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ATI RN Comprehensive Predictor — 100 Original Practice Questions
Management of Care & Prioritization (1–15)
1. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A) Client with COPD and SpO₂ 89% on 2 L nasal cannula
B) Client post-appendectomy day 2 with temperature 38.3°C
C) Client with heart failure and 3+ pitting edema
D) Client with new onset confusion and bounding pulse
Answer: D. New onset confusion with bounding pulse suggests hypercapnia or fluid overload
affecting cerebral perfusion. This is a change in neurological status, which is always the
priority. Option A is expected in COPD; Option B is post-op inflammation; Option C is a
chronic finding .
2. A charge nurse is assigning clients. Which client should be assigned to the LPN?
A) Client 1 hour post-cardiac catheterization with bleeding
B) Client with stable diabetes requiring insulin and foot care
C) Client newly admitted with stroke and altered mental status
D) Client receiving IV heparin with PTT of 98 seconds
Answer: B. LPNs can administer insulin, perform stable wound care, and monitor stable
clients. Options A, C, and D require RN assessment (bleeding, neurological changes, critical
lab monitoring) .
3. A nurse witnesses a colleague diverting narcotics. What is the priority action?
A) Confront the colleague privately
B) Report to the nurse manager immediately
C) Ignore it to avoid conflict
D) Document in the client's chart
Answer: B. Impaired practice must be reported to management/administration to protect
client safety. Confrontation is unsafe and not the nurse's role .
4. A client refuses a blood transfusion due to religious beliefs. Which actions should the
nurse take? (Select all that apply.)
A) Verify the patient understands risks
B) Document the refusal
C) Administer the transfusion if Hgb is critical
D) Notify the provider
E) Ask the family to override the decision
Answer: A, B, D. Competent adults have autonomy. The nurse ensures informed refusal,
documents, and notifies the provider. Forcing treatment or involving family to override is
unethical .
5. A nurse is delegating tasks to an AP. Which task is appropriate to delegate?
A) Teaching a client about insulin administration
, 2
B) Ambulating a stable client
C) Assessing a post-op client's incision
D) Administering oral medications
Answer: B. Ambulating a stable client is within AP scope. Teaching, assessing, and
medication administration require an RN .
6. A nurse delegates vital signs to an assistive personnel (AP). Which client should the AP
NOT be assigned to?
A) Client with pneumonia on room air
B) Client post-op day 3 with stable vitals
C) Client with frequent loose stools and orthostatic hypotension
D) Client with hypertension controlled on lisinopril
Answer: C. Orthostatic hypotension requires skilled assessment (measuring lying, sitting,
standing). APs can take routine vital signs but should not perform orthostatic checks on
unstable clients .
7. A charge nurse is teaching newly licensed nurses about the correct use of restraints.
Which instruction should the nurse include?
A) Place a belt restraint on a school-age child who has seizures
B) Secure wrist restraints to the bed rails for an adolescent
C) Apply elbow immobilizers for an infant receiving cleft lip repair
D) Keep the side rails of a toddler's crib elevated
Answer: C. Elbow immobilizers prevent infants from touching surgical sites (cleft lip/palate
repair). Restraints should never be secured to bed rails (risk of entrapment); belt restraints
are contraindicated for seizure clients .
8. A nurse is preparing to discharge a client. Which statement indicates understanding of fall
precautions?
A) "I will keep my walker close to my bed at night."
B) "I will wear socks without grippers to bed."
C) "I will dim the lights to reduce glare."
D) "I will remove my bed alarm since I feel safe now."
Answer: A. Keeping assistive devices close to the bed prevents falls during transfers. Socks
should have non-skid grips, lights should be bright enough for safety, and bed alarms should
remain in place per provider order .
9. A charge nurse is making client assignments. Which client should be assigned to the most
experienced RN?
A) Client with diabetes mellitus requiring insulin
B) Client admitted with unstable angina and cardiac monitoring
C) Client with pneumonia requiring IV antibiotics
D) Client with a urinary tract infection
, 3
Answer: B. Unstable angina with cardiac monitoring requires advanced assessment skills and
rapid decision-making. This client should be assigned to the most experienced RN .
