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VATI RN 2ND COMPREHENSIVE PREDICTOR
FOCUSED FINAL PAPER 2026 CERTIFICATION
◉ A nurse is interpreting the cardiac rhythm strip of a client who was admitted with syncope. Which of the following images indicates that the client has atrial fibrillation. Answer: ◉ A charge nurse on a pediatric unit is making assignments for a float nurse from the medical unit. Which of the following clients is appropriate to assign to the float nurse? A. A 10-year-old client who has pneumonia and is receiving respiratory treatments B. A 4-year-old client who has a Wilms tumor and is receiving chemotherapy C. An 8-month-old client who is scheduled for a surgical repair of a ventricular septal defect tomorrow D. A 14-year-old client who is scheduled for discharge today following placement of a Harrington rod. Answer: A. A 10-year-old client who has pneumonia and is receiving respiratory treatments ◉ A nurse is assessing an infant who has water intoxication. Which of the following findings should the nurse expect? A. Generalized edema
B. Elevated urine specific gravity C. Thready pulse D. Increased hematocrit. Answer: A. Generalized edema ◉ A nurse is discussing the z-track administration of hydroxyzine with a newly licensed nurse. Which of the following statements indicates the newly licensed nurse understands the purpose of the technique? A. This technique prevents injury to the sciatic nerve B. This technique decreases the risk of subcutaneous infiltration C. This technique allows a larger amount of medication to be injected D. This technique increases the absorption rate of the drug. Answer: This technique decreases the risk of subcutaneous infiltration ◉ A nurse is creating a plan of care for a client who has anorexia nervosa. Which of the following interventions should the nurse include in the plan? A. Encourage the client to gain 2.3 kg per week B. Weigh the client once per week throughout hospitalization C. Monitor the client for 1 hr after meals D. Allow the client to choose mealtimes. Answer: C. Monitor the client for 1 hr after meals
◉ A nurse is caring for a client following an open colectomy. Which of the following findings places the client at risk for delayed wound healing? A. INR 1. B. Hyperemesis C. HbA1c 5.6% D. Uncontrolled pain. Answer: B. Hyperemesis ◉ A home health nurse is reviewing treatment goals with a client who has diabetes mellitus. The nurse should evaluate which of the following laboratory tests to determine effective long-term management of blood glucose levels? A. 3-hr oral glucose tolerance test B. HbA1c C. Fasting blood glucose test D. Urinalysis for ketones. Answer: B. HbA1c ◉ A nurse is caring for a client who has neutropenia due to HIV. Which of the following precautions should the nurse take while caring for this client? A. Wear an N95 respirator B. Insert an indwelling urinary catheter to monitor urinary output C. Monitor the client's vital signs every 8 hr
D. Use a dedicated stethoscope. Answer: D. Use a dedicated stethoscope ◉ A nurse is caring for a client who reports difficulty falling asleep at night. Which of the following actions should the nurse take? A. Encourage the client to ambulate in the hallway 1 hr before bedtime B. Tell the client to avoid drinking fluids 1 hr before bedtime C. Schedule routine care tasks during hours when the client is awake D. Advise the client to leave the television in the room on when trying to fall asleep. Answer: C. Schedule routine care tasks during hours when the client is awake ◉ A nurse is planning care for a newborn who has hyperbilirubinemia and is to receive phototherapy. Which of the following interventions should the nurse include? A. Clothe the newborn in light cotton B. Check the newborn's temperature every 8 hrs. (every 4) C. Administer 120 mL of water between feedings D. Place the newborn 45 cm (18 in) from the light source. Answer: D. Place the newborn 45 cm (18 in) from the light source
C. Swollen ankles D. Urinary frequency. Answer: B. Indigestion ◉ A nurse is caring for a client who has just returned to the unit following a bronchoscopy. Which of the following actions by the assistive personnel requires the nurse to intervene? A. Encourages the client to use the incentive spirometer B. Elevates the head of the client's bed C. Offers oral fluids to the client D. Checks the client's pulse oximetry. Answer: C. Offers oral fluids to the client ◉ A nurse on a medical unit has just received change-of-shift report. Which of the following clients should the nurse assess first? A. A 68-year-old client who had a myocardial infarction 2 days ago and reports chest pain 4 on a scale of 0 to 10 B. A 48-year-old client who has AIDS, pneumocystis pneumonia, and a temperature of 38.3 C (101F) C. A 60-year-old client who has COPD, is receiving 2 L/min O2 via a nasal cannula, and has an oxygen saturation of 89% D. A 26-year-old female client who has pelvic inflammatory disease and is unable to void. Answer: A 68-year-old client who had a myocardial infarction 2 days ago and reports chest pain 4 on a scale of 0 to 10
