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NCLEX Final ATI Exam Questions and Answers (Latest 2020) 100% Score.

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NCLEX Final ATI An 18 month old infant admitted with Pneumocystis carinii pneumonia has enzyme linked immunosorbent assay (ELISA) testing and is diagnosed as being human immunodeficiency virus (HIV) ... positive. In planning care, the nurse should be aware that An adolescent client who has had no prenatal care is admitted in labor and gives birth to a stillborn preterm fetus. The client is crying and says to the nurse, "Why did this happen to me?" Which of the following responses is appropriate from the nurse at this time? After 30 min of rambling about the "ozone layer" and being "doomed to die," a client begins pacing in an increasingly agitated manner. What should the nurse do first? After an exploratory laparotomy, a client is admitted to the medical surgical unit with an indwelling urinary catheter and a Jackson Pratt (JP) drainage tube. Which finding should indicate to the nurse that the client may be experiencing a postoperative complication? At a maternal health clinic, a nurse talks with several prenatal clients on the phone. Which client report does the nurse realize is a normal physiologic adaptation to pregnancy? At the first prenatal visit, a nurse learns that a pregnant client is lactose intolerant. Which of the following foods should the nurse include on a list of calcium sources for this client? A charge nurse on a pediatric floor receives the results from the morning laboratory work. Which of the following client results will require the nurse call to the primary care provider first? A client admitted with borderline personality disorder is expressing concern about requiring a prolonged hospitalization. What is the therapeutic statement the nurse could make when interacting with this client? A client asks the nurse if it is common to experience vaginal yeast infections during pregnancy. Which of the following is an appropriate response? A client being treated for antisocial personality disorder is becoming increasingly loud and belligerent on the mental health unit. Which approach should the nurse use to manage this client's potentially violent behavior? A client comes to the emergency department reporting fever and severe upper left quadrant abdominal pain. The primary care provider suspects pancreatitis. Based on this information, the nurse expects to see an elevation in the client's serum A client comes to the emergency department with deep, rapid respirations. Arterial blood gas analysis includes these values: pH 7.25, PCO2 40, and HCO3- 18. The nurse reports to the provider that the client is experiencing A client diagnosed with acute systemic lupus erythematosus (SLE) is to begin treatment for systemic manifestations. The nurse should recognize that the preferred classification of medications to be used is A client diagnosed with multidrug resistant tuberculosis (MDR TB) has been prescribed ethambutol (Myambutol). The nurse plans to instruct the client that it is likely he will experience A client has pseudomembranous colitis caused by clostridium difficile. The priority nursing intervention for this client is performing hand hygiene before and after contact with the client. A client is admitted with a suspected diagnosis of tuberculosis. Which nursing action is of highest priority? A client is in the dayroom when another client asks if two items of clothing match. The client with schizophrenia replies, "A match. I like matches. They are the givers of light, the light of the world. God will light the world if you let Him. Let your light shine in." Which of the following is the client demonstrating? A client is scheduled to have an electroencephalogram (EEG) in the morning. While preparing the client for the EEG, it is appropriate for the nurse to tell the client which of the following? A client receiving chemotherapy has developed neutropenia. Which statement by the client indicates to the nurse that the client needs further instructions? A client recently received a Mantoux skin test. After 48 hr , the test was evaluated by the nurse and reveals 10 mm of induration with slight redness. This indicates to the nurse that the Clients on neuroleptic antipsychotic medications are at a higher risk for developing agranulocytosis. What client data should the nurse review for the earliest indication of this problem? A client's provider informs the nurse that the client's abdominal aortic aneurysm (AAA) is extending. A client who has been treated for a transient ischemic attack (TIA) is being discharged. The nurse's discharge teaching plan related to this admission should reinforce the importance of monitoring A client who is regularly exposed to sunlight comes to the clinic to have several skin lesions evaluated. Which assessment finding should alert the nurse to the possibility of malignant melanoma? A client with Addison's disease comes to the emergency department reporting nausea, vomiting, diarrhea, and abdominal pain. To prevent Addisonian crisis, the nurse anticipates that the provider will prescribe IV administration of. A client with a history of chronic renal failure (CRF) has routine laboratory tests done with the following results: potassium 6.8 mEq/L, calcium 7.4 mg/dL, hemoglobin 10.2 g/dL, and albumin 3.0 g/dL. Which result should the nurse report to the client's primary care provider immediately? A client with an acute visual disturbance describes it as a "curtain" pulled over the visual area with occasional flashes of light. The nurse should notify the provider immediately of the possibility of A client with extensive deep partial