ATI RN Comprehensive Predictor 2026
Proctored Exams 170+ Multiple Choice
Questions with Bold Italic Answers and Italic
Explanations A+ Grade
MANAGEMENT OF CARE (DELEGATION, PRIORITIZATION, ETHICS)
1. A charge nurse is making client assignments on a medical-surgical unit. Which client should be
assigned to the most experienced RN?
A) Client with diabetes requiring routine insulin administration
B) Client with pneumonia requiring q4h vital signs
C) Client with chest tubes and new-onset respiratory distress
D) Client with a urinary tract infection requiring IV antibiotics
The client with chest tubes and new-onset respiratory distress is unstable and requires complex
assessment and intervention by the most experienced RN. Stable clients with routine care can be
assigned to LPNs or less experienced RNs under supervision.
2. A nurse is caring for four clients. Which client should the nurse assess first?
A) Client with COPD and SpO₂ 89% on 2L nasal cannula
B) Client post-appendectomy day 2 with temperature 38.3°C (101°F)
C) Client with heart failure and 3+ pitting edema
D) Client with new onset confusion and bounding pulse
New onset confusion with bounding pulse suggests hypercapnia or fluid overload affecting cerebral
perfusion. This represents a change in neurological status, which is always the priority. The COPD finding
is expected, post-op inflammation is anticipated, and chronic edema is a stable finding.
3. A charge nurse is assigning staff. 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
,LPNs can administer insulin, perform stable wound care, and monitor stable clients. Options A, C, and D
require RN assessment for bleeding complications, neurological changes, and critical lab monitoring.
4. A nurse is delegating a task to an LPN. Which task is appropriate to delegate?
A) Performing the initial admission assessment
B) Inserting a nasogastric (NG) tube for decompression
C) Administering IV push medications
D) Creating the plan of care for a stable client
Inserting an NG tube is within the LPN scope of practice under RN supervision. Initial assessments, IV
push medications, and care plan development are RN responsibilities.
5. 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
Orthostatic hypotension requires skilled assessment (measuring lying, sitting, standing positions). APs
can take routine vital signs but should not perform orthostatic checks on unstable clients.
6. A nurse is preparing to give a change-of-shift report. Which method is most effective for handoff
communication?
A) SHAR report
B) SOAP
C) SBAR
D) PIE
SBAR (Situation, Background, Assessment, Recommendation) is the standard handoff communication
method that reduces errors and improves patient safety. It provides a structured framework for concise,
accurate information transfer.
7. A nurse is caring for a patient who is being discharged against medical advice (AMA). What is the
nurse's priority action?
A) Notify security to prevent the patient from leaving
B) Have the patient sign an AMA form and document the patient's condition
C) Ask the family to convince the patient to stay
D) Call the provider to obtain an order to detain the patient
,Patients have the legal right to leave AMA. The nurse should have the patient sign an AMA form,
document the patient's mental status and understanding of risks, and notify the provider. Restraining or
detaining a competent patient is unlawful.
8. A nurse is teaching a client about advance directives. Which statement by the client indicates
understanding?
A) "My advance directive will be followed regardless of my wishes."
B) "I can change my advance directive at any time."
C) "The nurse will create my advance directive for me."
D) "I must have an advance directive to receive care."
Advance directives can be changed or revoked at any time by the patient as long as they are competent.
They reflect the patient's wishes and are not mandatory for receiving care.
9. A charge nurse is evaluating a newly licensed nurse's understanding of informed consent. Which
statement by the new nurse indicates understanding?
A) "The nurse is responsible for obtaining informed consent."
B) "Informed consent must be obtained before administering preoperative medications."
C) "The physician is responsible for explaining the procedure and risks."
D) "A family member can sign consent if the patient is anxious."
The physician performing the procedure is responsible for explaining the risks, benefits, and alternatives.
The nurse witnesses the signature and ensures the patient understands.
10. A nurse is caring for a patient with a do-not-resuscitate (DNR) order. The patient's family requests
that the patient be resuscitated if cardiac arrest occurs. What is the nurse's best response?
