ATI Comprehensive Assessment a Study Guide

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Sample questions from ATI Comprehensive Assessment a Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.A nurse is reassessing four adult clients on a medical-surgical unit. Which client should the nurse assess first?

   • A.A client with heart failure who has gained 1 kg over the past 24 hours and has bilateral ankle edema
   • B.A client with pneumonia who is newly confused, has a respiratory rate of 32/min, and has an oxygen saturation of 86% on 2 L/min by nasal cannula
   • C.A client with chronic kidney disease who has a creatinine level of 3.2 mg/dL, unchanged from the previous day
   • D.A client who is 1 day postoperative and reports incisional pain of 7 on a 0-to-10 scale when coughing

   Rationale: New confusion, tachypnea, and hypoxemia despite supplemental oxygen indicate acute respiratory deterioration requiring immediate assessment and intervention. Weight gain and edema require follow-up for fluid retention but are less urgent without respiratory distress. An unchanged elevated creatinine is consistent with the client's chronic kidney disease. Postoperative pain requires treatment but does not take priority over impaired oxygenation.

2. 2.A nurse is preparing to administer scheduled insulin lispro and insulin glargine to a client with type 1 diabetes. The client's blood glucose is 118 mg/dL, but the breakfast tray has been delayed. Which action is most appropriate?

   • A.Administer both insulins now because the blood glucose is within the target range
   • B.Withhold both insulins until the client has finished eating breakfast
   • C.Delay the mealtime lispro until food is available and administer the prescribed glargine after verifying the order
   • D.Mix the lispro and glargine in one syringe and administer them when breakfast arrives

   Rationale: Lispro acts rapidly and should be coordinated with food availability to reduce hypoglycemia risk. Glargine supplies basal insulin and is generally continued as prescribed in type 1 diabetes, even when meals are delayed. Giving lispro without available food risks hypoglycemia. Automatically withholding basal insulin can promote hyperglycemia and ketosis. Glargine must not be mixed with other insulins.

3. 3.One hour after a vaginal birth, a client has heavy vaginal bleeding. The nurse finds a boggy uterus displaced to the right. Which action should the nurse take first?

   • A.Massage the uterine fundus while activating assistance for postpartum hemorrhage
   • B.Assist the client to walk to the bathroom to empty the bladder
   • C.Inspect the perineum for a laceration before intervening
   • D.Document the findings and reassess uterine tone in 15 minutes

   Rationale: A boggy uterus with heavy bleeding suggests uterine atony. Immediate fundal massage and assistance address the urgent hemorrhage risk. Rightward displacement suggests bladder distention, which should also be corrected promptly, but walking a client with active heavy bleeding is unsafe and delays initial treatment. Lacerations can cause bleeding, especially with a firm uterus, but the current findings prioritize atony management. Waiting 15 minutes risks worsening blood loss.

4. 4.A school-age child has a lower-leg cast applied after a fracture. Two hours later, the child reports increasing pain despite prescribed analgesia. Passive extension of the toes produces severe pain, and the child reports tingling. The toes remain warm with a palpable pedal pulse. Which action should the nurse take?

   • A.Reassure the family that a palpable pulse rules out compromised circulation
   • B.Elevate the casted leg well above heart level and reassess in 1 hour
   • C.Apply a warm compress over the cast to reduce muscle discomfort
   • D.Notify the orthopedic provider immediately and maintain the extremity at heart level

   Answer and rationale are in the full material.

5. 5.A registered nurse is coordinating care with an experienced assistive personnel member on an adult medical-surgical unit. Which task is appropriate to delegate?

   • A.Assess a newly admitted client's risk for pressure injury
   • B.Obtain and record a daily weight for a stable client with chronic heart failure
   • C.Teach a client how to use a walker before the first postoperative ambulation
   • D.Evaluate whether a client's pain decreased after an intravenous opioid

   Answer and rationale are in the full material.