10. A nurse is caring for a client who is post-operative day 1 following a total hip
arthroplasty. Which finding requires immediate intervention?
A) Pain rating of 4 on a 0-10 scale
B) Oxygen saturation of 88% on room air
C) Incisional drainage of 2 cm
D) Client requests pain medication
Answer: B. An SpO₂ of 88% indicates hypoxemia and possible pulmonary complications
(atelectasis, PE). This is an ABC priority requiring immediate intervention before pain
management or routine assessment .
11. A nurse is preparing to administer a blood transfusion. Which action is most important to
prevent a transfusion reaction?
A) Verify the client's identity with one identifier
B) Verify the client's identity with two identifiers and check the blood product against the
order
C) Administer the blood product rapidly
D) Pre-medicate with diphenhydramine
Answer: B. Two-client identification and verification of the blood product against the order
are essential to prevent ABO incompatibility reactions. Rapid administration and pre-
medication do not prevent the most serious transfusion reactions .
12. A nurse is caring for a client who is being discharged with a prescription for warfarin.
Which statement by the client indicates understanding?
A) "I will avoid eating large amounts of green leafy vegetables."
B) "I can take aspirin for headaches while on this medication."
C) "I will stop taking the medication if I notice bruising."
D) "I will have my blood drawn monthly for PT/INR."
Answer: A. Green leafy vegetables are high in vitamin K, which can decrease warfarin's
effectiveness. Aspirin increases bleeding risk; bruising is expected and should be reported,
not a reason to stop the medication; INR monitoring is typically weekly at initiation then
monthly .
13. A nurse is planning care for a client with a spinal cord injury. Which intervention is most
important to prevent autonomic dysreflexia?
A) Provide a high-fiber diet
B) Prevent and treat bladder distention
C) Perform passive range-of-motion exercises
D) Administer stool softeners
Answer: B. Bladder distention is the most common trigger of autonomic dysreflexia in
clients with spinal cord injury above T6 .
ATI RN Comprehensive Predictor — 100 Original Practice Questions
Management of Care & Prioritization (1–15)
1. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A) Client with COPD and SpO₂ 89% on 2 L nasal cannula
B) Client post-appendectomy day 2 with temperature 38.3°C
C) Client with heart failure and 3+ pitting edema
D) Client with new onset confusion and bounding pulse
Answer: D. New onset confusion with bounding pulse suggests hypercapnia or fluid overload
affecting cerebral perfusion. This is a change in neurological status, which is always the
priority. Option A is expected in COPD; Option B is post-op inflammation; Option C is a
chronic finding .
2. A charge nurse is assigning clients. Which client should be assigned to the LPN?
A) Client 1 hour post-cardiac catheterization with bleeding
B) Client with stable diabetes requiring insulin and foot care
C) Client newly admitted with stroke and altered mental status
D) Client receiving IV heparin with PTT of 98 seconds
Answer: B. LPNs can administer insulin, perform stable wound care, and monitor stable
clients. Options A, C, and D require RN assessment (bleeding, neurological changes, critical
lab monitoring) .
3. A nurse witnesses a colleague diverting narcotics. What is the priority action?
A) Confront the colleague privately
B) Report to the nurse manager immediately
C) Ignore it to avoid conflict
D) Document in the client's chart
Answer: B. Impaired practice must be reported to management/administration to protect
client safety. Confrontation is unsafe and not the nurse's role .
4. A client refuses a blood transfusion due to religious beliefs. Which actions should the
nurse take? (Select all that apply.)
A) Verify the patient understands risks
B) Document the refusal
C) Administer the transfusion if Hgb is critical
D) Notify the provider
E) Ask the family to override the decision
Answer: A, B, D. Competent adults have autonomy. The nurse ensures informed refusal,
documents, and notifies the provider. Forcing treatment or involving family to override is
unethical .
