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ATI Comprehensive Practice Assessments |
200 Advanced NGN-Aligned Questions with Verified Answers &
Detailed Rationales | Complete Review for ATI RN Comprehensive
Predictor & Nursing Exit Exams | Graded A+
SECTION 1: MANAGEMENT OF CARE – DELEGATION, PRIORITIZATION,
AND LEGAL/ETHICAL ISSUES (Questions 1–30)
1. A charge nurse is making assignments on a medical-surgical unit.
Which client should the charge nurse assign to the LPN/LVN?
A. A client with a new tracheostomy requiring frequent suctioning
B. A client who is 1 hour post-hip replacement with a blood pressure of
88/52 mmHg
C. A client with diabetes who requires a sterile wound dressing change
D. A client with hypertension who needs oral medications administered
Valid answer: D
Rationale: LPNs can administer oral medications to stable clients. Clients
with new tracheostomies (unstable airway), post-surgical hypotension
(unstable), and sterile wound dressing changes (requires RN assessment
and sterile technique) should be assigned to RNs. Task delegation must
match scope of practice.
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2. A nurse is preparing to delegate tasks to an unlicensed assistive
personnel (UAP). Which task is appropriate for the nurse to delegate?
A. Administering a blood transfusion
B. Performing a sterile wound dressing change
C. Assisting a client with ambulation using a gait belt
D. Assessing a client's lung sounds
Valid answer: C
Rationale: UAPs can assist with activities of daily living, including
ambulation with a gait belt. RNs must perform sterile procedures,
administer blood products, and conduct assessments.
3. A nurse receives handoff report on four clients. Which client should
the nurse see FIRST?
A. A client with pneumonia with an oxygen saturation of 91% on 3L nasal
cannula
B. A client with diabetes with a blood glucose of 180 mg/dL
C. A client with a fractured femur reporting pain of 6 on a 0–10 scale
D. A client with a urinary tract infection with a temperature of 100.4°F
(38°C)
Valid answer: A
Rationale: The client with an oxygen saturation of 91% is experiencing
hypoxia and requires immediate assessment and intervention (ABCs—
Airway, Breathing, Circulation). The other clients are stable and can be seen
after addressing the hypoxic client.
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4. A client with a valid Do Not Resuscitate (DNR) order becomes
pulseless and apneic. The client's family member demands that the
nurse "do everything." What should the nurse do FIRST?
A. Initiate CPR immediately per the family's request
B. Respect the DNR order and provide comfort measures while supporting
the family
C. Page the provider for clarification of the DNR order
D. Call the hospital ethics committee for consultation
Valid answer: B
Rationale: A valid DNR order must be respected. The nurse should provide
comfort measures and support the family, explaining the DNR order
compassionately. CPR should not be initiated against a valid DNR.
5. A nurse suspects a colleague is impaired due to the smell of alcohol
on their breath. What is the priority action?
A. Confront the colleague privately
B. Notify the nursing supervisor immediately
C. Ignore the situation to avoid conflict
D. Ask the colleague to go home for the day
Valid answer: B
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Rationale: Patient safety is paramount. The nurse must report suspected
impairment to the nursing supervisor immediately to ensure patient safety
and follow legal and ethical obligations.
6. A client refuses a blood transfusion due to religious beliefs. What is
the nurse's BEST response?
A. Document the refusal and notify the provider
B. Explain the consequences of refusing the transfusion
C. Ask the family to convince the client to accept the transfusion
D. Administer the transfusion and document the client's objection
Valid answer: A
Rationale: The nurse must respect client autonomy. The provider should be
notified so alternatives can be discussed. The refusal should be
documented, and care should continue within the client's wishes.
7. A nurse manager is discussing "just culture" with staff. Which
statement reflects this concept?