A) Follow the family's request
B) Explain that the DNR order must be followed unless rescinded by the provider
C) Resuscitate the patient and then discuss with the provider
D) Ask the family to leave the room
The DNR order is a legal medical order. The nurse should explain that the order must be followed unless
the provider rescinds it. The family may request a discussion with the provider, but the nurse cannot
independently override the DNR order.
SAFETY & INFECTION CONTROL
11. A nurse notices a frayed electrical cord on a client's continuous passive motion (CPM) device.
Which action should the nurse take first?
, A) Initiate a requisition for a replacement CPM device
B) Report the defect to the equipment maintenance staff
C) Remove the device from the room
D) Ensure the device inspection sticker is current
Client safety is the priority. A frayed electrical cord poses an immediate fire and electrocution hazard.
The nurse must remove the device from the room immediately to prevent harm, then follow up with
reporting and replacement.
12. A client with C. difficile infection is on contact precautions. What PPE is required for entering the
room?
A) Surgical mask and gloves
B) N95 respirator and gown
C) Gloves and gown
D) Gloves, gown, and eye protection
Contact precautions require gloves and gown for all interactions. C. difficile is transmitted via spores;
hand hygiene with soap and water (not alcohol-based sanitizer) is essential. Masks and eye protection
are not required for contact precautions.
13. A client is on contact precautions. Which action by the nurse indicates correct understanding of
infection control?
A) Using alcohol-based hand sanitizer after leaving the room
B) Wearing gloves and gown when entering the room
C) Placing the client in a negative pressure room
D) Wearing an N95 respirator during care
Contact precautions require gloves and gown. C. difficile requires soap and water hand hygiene.
Negative pressure is for airborne precautions.
14. A nurse is preparing to administer a blood transfusion. Which action is essential to ensure patient
safety?
A) Verify the patient's identity with two identifiers
B) Check the blood type and Rh factor with another nurse
C) Assess vital signs before and after the transfusion
D) All of the above
All of these actions are essential: two-client verification (name and date of birth), two-nurse verification
of blood product, and vital sign monitoring before, during, and after transfusion.
Proctored Exams 170+ Multiple Choice
Questions with Bold Italic Answers and Italic
Explanations A+ Grade
MANAGEMENT OF CARE (DELEGATION, PRIORITIZATION, ETHICS)
1. A charge nurse is making client assignments on a medical-surgical unit. Which client should be
assigned to the most experienced RN?
A) Client with diabetes requiring routine insulin administration
B) Client with pneumonia requiring q4h vital signs
C) Client with chest tubes and new-onset respiratory distress
D) Client with a urinary tract infection requiring IV antibiotics
The client with chest tubes and new-onset respiratory distress is unstable and requires complex
assessment and intervention by the most experienced RN. Stable clients with routine care can be
assigned to LPNs or less experienced RNs under supervision.
2. A nurse is caring for four clients. Which client should the nurse assess first?
A) Client with COPD and SpO₂ 89% on 2L nasal cannula
B) Client post-appendectomy day 2 with temperature 38.3°C (101°F)
C) Client with heart failure and 3+ pitting edema
D) Client with new onset confusion and bounding pulse
New onset confusion with bounding pulse suggests hypercapnia or fluid overload affecting cerebral
perfusion. This represents a change in neurological status, which is always the priority. The COPD finding
is expected, post-op inflammation is anticipated, and chronic edema is a stable finding.
3. A charge nurse is assigning staff. 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
,LPNs can administer insulin, perform stable wound care, and monitor stable clients. Options A, C, and D
require RN assessment for bleeding complications, neurological changes, and critical lab monitoring.
4. A nurse is delegating a task to an LPN. Which task is appropriate to delegate?
A) Performing the initial admission assessment
B) Inserting a nasogastric (NG) tube for decompression
C) Administering IV push medications
D) Creating the plan of care for a stable client
Inserting an NG tube is within the LPN scope of practice under RN supervision. Initial assessments, IV
push medications, and care plan development are RN responsibilities.
5. 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
Orthostatic hypotension requires skilled assessment (measuring lying, sitting, standing positions). APs
can take routine vital signs but should not perform orthostatic checks on unstable clients.
