2026 ATI PN Comprehensive Predictor Exit Exam |
Level 3 | Comprehensive Practice and Review |
Questions with Rationales
1. A nurse is caring for a client who is 1 day postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
• A. Place a pillow between the client's legs when turning.
• B. Keep the client's hip flexed at a 90-degree angle.
• C. Encourage the client to cross their legs when sitting.
• D. Position the client on the operative side for the first 24 hours.
Correct Answer: A. Place a pillow between the client's legs when turning.
Rationale: Placing a pillow (abduction pillow) between the legs maintains the
hip in an abducted position, preventing dislocation of the new hip prosthesis.
Flexing the hip beyond 90 degrees, crossing the legs, or turning onto the operative
side without proper precautions can increase the risk of dislocation.
2. A nurse is reinforcing teaching with a client who has a new prescription for
furosemide. Which of the following instructions should the nurse include?
• A. "Take this medication in the evening before bed."
• B. "Increase your intake of potassium-rich foods."
• C. "Expect your blood pressure to increase."
• D. "Limit your fluid intake to 1 liter per day."
Correct Answer: B. "Increase your intake of potassium-rich foods."
Rationale: Furosemide is a loop diuretic that can cause hypokalemia (low
potassium). The nurse should instruct the client to consume potassium-rich foods
like bananas, oranges, and potatoes. Taking the medication in the evening can
cause nocturia. Furosemide is used to decrease blood pressure, not increase it.
,3. A nurse is assessing a client who is at 38 weeks of gestation. Which of the
following findings should the nurse report to the provider?
• A. Vaginal spotting after a pelvic exam.
• B. A blood pressure of 138/88 mm Hg.
• C. A sudden gush of clear fluid from the vagina.
• D. Irregular, painless contractions.
Correct Answer: C. A sudden gush of clear fluid from the vagina.
Rationale: A sudden gush of clear fluid indicates a rupture of membranes
(ROM). This finding must be reported immediately as it increases the risk of
infection and cord prolapse. Irregular, painless contractions (Braxton Hicks) are
common. A blood pressure of 138/88 is within normal limits for pregnancy.
Spotting after a pelvic exam can be a normal finding.
4. A nurse is caring for a toddler who is experiencing severe dehydration. Which
of the following findings should the nurse expect?
• A. Bulging fontanels.
• B. Capillary refill of 2 seconds.
• C. Urine specific gravity of 1.005.
• D. Tachycardia.
Correct Answer: D. Tachycardia.
Rationale: Tachycardia is an early sign of dehydration as the body attempts to
maintain cardiac output. Other signs include dry mucous membranes, poor skin
turgor, and oliguria. A bulging fontanel is a sign of increased intracranial pressure.
A capillary refill of 2 seconds is within normal limits. A urine specific gravity of
1.005 is very dilute, which is not expected in dehydration.
5. A nurse is assisting with the care of a client who has major depressive
disorder and is not eating. Which of the following actions should the nurse take
first?
, • A. Encourage the client to eat with other clients.
• B. Weigh the client daily.
• C. Sit with the client during meals.
• D. Offer the client high-calorie finger foods.
Correct Answer: C. Sit with the client during meals.
Rationale: The first action is to establish a therapeutic relationship and
provide support. Sitting with the client during meals provides companionship and
encouragement, which can help reduce feelings of isolation and may improve
their willingness to eat. The other options are appropriate but not the first
priority.
6. A nurse is preparing to administer digoxin to a client who has heart failure.
Which of the following findings should the nurse report to the provider before
administering the medication?
• A. Heart rate of 68/min.
• B. Potassium level of 3.2 mEq/L.
• C. Blood pressure of 110/70 mm Hg.
• D. Weight loss of 1 kg (2.2 lb) in 24 hours.
Correct Answer: B. Potassium level of 3.2 mEq/L.
Rationale: Hypokalemia increases the risk of digoxin toxicity. A potassium
level of 3.2 mEq/L is below the expected reference range (3.5-5.0 mEq/L). The
nurse should hold the digoxin and notify the provider. A heart rate of 68/min is
within the expected range for administration (hold if <60/min in adults). The other
findings are not contraindications.
7. A nurse is reinforcing teaching with a client who has a new prescription for
warfarin. Which of the following statements by the client indicates an
understanding of the teaching?
• A. "I will increase my intake of leafy green vegetables."
, • B. "I will take aspirin for headaches."
• C. "I will use a soft toothbrush."
• D. "I will double my dose if I miss one."
Correct Answer: C. "I will use a soft toothbrush."
Rationale: Warfarin is an anticoagulant, which increases the risk of bleeding.
Using a soft toothbrush helps prevent bleeding gums. The client should maintain a
consistent intake of leafy green vegetables (which contain vitamin K), not increase
it. Aspirin can increase the risk of bleeding and should be avoided. The client
should never double a dose of warfarin.
8. A nurse is assessing a client who is 2 hours postpartum. The nurse notes the
client's fundus is boggy and located above the umbilicus. Which of the following
actions should the nurse take first?
• A. Notify the provider.
• B. Massage the fundus.
• C. Administer a uterotonic medication.
• D. Have the client empty her bladder.
Correct Answer: B. Massage the fundus.
Rationale: A boggy, elevated fundus indicates uterine atony, which is the most
common cause of postpartum hemorrhage. The first action is to massage the
fundus to stimulate contraction. If the fundus remains boggy after massage, the
nurse should then notify the provider and administer medications as prescribed.
Emptying the bladder can help if a full bladder is displacing the uterus.
9. A nurse is caring for a client who is experiencing alcohol withdrawal. Which of
the following findings should the nurse expect?
• A. Bradycardia.
• B. Hypotension.
