ATI RN VATI COMPREHENSIVE PREDICTOR
Complete NCLEX Exam Review & Verified Clinical Explanations
Target Exam: ATI RN VATI / NCLEX-RN Content: High-Yield Q&A with Rationales Format: Print-Ready Study Guide
📌 Study Guide Overview & Exam Strategy
This document consolidates key questions, correct answer keys, and detailed clinical rationales from the ATI RN VATI
Comprehensive Predictor Form C assessment. Questions are categorized by major NCLEX client needs categories to optimize
retention, critical thinking, and clinical judgment skills.
Pharmacology & Medication Safety
Q1 A client is postoperative following a lumbar discectomy and is having difficulty voiding. Which of the
following medications places the client at risk for urinary retention?
• Ketorolac
• Hydromorphone (Dilaudid)
• Bethanechol (Urecholine)
• Tobramycin (Nebcin)
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Hydromorphone (Dilaudid)
Rationale: Opioid analgesics like hydromorphone increase smooth muscle tone in the urinary bladder sphincter and decrease
bladder awareness, leading to urinary retention. Bethanechol is a cholinergic agonist used to treat retention, not cause it.
Q2 A nurse is reinforcing teaching with a client who has hypertension and is beginning medication therapy
with captopril. Which of the following over-the-counter medications should the nurse instruct the client to
avoid?
• Acetaminophen (Tylenol)
• Diphenhydramine
• Ibuprofen (Advil)
• Guaifenesin (Robitussin)
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Ibuprofen (Advil)
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen reduce the antihypertensive efficacy of ACE inhibitors
(captopril) and increase the risk of renal impairment and hyperkalemia.
ATI RN VATI Comprehensive Predictor — Master Study Guide Page 1 of 23
, Q3 A nurse is reinforcing teaching for a client who has a new prescription for lithium carbonate. Which of the
following instructions should the nurse include?
• Eliminate all foods containing tyramine
• Drink 2 to 3 liters of fluid each day
• Take lithium carbonate on an empty stomach
• Reduce your daily sodium intake to 1,000 mg
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Drink 2 to 3 liters of fluid each day
Rationale: Maintaining adequate fluid intake (2,000–3,000 mL/day) and consistent sodium intake prevents lithium toxicity.
Reduced sodium levels or dehydration cause the kidneys to reabsorb lithium, raising serum levels to toxic ranges.
Q4 A nurse is reinforcing teaching to a client who has a new prescription for atorvastatin. For which of the
following should the nurse tell the client to monitor and report to the provider?
• Anorexia
• Muscle tenderness
• Facial flushing
• Insomnia
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Muscle tenderness
Rationale: Statins can cause myopathy and rhabdomyolysis. Unexplained muscle pain, tenderness, or weakness must be
reported immediately, and serum creatine kinase (CK) levels evaluated.
Q5 A nurse is reinforcing discharge teaching for a client who has a new prescription for digoxin. Which of the
following should the nurse include in the instructions as an indication of digoxin toxicity?
• Visual changes
• Skin irritation
• Fever
• Angina
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Visual changes
Rationale: Early signs of digoxin toxicity include gastrointestinal upset (anorexia, nausea, vomiting) and neurological/visual
disturbances such as yellow-green halos, blurred vision, or diplopia.
Q6 A nurse is reinforcing teaching for a client who has a new prescription for sublingual nitroglycerin. Which
of the following statements indicates client understanding?
• I will take half a tablet before I exercise
• I can take up to four tablets to relieve my pain
• I will put the tablets in a medication container for easy access
• I may develop a headache after taking this medication
✓ CORRECT ANSWER & CLINICAL EXPLANATION
I may develop a headache after taking this medication
Rationale: Nitroglycerin causes systemic vasodilation, which commonly leads to a transient throbbing headache and facial
flushing. Patients should be reassured this is an expected pharmacological effect.
ATI RN VATI Comprehensive Predictor — Master Study Guide Page 2 of 23
, Q7 A nurse is preparing to administer a dose of furosemide 30 min past the scheduled time. The nurse notes
that there is a new potassium value alert on the client's electronic record. Which action should the nurse take?