6. A nurse is preparing to give a change-of-shift report. Which method is most effective for handoff
communication?
A) SHAR report
B) SOAP
C) SBAR
D) PIE
SBAR (Situation, Background, Assessment, Recommendation) is the standard handoff communication
method that reduces errors and improves patient safety. It provides a structured framework for concise,
accurate information transfer.
7. A nurse is caring for a patient who is being discharged against medical advice (AMA). What is the
nurse's priority action?
A) Notify security to prevent the patient from leaving
B) Have the patient sign an AMA form and document the patient's condition
C) Ask the family to convince the patient to stay
D) Call the provider to obtain an order to detain the patient
,Patients have the legal right to leave AMA. The nurse should have the patient sign an AMA form,
document the patient's mental status and understanding of risks, and notify the provider. Restraining or
detaining a competent patient is unlawful.
8. A nurse is teaching a client about advance directives. Which statement by the client indicates
understanding?
A) "My advance directive will be followed regardless of my wishes."
B) "I can change my advance directive at any time."
C) "The nurse will create my advance directive for me."
D) "I must have an advance directive to receive care."
Advance directives can be changed or revoked at any time by the patient as long as they are competent.
They reflect the patient's wishes and are not mandatory for receiving care.
9. A charge nurse is evaluating a newly licensed nurse's understanding of informed consent. Which
statement by the new nurse indicates understanding?
A) "The nurse is responsible for obtaining informed consent."
B) "Informed consent must be obtained before administering preoperative medications."
C) "The physician is responsible for explaining the procedure and risks."
D) "A family member can sign consent if the patient is anxious."
The physician performing the procedure is responsible for explaining the risks, benefits, and alternatives.
The nurse witnesses the signature and ensures the patient understands.
10. A nurse is caring for a patient with a do-not-resuscitate (DNR) order. The patient's family requests
that the patient be resuscitated if cardiac arrest occurs. What is the nurse's best response?
A) Follow the family's request
B) Explain that the DNR order must be followed unless rescinded by the provider
C) Resuscitate the patient and then discuss with the provider
D) Ask the family to leave the room
The DNR order is a legal medical order. The nurse should explain that the order must be followed unless
the provider rescinds it. The family may request a discussion with the provider, but the nurse cannot
independently override the DNR order.
SAFETY & INFECTION CONTROL
11. A nurse notices a frayed electrical cord on a client's continuous passive motion (CPM) device.
Which action should the nurse take first?
, A) Initiate a requisition for a replacement CPM device
B) Report the defect to the equipment maintenance staff
C) Remove the device from the room
D) Ensure the device inspection sticker is current
Client safety is the priority. A frayed electrical cord poses an immediate fire and electrocution hazard.
The nurse must remove the device from the room immediately to prevent harm, then follow up with
reporting and replacement.
12. A client with C. difficile infection is on contact precautions. What PPE is required for entering the
room?
A) Surgical mask and gloves
B) N95 respirator and gown
C) Gloves and gown
D) Gloves, gown, and eye protection
Contact precautions require gloves and gown for all interactions. C. difficile is transmitted via spores;
hand hygiene with soap and water (not alcohol-based sanitizer) is essential. Masks and eye protection
are not required for contact precautions.
13. A client is on contact precautions. Which action by the nurse indicates correct understanding of
infection control?
A) Using alcohol-based hand sanitizer after leaving the room
B) Wearing gloves and gown when entering the room
C) Placing the client in a negative pressure room
D) Wearing an N95 respirator during care
Contact precautions require gloves and gown. C. difficile requires soap and water hand hygiene.
Negative pressure is for airborne precautions.
14. A nurse is preparing to administer a blood transfusion. Which action is essential to ensure patient
safety?
A) Verify the patient's identity with two identifiers
B) Check the blood type and Rh factor with another nurse
C) Assess vital signs before and after the transfusion
D) All of the above
All of these actions are essential: two-client verification (name and date of birth), two-nurse verification
of blood product, and vital sign monitoring before, during, and after transfusion.
