ATI RN Comprehensive Predictor 2025 – Practice Test
Management of Care
The charge nurse is making shift assignments. Which client should the nurse assign
to the LPN?
A. A client who was just extubated and requires assessment of the airway.
B. A client who is 12 hours post-op following a bowel resection with a new
colostomy.
C. A client who is admitted with diabetic ketoacidosis and has a potassium level of
3.2 mEq/L.
D. A client who is receiving a continuous heparin infusion and requires an aPTT
draw.
B
1. LPNs can care for stable clients with predictable outcomes. A client who is 12
hours post-op with a new stoma is stable and requires standard care.
Extubation (assessment), DKA with critical lab values, and continuous heparin
requiring titration based on lab results require RN assessment and critical
thinking.
Which task is appropriate for the nurse to delegate to an unlicensed assistive
personnel (UAP)?
A. Measuring the intake and output for a client with acute congestive heart failure.
B. Ambulating a client who is 1 day post-operative following a total knee
replacement.
C. Teaching a newly diagnosed diabetic client about insulin administration.
D. Assessing a client’s pain level using a standardized pain scale.
B
2. Ambulating a stable post-op client is within the UAP scope of practice.
Measuring I&O on an unstable client, teaching, and assessing pain are
nursing responsibilities that require clinical judgment and cannot be
delegated.
The nurse receives change-of-shift report on four clients. Which client should the
nurse assess first?
A. A client with chronic obstructive pulmonary disease (COPD) who has a respiratory
rate of 22 breaths per minute.
B. A client with heart failure who has 2+ pitting edema in the lower extremities.
C. A client 2 days post-appendectomy who has a temperature of 100.4°F (38°C).
D. A client with a history of hypertension whose blood pressure is 150/90 mmHg.
,A
3. Using the ABC priority framework, the client with COPD and an elevated
respiratory rate (Airway/Breathing) is the priority. While the others need
attention, an altered respiratory status is a life-threatening emergency
compared to chronic edema, low-grade post-op fever, or chronic
hypertension.
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted
with shortness of breath. The nurse notes the client is positioned in high-Fowler's
position. What is the rationale for this intervention?
A. To promote vasoconstriction and reduce cardiac preload.
B. To decrease the work of breathing by allowing maximum diaphragm excursion.
C. To increase venous return and improve cardiac output.
D. To prevent atelectasis.
B
4. High-Fowler's position (sitting upright at a 90-degree angle) allows the
diaphragm to drop and fully expand, decreasing the work of breathing, which
is the primary issue for a client in respiratory distress. Promoting
vasoconstriction (A) is incorrect; Fowler's causes vasodilation. Increasing
venous return (C) increases preload, which is contraindicated in heart failure
(though not the issue here). Preventing atelectasis (D) is a benefit of frequent
repositioning and deep breathing, but the primary reason for this specific
position in this specific scenario is respiratory mechanics.
Select all that apply. A nurse is caring for a client with acute confusion. Which
interventions should the nurse implement? (Select all that apply).
A. Provide a calm, quiet environment.
B. Keep the room brightly lit at night.
C. Place a calendar and clock in the room.
D. Restrain the client to prevent falls.
E. Use reorientation techniques frequently.
A, C, E
5. A calm environment reduces stimulation and agitation. A calendar and clock
provide reality orientation. Frequent reorientation helps ground the client. A
brightly lit room at night disrupts the circadian rhythm and increases confusion
(sundowning). Restraints increase agitation and are a last resort only when
less restrictive measures fail and a physician order is obtained.
A nurse is reviewing the medical record of a client and notes an advance directive in
the chart. Which statement by the nurse indicates an understanding of this legal
document?
,A. "The advance directive takes effect only when the client is deemed incompetent
by a physician."
B. "The advance directive allows the client to specify end-of-life wishes in the event
they become incapacitated."
C. "The advance directive is only valid if it is notarized by a lawyer."
D. "The advance directive allows the family to override the client's stated wishes."
B
6. An advance directive allows a competent client to document their wishes
regarding medical treatment in advance, should they lose the ability to make
decisions (incapacitated). It does not require a lawyer to be valid in most
states. It takes effect upon incapacitation, not physician declaration of
incompetence. Families cannot legally override the client's documented
wishes.
The nurse is caring for a client who states, "I do not want to take this medication."
What is the nurse's best initial action?
A. Document the refusal and inform the physician.
B. Explain the consequences of not taking the medication and force the client to take
it.
C. Ask the client why they are refusing the medication.
D. Administer the medication while the client is sleeping to ensure compliance.
C
7. The first step is to explore the reason for refusal (e.g., cost, side effects,
misunderstanding of purpose). Forcing a medication is assault. Administering
it covertly is illegal and unethical. Documenting the refusal and notifying the
physician is required, but understanding the client's perspective is the first
therapeutic step.
A nurse is preparing to administer a blood transfusion. Which action is correct?
