ATI 180 Material

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Sample questions from ATI 180 Material

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a labor unit, a nurse receives report on four clients. Which client should the nurse assess first?

   • A.A client 2 hours after an uncomplicated vaginal birth who has a firm fundus and a moderate amount of lochia rubra
   • B.A client at 34 weeks with preeclampsia whose blood pressure is 158/96 mm Hg and who reports a mild headache unchanged from the previous hour
   • C.A client at 37 weeks receiving oxytocin whose contractions last 100 seconds and whose fetal heart rate has recurrent late decelerations
   • D.A client at 39 weeks with contractions every 3 minutes who reports new rectal pressure and has a fetal heart rate of 140/min

   Rationale: Recurrent late decelerations with prolonged contractions during oxytocin infusion suggest impaired fetal oxygenation and require immediate intrauterine resuscitation and evaluation of the infusion. The client reporting rectal pressure may be progressing rapidly, but the reported fetal rate is reassuring and the nurse should assess promptly after addressing the fetal compromise. The elevated blood pressure and unchanged mild headache require follow-up, but are less urgent than a current nonreassuring fetal pattern; the firm fundus and moderate lochia are expected findings.

2. 2.In a prenatal clinic, a 16-year-old at 20 weeks' gestation tells the nurse privately that a partner is pressuring her to continue the pregnancy and monitors her phone. Which action is the nurse's priority?

   • A.Provide a list of adoption agencies before asking about the client's immediate safety
   • B.Promise the client that everything she shares will remain confidential under all circumstances
   • C.Contact the partner to clarify the client's living situation
   • D.Ask the client whether she feels safe returning home today and assess immediate risk in private

   Rationale: The nurse should first assess immediate safety and possible coercion in a private, supportive manner, then follow applicable safeguarding and reporting requirements. Contacting the partner could increase risk and breaches the client's privacy. An absolute promise of confidentiality is inappropriate because limits may apply, and discussing options before assessing immediate danger does not address the priority risk.

3. 3.A 29-year-old client at 31 weeks' gestation is admitted to a high-risk unit with severe preeclampsia and is receiving magnesium sulfate. Which tasks may the registered nurse delegate to experienced unlicensed assistive personnel (UAP) after providing directions? Select all that apply.

   • A.Obtain and report the client's blood pressure and oxygen saturation at the scheduled interval
   • B.Measure and document urine output from the collection device
   • C.Evaluate the fetal heart rate tracing for recurrent late decelerations
   • D.Assist the client with repositioning while maintaining seizure precautions
   • E.Assess deep tendon reflexes and report whether they are present
   • F.Determine whether the magnesium sulfate infusion should be paused

   Rationale: UAP may collect and report routine vital signs, measure and document urine output, and assist with repositioning when given clear directions and appropriate safety precautions. Assessing deep tendon reflexes requires nursing assessment and interpretation, while evaluating a fetal tracing requires clinical judgment. Deciding whether to pause a high-risk medication infusion is a registered nurse responsibility and cannot be delegated.

4. 4.The provider prescribes an urgent cesarean birth for a 27-year-old at 38 weeks because of persistent fetal bradycardia. The client is alert, has decision-making capacity, and says, "I need another minute to understand the risks." Which response by the nurse is best?

   • A.Ask the support person to sign the consent so the operating room can proceed
   • B.Explain that the provider must answer the client's questions, promptly notify the provider, and support the client's decision
   • C.Tell the client that refusing to sign will make the fetal outcome the client's responsibility
   • D.Sign the consent as a witness and tell the client the procedure is required

   Answer and rationale are in the full material.

5. 5.During a home visit, a 22-year-old who is 5 days postpartum reports soaking one pad in 20 minutes and feeling faint when standing. The client is alone with an infant; the home blood pressure is 88/54 mm Hg and pulse is 122/min. What should the nurse do first?

   • A.Ask the client to lie down, activate emergency medical services, and remain with the client
   • B.Ask a neighbor to drive the client and infant to the clinic
   • C.Arrange routine follow-up with the obstetric clinic later today
   • D.Teach the client to increase oral fluids and recheck the blood pressure in an hour

   Answer and rationale are in the full material.