• Review the laboratory value prior to preparing the medication
• Administer the medication, and then review the client's laboratory values
• Hold the dose of medication until the provider makes rounds
• Administer the medication, and notify the provider that new laboratory values are available
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Review the laboratory value prior to preparing the medication
Rationale: Furosemide is a potassium-wasting loop diuretic. Severe hypokalemia increases the risk of cardiac dysrhythmias. The
nurse must verify serum potassium before administration.
Q8 A nurse is reinforcing discharge teaching with a client about adverse effects of prescribed medications.
The nurse should tell the client that if black, tarry stools are noted, the client should stop taking which
medication and notify the provider?
• Acetaminophen
• Aspirin
• Guaifenesin
• Loratadine
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Aspirin
Rationale: Aspirin inhibits platelet aggregation and COX-1, leading to gastric mucosal irritation and upper GI bleeding, manifested
as melena (black, tarry stools).
Q9 A provider prescribes levothyroxine 0.3 mg PO daily. Available is levothyroxine 150 mcg/tablet. How many
tablets should the nurse administer?
• 0.5 tablet
• 1 tablet
• 1.5 tablets
• 2 tablets
✓ CORRECT ANSWER & CLINICAL EXPLANATION
2 tablets
Rationale: Convert 0.3 mg to micrograms: 0.3 mg × 1000 = 300 mcg. Dose desired / Dose on hand = 300 mcg / 150 mcg = 2
tablets.
Q10 A nurse is reinforcing teaching with a client who has a prescription for isoniazid and rifampin to treat
tuberculosis. Which of the following should the nurse include in the teaching?
• You may need to take medications to treat tuberculosis for as long as two years
• You can take isoniazid with an antacid if it upsets your stomach
• You will need to have a tuberculin test in 3 months to determine effectiveness
• You should notify the provider if your urine turns orange while taking the medication
✓ CORRECT ANSWER & CLINICAL EXPLANATION
You should notify the provider if your urine turns orange while taking the medication
Rationale: Rifampin causes harmless red-orange discoloration of bodily fluids (urine, sweat, tears). Patients must be educated
about this benign effect, but should report signs of hepatotoxicity (jaundice, dark urine, pale stools).
ATI RN VATI Comprehensive Predictor — Master Study Guide Page 3 of 23
Complete NCLEX Exam Review & Verified Clinical Explanations
Target Exam: ATI RN VATI / NCLEX-RN Content: High-Yield Q&A with Rationales Format: Print-Ready Study Guide
📌 Study Guide Overview & Exam Strategy
This document consolidates key questions, correct answer keys, and detailed clinical rationales from the ATI RN VATI
Comprehensive Predictor Form C assessment. Questions are categorized by major NCLEX client needs categories to optimize
retention, critical thinking, and clinical judgment skills.
Pharmacology & Medication Safety
Q1 A client is postoperative following a lumbar discectomy and is having difficulty voiding. Which of the
following medications places the client at risk for urinary retention?
• Ketorolac
• Hydromorphone (Dilaudid)
• Bethanechol (Urecholine)
• Tobramycin (Nebcin)
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Hydromorphone (Dilaudid)
Rationale: Opioid analgesics like hydromorphone increase smooth muscle tone in the urinary bladder sphincter and decrease
bladder awareness, leading to urinary retention. Bethanechol is a cholinergic agonist used to treat retention, not cause it.
Q2 A nurse is reinforcing teaching with a client who has hypertension and is beginning medication therapy
with captopril. Which of the following over-the-counter medications should the nurse instruct the client to
avoid?
• Acetaminophen (Tylenol)
• Diphenhydramine
• Ibuprofen (Advil)
• Guaifenesin (Robitussin)
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Ibuprofen (Advil)
Rationale: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen reduce the antihypertensive efficacy of ACE inhibitors
(captopril) and increase the risk of renal impairment and hyperkalemia.
ATI RN VATI Comprehensive Predictor — Master Study Guide Page 1 of 23
, Q3 A nurse is reinforcing teaching for a client who has a new prescription for lithium carbonate. Which of the
following instructions should the nurse include?
• Eliminate all foods containing tyramine
• Drink 2 to 3 liters of fluid each day
• Take lithium carbonate on an empty stomach
• Reduce your daily sodium intake to 1,000 mg
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Drink 2 to 3 liters of fluid each day
Rationale: Maintaining adequate fluid intake (2,000–3,000 mL/day) and consistent sodium intake prevents lithium toxicity.
