ATI RN VATI Comprehensive Predictor
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Free ATI RN VATI Comprehensive Predictor Questions
A nurse is caring for a client who has a strained knee and a prescription for ice therapy. Which of the following actions should the nurse take?
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Check the client's skin after 15 min
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Apply ice directly on the client's skin
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Tell the client ice therapy will increase blood flow
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Apply heat after 30 min of ice therapy
Explanation
Correct Answer: A) Check the client's skin after 15 min
Ice therapy should be applied for no longer than 15–20 minutes at a time. Checking the skin after 15 minutes allows the nurse to assess for ice burn, excessive numbness, or skin damage. Ice should never be applied directly to skin — it must be wrapped in a cloth or towel to prevent frostbite. Ice causes vasoconstriction and reduces blood flow, not increases it. Applying heat immediately after ice is not a standard or recommended practice.
A nurse in a clinic is teaching a client who is postmenopausal about estrogen therapy. Which of the following information should the nurse include in the teaching?
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Estrogen therapy decreases the risk for breast cancer.
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Estrogen therapy increases the risk for thrombus formation.
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Estrogen therapy can cause weight loss.
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Estrogen therapy increases the risk for seizures.
Explanation
Estrogen therapy is associated with an increased risk for thrombus formation due to its effects
on coagulation factors. Postmenopausal hormone therapy increases the likelihood of developing
deep vein thrombosis (DVT), pulmonary embolism, and stroke. This is one of the most important
safety considerations the nurse must discuss, especially in clients who smoke, are immobilized,
or have existing cardiovascular risks.
A nurse is providing discharge teaching about disease prevention to a client who has active tuberculosis. Which of the following should the nurse include?
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Educating the client how to cover nose and mouth with tissues when coughing
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Recommending the client may return to work after two negative sputum cultures
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Instructing the client that he is no longer contagious after 1 week of medication therapy
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Teaching the client’s family to wear protective masks while with the client
Explanation
A. Educating the client how to cover nose and mouth with tissues
when coughing
:
Clients with active tuberculosis must follow strict respiratory hygiene to prevent spreading
airborne droplets. Covering the mouth and nose when coughing or sneezing significantly reduces
transmission to others. This is an essential component of TB control and applies both inside and
outside the home until the disease is no longer contagious. Teaching this behavior directly
prevents spread.
A nurse is caring for a client who is requesting treatment for a gambling disorder. Which of the following medications should the nurse expect the provider to prescribe?
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Varenicline
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Disulfiram
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Sertraline
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Clonidine
Explanation
Correct Answer: C) Sertraline
Sertraline is a selective serotonin reuptake inhibitor (SSRI) and is among the pharmacological agents used in the treatment of gambling disorder. SSRIs are prescribed to address the impulsivity, compulsive behavior, and underlying mood dysregulation associated with gambling disorder, often used in combination with cognitive behavioral therapy.
Varenicline is a nicotinic receptor partial agonist used specifically for smoking cessation and has no established role in gambling disorder treatment. Disulfiram is an alcohol deterrent medication used in alcohol use disorder — it causes an unpleasant reaction when alcohol is consumed and is not indicated for gambling disorder. Clonidine is an alpha-2 adrenergic agonist used for hypertension, ADHD, and opioid withdrawal management — it is not a treatment for gambling disorder.
Exhibit 1 — Nurses' Notes, Today 1200: The neonate is 3 days old. Lung sounds clear to auscultation. Frequent episodes of apnea, responds to tactile stimuli. Oxygen saturation 95% to 98% via nasal cannula. Neonate on radiant warmer. Temperature 36.3°C (97.3°F), Heart rate 158/min, Respiratory rate 70/min. Substernal retractions and nasal flaring noted. Orogastric (OG) tube placement verified. Continuous breast milk feedings via OG tube initiated 12 hours ago. Umbilical arterial catheter (UAC) site is clean, dry, and intact.
Exhibit 2 — History and Physical: Neonate born at 34 weeks of gestation. Spontaneous vaginal birth. Preterm premature rupture of membranes. Small for gestational age. 1-minute Apgar score: 4. 5-minute Apgar score: 7.
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Gestational age
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UAC
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Abdominal circumference
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5-minute Apgar score
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Respiratory distress
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Feeding route
Explanation
Correct Answers: A) Gestational age, B) UAC, C) Abdominal circumference, E) Respiratory distress, and F) Feeding route
Gestational age — Born at 34 weeks, this neonate is preterm and small for gestational age, placing them at significantly higher risk for complications including necrotizing enterocolitis (NEC), respiratory distress syndrome, apnea of prematurity, infection, and intraventricular hemorrhage.
UAC (Umbilical Arterial Catheter) — Any indwelling vascular catheter is a direct risk factor for serious complications including catheter-associated bloodstream infection, thrombosis, and vascular compromise — all critical concerns in a fragile preterm neonate.
Abdominal circumference — The documented 1 cm increase in abdominal circumference since the prior assessment, combined with recent initiation of enteral feedings in a preterm neonate, is a significant risk factor and early warning sign for NEC development.
Respiratory distress — The presence of substernal retractions, nasal flaring, tachypnea (RR 70/min), and oxygen requirement indicates active respiratory distress, which is both a complication itself and a risk factor for further deterioration including respiratory failure and infection.
Feeding route — Continuous breast milk feedings via OG tube initiated only 12 hours ago in a preterm, small-for-gestational-age neonate places the infant at risk for feeding intolerance and NEC, as the immature gut is highly vulnerable in the early days of enteral feeding initiation.