5. A nurse is delegating tasks to an AP. Which task is appropriate to delegate?
A) Teaching a client about insulin administration
, 2
B) Ambulating a stable client
C) Assessing a post-op client's incision
D) Administering oral medications
Answer: B. Ambulating a stable client is within AP scope. Teaching, assessing, and
medication administration require an RN .
6. A nurse delegates vital signs to an assistive personnel (AP). Which client should the AP
NOT be assigned to?
A) Client with pneumonia on room air
B) Client post-op day 3 with stable vitals
C) Client with frequent loose stools and orthostatic hypotension
D) Client with hypertension controlled on lisinopril
Answer: C. Orthostatic hypotension requires skilled assessment (measuring lying, sitting,
standing). APs can take routine vital signs but should not perform orthostatic checks on
unstable clients .
7. A charge nurse is teaching newly licensed nurses about the correct use of restraints.
Which instruction should the nurse include?
A) Place a belt restraint on a school-age child who has seizures
B) Secure wrist restraints to the bed rails for an adolescent
C) Apply elbow immobilizers for an infant receiving cleft lip repair
D) Keep the side rails of a toddler's crib elevated
Answer: C. Elbow immobilizers prevent infants from touching surgical sites (cleft lip/palate
repair). Restraints should never be secured to bed rails (risk of entrapment); belt restraints
are contraindicated for seizure clients .
8. A nurse is preparing to discharge a client. Which statement indicates understanding of fall
precautions?
A) "I will keep my walker close to my bed at night."
B) "I will wear socks without grippers to bed."
C) "I will dim the lights to reduce glare."
D) "I will remove my bed alarm since I feel safe now."
Answer: A. Keeping assistive devices close to the bed prevents falls during transfers. Socks
should have non-skid grips, lights should be bright enough for safety, and bed alarms should
remain in place per provider order .
9. A charge nurse is making client assignments. Which client should be assigned to the most
experienced RN?
A) Client with diabetes mellitus requiring insulin
B) Client admitted with unstable angina and cardiac monitoring
C) Client with pneumonia requiring IV antibiotics
D) Client with a urinary tract infection
, 3
Answer: B. Unstable angina with cardiac monitoring requires advanced assessment skills and
rapid decision-making. This client should be assigned to the most experienced RN .
10. A nurse is caring for a client who is post-operative day 1 following a total hip
arthroplasty. Which finding requires immediate intervention?
A) Pain rating of 4 on a 0-10 scale
B) Oxygen saturation of 88% on room air
C) Incisional drainage of 2 cm
D) Client requests pain medication
Answer: B. An SpO₂ of 88% indicates hypoxemia and possible pulmonary complications
(atelectasis, PE). This is an ABC priority requiring immediate intervention before pain
management or routine assessment .
11. A nurse is preparing to administer a blood transfusion. Which action is most important to
prevent a transfusion reaction?
A) Verify the client's identity with one identifier
B) Verify the client's identity with two identifiers and check the blood product against the
order
C) Administer the blood product rapidly
D) Pre-medicate with diphenhydramine
Answer: B. Two-client identification and verification of the blood product against the order
are essential to prevent ABO incompatibility reactions. Rapid administration and pre-
medication do not prevent the most serious transfusion reactions .
12. A nurse is caring for a client who is being discharged with a prescription for warfarin.
Which statement by the client indicates understanding?
A) "I will avoid eating large amounts of green leafy vegetables."
B) "I can take aspirin for headaches while on this medication."
C) "I will stop taking the medication if I notice bruising."
D) "I will have my blood drawn monthly for PT/INR."
Answer: A. Green leafy vegetables are high in vitamin K, which can decrease warfarin's
effectiveness. Aspirin increases bleeding risk; bruising is expected and should be reported,
not a reason to stop the medication; INR monitoring is typically weekly at initiation then
monthly .
13. A nurse is planning care for a client with a spinal cord injury. Which intervention is most
important to prevent autonomic dysreflexia?
A) Provide a high-fiber diet
B) Prevent and treat bladder distention
C) Perform passive range-of-motion exercises
D) Administer stool softeners
Answer: B. Bladder distention is the most common trigger of autonomic dysreflexia in
clients with spinal cord injury above T6 .