◉ A nurse is assessing a client prior to performing a blood draw. The nurse should identify that an allergy to which of the following food can indicate that the client has an allergy to latex? A. Peanuts B. Shellfish C. Avocados D. Eggs. Answer: C. Avocados ◉ A nurse is preparing to witness a client's signature on an informed consent for a total knee arthroplasty. Which of the following client statements indicates the nurse should contact the surgeon? A. I wonder if the metal in my knee will show up in airport screenings B. The physical therapy has not been working, so I will need to have the surgery C. I look forward to being able to bend my knee again when I sit in a chair D. I am thankful there are no serious complications from this type of surgery. Answer: D. I am thankful there are no serious complications from this type of surgery ◉ A nurse is teaching the parent of a school-age child who has scabies about the application of permethrin 5% cream. The nurse
D. Increase the time between voiding. Answer: C. Empty the bladder before and after intercourse ◉ A nurse is providing discharge teaching to a client who is postpartum and plans to breastfeed. Which of the following should the nurse recommend the client increase in their diet during lactation? A. Vitamin D B. Iron C. Vitamin A D. Calcium. Answer: D. Calcium ◉ A nurse is providing teaching about preventing mastitis to a client who is postpartum and breastfeeding her newborn. Which of the following instructions should the nurse include? A. "Wear an underwire bra between feedings." B. "Cover your breasts immediately after feedings." C. "Apply cold compresses to your breasts before feedings." D. "Try to have your baby empty your breasts with each feeding.". Answer: D. "Try to have your baby empty your breasts with each feeding." ◉ A nurse is caring for a client who reports chest pain. Which of the following findings indicates myocardial damage?
A. aPTT 80 seconds B. Troponin I 1.8 ng/mL C. Erythrocyte sedimentation rate 17 mm/hr D. Human B-type natriuretic peptide 88 pg/mL. Answer: B. Troponin I 1.8 ng/mL ◉ A nurse is providing teaching about car seat safety to the parent of a term newborn. Which of the following statements by the parent indicates an understanding of the teaching? A. "I should place a rolled blanket along each side of my baby's head in the car seat." B. "I should place my baby's car seat rear-facing until 6 months of age." C. "I should put the car seat retainer clip at the level of my baby's belly button." D. "I should position my baby's car seat at a 90-degree angle in the car.". Answer: A. "I should place a rolled blanket along each side of my baby's head in the car seat." ◉ A nurse is performing high-frequency chest compressions using a mechanical chest compression device for a child who has cystic fibrosis. Which of the following findings indicates the treatment has been effective? A. The child develops a dry, hacking cough B. The child has increased nasal secretions
B. Observe the client's level of mobility C. Administer prescribed medications D. Electronically enter the prescriptions from the provider. Answer: B. Observe the client's level of mobility ◉ A nurse at a public health clinic is caring for a group of clients. Which of the following should the nurse identify as a reportable diagnosis to the CDC? A. Herpes simplex virus (HSV) type 1 B. Hepatitis A C. Human papillomavirus (HPV) D. Pediculosis capitis. Answer: B. Hepatitis A ◉ A charge nurse is evaluating the time management skills of a newly licensed nurse. Which of the following actions should the charge nurse identify as an effective time management skill? A. Delegates creation of a client's teaching plan to a licensed practical nurse B. Completes activities for one client before moving to the next client C. Focuses on activities rather than objectives D. Skips break times to catch up on charting. Answer: B. Completes activities for one client before moving to the next client
◉ A nurse delegates tasks to a licensed practical nurse and an assistive personnel. When admitting a client who is experiencing acute liver failure and who has ascites and an NG tube, which of the following tasks is most appropriate for the nurse to delegate to the LPN? A. Insert an indwelling catheter if the client has not voided in 3 hr B. Obtain the abdominal girth now and every 4 hr C. Assess and document the level of consciousness every hour D. Measure the amount of gastric drainage every 2 hr. Answer: A. Insert an indwelling catheter if the client has not voided in 3 hr ◉ A nurse is assessing a client who has a long arm cast. For which of the following findings should the nurse monitor when assessing for acute compartment syndrome A. Edema B. Shortness of breath C. Petechiae D. Change in mental status. Answer: A. Edema ◉ A nurse is caring for a client who has opioid use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect? A. Hyperreflexia B. Meiosis (mydriasis)
