ATI RN Comprehensive Predictor 2026: Essential Topics and Rationales for Mastery

Mastery A nurse is caring for a client who is in active labor and notes the fetal heart rate (FHR) baseline is 100/min for the past 15 minutes. Which of the following conditions is a possible cause of fetal bradycardia? A. Maternal fever B. Fetal anemia C. Maternal hypoglycemia D. Chorioamnionitis RATIONALE: Maternal hypoglycemia can lead to decreased fetal glucose availability, resulting in fetal bradycardia. Maternal fever and chorioamnionitis typically cause fetal tachycardia, while fetal anemia may cause variable decelerations but not a sustained baseline bradycardia. A nurse is assessing a school-age child who has a urinary tract infection. Which of the following findings should the nurse expect? A. Periorbital edema B. Decreased frequency of urination C. Enuresis D. Diarrhea RATIONALE: Enuresis (bedwetting) can be a sign of a urinary tract infection in children. Periorbital edema is more associated with kidney disease, decreased urination is not typical in UTI, and diarrhea is not a common symptom. A charge nurse is assisting with emergency response planning following an external disaster. Which current client should be recommended for early discharge? A. A client with COPD and RR 44/min B. A client with cancer with a sealed implant for radiation therapy C. A client receiving heparin for DVT D. A client 1 day postoperative following a vertebroplasty RATIONALE: A stable postoperative client with minimal complications can be discharged early to make room for critical admissions. Clients with respiratory distress, cancer therapy implants, or anticoagulation therapy are higher risk and should remain hospitalized. A nurse is preparing to administer dopamine hydrochloride 4 mcg/kg/min via continuous infusion. The client weighs 80 kg. Available is 800 mg in 250 mL. How many mL/hr should the nurse set the IV to deliver? 6 mL/hr RATIONALE: Correct calculation ensures accurate drug delivery. Other rates could lead to underdosing or overdosing, potentially causing hypotension or tachycardia. A nurse is providing teaching to parents about newborn genetic screening. Which statement should the nurse include? A. "This test should be performed after your baby is 24 hours old." B. "A nurse will draw blood from your baby's inner elbow." C. "Your baby will be given 2 ounces of water to drink prior to the test." D. "This test will be repeated when your baby is 2 months old." RATIONALE: Newborn genetic screening is recommended after 24 hours to allow sufficient metabolic activity for accurate results. Blood is drawn from the heel, not the inner elbow, water is not given, and the test is not typically repeated at 2 months unless indicated. A nurse is providing discharge teaching to a client with a new ascending colostomy. Which statement indicates understanding? A. "My stool will become fully formed within 3 weeks" B. "My skin will need to be cleaned with alcohol before I apply a new pouch" C. "I should avoid eating popcorn and fresh pineapple" D. "I should expect bruising around the stoma" RATIONALE: Certain foods like popcorn and pineapple can cause blockage or irritation at the stoma site. Stool consistency will vary and alcohol can damage skin; bruising is not expected around a healthy stoma. A nurse is admitting a client post-stroke with facial drooping, drooling, and hoarseness. What is the priority action? A. Refer to a speech-language pathologist B. Monitor prealbumin levels C. Measure weight D. Place the client on NPO status RATIONALE: Drooling and facial droop indicate dysphagia, putting the client at risk for aspiration. Placing the client NPO prevents aspiration until a swallowing assessment is completed. Other actions are important but not immediately lifesaving. A nurse is teaching a client with heart failure and new prescription for furosemide. Which statement is correct? A. "Taking furosemide can cause your potassium levels to be high" B. "Eat foods that are high in sodium" C. "Rise slowly when getting out of bed" D. "Taking furosemide can cause you to be overhydrated" RATIONALE: Furosemide is a diuretic that can cause orthostatic hypotension; clients should rise slowly. It can cause hypokalemia, not hyperkalemia. High-sodium foods should be limited, and furosemide causes fluid loss, not overhydration. A nurse is caring for a client who is 2 days postoperative following abdominal surgery. The client reports nausea and vomiting. Which intervention should the nurse implement first? A. Encourage the client to ambulate B. Offer a high-protein snack C. Assess the client’s bowel sounds D. Administer a stool softener RATIONALE: Assessing bowel sounds is the first step to determine if the gastrointestinal system is functioning before implementing interventions. Ambulation, snacks, and stool softeners are secondary until GI status is confirmed. A nurse is caring for a client with a prescription for morphine sulfate 4 mg IV every 4 hours as needed for pain. The client reports a pain level of 8/10. The nurse should: A. Administer morphine sulfate 4 mg IV now B. Hold the medication until the client’s next scheduled dose C. Notify the provider before giving the dose D. Offer non-pharmacologic pain management only RATIONALE: Morphine is indicated for moderate to severe pain and should be administered per prescription. Holding or delaying may increase patient discomfort; non-pharmacologic measures can be adjuncts but are insufficient alone. A nurse is preparing to administer a blood transfusion. Which action is the priority? A. Prime the IV tubing with 0.9% sodium chloride B. Obtain baseline vital signs C. Verify the provider’s prescription D. Verify the client’s blood type and crossmatch with another nurse RATIONALE: Correct blood verification is critical to prevent hemolytic reactions, which can be life-threatening. Other actions are important but secondary to ensuring compatibility. A nurse is teaching a client with asthma about using a metered-dose inhaler (MDI). Which statement indicates correct understanding? A. "I should inhale quickly and forcefully while pressing the canister" B. "I should rinse my mouth after every use of a bronchodilator" C. "I should shake the inhaler before each use" D. "I should use my inhaler only when symptoms occur" RATIONALE: Shaking the inhaler ensures proper medication delivery. Rapid forceful inhalation is incorrect; rinsing is mainly needed after steroid inhalers, and rescue inhalers are used as needed, but maintenance inhalers require scheduled use. A nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which finding requires immediate intervention? A. Hyperglycemia B. Fever and chills C. Mild nausea D. Dry skin RATIONALE: Fever and chills may indicate a catheter-related bloodstream infection, which is an emergency. Hyperglycemia, nausea, and dry skin are common complications but not immediately life-threatening. A nurse is caring for a client with chronic kidney disease who is experiencing hyperkalemia. Which intervention should the nurse implement first? A. Encourage the client to eat a low-potassium diet B. Administer sodium polystyrene sulfonate C. Place the client on a cardiac monitor D. Initiate hemodialysis RATIONALE: Hyperkalemia can cause life-threatening cardiac arrhythmias. Continuous cardiac monitoring is the priority to detect arrhythmias immediately. Dietary changes, medications, and dialysis are secondary interventions.