and full thickness burns has been prescribed a topical antimicrobial drug. The nurse understands that the goal of this therapy is to reduce A clinic nurse is assessing a 66 year old client a for a routine physical. The client is new to the area and does not have old medical or immunization records available. When the nurse asks if the client has received the pneumococcal vaccine, the client replies, "I am not sure but I haven't had any immunizations in at least 5 years." The nurse should recognize that in this circumstance A clinic nurse is caring for an older adult client with an in-the-canal hearing aid. The client states that the hearing aid is making a whistling sound. The nurse explains that whistling in hearing aids is often caused by A community health nurse is conducting a class on body mechanics for county office workers. Which of the following should the nurse include in the teaching? (Select all that apply.) A disabled client is taking phenelzine (Nardil) for depression. The nurse is teaching the client's new home health aide about the client's diet restrictions due to the medication. The nurse evaluates that the teaching has been effective when the home health aid selects which of the following for the client's lunch? The disaster plan for a hospital has been initiated following a community flood. Which of the following actions is the responsibility of the nurse during the disaster? During a change of shift, a nurse is reviewing the medication administration records (MAR) for her assigned clients. The nurse notes that a prescribed dose of a medication is above the recommended safe range, and the dose was administered on the previous shift by a nurse. Which of the following actions should the nurse take? During a client care unit meeting, the nurse manager discusses potential problems with data security related to confidential client information. The nurse manager explains that safe, effective environments where client information may be discussed include During preoperative teaching for a client scheduled for laser assisted in situ keratomileusis (LASIK) surgery, the nurse should tell the client that he A family member of a client receiving hospice services asks the hospice nurse for assistance. The family member states that the client has insomnia almost nightly. The nurse assesses the client and documents the following: "Vital signs are stable, takes a short nap once a day as needed, walks around the neighborhood once a day if feeling ok, likes to watch television (TV) in bed during the day, goes to bed at 10 pm every night, drinks hot herbal tea before going to bed, and gets up to go to the bathroom once during the night." Which of the following mostly likely contributes to the client's insomnia? A female client with a history of recurrent cystitis asks the nurse about preventing future episodes. Which client statement describes a self care activity that the nurse should discourage? A high carbohydrate, low protein diet is prescribed for a client who has chronic renal failure. The nurse explains to the client that the carbohydrates in this diet will help A hospital receives a bomb threat and the charge nurse has to coordinate the evacuation of the clients. Which of the following actions should the nurse take when implementing the evacuation process? An individual wearing a hospital-issued identification badge greets the charge nurse on the postsurgical unit and states, "I am a surgical resident assigned to this unit." The individual then asks the charge nurse for an access code to review a client's online record stating, "I'm not scheduled to attend the computer class until next week." Which of the following actions should the nurse take? In planning care for a child with severe reactive airway disease, the nurse knows that when chronic steroid use is indicated, inhaled steroids are preferred over oral steroids for which of the following reasons? A newly licensed nurse is caring for a child who is brought to the emergency department with bruises that the nurse believes are due to child abuse. What should be the nurse's action at this time? A nurse admits an child with a urinary tract infection (UTI) who has a history of myelomeningocele. After completion of the admission history, which action should the nurse take? A nurse at an acute care clinic is talking with a client who reports that her arthritis pain is increasing each day. The client wants to discuss nonpharmacological approaches that would help relieve her. Which intervention should the nurse suggest? A nurse at an extended care facility hears an assistive personnel (AP) talking with an older adult client with dementia who has periods of confusion. Which of the following statements made by the AP should indicate to the nurse that the AP needs additional teaching about working with clients who have dementia? A nurse at the family planning clinic is preparing to teach a class on the use of a diaphragm. Which of the following should the nurse include in the teaching session? A nurse caring for a client with hypocalcemia should expect to see which of the following on the client's ECG? A nurse is caring for a client who has undergone a subtotal thyroidectomy is returning to the nursing unit. Which emergency equipment should the nurse have available on the unit for this client? A nurse has delegated an assistive personnel (AP) to provide one on one observation to a client who is recovering from a closed head injury. The nurse notes that the client is impulsive and has experienced one fall. Which of the following actions by the AP indicates to the nurse further teaching is needed? A nurse has taught the parent of a child diagnosed with type 1 diabetes mellitus how to