◉ A nurse is assessing a client who is postoperative following abdominal surgery. The client states, "I feel like my incision ripped open." The nurse notes dehiscence of the incision. Which of the following actions should the nurse take? Med Surg page 670 A. Extend the client's legs above heart level B. Place the client in a low-Fowler's position C. Instruct the client to perform the Valsalva maneuver D. Apply a dry gauze dressing to the incision. Answer: B. Place the client in a low-Fowler's position ◉ A nurse is providing teaching to the parent of a 6-month-old infant who is teething and having difficulty sleeping. Which of the following instructions should the nurse include? A. Rub your child's gums with an aspirin tablet before bedtime B. Place an amber teething necklace on your child before bedtime C. Administer acetaminophen drops to your child before bedtime. Answer: C. Administer acetaminophen drops to your child before bedtime ◉ A nurse is providing dietary teaching to a client who has an increased cholesterol level. Which of the following foods should the nurse recommend? A. Beef liver B. Egg whites
C. Steamed claims D. Broiled lobster. Answer: B. Egg whites ◉ A home health nurse is teaching a guardian about administering tube feedings to their 3-month-old infant. Which of the following information should the nurse include in the teaching? A. Allow the infant to suck on a pacifier during feedings B. Place enough formula for 12 hr in the feeding container C. Change the tube feeding setup every 36 hr D. Flush the tube with 30 mL of water between feedings. Answer: A. Allow the infant to suck on a pacifier during feedings ◉ A nurse is assessing a client who has pericarditis. Which of the following findings is the priority? A. Dependent edema B. Pericardial friction rub C. Paradoxical pulse D. Substernal chest pain. Answer: C. Paradoxical pulse ◉ A charge nurse is creating assignments for the next shift for several nurses and one of the nurses is pregnant. Which of the following clients should the charge nurse assign to a nurse who is not pregnant? A. A 60-year-old client who is recovering from shingles
◉ A nurse is assessing a client who is gravida 2, para 1. The client is at 41 weeks of gestation and is receiving oxytocin for the augmentation of labor. The nurse should decrease the infusion rate for which of the following findings? A. Contractions are strong to palpation B. Cervix is dilating at 1 cm every 4 hr C. Consistent contractions last 80 seconds D. Contractions occur every 90 seconds. Answer: C. Consistent contractions last 80 seconds ◉ A nurse is caring for a client who has constricted pupils, delayed reflexes, and decreased blood pressure. The nurse should identify that these findings are potential manifestations of which of the following? A. Cannabis withdrawal B. Opioid intoxication C. Amphetamine intoxication D. Alcohol withdrawal. Answer: B. Opioid intoxication ◉ A nurse is precepting a nursing student who brings the following client observations to the nurse's attention. Which of the following clients should the nurse assess first? A. A client who is 3 hr post foley catheter removal and has not voided
B. A client who is 3 days postoperative colectomy with a large, loose melena stool C. A client who is 1-day postoperative total hip replacement with a pain level of 7 on a scale of 0 to 10 D. A client who is coughing up pink-tinged sputum following a bronchoscopy and lung biopsy 1 hr ago. Answer: B. A client who is 3 days postoperative colectomy with a large, loose melena stool ◉ A nurse manager is reviewing documentation standards with a group of newly licensed nurses. Which of the following statements should the nurse manager include in the teaching? A. Include the complete name of the medication morphine sulfate B. Do not use a leading zero prior to a decimal point C. Write the letter U when noting the dosage of insulin D. Use the abbreviation QOD when indicating every other day. Answer: A. Include the complete name of the medication morphine sulfate ◉ A nurse is planning care for a newly admitted client. Which of the following interventions should the nurse plan to take first? A. Initiate an IV access for the client B. Administer pain medication to the client C. Send the client to radiology for a CT scan