A nurse is planning the discharge of an infant who has tetralogy of Fallot. The nurse anticipates the need for which of the following equipment?
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Portable suction
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Cervical collar
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Hemodialyzer
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Pulse oximeter
Explanation
D. Pulse oximeter: Infants with tetralogy of Fallot require continuous monitoring of
oxygen saturation levels at home. These infants are prone to "tet spells" - sudden
episode of cyanosis and hypoxia triggered by crying, feeding, or dehydration. A pulse
oximeter allows parents to monitor the infant's oxygen saturation and recognize early
signs of deterioration, enabling prompt intervention. The other equipment is not
indicated: portable suction is for airway secretions management (not typically needed),
cervical collars are for spinal immobilization, and hemodialyzers are for renal failure
treatment.
A nurse is caring for a client who is receiving a blood transfusion at 125 mL/hr and develops a hemolytic reaction. Which of the following actions should the nurse perform?
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Infuse 0.9% sodium chloride IV.
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Administer an antipyretic.
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Decrease the infusion rate to 75 mL/hr.
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Place the client in a left lateral position.
Explanation
Correct Answer: A) Infuse 0.9% sodium chloride IV.
A hemolytic transfusion reaction is a life-threatening emergency caused by ABO incompatibility. The first priority after stopping the transfusion immediately is to maintain IV access and infuse 0.9% normal saline to maintain blood pressure, promote renal perfusion, and prevent acute kidney injury from free hemoglobin and red blood cell breakdown products clogging the renal tubules. The IV line must be kept open with normal saline — never with the existing blood tubing.
An antipyretic addresses fever but does not treat the underlying hemolysis or prevent acute kidney injury — it is not the priority action in a hemolytic reaction. Decreasing the infusion rate is incorrect — the transfusion must be stopped completely and immediately, not slowed, when a hemolytic reaction is suspected. Placing the client in the left lateral position is used for cord prolapse or fetal distress in obstetric emergencies — it has no therapeutic role in managing a hemolytic transfusion reaction.
A nurse is teaching a client who has osteoporosis about how to increase calcium in their diet. The nurse should instruct the client that which of the following foods is the best source of calcium?
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1/2 cup raw carrots
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3 oz canned tuna
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6 oz low-fat yogurt
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1 slice whole-wheat bread
Explanation
Low-fat yogurt is one of the richest dietary sources of calcium, providing approximately 300 mg
per 6-oz serving. For clients with osteoporosis, adequate daily calcium intake is essential for
slowing bone loss and maintaining bone density. Dairy products, especially yogurt, milk, and
cheese, contain highly absorbable calcium, making them superior to plant or grain sources for
meeting recommended intake levels.
A nurse is caring for a client who is receiving gentamicin. Which of the following findings indicates the client is developing toxicity?
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Lethargy
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Weight gain
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Tinnitus
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Blurred vision
Explanation
Tinnitus is a classic early sign of ototoxicity, a well-known adverse effect of gentamicin.
Aminoglycosides damage the hair cells of the cochlea, leading to ringing in the ears, hearing
loss, or balance disturbances. Because ototoxicity can become permanent, this finding requires
immediate provider notification and discontinuation or adjustment of the medication. Monitoring
for tinnitus is essential during gentamicin therapy.
A nurse is caring for a client who is at 20 weeks of gestation. Exhibit 1 History and Physical Gravida 2 Para 2 ABO blood type: A negative Exhibit 2 Nurses' Notes Client is alert and oriented to person, place, time, and situation. Reports nausea, cramping, and dark brown vaginal discharge. Skin warm, dry, and intact. Heart rate 98/min. Respirations even and nonlabored. Lungs clear to auscultation anterior and posterior fields. Fundal height measures 24 cm. Deep tendon reflexes 3+ bilateral. +2 pitting edema to bilateral lower extremities. Exhibit 3 Diagnostic Results Day 1: Transvaginal ultrasound: Trophoblastic tissue Blood human chorionic gonadotropin (hCG) 1 million IU/L Day 2: Blood human chorionic gonadotropin (hCG) 1.1 million IU/L Which of the following actions should the nurse plan to take? Select all that apply.
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Apply internal fetal monitor.
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Prepare client for dilation and curettage with suction.
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Administer 1-hr glucose tolerance test.
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Refer client to perinatal loss support group.
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Provide the client with instructions on medroxyprogesterone therapy.
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Administer Rho(D) immune globulin.
Explanation
B. Prepare client for dilation and curettage with suction:
The client’s findings—extremely elevated and rising hCG levels, trophoblastic tissue on
transvaginal ultrasound, uterine size larger than gestational age (fundal height 24 cm at 20
weeks), nausea, cramping, and dark brown discharge—are classic indicators of a hydatidiform
mole (molar pregnancy). The appropriate management is evacuation of the uterus via dilation
and curettage with suction to prevent complications such as hemorrhage and choriocarcinoma.
The nurse should prepare the client for this procedure.
D. Refer client to perinatal loss support group:
A molar pregnancy is a nonviable gestation that results in pregnancy loss. Clients often
experience grief similar to other pregnancy losses. Providing emotional support and referring the
client to a perinatal loss support group is appropriate to help process psychological distress and
provide resources for coping during recovery.
F. Administer Rho(D) immune globulin:
The client has blood type A negative, placing her at risk for Rh sensitization if any fetal tissue is
present. Following uterine evacuation for a molar pregnancy, Rho(D) immune globulin should be
administered to prevent isoimmunization. This is standard care for Rh-negative clients who
experience pregnancy loss or undergo uterine evacuation.
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