ATI RN COMPREHENSIVE ADN
PREDICTOR: PRACTICE QUESTIONS &
DETAILED RATIONALES
1. A charge nurse is assigning rooms for four clients. Which client
should be placed in a private room?
A) Client with pneumonia
B) Client with methicillin-resistant Staphylococcus aureus (MRSA)
C) Client with diabetic foot ulcer
D) Client with chronic obstructive pulmonary disease (COPD)
Correct Answer: B
Rationale: MRSA requires contact isolation; a private room is essential to
prevent transmission to other clients. Pneumonia may require droplet
precautions, but MRSA-contact precautions are the priority for single-room
assignment. The diabetic foot ulcer client requires standard or wound
precautions, and COPD is not contagious.
2. A charge nurse is assigning a float RN who usually works in
postpartum to a medical-surgical unit. Which client is most
appropriate to assign?
A) Client in diabetic ketoacidosis (DKA)
B) Client who is postoperative day 2 following an appendectomy, stable
,C) Client with a chest tube for a pneumothorax
D) Client receiving IV heparin for deep vein thrombosis
Correct Answer: B
Rationale: A stable, low-acuity postoperative client is safest for a float
nurse from a different specialty. Complex or unstable clients (chest tube,
titratable heparin with critical lab values, DKA) require an RN with current
experience in those areas. Prioritization follows the ABC framework, and the
stable client represents the safest assignment.
3. A nurse is delegating tasks to an assistive personnel (AP). Which
task is appropriate to delegate?
A) Assess a postoperative incision
B) Teach a client how to use a walker
C) Obtain a capillary blood glucose level
D) Evaluate a client's pain level
Correct Answer: C
Rationale: APs can perform capillary blood glucose testing, obtain vital
signs, and assist with activities of daily living. Assessment, teaching, and
evaluation all require nursing judgment and fall outside the AP's scope of
practice. The RN remains responsible for supervision and evaluation.
4. A competent adult client refuses a blood transfusion for religious
reasons. Which actions should the nurse take? (Select all that apply)
A) Verify the client 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
,Correct Answer: A, B, D
Rationale: Competent adults have autonomy and the right to refuse
treatment. The nurse ensures informed refusal by verifying understanding,
documents the refusal per facility policy, and notifies the provider.
Administering the transfusion against the client's wishes or asking the
family to override violates client rights and ethical principles.
5. A nurse is caring for a client who is 2 hours postoperative following
a thyroidectomy. Which finding should the nurse report to the
provider immediately?
A) Pain rated 4/10
B) Heart rate of 90/min
C) Hoarse voice
D) Stridor on auscultation
Correct Answer: D
Rationale: Stridor is a high-pitched, harsh respiratory sound indicating
airway obstruction, which is a life-threatening emergency in a post-
thyroidectomy client due to potential tracheal compression from edema or
hemorrhage. The airway is the priority. A hoarse voice is expected post-
thyroidectomy, and mild pain with slightly elevated heart rate is expected.
6. A nurse is caring for a client with heart failure receiving furosemide.
Which laboratory value should the nurse monitor most closely?
A) Sodium
B) Potassium
, C) Magnesium
D) Calcium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium
loss through the kidneys, leading to hypokalemia. Hypokalemia can cause
cardiac arrhythmias, especially in clients with heart failure who may also be
receiving digoxin. While sodium, magnesium, and calcium levels are also
affected, potassium is the most critical electrolyte to monitor.
7. A nurse is caring for a client with a prescription for digoxin. Which
assessment finding indicates digoxin toxicity?
A) Heart rate of 68/min with regular rhythm
B) BP 130/80 mmHg
C) Serum potassium of 3.0 mEq/L
D) Serum sodium of 140 mEq/L
Correct Answer: C
Rationale: Hypokalemia (potassium < 3.5 mEq/L) increases the risk of
digoxin toxicity. Digoxin competes with potassium for binding sites on the
sodium-potassium ATPase pump, making the heart more sensitive to
digoxin's effects. Signs of toxicity include visual disturbances (halos), GI
symptoms, and dysrhythmias.
8. A nurse is providing teaching to a client with a depressive disorder
and a new prescription for amitriptyline. Which statement indicates
understanding?
