ATI RN Comprehensive Predictor 2026/2027
| Practice Questions & Verified Answers |
Comprehensive Nursing Exam Review
Question 1
A charge nurse is making client assignments for the oncoming
shift. The unit has four clients and four staff members: one RN,
one LPN/LVN, and two assistive personnel (AP). Which client
should the charge nurse assign to the RN?
Client Roster:
Client A: 72-year-old with heart failure receiving IV
furosemide, reports increasing shortness of breath
Client B: 45-year-old post-appendectomy, day 2, requesting
assistance with ambulation
Client C: 68-year-old with stable chronic obstructive pulmonary
disease (COPD) requiring routine vital signs
Client D: 55-year-old with diabetes requiring a blood glucose
check before lunch
Options:
A. Client A
B. Client B
C. Client C
D. Client D
,Correct Answer: A
Detailed Rationale:
The RN is responsible for clients whose conditions are unstable,
complex, or require ongoing assessment and clinical judgment.
Client A has heart failure and is receiving IV furosemide—a
potent loop diuretic—and is now reporting increasing shortness
of breath. This finding suggests possible fluid overload,
worsening heart failure, or pulmonary edema. The RN must
assess respiratory status, lung sounds, oxygen saturation, and
response to diuretic therapy. The client's condition is unstable
and requires the RN's scope of practice for assessment,
interpretation of findings, and intervention. The LPN/LVN
could administer routine medications and perform focused
assessments, but the unstable cardiac client requires the RN's
clinical judgment. Assistive personnel can perform vital signs
and ambulation for stable clients. The principle here is: assign
unstable, complex, or unpredictable clients to the RN; stable,
predictable clients can be delegated to LPN/LVN or AP within
their scope.
Why Each Distractor Is Incorrect:
B: Client B is post-operative day 2 and requesting assistance
with ambulation. This is a stable, predictable task that can be
delegated to assistive personnel (AP) or the LPN/LVN,
depending on facility policy and the AP's competency. The RN
does not need to perform this task.
C: Client C has stable COPD and requires routine vital signs.
This is a stable, chronic condition with no acute changes. This
,can be assigned to the LPN/LVN or AP.
D: Client D requires a blood glucose check before lunch. This is
a routine, predictable task that can be delegated to the LPN/LVN
or, in many facilities, to assistive personnel who have been
trained and validated in this skill. The RN does not need to
perform this task when more acute clients require attention.
Clinical Pearl: "Unstable = RN. Stable = LPN/LVN or AP." Use
the ABCs (Airway, Breathing, Circulation) plus acute change in
condition as your prioritization framework when assigning
clients.
Learning Objective: Apply principles of delegation and
assignment to determine the appropriate staff member for a
given client based on acuity and scope of practice.
Difficulty Level: Moderate
Cognitive Level: Clinical Judgment
Question 2
A nurse is caring for four clients. Which client should the nurse
assess first?
Options:
A. A client who is 2 days post-operative and reports incisional
pain rated 6/10
B. A client with pneumonia who has an oxygen saturation of
89% on room air
C. A client with diabetes who has a blood glucose of 210 mg/dL
, D. A client who is scheduled for discharge and needs discharge
teaching
Correct Answer: B
Detailed Rationale:
The nurse should prioritize assessment based on the ABCs—
Airway, Breathing, Circulation. An oxygen saturation of 89% on
room air indicates hypoxemia and potential respiratory
compromise. This client is at risk for further desaturation,
respiratory failure, and inadequate tissue perfusion. The nurse
must assess lung sounds, respiratory rate, work of breathing, and
initiate supplemental oxygen as prescribed. This is a
physiological need that takes precedence over pain, chronic
hyperglycemia, or discharge teaching. Using Maslow's
hierarchy, oxygenation is a basic physiological need that must
be met before higher-level needs such as comfort, education, or
psychosocial support.
Why Each Distractor Is Incorrect:
A: Incisional pain at 6/10 is important to address for comfort,
but it is not immediately life-threatening. Pain management can
be addressed after the hypoxemic client is stabilized. The nurse
can delegate pain assessment follow-up or medicate after the
critical client is addressed.