manage the child's condition during illness, such as colds or flu. The nurse evaluates that the child's parent understands the teaching when the parent states, A nurse in a rehabilitation facility is observing an assistive personnel (AP) help a client transfer from the bed to a wheelchair. Which action taken by the AP indicates to the nurse an understanding of the proper technique to use for this type of transfer? A nurse in a substance abuse program is interacting with a client. The client is a nurse who has entered into the program as requirement of the state's board of nursing. Which statement by the client indicates to the nurse that the client is using intellectualization as a way of coping with the anxiety of admission? A nurse in a clinic cares for several children who all are admitted with symptoms of influenza. After routine laboratory work is obtained from the children, which child should the nurse bring to the primary care provider's attention immediately? A nurse is admitting a client to the medical unit and asks if the client has an advance directive. The client states "I have a document with me that names someone who can make health care decisions for me if I am not able." The client is referring to which of the following documents? A nurse is assessing a client who is prescribed rosiglitazone (Avandia). For which of the following should the nurse monitor? A nurse is assessing a client who is taking varenicline (Chantix) for smoking cessation. Which of the following client reports is the highest priority finding? A nurse is assigned to care for several postoperative clients. The nurse identifies a client as having a high risk for delayed wound healing if the client has A nurse is assisting with breastfeeding immediately following the birth of a newborn. Which of the following is the most important benefit of breastfeeding during the fourth stage of labor? A nurse is caring for a 2 year old child. The parents request a toy for their child. The nurse understands that the most appropriate toy from the playroom for this child is which of the following? A nurse is caring for a 2 year old child who was admitted for laryngotracheobronchitis. The child is placed in a crib with a cool mist tent. Which toy would be most suitable for the child at this time? A nurse is caring for a 3-year-old child who has persistent otitis media. When obtaining the history of the child from her parent, which of the following would be the most appropriate for the nurse to ask regarding the child's recurrent otitis media? A nurse is caring for a 3-year-old toddler who is undergoing insertion of pressure equalization (PE) tubes. The toddler's parent asks the nurse, "When will these tubes be removed?" Which of the following responses by the nurse is the most appropriate? A nurse is caring for a 4 year old child who is admitted to the pediatric unit through the emergency department and will be having a procedure in the morning. The child has been crying throughout the night and experiencing night terrors despite the parent's presence at the bedside. The nurse should understand that engaging the child in therapeutic play may provide which of the following benefits? A nurse is caring for a child who has epistaxis. Which of the following actions would be the most appropriate for the nurse to take? A nurse is caring for a child who is diagnosed with strabismus. The nurse explains to the parents that to prevent the development of amblyopia, it will be necessary to do which of the following? A nurse is caring for a child who is receiving bleomycin (Blenoxane) IV and is not voiding adequately. What is the appropriate nursing action? A nurse is caring for a child with celiac disease. Which of the following nursing assessments is consistent with celiac disease? A nurse is caring for a client diagnosed with hyperthyroidism. When developing a teaching plan, it is important for the nurse to encourage the client to A nurse is caring for a client taking warfarin (Coumadin). Which of the following laboratory values indicates to the nurse an effective response to the medication? A nurse is caring for a client who has been hospitalized due to methicillin-resistant Staphylococcus aureus (MRSA) in the sputum. The dietary assistant asks the nurse what precautions are necessary to enter the client's room with the lunch tray. Which instructions should the nurse provide to the dietary assistant? A nurse is caring for a client who has recently had a myocardial infarction (MI). The client calls the nurse to report some manifestations similar to those the client experienced the day of the MI. Which of the following should alert the nurse to the possibility of a recurrence? (Select all that apply.) A nurse is caring for a client who is receiving hemodialysis for the first time. Which of the following indicates to the nurse that the client is at imminent risk for developing dialysis disequilibrium syndrome (DDS)? A nurse is caring for a client who is scheduled for discharge this morning and does not speak English. The client's child arrives accompanied by a neighbor to pick up the client. Both the child and neighbor speak the client's native language and English fluently. Which of the following actions should the nurse take when providing discharge instructions? A nurse is caring for a client with a history of an above-knee amputation and chronic phantom pain. Which of the following medication prescriptions should the nurse question? A nurse is caring for a client with chronic atrial fibrillation who takes warfarin (Coumadin). The client has early manifestations of Alzheimer's disease. The client's spouse asks the nurse if the client would benefit from taking ginkgo biloba. Which