ATI RN VATI Comprehensive Predictor
2019 Form A B AN C
1. A nurse is receiving handoff reports on four clients. Which client should the nurse assess
first?
A. A client with diabetes mellitus and an HbA1c of 7.2%
B. A client with a hip fracture who has new-onset shortness of breath
C. A client with an epidural infusion who reports bilateral lower extremity weakness
D. A client in sinus arrhythmia who is on continuous cardiac monitoring
Correct Answer: B
Rationale: New-onset shortness of breath in a client with a hip fracture is a classic sign of a
pulmonary embolism or fat embolism syndrome — both are life-threatening emergencies
requiring immediate assessment and intervention. Option A is a chronic, stable finding. Option C
requires assessment but is not immediately life-threatening. Option D — sinus arrhythmia — is
a normal variant, especially in young clients, and is not emergent.
2. A nurse is teaching a newly licensed nurse about delegation principles. Which task is
appropriate to delegate to an assistive personnel (AP)?
A. Performing a dressing change on a client who just had an amputation
B. Evaluating the effectiveness of an antiemetic medication
C. Placing a condom catheter on a client with a spinal cord injury
D. Providing discharge teaching to a client with heart failure
Correct Answer: C
Rationale: Placing a condom catheter is a predictable, routine task that can be safely
delegated to AP under the nurse's supervision and after the nurse has assessed the client.
Dressing changes require sterile technique and wound assessment (RN responsibility).
Evaluating medication effectiveness requires nursing assessment and clinical judgment.
Discharge teaching is an RN responsibility and cannot be delegated.
,3. A nurse is about to administer a medication when the client states, "This pill looks different
from the one I take at home." Which of the following responses by the nurse is most
appropriate?
A. "I recommend you take it as prescribed."
B. "I will contact the pharmacist to verify this medication right now."
C. "It is probably just a different manufacturer."
D. "You can take it and let me know if you have any problems."
Correct Answer: B
Rationale: The client has the right to refuse and to question the medication. The nurse
should verify the medication with the pharmacist before administering it. Administering a
medication that looks different without verification violates the client's rights and the six rights
of medication administration. Options A, C, and D dismiss the client's legitimate concern.
4. A client with schizophrenia has a new prescription for clozapine. The nurse should instruct
the client to report which of the following symptoms immediately?
A. Constipation
B. Blurred vision
C. Fever
D. Dry mouth
Correct Answer: C
Rationale: Clozapine carries a black box warning for severe neutropenia and
agranulocytosis. Fever and sore throat are the earliest signs of infection related to neutropenia
and require immediate reporting. Constipation, blurred vision, and dry mouth are common
anticholinergic side effects that are uncomfortable but not life-threatening.
5. A nurse is caring for a client who has suicidal ideation. The client states, "There's no point
in living. Why not just end it all?" Which response by the nurse is most appropriate?
A. "You should think about your family."
B. "You're having thoughts of ending your life, and that concerns me. Let's talk about how we
can keep you safe."
C. "You don't really mean that."
D. "Everyone has ups and downs in life."
, Correct Answer: B
Rationale: Therapeutic communication requires the nurse to directly and honestly
acknowledge the client's feelings, express concern, and assess the severity of the suicidal
ideation while planning safety interventions. Options A and D minimize the client's feelings.
Option C denies the client's stated intention.
6. A nurse is making client assignments for a pregnant staff member. Which client should the
nurse avoid assigning to this staff member?
A. A 60-year-old client recovering from herpes zoster (shingles)
B. A 20-year-old client who is HIV-positive
C. A 40-year-old client with suspected tuberculosis
D. An 80-year-old client with alcoholic pancreatitis and impetigo
Correct Answer: C
Rationale: Suspected tuberculosis requires airborne precautions. A pregnant nurse is at
increased risk for complications from airborne infections and should not care for this client if
avoidable. Herpes zoster requires standard precautions. HIV requires standard precautions.
Impetigo requires contact precautions — all safe with appropriate PPE.
7. A nurse is administering divalproex sodium extended-release to a client with dysphagia.
How should the nurse administer this medication?
A. Crush the tablet and mix it with water.
B. Administer the whole tablet with applesauce.
C. Dissolve the tablet in juice.
D. Open the capsule and sprinkle the contents on food.
Correct Answer: B
Rationale: Extended-release formulations must NOT be crushed, chewed, or opened, as this
destroys the release mechanism and can cause dose dumping (rapid release of the entire dose),
leading to toxicity. Administering the whole tablet with a soft food like applesauce helps with
swallowing. Juices can interfere with the absorption of some medications.
, 8. A nurse is assessing a Jewish client's adherence to a kosher diet. Which behavior should the
nurse expect?
A. Eating leavened bread during Passover
B. Frequently eating shellfish
C. Separating meat and dairy products
D. Fasting from meat during Hanukkah
Correct Answer: C
Rationale: Kosher dietary laws require strict separation of meat and dairy products — they
cannot be eaten together or prepared with the same utensils. Shellfish is not kosher. Leavened
bread is prohibited during Passover. Hanukkah does not require fasting from meat.