C: A blood glucose of 210 mg/dL is elevated but not
immediately dangerous in the acute setting (typically requires
intervention for values >250–300 mg/dL with symptoms of
hyperglycemia or ketosis). This is a chronic management issue
| Practice Questions & Verified Answers |
Comprehensive Nursing Exam Review
Question 1
A charge nurse is making client assignments for the oncoming
shift. The unit has four clients and four staff members: one RN,
one LPN/LVN, and two assistive personnel (AP). Which client
should the charge nurse assign to the RN?
Client Roster:
Client A: 72-year-old with heart failure receiving IV
furosemide, reports increasing shortness of breath
Client B: 45-year-old post-appendectomy, day 2, requesting
assistance with ambulation
Client C: 68-year-old with stable chronic obstructive pulmonary
disease (COPD) requiring routine vital signs
Client D: 55-year-old with diabetes requiring a blood glucose
check before lunch
Options:
A. Client A
B. Client B
C. Client C
D. Client D
,Correct Answer: A
Detailed Rationale:
The RN is responsible for clients whose conditions are unstable,
complex, or require ongoing assessment and clinical judgment.
Client A has heart failure and is receiving IV furosemide—a
potent loop diuretic—and is now reporting increasing shortness
of breath. This finding suggests possible fluid overload,
worsening heart failure, or pulmonary edema. The RN must
assess respiratory status, lung sounds, oxygen saturation, and
response to diuretic therapy. The client's condition is unstable
and requires the RN's scope of practice for assessment,
interpretation of findings, and intervention. The LPN/LVN
could administer routine medications and perform focused
assessments, but the unstable cardiac client requires the RN's
clinical judgment. Assistive personnel can perform vital signs
and ambulation for stable clients. The principle here is: assign
unstable, complex, or unpredictable clients to the RN; stable,
predictable clients can be delegated to LPN/LVN or AP within
their scope.
Why Each Distractor Is Incorrect:
B: Client B is post-operative day 2 and requesting assistance
with ambulation. This is a stable, predictable task that can be
delegated to assistive personnel (AP) or the LPN/LVN,
depending on facility policy and the AP's competency. The RN
does not need to perform this task.
C: Client C has stable COPD and requires routine vital signs.
This is a stable, chronic condition with no acute changes. This
,can be assigned to the LPN/LVN or AP.
D: Client D requires a blood glucose check before lunch. This is
a routine, predictable task that can be delegated to the LPN/LVN
or, in many facilities, to assistive personnel who have been
trained and validated in this skill. The RN does not need to
perform this task when more acute clients require attention.
Clinical Pearl: "Unstable = RN. Stable = LPN/LVN or AP." Use
the ABCs (Airway, Breathing, Circulation) plus acute change in
condition as your prioritization framework when assigning
clients.
Learning Objective: Apply principles of delegation and
assignment to determine the appropriate staff member for a
given client based on acuity and scope of practice.
Difficulty Level: Moderate
Cognitive Level: Clinical Judgment
Question 2
A nurse is caring for four clients. Which client should the nurse
assess first?
Options:
A. A client who is 2 days post-operative and reports incisional
pain rated 6/10
B. A client with pneumonia who has an oxygen saturation of
89% on room air
C. A client with diabetes who has a blood glucose of 210 mg/dL
, D. A client who is scheduled for discharge and needs discharge
teaching
Correct Answer: B
Detailed Rationale:
The nurse should prioritize assessment based on the ABCs—
Airway, Breathing, Circulation. An oxygen saturation of 89% on
room air indicates hypoxemia and potential respiratory
compromise. This client is at risk for further desaturation,
respiratory failure, and inadequate tissue perfusion. The nurse
must assess lung sounds, respiratory rate, work of breathing, and
initiate supplemental oxygen as prescribed. This is a
physiological need that takes precedence over pain, chronic
hyperglycemia, or discharge teaching. Using Maslow's
hierarchy, oxygenation is a basic physiological need that must
be met before higher-level needs such as comfort, education, or
psychosocial support.
Why Each Distractor Is Incorrect:
A: Incisional pain at 6/10 is important to address for comfort,
but it is not immediately life-threatening. Pain management can
be addressed after the hypoxemic client is stabilized. The nurse
can delegate pain assessment follow-up or medicate after the
critical client is addressed.
C: A blood glucose of 210 mg/dL is elevated but not
immediately dangerous in the acute setting (typically requires
intervention for values >250–300 mg/dL with symptoms of
hyperglycemia or ketosis). This is a chronic management issue
