A Comprehensive and Detailed Overview and Analysis of the
ATI PN Comprehensive Predictor 2023 Examination,
Specifically the Advanced Clinical Judgment Edition,
Designed to Evaluate Practical Nursing Students’ Readiness
for the NCLEX-PN Licensure Exam
ATI PN Comprehensive Predictor 2023 –
Introduction
This practice set is designed to simulate the style and complexity of the ATI PN
Comprehensive Predictor Exit Exam. Each question includes four answer choices
(A, B, C, D) followed by the correct answer and a detailed rationale explaining the
clinical reasoning behind it. Use these questions to assess your knowledge,
identify areas for further review, and build confidence for the proctored exam.
For optimal learning, focus on understanding the rationales rather than
memorizing answers.
1. A nurse is caring for a client who has a prescription for a 24-hour urine
collection to measure creatinine clearance. Which of the following actions should
the nurse take?
A) Discard the first voided specimen
B) Keep the urine container at room temperature
C) Instruct the client to void and save the first morning specimen
D) Collect all urine after the final void of the collection period
Correct Answer: A) Discard the first voided specimen
Rationale: For a 24-hour urine collection, the first voided specimen is discarded
because it represents urine produced before the collection period began. All
subsequent urine is collected for 24 hours, and the final void at the end of the
period is included. The container should be refrigerated or kept on ice to prevent
bacterial growth and breakdown of components.
,2. A nurse is reinforcing teaching with a client who has a new diagnosis of type 2
diabetes mellitus and a prescription for metformin. Which of the following
statements by the client indicates an understanding of the teaching?
A) "I will take this medication on an empty stomach."
B) "I will stop taking this medication if I have muscle pain."
C) "I will monitor my blood glucose levels daily."
D) "I will expect to gain weight while taking this medication."
Correct Answer: C) "I will monitor my blood glucose levels daily."
Rationale: Daily blood glucose monitoring is essential for clients with diabetes to
evaluate medication effectiveness and guide management. Metformin is typically
taken with meals to reduce gastrointestinal side effects. Muscle pain should be
reported as it may indicate lactic acidosis, but the client should not stop the
medication without consulting the provider. Metformin is weight-neutral or may
cause modest weight loss, not weight gain.
3. A nurse is assessing a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following findings should the nurse report to the
provider immediately?
A) Pain level of 4 on a 0-10 scale
B) Urinary output of 30 mL per hour
C) Temperature of 37.8°C (100.0°F)
D) Shortness of breath
Correct Answer: D) Shortness of breath
Rationale: Shortness of breath in a postoperative client may indicate pulmonary
embolism, a life-threatening complication following hip surgery. This finding
requires immediate reporting and intervention. Mild pain is expected. Urinary
output of 30 mL/hr is within normal limits (minimum 30 mL/hr). Low-grade fever
is common postoperatively due to inflammatory response.
,4. A nurse is reinforcing teaching with a client who has a new prescription for
warfarin. Which of the following statements by the client indicates a need for
further teaching?
A) "I will use a soft-bristled toothbrush."
B) "I will eat the same amount of green leafy vegetables each week."
C) "I will take ibuprofen if I have a headache."
D) "I will have my INR checked regularly."
Correct Answer: C) "I will take ibuprofen if I have a headache."
Rationale: Ibuprofen (NSAID) increases bleeding risk when taken with warfarin.
Clients should use acetaminophen for pain or headache. Soft-bristled
toothbrushes reduce gum bleeding. Consistent intake of vitamin K (green leafy
vegetables) helps maintain stable INR. Regular INR monitoring is essential for
warfarin therapy.
5. A nurse is caring for a client who has a chest tube following a lobectomy. Which
of the following findings should the nurse report to the provider?
A) Drainage of 75 mL in the first hour
B) Tidaling in the water seal chamber
C) Continuous bubbling in the water seal chamber
D) Crepitus around the insertion site
Correct Answer: C) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak,
which requires intervention. Drainage of up to 100 mL in the first hour is
expected. Tidaling (fluctuation with respirations) is normal. Crepitus
(subcutaneous emphysema) should be monitored but is not immediately critical
unless extensive.
6. A nurse is reinforcing teaching with a client who is scheduled for a colonoscopy.
Which of the following instructions should the nurse include?
, A) "You may have a light breakfast the morning of the procedure."
B) "You will need to follow a clear liquid diet for 24 hours before."
C) "You should stop taking all medications 3 days before."
D) "You will be fully awake during the procedure."
Correct Answer: B) "You will need to follow a clear liquid diet for 24 hours
before."
Rationale: A clear liquid diet is required for 24 hours prior to colonoscopy to
ensure adequate bowel cleansing. Clients are typically NPO after midnight. Clients
should not stop essential medications without provider guidance. Moderate
sedation is used, so the client is not fully awake.
7. A nurse is assessing a client who has hyperthyroidism. Which of the following
findings should the nurse expect?
A) Bradycardia
B) Weight gain
C) Cold intolerance
D) Exophthalmos
Correct Answer: D) Exophthalmos
Rationale: Exophthalmos (protruding eyes) is associated with Graves' disease, a
common cause of hyperthyroidism. Other findings include tachycardia, weight
loss, and heat intolerance. Bradycardia, weight gain, and cold intolerance are
associated with hypothyroidism.
8. A nurse is caring for a client who is receiving a blood transfusion and reports
chills and back pain. Which of the following actions should the nurse take first?