of the following is an appropriate response? A nurse is caring for a client with hypothyroidism who is taking levothyroxine sodium (Synthroid). The nurse teaches the client to report which adverse effect of this medication to the provider immediately? A nurse is caring for a client with schizophrenia in an inpatient mental health facility. The client asks the nurse, "Can I vote in the upcoming presidential election?" Which of the following is an appropriate response? A nurse is caring for a group of clients in a long-term care setting. One of the clients is found walking in the hallway, bumping into walls, and unresponsive to his name. Which of the following actions should the nurse take first? A nurse is caring for a hospitalized client who is dying. The family has been involved in the client's care for several days. The family is exploring the possibility of caring for the client at home. Which of the following statements indicates that the nurse has a good understanding of family-centered care? A nurse is caring for an infant with dehydration. Which of the following is the most accurate assessment for hydration status? A nurse is caring for a postoperative client following a hip arthroplasty. In the client's medical record, the nurse notes a history of chronic obstructive pulmonary disease (COPD). The nurse knows that the oxygen delivery system appropriate for the client is a A nurse is caring for a school age child on a children's mental health unit. What comment by the nurse would foster rapport to engage the client in conversation? A nurse is caring for a school age child who has received a fiberglass cast following a lower extremity fracture. Which instructions should the nurse give the child and his parents about caring for the casted extremity in the first 48 hr? The nurse is caring for a toddler who is hospitalized for Pneumocystis carinii pneumonia. The child is taking zidovudine (AZT). Which laboratory tests should the nurse monitor related to this medication? A nurse is caring for a toddler with acquired immune deficiency syndrome. During the assessment, the nurse understands that which of the following would indicate an opportunistic infection? A nurse is developing a plan of care for a client with gastroesophageal reflux disease (GERD). Because of the complications commonly associated with this disorder, the nurse plans to monitor the client for aspiration A nurse is developing a teaching plan for a client diagnosed with type 2 diabetes mellitus. The client states, "I eat pasta every day. I can't imagine giving it up." Which of the following is an appropriate nursing response? A nurse is helping plan a health fair for adults in the community. One booth will focus on primary and secondary prevention actions for colorectal cancer. The nurse should include information on the A nurse is instructing a client on postoperative care related to a surgical procedure that will occur later in the day. The client states that no one has spoken to him about this before. Which of the following actions should the nurse take? A nurse is participating in a disaster drill with the local health department. Staged victims are being used in the drill to simulate a bomb explosion at a sporting event. The nurse is one of the first responders on the scene and starts to triage the victims. Which of the following actions should the nurse take first? A nurse is performing an assessment on a client. Which of the following in the client's history is a contraindication to use of sildenafil (Viagra)? A nurse is planning care for a client admitted with syndrome of inappropriate antidiuretic hormone (SIADH). The nurse expects the treatment for this client to include fluid restriction plus hypertonic sodium chloride and furosemide (Lasix). A nurse is planning care for an older adult client. An increase in which of the following is a normal physiological change associated with aging? A nurse is planning recreational activity for a young adult client with an acute exacerbation of schizophrenia. Assuming that the client is capable of all of the following, which activity should the nurse consider appropriate? A nurse is planning to delegate care of a postoperative client following an appendectomy. Which of the following should the nurse delegate to an assistive personnel (AP)? A nurse is preparing to administer a feeding via a gastrostomy tube to a client recovering from a cerebrovascular accident. The prescription is for tube feedings to be administered every 4 hr. Which action should the nurse take prior to initiating the feeding? A nurse is preparing to administer medications to an unconscious client. The nurse should bring the medication administration record (MAR) to the client's bedside and A nurse is preparing to care for a client in balanced skeletal traction with a femur fracture. Which of the following is an appropriate nursing intervention for this client? A nurse is providing discharge instructions to a client who is prescribed metoprolol (Toprol-XL). Which of the following instructions should the nurse include? (Select all that apply.) A nurse is providing discharge teaching to parents whose infant has had a ventriculoperitoneal shunt placed. The nurse evaluates that teaching was effective when the parent states which of the following? A nurse is providing teaching to a client who is prescribed albuterol (Proventil) via a metered-dose inhaler. After removing the cap from the inhaler and shaking the canister, the nurse should instruct the client to take which of the following actions next? The client should hold the mouth piece 1/2 to 2 inches from his mouth, tilt his head back slightly and then open his mouth. Next, he should press the inhaler