Reduced sodium levels or dehydration cause the kidneys to reabsorb lithium, raising serum levels to toxic ranges.
Q4 A nurse is reinforcing teaching to a client who has a new prescription for atorvastatin. For which of the
following should the nurse tell the client to monitor and report to the provider?
• Anorexia
• Muscle tenderness
• Facial flushing
• Insomnia
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Muscle tenderness
Rationale: Statins can cause myopathy and rhabdomyolysis. Unexplained muscle pain, tenderness, or weakness must be
reported immediately, and serum creatine kinase (CK) levels evaluated.
Q5 A nurse is reinforcing discharge teaching for a client who has a new prescription for digoxin. Which of the
following should the nurse include in the instructions as an indication of digoxin toxicity?
• Visual changes
• Skin irritation
• Fever
• Angina
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Visual changes
Rationale: Early signs of digoxin toxicity include gastrointestinal upset (anorexia, nausea, vomiting) and neurological/visual
disturbances such as yellow-green halos, blurred vision, or diplopia.
Q6 A nurse is reinforcing teaching for a client who has a new prescription for sublingual nitroglycerin. Which
of the following statements indicates client understanding?
• I will take half a tablet before I exercise
• I can take up to four tablets to relieve my pain
• I will put the tablets in a medication container for easy access
• I may develop a headache after taking this medication
✓ CORRECT ANSWER & CLINICAL EXPLANATION
I may develop a headache after taking this medication
Rationale: Nitroglycerin causes systemic vasodilation, which commonly leads to a transient throbbing headache and facial
flushing. Patients should be reassured this is an expected pharmacological effect.
ATI RN VATI Comprehensive Predictor — Master Study Guide Page 2 of 23
, Q7 A nurse is preparing to administer a dose of furosemide 30 min past the scheduled time. The nurse notes
that there is a new potassium value alert on the client's electronic record. Which action should the nurse take?
• Review the laboratory value prior to preparing the medication
• Administer the medication, and then review the client's laboratory values
• Hold the dose of medication until the provider makes rounds
• Administer the medication, and notify the provider that new laboratory values are available
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Review the laboratory value prior to preparing the medication
Rationale: Furosemide is a potassium-wasting loop diuretic. Severe hypokalemia increases the risk of cardiac dysrhythmias. The
nurse must verify serum potassium before administration.
Q8 A nurse is reinforcing discharge teaching with a client about adverse effects of prescribed medications.
The nurse should tell the client that if black, tarry stools are noted, the client should stop taking which
medication and notify the provider?
• Acetaminophen
• Aspirin
• Guaifenesin
• Loratadine
✓ CORRECT ANSWER & CLINICAL EXPLANATION
Aspirin
Rationale: Aspirin inhibits platelet aggregation and COX-1, leading to gastric mucosal irritation and upper GI bleeding, manifested
as melena (black, tarry stools).
Q9 A provider prescribes levothyroxine 0.3 mg PO daily. Available is levothyroxine 150 mcg/tablet. How many
tablets should the nurse administer?
• 0.5 tablet
• 1 tablet
• 1.5 tablets
• 2 tablets
✓ CORRECT ANSWER & CLINICAL EXPLANATION
2 tablets
Rationale: Convert 0.3 mg to micrograms: 0.3 mg × 1000 = 300 mcg. Dose desired / Dose on hand = 300 mcg / 150 mcg = 2
tablets.
Q10 A nurse is reinforcing teaching with a client who has a prescription for isoniazid and rifampin to treat
tuberculosis. Which of the following should the nurse include in the teaching?
• You may need to take medications to treat tuberculosis for as long as two years
• You can take isoniazid with an antacid if it upsets your stomach
• You will need to have a tuberculin test in 3 months to determine effectiveness
• You should notify the provider if your urine turns orange while taking the medication
✓ CORRECT ANSWER & CLINICAL EXPLANATION
You should notify the provider if your urine turns orange while taking the medication
Rationale: Rifampin causes harmless red-orange discoloration of bodily fluids (urine, sweat, tears). Patients must be educated
about this benign effect, but should report signs of hepatotoxicity (jaundice, dark urine, pale stools).
ATI RN VATI Comprehensive Predictor — Master Study Guide Page 3 of 23