A) "I can continue taking St. John's wort while taking this medication"
B) "I know it will be a couple of weeks before the medication helps me feel
better"
PREDICTOR: PRACTICE QUESTIONS &
DETAILED RATIONALES
1. A charge nurse is assigning rooms for four clients. Which client
should be placed in a private room?
A) Client with pneumonia
B) Client with methicillin-resistant Staphylococcus aureus (MRSA)
C) Client with diabetic foot ulcer
D) Client with chronic obstructive pulmonary disease (COPD)
Correct Answer: B
Rationale: MRSA requires contact isolation; a private room is essential to
prevent transmission to other clients. Pneumonia may require droplet
precautions, but MRSA-contact precautions are the priority for single-room
assignment. The diabetic foot ulcer client requires standard or wound
precautions, and COPD is not contagious.
2. A charge nurse is assigning a float RN who usually works in
postpartum to a medical-surgical unit. Which client is most
appropriate to assign?
A) Client in diabetic ketoacidosis (DKA)
B) Client who is postoperative day 2 following an appendectomy, stable
,C) Client with a chest tube for a pneumothorax
D) Client receiving IV heparin for deep vein thrombosis
Correct Answer: B
Rationale: A stable, low-acuity postoperative client is safest for a float
nurse from a different specialty. Complex or unstable clients (chest tube,
titratable heparin with critical lab values, DKA) require an RN with current
experience in those areas. Prioritization follows the ABC framework, and the
stable client represents the safest assignment.
3. A nurse is delegating tasks to an assistive personnel (AP). Which
task is appropriate to delegate?
A) Assess a postoperative incision
B) Teach a client how to use a walker
C) Obtain a capillary blood glucose level
D) Evaluate a client's pain level
Correct Answer: C
Rationale: APs can perform capillary blood glucose testing, obtain vital
signs, and assist with activities of daily living. Assessment, teaching, and
evaluation all require nursing judgment and fall outside the AP's scope of
practice. The RN remains responsible for supervision and evaluation.
4. A competent adult client refuses a blood transfusion for religious
reasons. Which actions should the nurse take? (Select all that apply)
A) Verify the client 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
,Correct Answer: A, B, D
Rationale: Competent adults have autonomy and the right to refuse
treatment. The nurse ensures informed refusal by verifying understanding,
documents the refusal per facility policy, and notifies the provider.
Administering the transfusion against the client's wishes or asking the
family to override violates client rights and ethical principles.
5. A nurse is caring for a client who is 2 hours postoperative following
a thyroidectomy. Which finding should the nurse report to the
provider immediately?
A) Pain rated 4/10
B) Heart rate of 90/min
C) Hoarse voice
D) Stridor on auscultation
Correct Answer: D
Rationale: Stridor is a high-pitched, harsh respiratory sound indicating
airway obstruction, which is a life-threatening emergency in a post-
thyroidectomy client due to potential tracheal compression from edema or
hemorrhage. The airway is the priority. A hoarse voice is expected post-
thyroidectomy, and mild pain with slightly elevated heart rate is expected.
6. A nurse is caring for a client with heart failure receiving furosemide.
Which laboratory value should the nurse monitor most closely?
A) Sodium
B) Potassium
, C) Magnesium
D) Calcium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium
loss through the kidneys, leading to hypokalemia. Hypokalemia can cause
cardiac arrhythmias, especially in clients with heart failure who may also be
receiving digoxin. While sodium, magnesium, and calcium levels are also
affected, potassium is the most critical electrolyte to monitor.
7. A nurse is caring for a client with a prescription for digoxin. Which
assessment finding indicates digoxin toxicity?
A) Heart rate of 68/min with regular rhythm
B) BP 130/80 mmHg
C) Serum potassium of 3.0 mEq/L
D) Serum sodium of 140 mEq/L
Correct Answer: C
Rationale: Hypokalemia (potassium < 3.5 mEq/L) increases the risk of
digoxin toxicity. Digoxin competes with potassium for binding sites on the
sodium-potassium ATPase pump, making the heart more sensitive to
digoxin's effects. Signs of toxicity include visual disturbances (halos), GI
symptoms, and dysrhythmias.
8. A nurse is providing teaching to a client with a depressive disorder
and a new prescription for amitriptyline. Which statement indicates
understanding?
A) "I can continue taking St. John's wort while taking this medication"
B) "I know it will be a couple of weeks before the medication helps me feel
better"
