ATI Concept Based Level 3

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Sample questions from ATI Concept Based Level 3

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

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

   • A.A client with diabetes whose blood glucose is 68 mg/dL and who is alert and requesting juice
   • B.A client 6 hours after thyroidectomy who has new inspiratory stridor
   • C.A client with heart failure who has bilateral ankle edema and is due for a diuretic
   • D.A client with COPD whose oxygen saturation is 90% on the prescribed 2 L/min and who is speaking comfortably

   Rationale: New inspiratory stridor after thyroidectomy suggests airway obstruction from swelling or bleeding and requires immediate assessment and intervention. The client with COPD is at the prescribed oxygen level, and the alert client with mild hypoglycemia can take oral carbohydrate. Edema requires follow-up but is not as immediately life-threatening as an obstructed airway.

2. 2.During a home visit, a 78-year-old client with heart failure reports increased fatigue. The chart shows weight increased from 68.0 kg yesterday to 70.1 kg today, new orthopnea, and crackles at both lung bases; BP is 148/86 mm Hg and SpO2 is 91% on room air. Which actions should the nurse take? Select all that apply.

   • A.Notify the provider of the acute weight gain and respiratory findings
   • B.Assess respiratory effort and oxygenation promptly
   • C.Advise the client to wait a week and recheck weight
   • D.Encourage the client to drink extra fluids to thin secretions
   • E.Review prescribed diuretic use and whether doses were missed

   Rationale: Prompt respiratory assessment is warranted because orthopnea, crackles, and decreased oxygen saturation suggest worsening congestion. Reporting the 2.1-kg gain and symptoms allows timely treatment, and checking diuretic adherence helps identify a contributing factor. Extra fluids can worsen fluid overload, and delaying follow-up is unsafe with new respiratory symptoms.

3. 3.In a rehabilitation unit, an RN is assigning tasks to assistive personnel (AP). Which task is appropriate to delegate to the AP?

   • A.Teach a client how to use a walker safely
   • B.Assess a newly admitted client's ability to swallow
   • C.Evaluate a client's response to a first dose of an antihypertensive
   • D.Obtain routine vital signs for a stable client before physical therapy

   Rationale: Obtaining routine vital signs for a stable client is a predictable task that can be delegated to trained AP. Swallow assessment, teaching, and evaluation of a medication response require nursing judgment. The RN remains responsible for interpreting the vital signs and following up on abnormal findings.

4. 4.Refer to the client's chart. Which actions should the nurse take now? Select all that apply.

   • A.Restart the same unit at a slower rate after the chills resolve
   • B.Recheck the client's identity and blood product label
   • C.Maintain IV access with normal saline using new tubing
   • D.Stop the current transfusion
   • E.Notify the provider and blood bank and send the product per policy

   Answer and rationale are in the full material.

5. 5.A provider prescribes a new medication for a hospitalized client. The client says, "That pill is a different color from the one I take at home." Which response by the nurse is best?

   • A."I will compare the medication with your prescription and verify it with the pharmacy before giving it."
   • B."You can refuse all medications until your family brings yours from home."
   • C."I will ask another client whether this medication looks familiar."
   • D."The pharmacy sends medications in different colors, so take it now."

   Answer and rationale are in the full material.