A. Verify the client's blood type with the blood product using two unique identifiers
before starting the transfusion.
B. Prime the tubing with normal saline and set the rate to 200 mL/hr for the first 15
minutes.
C. Pre-medicate with diphenhydramine (Benadryl) only if the client has a history of
allergies.
D. Administer the blood product through a 22-gauge IV catheter.
A
8. *Patient safety is paramount. The nurse must verify the right patient using two
identifiers (e.g., name and date of birth) against the blood product label to
prevent a fatal hemolytic transfusion reaction. The initial rate should be slow
(usually 50-100 mL/hr) to monitor for acute reactions, not 200 mL/hr.
, Premedication is often done, but the core safety check is the verification
process. Large-bore catheters (18 or 20 gauge) are preferred for blood
products; a 22-gauge is too small and could hemolyze the red blood cells.
A client is scheduled for surgery and asks the nurse to explain the procedure. Which
response by the nurse is appropriate?
A. "I will explain the procedure; the surgeon will obtain the informed consent."
B. "You should ask the surgeon to explain the procedure and sign the consent form."
C. "Do not worry; the surgeon will take care of everything."
D. "I will have you sign the consent form and send it to the operating room."
B
9. Informed consent is a legal process where the provider (the person
performing the procedure) explains the risks, benefits, and alternatives to the
client. The nurse can witness the signature, but cannot legally "obtain" the
consent for an invasive procedure. The nurse can clarify information, but the
primary explanation must come from the surgeon.
A nurse is caring for a client who has been placed in seclusion. Which intervention is
required by the facility policy?
A. Check on the client once per shift.
B. Keep the client in seclusion for 24 hours before reassessment.
C. Continuously observe the client and offer fluids and toileting every 15 to 30
minutes.
D. Place the client in a dark, quiet room without stimulation.
C
10.*Seclusion is a temporary intervention for severe agitation. To ensure the
client's safety and dignity, the nurse must continuously observe them (often
via a window or camera) and offer basic needs (hydration, toileting) at
frequent intervals (typically every 15 to 30 minutes, per CMS guidelines). The
environment should not be dark and isolating; it should be kept safe but
humanizing.
Safety and Infection Control
A nurse is caring for a client diagnosed with active tuberculosis (TB). Which type of
isolation precautions should the nurse implement?
A. Contact precautions.
B. Droplet precautions.
C. Airborne precautions.
D. Standard precautions only.
C
Management of Care
The charge nurse is making shift assignments. Which client should the nurse assign
to the LPN?
A. A client who was just extubated and requires assessment of the airway.
B. A client who is 12 hours post-op following a bowel resection with a new
colostomy.
C. A client who is admitted with diabetic ketoacidosis and has a potassium level of
3.2 mEq/L.
D. A client who is receiving a continuous heparin infusion and requires an aPTT
draw.
B
1. LPNs can care for stable clients with predictable outcomes. A client who is 12
hours post-op with a new stoma is stable and requires standard care.
Extubation (assessment), DKA with critical lab values, and continuous heparin
requiring titration based on lab results require RN assessment and critical
thinking.
Which task is appropriate for the nurse to delegate to an unlicensed assistive
personnel (UAP)?
A. Measuring the intake and output for a client with acute congestive heart failure.
B. Ambulating a client who is 1 day post-operative following a total knee
replacement.
C. Teaching a newly diagnosed diabetic client about insulin administration.
D. Assessing a client’s pain level using a standardized pain scale.
B
2. Ambulating a stable post-op client is within the UAP scope of practice.
Measuring I&O on an unstable client, teaching, and assessing pain are
nursing responsibilities that require clinical judgment and cannot be
delegated.
The nurse receives change-of-shift report on four clients. Which client should the
nurse assess first?
A. A client with chronic obstructive pulmonary disease (COPD) who has a respiratory
rate of 22 breaths per minute.
B. A client with heart failure who has 2+ pitting edema in the lower extremities.
C. A client 2 days post-appendectomy who has a temperature of 100.4°F (38°C).
D. A client with a history of hypertension whose blood pressure is 150/90 mmHg.
,A
3. Using the ABC priority framework, the client with COPD and an elevated
respiratory rate (Airway/Breathing) is the priority. While the others need
attention, an altered respiratory status is a life-threatening emergency
compared to chronic edema, low-grade post-op fever, or chronic
hypertension.
A client with a history of chronic obstructive pulmonary disease (COPD) is admitted
with shortness of breath. The nurse notes the client is positioned in high-Fowler's
position. What is the rationale for this intervention?