• C. Tremors.
Level 3 | Comprehensive Practice and Review |
Questions with Rationales
1. A nurse is caring for a client who is 1 day postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
• A. Place a pillow between the client's legs when turning.
• B. Keep the client's hip flexed at a 90-degree angle.
• C. Encourage the client to cross their legs when sitting.
• D. Position the client on the operative side for the first 24 hours.
Correct Answer: A. Place a pillow between the client's legs when turning.
Rationale: Placing a pillow (abduction pillow) between the legs maintains the
hip in an abducted position, preventing dislocation of the new hip prosthesis.
Flexing the hip beyond 90 degrees, crossing the legs, or turning onto the operative
side without proper precautions can increase the risk of dislocation.
2. A nurse is reinforcing teaching with a client who has a new prescription for
furosemide. Which of the following instructions should the nurse include?
• A. "Take this medication in the evening before bed."
• B. "Increase your intake of potassium-rich foods."
• C. "Expect your blood pressure to increase."
• D. "Limit your fluid intake to 1 liter per day."
Correct Answer: B. "Increase your intake of potassium-rich foods."
Rationale: Furosemide is a loop diuretic that can cause hypokalemia (low
potassium). The nurse should instruct the client to consume potassium-rich foods
like bananas, oranges, and potatoes. Taking the medication in the evening can
cause nocturia. Furosemide is used to decrease blood pressure, not increase it.
,3. A nurse is assessing a client who is at 38 weeks of gestation. Which of the
following findings should the nurse report to the provider?
• A. Vaginal spotting after a pelvic exam.
• B. A blood pressure of 138/88 mm Hg.
• C. A sudden gush of clear fluid from the vagina.
• D. Irregular, painless contractions.
Correct Answer: C. A sudden gush of clear fluid from the vagina.
Rationale: A sudden gush of clear fluid indicates a rupture of membranes
(ROM). This finding must be reported immediately as it increases the risk of
infection and cord prolapse. Irregular, painless contractions (Braxton Hicks) are
common. A blood pressure of 138/88 is within normal limits for pregnancy.
Spotting after a pelvic exam can be a normal finding.
4. A nurse is caring for a toddler who is experiencing severe dehydration. Which
of the following findings should the nurse expect?
• A. Bulging fontanels.
• B. Capillary refill of 2 seconds.
• C. Urine specific gravity of 1.005.
• D. Tachycardia.
Correct Answer: D. Tachycardia.
Rationale: Tachycardia is an early sign of dehydration as the body attempts to
maintain cardiac output. Other signs include dry mucous membranes, poor skin
turgor, and oliguria. A bulging fontanel is a sign of increased intracranial pressure.
A capillary refill of 2 seconds is within normal limits. A urine specific gravity of
1.005 is very dilute, which is not expected in dehydration.
5. A nurse is assisting with the care of a client who has major depressive
disorder and is not eating. Which of the following actions should the nurse take
first?
, • A. Encourage the client to eat with other clients.
• B. Weigh the client daily.
• C. Sit with the client during meals.
• D. Offer the client high-calorie finger foods.
Correct Answer: C. Sit with the client during meals.
Rationale: The first action is to establish a therapeutic relationship and
provide support. Sitting with the client during meals provides companionship and
encouragement, which can help reduce feelings of isolation and may improve
their willingness to eat. The other options are appropriate but not the first
priority.
6. A nurse is preparing to administer digoxin to a client who has heart failure.
Which of the following findings should the nurse report to the provider before
administering the medication?
• A. Heart rate of 68/min.
• B. Potassium level of 3.2 mEq/L.
• C. Blood pressure of 110/70 mm Hg.
• D. Weight loss of 1 kg (2.2 lb) in 24 hours.
Correct Answer: B. Potassium level of 3.2 mEq/L.
Rationale: Hypokalemia increases the risk of digoxin toxicity. A potassium
level of 3.2 mEq/L is below the expected reference range (3.5-5.0 mEq/L). The
nurse should hold the digoxin and notify the provider. A heart rate of 68/min is
within the expected range for administration (hold if <60/min in adults). The other
findings are not contraindications.
7. A nurse is reinforcing teaching with a client who has a new prescription for
warfarin. Which of the following statements by the client indicates an
understanding of the teaching?
• A. "I will increase my intake of leafy green vegetables."
, • B. "I will take aspirin for headaches."
• C. "I will use a soft toothbrush."
• D. "I will double my dose if I miss one."
Correct Answer: C. "I will use a soft toothbrush."
Rationale: Warfarin is an anticoagulant, which increases the risk of bleeding.
Using a soft toothbrush helps prevent bleeding gums. The client should maintain a
consistent intake of leafy green vegetables (which contain vitamin K), not increase
it. Aspirin can increase the risk of bleeding and should be avoided. The client
should never double a dose of warfarin.
8. A nurse is assessing a client who is 2 hours postpartum. The nurse notes the
client's fundus is boggy and located above the umbilicus. Which of the following
actions should the nurse take first?
• A. Notify the provider.
• B. Massage the fundus.
• C. Administer a uterotonic medication.
• D. Have the client empty her bladder.
Correct Answer: B. Massage the fundus.
Rationale: A boggy, elevated fundus indicates uterine atony, which is the most
common cause of postpartum hemorrhage. The first action is to massage the
fundus to stimulate contraction. If the fundus remains boggy after massage, the
nurse should then notify the provider and administer medications as prescribed.
Emptying the bladder can help if a full bladder is displacing the uterus.
9. A nurse is caring for a client who is experiencing alcohol withdrawal. Which of
the following findings should the nurse expect?
• A. Bradycardia.
• B. Hypotension.
• C. Tremors.