A) Stop the transfusion
B) Notify the provider
C) Administer acetaminophen
D) Obtain a urine specimen
Correct Answer: A) Stop the transfusion
ATI PN Comprehensive Predictor 2023 Examination,
Specifically the Advanced Clinical Judgment Edition,
Designed to Evaluate Practical Nursing Students’ Readiness
for the NCLEX-PN Licensure Exam
ATI PN Comprehensive Predictor 2023 –
Introduction
This practice set is designed to simulate the style and complexity of the ATI PN
Comprehensive Predictor Exit Exam. Each question includes four answer choices
(A, B, C, D) followed by the correct answer and a detailed rationale explaining the
clinical reasoning behind it. Use these questions to assess your knowledge,
identify areas for further review, and build confidence for the proctored exam.
For optimal learning, focus on understanding the rationales rather than
memorizing answers.
1. A nurse is caring for a client who has a prescription for a 24-hour urine
collection to measure creatinine clearance. Which of the following actions should
the nurse take?
A) Discard the first voided specimen
B) Keep the urine container at room temperature
C) Instruct the client to void and save the first morning specimen
D) Collect all urine after the final void of the collection period
Correct Answer: A) Discard the first voided specimen
Rationale: For a 24-hour urine collection, the first voided specimen is discarded
because it represents urine produced before the collection period began. All
subsequent urine is collected for 24 hours, and the final void at the end of the
period is included. The container should be refrigerated or kept on ice to prevent
bacterial growth and breakdown of components.
,2. A nurse is reinforcing teaching with a client who has a new diagnosis of type 2
diabetes mellitus and a prescription for metformin. Which of the following
statements by the client indicates an understanding of the teaching?
A) "I will take this medication on an empty stomach."
B) "I will stop taking this medication if I have muscle pain."
C) "I will monitor my blood glucose levels daily."
D) "I will expect to gain weight while taking this medication."
Correct Answer: C) "I will monitor my blood glucose levels daily."
Rationale: Daily blood glucose monitoring is essential for clients with diabetes to
evaluate medication effectiveness and guide management. Metformin is typically
taken with meals to reduce gastrointestinal side effects. Muscle pain should be
reported as it may indicate lactic acidosis, but the client should not stop the
medication without consulting the provider. Metformin is weight-neutral or may
cause modest weight loss, not weight gain.
3. A nurse is assessing a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following findings should the nurse report to the
provider immediately?
A) Pain level of 4 on a 0-10 scale
B) Urinary output of 30 mL per hour
C) Temperature of 37.8°C (100.0°F)
D) Shortness of breath
Correct Answer: D) Shortness of breath
Rationale: Shortness of breath in a postoperative client may indicate pulmonary
embolism, a life-threatening complication following hip surgery. This finding
requires immediate reporting and intervention. Mild pain is expected. Urinary
output of 30 mL/hr is within normal limits (minimum 30 mL/hr). Low-grade fever
is common postoperatively due to inflammatory response.
,4. A nurse is reinforcing teaching with a client who has a new prescription for
warfarin. Which of the following statements by the client indicates a need for
further teaching?
A) "I will use a soft-bristled toothbrush."
B) "I will eat the same amount of green leafy vegetables each week."
C) "I will take ibuprofen if I have a headache."
D) "I will have my INR checked regularly."
Correct Answer: C) "I will take ibuprofen if I have a headache."
Rationale: Ibuprofen (NSAID) increases bleeding risk when taken with warfarin.
Clients should use acetaminophen for pain or headache. Soft-bristled
toothbrushes reduce gum bleeding. Consistent intake of vitamin K (green leafy
vegetables) helps maintain stable INR. Regular INR monitoring is essential for
warfarin therapy.
5. A nurse is caring for a client who has a chest tube following a lobectomy. Which
of the following findings should the nurse report to the provider?
A) Drainage of 75 mL in the first hour
B) Tidaling in the water seal chamber
C) Continuous bubbling in the water seal chamber
D) Crepitus around the insertion site
Correct Answer: C) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak,
which requires intervention. Drainage of up to 100 mL in the first hour is
expected. Tidaling (fluctuation with respirations) is normal. Crepitus
(subcutaneous emphysema) should be monitored but is not immediately critical
unless extensive.
6. A nurse is reinforcing teaching with a client who is scheduled for a colonoscopy.
Which of the following instructions should the nurse include?
, A) "You may have a light breakfast the morning of the procedure."
B) "You will need to follow a clear liquid diet for 24 hours before."
C) "You should stop taking all medications 3 days before."
D) "You will be fully awake during the procedure."
Correct Answer: B) "You will need to follow a clear liquid diet for 24 hours
before."
Rationale: A clear liquid diet is required for 24 hours prior to colonoscopy to
ensure adequate bowel cleansing. Clients are typically NPO after midnight. Clients
should not stop essential medications without provider guidance. Moderate
sedation is used, so the client is not fully awake.
7. A nurse is assessing a client who has hyperthyroidism. Which of the following
findings should the nurse expect?
A) Bradycardia
B) Weight gain
C) Cold intolerance
D) Exophthalmos
Correct Answer: D) Exophthalmos
Rationale: Exophthalmos (protruding eyes) is associated with Graves' disease, a
common cause of hyperthyroidism. Other findings include tachycardia, weight
loss, and heat intolerance. Bradycardia, weight gain, and cold intolerance are
associated with hypothyroidism.
8. A nurse is caring for a client who is receiving a blood transfusion and reports
chills and back pain. Which of the following actions should the nurse take first?
A) Stop the transfusion
B) Notify the provider
C) Administer acetaminophen
D) Obtain a urine specimen
Correct Answer: A) Stop the transfusion