A. "We analyze system failures, not just individual mistakes"
B. "All errors should result in disciplinary action"
C. "Staff should be blamed for all adverse events"
D. "Just culture means no one is ever held accountable"
Valid answer: A
ATI Comprehensive Practice Assessments |
200 Advanced NGN-Aligned Questions with Verified Answers &
Detailed Rationales | Complete Review for ATI RN Comprehensive
Predictor & Nursing Exit Exams | Graded A+
SECTION 1: MANAGEMENT OF CARE – DELEGATION, PRIORITIZATION,
AND LEGAL/ETHICAL ISSUES (Questions 1–30)
1. A charge nurse is making assignments on a medical-surgical unit.
Which client should the charge nurse assign to the LPN/LVN?
A. A client with a new tracheostomy requiring frequent suctioning
B. A client who is 1 hour post-hip replacement with a blood pressure of
88/52 mmHg
C. A client with diabetes who requires a sterile wound dressing change
D. A client with hypertension who needs oral medications administered
Valid answer: D
Rationale: LPNs can administer oral medications to stable clients. Clients
with new tracheostomies (unstable airway), post-surgical hypotension
(unstable), and sterile wound dressing changes (requires RN assessment
and sterile technique) should be assigned to RNs. Task delegation must
match scope of practice.
, 2
2. A nurse is preparing to delegate tasks to an unlicensed assistive
personnel (UAP). Which task is appropriate for the nurse to delegate?
A. Administering a blood transfusion
B. Performing a sterile wound dressing change
C. Assisting a client with ambulation using a gait belt
D. Assessing a client's lung sounds
Valid answer: C
Rationale: UAPs can assist with activities of daily living, including
ambulation with a gait belt. RNs must perform sterile procedures,
administer blood products, and conduct assessments.
3. A nurse receives handoff report on four clients. Which client should
the nurse see FIRST?
A. A client with pneumonia with an oxygen saturation of 91% on 3L nasal
cannula
B. A client with diabetes with a blood glucose of 180 mg/dL
C. A client with a fractured femur reporting pain of 6 on a 0–10 scale
D. A client with a urinary tract infection with a temperature of 100.4°F
(38°C)
Valid answer: A
Rationale: The client with an oxygen saturation of 91% is experiencing
hypoxia and requires immediate assessment and intervention (ABCs—
Airway, Breathing, Circulation). The other clients are stable and can be seen
after addressing the hypoxic client.
, 3
4. A client with a valid Do Not Resuscitate (DNR) order becomes
pulseless and apneic. The client's family member demands that the
nurse "do everything." What should the nurse do FIRST?
A. Initiate CPR immediately per the family's request
B. Respect the DNR order and provide comfort measures while supporting
the family
C. Page the provider for clarification of the DNR order
D. Call the hospital ethics committee for consultation
Valid answer: B
Rationale: A valid DNR order must be respected. The nurse should provide
comfort measures and support the family, explaining the DNR order
compassionately. CPR should not be initiated against a valid DNR.
5. A nurse suspects a colleague is impaired due to the smell of alcohol
on their breath. What is the priority action?
A. Confront the colleague privately
B. Notify the nursing supervisor immediately
C. Ignore the situation to avoid conflict
D. Ask the colleague to go home for the day
Valid answer: B
, 4
Rationale: Patient safety is paramount. The nurse must report suspected
impairment to the nursing supervisor immediately to ensure patient safety
and follow legal and ethical obligations.
6. A client refuses a blood transfusion due to religious beliefs. What is
the nurse's BEST response?
A. Document the refusal and notify the provider
B. Explain the consequences of refusing the transfusion
C. Ask the family to convince the client to accept the transfusion
D. Administer the transfusion and document the client's objection
Valid answer: A
Rationale: The nurse must respect client autonomy. The provider should be
notified so alternatives can be discussed. The refusal should be
documented, and care should continue within the client's wishes.
7. A nurse manager is discussing "just culture" with staff. Which
statement reflects this concept?
A. "We analyze system failures, not just individual mistakes"
B. "All errors should result in disciplinary action"
C. "Staff should be blamed for all adverse events"
D. "Just culture means no one is ever held accountable"
Valid answer: A