while taking a deep breath to facilitate delivery of the medication to the air passages. After holding his breath for 10 seconds, the client A nurse is providing teaching to a client who is prescribed doxycycline (Vibramycin) for actinomycosis. The nurse should observe the client for which of the following? A nurse is providing teaching to a client who is prescribed insulin for a new diagnosis of diabetes mellitus. The nurse should explain the need for subcutaneous injections of insulin by responding that insulin A nurse is providing teaching to parents of a child who is prescribed lamotrigine (Lamictal) for a seizure disorder. The nurse should instruct the parents to notify the primary care provider immediately if the child develops which of the following? A nurse is reinforcing teaching with the family of a child who has Asperger's syndrome. Which comment would indicate to the nurse that adequate learning has taken place? A nurse is reviewing the laboratory data of a client who reports symptoms that suggest systemic lupus erythematosus (SLE). If this diagnosis is accurate, the nurse expects to note an increased A nurse is taking a history from a client with presbyopia. With which of the following should the nurse expect the client to have difficulty? A nurse is talking with an unmarried couple who have come to the family planning clinic for advice. Which of the following is an appropriate response regarding the risks associated with an intrauterine device (IUD)? A nurse is talking with a parent of a preschooler. The parent reports that it is very difficult to get her child to go to bed at a proper time consistently. She tells the nurse that the child gets out of bed, enters her room, and cries when told to stay in bed. Which instructions should the nurse give the parent to foster a consistent bedtime for this child? A nurse is talking with the parent of a 4 month old infant about normal growth and development. Which comment made by the parent should indicate to the nurse a need for further teaching? A nurse is teaching a client who is a paraplegic to perform intermittent urinary self catheterization at home after discharge. Which statement by the client demonstrates to the nurse that the client understands the procedure? A nurse is teaching a group of clients at an older adult center about the risk for the development of osteoporosis. Which of the following statements should the nurse include in the teaching session? A nurse is teaching the parents of an infant about treatment options for profound sensorineural hearing loss. The nurse explains that cochlear implants work by which of the following? A nurse on a mental health unit is taking care of a client diagnosed with depression. Which nursing intervention would foster a therapeutic environment for this client? A nurse on an oncology unit receives a report about the postoperative clients assigned to the nurse's team. Which client should the nurse see first? A nurse on the antepartum unit is caring for a client who is at 28 weeks of gestation and expecting twins. The client reports feeling "lightheaded." Which position should the nurse assist the client into at this time? A nurse participating in a community health fair is giving general information to clients who have an elevated reading during a blood pressure screening. While explaining the meaning of the results to a client, the nurse should A nurse responds to a call from the nursing assistant that a client has had a seizure and is unconscious. What is the nurse's priority at this time? A nurse working at a senior center notes that a client who is in the early stages of Alzheimer's disease has been having problems with orientation. Which of the following actions should the nurse take to improve the client's level of orientation? An older adult client is having trouble sleeping and comes to the primary care provider's office for evaluation. Which of the following statements should the nurse recognize as a potential rationale for the sleeping difficulties? A pregnant client who is Hindu is being seen at the women's health center for a 12 week check up. The primary care provider tells the client that she must get more protein in her diet and suggests that the client eat more animal products. Although the client initially states that she agrees, after the primary care provider leaves the examination room, the client tells the nurse that "eating animal products will cause her to miscarry." Which of the following is an appropriate response? A primary care provider prescribes 10 units of insulin glargine (Lantus) and 4 units of NPH insulin (Humulin N) to be given subcutaneously at 1700. The nurse should plan to draw the insulin glargine (Lantus) into one insulin syringe and the NPH insulin into a different insulin syringe and inject separately. A provider prescribes sertraline (Zoloft) for a client. The client asks the nurse if he should continue to take St. John's Wort for depression. The nurse should advise the client to do which of the following? When assessing a child with lymphocytic leukemia who is being treated with vincristine (Oncovin), the nurse should give the highest priority to which of the following reports? Which statement made by an assistive personnel (AP) to a nurse indicates that the AP needs more education about the use of side rails as a safety device? A nurse caring for a client with a history of atrial fibrillation who has been transferred from a postanesthesia care unit following a posterior lumbar laminectomy. When the client suddenly becomes short of breath, the nurse is most concerned that the client may have developed which of the following? [Show More]

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