ATI-Focused NCLEX Nursing Review

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Sample questions from ATI-Focused NCLEX Nursing Review

This material has 20 questions with answers and rationales. Here are the first 5.

1. 1.The nurse receives reports on four patients. Which patient should the nurse assess first?

   • A.A. A patient with chronic heart failure who has unchanged bilateral ankle edema
   • B.B. A patient 1 day after hip surgery who develops sudden dyspnea and pleuritic chest pain
   • C.C. A patient with a urinary catheter who requests assistance with hygiene
   • D.D. A patient with pneumonia whose temperature decreased after an antipyretic

   Rationale: B is correct because sudden postoperative dyspnea and pleuritic pain may indicate pulmonary embolism or another life-threatening problem. A describes a chronic unchanged finding, not demonstrated acute deterioration. C needs routine assistance but has no urgent threat. D describes an improving symptom, although ongoing monitoring remains necessary.

2. 2.A patient receiving IV morphine is difficult to awaken and has shallow respirations at 6/min. Oxygen saturation is 95% while receiving supplemental oxygen. Which action is the priority?

   • A.A. Document adequate oxygenation and reassess in 30 minutes
   • B.B. Give the next opioid dose by a different route
   • C.C. Stop opioid administration, activate assistance, support ventilation, and give naloxone as indicated
   • D.D. Remove oxygen to determine the patient's room-air saturation

   Rationale: C is correct because severe sedation and slow, shallow breathing indicate potentially fatal opioid-related ventilatory depression. A is unsafe because supplemental oxygen may conceal hypoventilation. B can worsen respiratory depression. D delays rescue and can worsen hypoxemia without correcting ventilation.

3. 3.Which prescription requires clarification before administration?

   • A.A. Potassium chloride 20 mEq by IV push now
   • B.B. Acetaminophen by mouth for mild pain within the prescribed daily limit
   • C.C. An isotonic crystalloid infusion using an infusion pump
   • D.D. Subcutaneous insulin with glucose monitoring and meal coordination

   Rationale: A is correct because IV push potassium can cause fatal dysrhythmias and must not be administered. B, C, and D describe potentially appropriate therapies when the patient, dose, indication, and orders have been verified. Their routine safeguards do not make IV push potassium acceptable.

4. 4.An alert patient with diabetes has a glucose of 58 mg/dL and can swallow without difficulty. Which intervention is most appropriate initially?

   • A.A. Administer the scheduled rapid-acting insulin
   • B.B. Give a high-fat meal and recheck glucose in 2 hours
   • C.C. Withhold all intake until the prescriber arrives
   • D.D. Give approximately 15 g of fast-acting carbohydrate and recheck glucose in about 15 minutes

   Answer and rationale are in the full material.

5. 5.The RN is planning care for a stable patient. Which task is most appropriate to delegate to trained assistive personnel?

   • A.A. Decide whether new dizziness represents orthostatic hypotension
   • B.B. Measure and record urine output and report output below the specified parameter
   • C.C. Teach the patient how a newly prescribed anticoagulant works
   • D.D. Determine whether the discharge goals have been achieved

   Answer and rationale are in the full material.