A. To promote vasoconstriction and reduce cardiac preload.
B. To decrease the work of breathing by allowing maximum diaphragm excursion.
C. To increase venous return and improve cardiac output.
D. To prevent atelectasis.
B
4. High-Fowler's position (sitting upright at a 90-degree angle) allows the
diaphragm to drop and fully expand, decreasing the work of breathing, which
is the primary issue for a client in respiratory distress. Promoting
vasoconstriction (A) is incorrect; Fowler's causes vasodilation. Increasing
venous return (C) increases preload, which is contraindicated in heart failure
(though not the issue here). Preventing atelectasis (D) is a benefit of frequent
repositioning and deep breathing, but the primary reason for this specific
position in this specific scenario is respiratory mechanics.
Select all that apply. A nurse is caring for a client with acute confusion. Which
interventions should the nurse implement? (Select all that apply).
A. Provide a calm, quiet environment.
B. Keep the room brightly lit at night.
C. Place a calendar and clock in the room.
D. Restrain the client to prevent falls.
E. Use reorientation techniques frequently.
A, C, E
5. A calm environment reduces stimulation and agitation. A calendar and clock
provide reality orientation. Frequent reorientation helps ground the client. A
brightly lit room at night disrupts the circadian rhythm and increases confusion
(sundowning). Restraints increase agitation and are a last resort only when
less restrictive measures fail and a physician order is obtained.
A nurse is reviewing the medical record of a client and notes an advance directive in
the chart. Which statement by the nurse indicates an understanding of this legal
document?
,A. "The advance directive takes effect only when the client is deemed incompetent
by a physician."
B. "The advance directive allows the client to specify end-of-life wishes in the event
they become incapacitated."
C. "The advance directive is only valid if it is notarized by a lawyer."
D. "The advance directive allows the family to override the client's stated wishes."
B
6. An advance directive allows a competent client to document their wishes
regarding medical treatment in advance, should they lose the ability to make
decisions (incapacitated). It does not require a lawyer to be valid in most
states. It takes effect upon incapacitation, not physician declaration of
incompetence. Families cannot legally override the client's documented
wishes.
The nurse is caring for a client who states, "I do not want to take this medication."
What is the nurse's best initial action?
A. Document the refusal and inform the physician.
B. Explain the consequences of not taking the medication and force the client to take
it.
C. Ask the client why they are refusing the medication.
D. Administer the medication while the client is sleeping to ensure compliance.
C
7. The first step is to explore the reason for refusal (e.g., cost, side effects,
misunderstanding of purpose). Forcing a medication is assault. Administering
it covertly is illegal and unethical. Documenting the refusal and notifying the
physician is required, but understanding the client's perspective is the first
therapeutic step.
A nurse is preparing to administer a blood transfusion. Which action is correct?
A. Verify the client's blood type with the blood product using two unique identifiers
before starting the transfusion.
B. Prime the tubing with normal saline and set the rate to 200 mL/hr for the first 15
minutes.
C. Pre-medicate with diphenhydramine (Benadryl) only if the client has a history of
allergies.
D. Administer the blood product through a 22-gauge IV catheter.
A
8. *Patient safety is paramount. The nurse must verify the right patient using two
identifiers (e.g., name and date of birth) against the blood product label to
prevent a fatal hemolytic transfusion reaction. The initial rate should be slow
(usually 50-100 mL/hr) to monitor for acute reactions, not 200 mL/hr.
, Premedication is often done, but the core safety check is the verification
process. Large-bore catheters (18 or 20 gauge) are preferred for blood
products; a 22-gauge is too small and could hemolyze the red blood cells.
A client is scheduled for surgery and asks the nurse to explain the procedure. Which
response by the nurse is appropriate?
A. "I will explain the procedure; the surgeon will obtain the informed consent."
B. "You should ask the surgeon to explain the procedure and sign the consent form."
C. "Do not worry; the surgeon will take care of everything."
D. "I will have you sign the consent form and send it to the operating room."
B
9. Informed consent is a legal process where the provider (the person
performing the procedure) explains the risks, benefits, and alternatives to the
client. The nurse can witness the signature, but cannot legally "obtain" the
consent for an invasive procedure. The nurse can clarify information, but the
primary explanation must come from the surgeon.
A nurse is caring for a client who has been placed in seclusion. Which intervention is
required by the facility policy?
A. Check on the client once per shift.
B. Keep the client in seclusion for 24 hours before reassessment.
C. Continuously observe the client and offer fluids and toileting every 15 to 30
minutes.
D. Place the client in a dark, quiet room without stimulation.
C
10.*Seclusion is a temporary intervention for severe agitation. To ensure the
client's safety and dignity, the nurse must continuously observe them (often
via a window or camera) and offer basic needs (hydration, toileting) at
frequent intervals (typically every 15 to 30 minutes, per CMS guidelines). The
environment should not be dark and isolating; it should be kept safe but
humanizing.
Safety and Infection Control
A nurse is caring for a client diagnosed with active tuberculosis (TB). Which type of
isolation precautions should the nurse implement?
A. Contact precautions.
B. Droplet precautions.
C. Airborne precautions.
D. Standard precautions only.
C
