is oriented to person and place only. Client states "It's 1975." Client reoriented. Day 1, 1200: Nurse found the client attempting to climb out of their hospital bed. Staff assisted client back in bed. Day 1, 1230: Client starts screaming "Can someone please call pest control and get these spiders off me and my bed! I can feel them crawling all over me!" Client oriented to person only and believes they are at home. Day 1, 1430: Provider at bedside. Prescriptions received. Client is restless with partner at bedside.
Exhibit 3 – Vital Signs Day 1, 1200: Blood pressure 88/50 mm Hg, Heart rate 105/min, Respiratory rate 18/min, Temperature 38.6°C (101.4°F) Day 1, 1430: Blood pressure 120/72 mm Hg, Heart rate 110/min, Respiratory rate 20/min, Temperature 39.1°C (102.5°F)
Exhibit 4 – Laboratory Results Day 1, 1000: WBC count 14,000/mm³ (5,000 to 10,000/mm³) Day 1, 1430: WBC count 15,000/mm³ (5,000 to 10,000/mm³)
Exhibit 5 – Provider Prescriptions Day 1, 1430: Cefazolin 500 mg IV twice daily Acetaminophen 650 mg PO PRN temperature greater than 38.3°C (101°F) Alprazolam 0.25 mg PO three times daily
Complete the following sentence by using the lists of options.
The nurse should first ensure administration of the client's ______ (Select 1: antibiotic / antipyretic / anti-anxiety medication) due to the client's ______ (Select 2: WBC count / restlessness / temperature).
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antibiotic
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antipyretic
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anti-anxiety medication
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WBC count
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restlessness
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temperature
Explanation
Correct Answer: The nurse should first ensure administration of the client's antipyretic due to the client's temperature.
Select 1 — Antipyretic (Acetaminophen): The client's temperature has risen from 38.6°C to 39.1°C (102.5°F), which exceeds the prescribed threshold of 38.3°C (101°F) for acetaminophen administration. The antipyretic should be administered first because the fever is an active, measurable, and immediately addressable symptom with a specific PRN order already in place.
Select 2 — Temperature: The temperature of 39.1°C directly triggers the PRN acetaminophen prescription and is the clinical finding that drives the priority of the antipyretic administration at this time.
Why Other Options are Incorrect:
Antibiotic — While cefazolin has been prescribed for the suspected infection, it is administered on a scheduled twice-daily basis rather than as an immediate PRN response. The antipyretic addresses an active, escalating symptom that requires more immediate attention at this moment.
Anti-anxiety medication — Alprazolam has been prescribed, and the client is noted to be restless. However, benzodiazepines such as alprazolam are generally used with caution in older adults with delirium as they can worsen confusion and agitation. The fever is the more urgent physiological concern to address first.
WBC count — While the rising WBC count from 14,000 to 15,000/mm³ supports the diagnosis of infection, it does not directly trigger any of the three prescriptions listed. It supports the need for the antibiotic but is not the immediate driver of the first priority action.
Restlessness — Although the client is restless, restlessness alone does not take priority over an actively elevated temperature that already meets the threshold for a prescribed PRN intervention.
A nurse is assisting with the plan of care for a group of clients. Which of the following tasks should the nurse delegate to an assistive personnel?
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Observing the patency of an intravenous catheter on a stable client
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Performing a gastrostomy feeding on a stable client
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Providing postmortem care to a client
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Changing a sterile dressing for a client who is postoperative
Explanation
Correct Answer: (C) Providing postmortem care to a client
Postmortem care involves bathing and preparing the body after death, which is a task that does not require clinical judgment or nursing assessment. It is within the scope of practice of assistive personnel (AP) and is an appropriate task to delegate as it involves routine physical care rather than clinical decision-making.
Why the other options are incorrect:
A. Observing the patency of an intravenous catheter on a stable client While APs can perform basic observations, assessing IV catheter patency requires clinical judgment to identify complications such as infiltration or phlebitis, which is within the nurse's scope of practice.
B. Performing a gastrostomy feeding on a stable client Gastrostomy tube feedings involve clinical knowledge and monitoring for complications such as aspiration or tube displacement. This task requires nursing assessment and should not be delegated to an AP.
D. Changing a sterile dressing for a client who is postoperative Sterile dressing changes require aseptic technique, wound assessment, and clinical judgment. This is a nursing responsibility and is not appropriate to delegate to assistive personnel.
A nurse is reinforcing dietary teaching with a client who is at 12 weeks of gestation. Which of the following statements should the nurse make?
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"Increase your dietary intake by 500 calories per day."
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"Limit your caffeine intake to 700 milligrams per day."
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"Consume 600 micrograms of folic acid per day."
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"Eat 40 milligrams of protein-rich foods per day."
Explanation
Folic acid (600 mcg/day) is recommended during pregnancy to prevent neural tube defects, especially in the first trimester.
Why the other options are incorrect:
A. "Increase your dietary intake by 500 calories per day." The recommended increase is only 300 calories per day during pregnancy, not 500.
B. "Limit your caffeine intake to 700 milligrams per day." The safe limit for caffeine during pregnancy is no more than 200 mg/day, not 700 mg.
D. "Eat 40 milligrams of protein-rich foods per day." Protein is measured in grams, not milligrams, and the recommended intake is approximately 71 grams per day during pregnancy.
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