9. A nurse is assessing a client who was in a motor vehicle crash and sustained minor injuries.
The client appears agitated and anxious. The nurse recognizes the client is in the alarm stage
of general adaptation syndrome (GAS). Which finding should the nurse expect?
A. Bradycardia
B. Tachycardia
C. Hypothermia
D. Hypoglycemia
Correct Answer: B
Rationale: The alarm stage is the "fight-or-flight" response, mediated by sympathetic
nervous system activation. This causes tachycardia, increased blood pressure, increased blood
glucose, and increased respiratory rate. Bradycardia, hypothermia, and hypoglycemia are
opposite to the expected findings.
10. A nurse is caring for a client on bed rest with Buck's traction following a femur fracture.
Which action should the nurse take?
A. Check the skin under the traction device every 8 hours.
B. Loosen the traction every 2 hours.
C. Place additional weights on the traction rope.
D. Position the client in semi-Fowler's position.
Correct Answer: A
2019 Form A B AN C
1. A nurse is receiving handoff reports on four clients. Which client should the nurse assess
first?
A. A client with diabetes mellitus and an HbA1c of 7.2%
B. A client with a hip fracture who has new-onset shortness of breath
C. A client with an epidural infusion who reports bilateral lower extremity weakness
D. A client in sinus arrhythmia who is on continuous cardiac monitoring
Correct Answer: B
Rationale: New-onset shortness of breath in a client with a hip fracture is a classic sign of a
pulmonary embolism or fat embolism syndrome — both are life-threatening emergencies
requiring immediate assessment and intervention. Option A is a chronic, stable finding. Option C
requires assessment but is not immediately life-threatening. Option D — sinus arrhythmia — is
a normal variant, especially in young clients, and is not emergent.
2. A nurse is teaching a newly licensed nurse about delegation principles. Which task is
appropriate to delegate to an assistive personnel (AP)?
A. Performing a dressing change on a client who just had an amputation
B. Evaluating the effectiveness of an antiemetic medication
C. Placing a condom catheter on a client with a spinal cord injury
D. Providing discharge teaching to a client with heart failure
Correct Answer: C
Rationale: Placing a condom catheter is a predictable, routine task that can be safely
delegated to AP under the nurse's supervision and after the nurse has assessed the client.
Dressing changes require sterile technique and wound assessment (RN responsibility).
Evaluating medication effectiveness requires nursing assessment and clinical judgment.
Discharge teaching is an RN responsibility and cannot be delegated.
,3. A nurse is about to administer a medication when the client states, "This pill looks different
from the one I take at home." Which of the following responses by the nurse is most
appropriate?
A. "I recommend you take it as prescribed."
B. "I will contact the pharmacist to verify this medication right now."
C. "It is probably just a different manufacturer."
D. "You can take it and let me know if you have any problems."
Correct Answer: B
Rationale: The client has the right to refuse and to question the medication. The nurse
should verify the medication with the pharmacist before administering it. Administering a
medication that looks different without verification violates the client's rights and the six rights
of medication administration. Options A, C, and D dismiss the client's legitimate concern.
4. A client with schizophrenia has a new prescription for clozapine. The nurse should instruct
the client to report which of the following symptoms immediately?
A. Constipation
B. Blurred vision
C. Fever
D. Dry mouth
Correct Answer: C
Rationale: Clozapine carries a black box warning for severe neutropenia and
agranulocytosis. Fever and sore throat are the earliest signs of infection related to neutropenia
and require immediate reporting. Constipation, blurred vision, and dry mouth are common
anticholinergic side effects that are uncomfortable but not life-threatening.
5. A nurse is caring for a client who has suicidal ideation. The client states, "There's no point
in living. Why not just end it all?" Which response by the nurse is most appropriate?
A. "You should think about your family."
B. "You're having thoughts of ending your life, and that concerns me. Let's talk about how we
can keep you safe."
C. "You don't really mean that."
D. "Everyone has ups and downs in life."
, Correct Answer: B
Rationale: Therapeutic communication requires the nurse to directly and honestly
acknowledge the client's feelings, express concern, and assess the severity of the suicidal
ideation while planning safety interventions. Options A and D minimize the client's feelings.
Option C denies the client's stated intention.
6. A nurse is making client assignments for a pregnant staff member. Which client should the
nurse avoid assigning to this staff member?
A. A 60-year-old client recovering from herpes zoster (shingles)
B. A 20-year-old client who is HIV-positive
C. A 40-year-old client with suspected tuberculosis
D. An 80-year-old client with alcoholic pancreatitis and impetigo
Correct Answer: C
Rationale: Suspected tuberculosis requires airborne precautions. A pregnant nurse is at
increased risk for complications from airborne infections and should not care for this client if
avoidable. Herpes zoster requires standard precautions. HIV requires standard precautions.
Impetigo requires contact precautions — all safe with appropriate PPE.
7. A nurse is administering divalproex sodium extended-release to a client with dysphagia.
How should the nurse administer this medication?
A. Crush the tablet and mix it with water.
B. Administer the whole tablet with applesauce.
C. Dissolve the tablet in juice.
D. Open the capsule and sprinkle the contents on food.
Correct Answer: B
Rationale: Extended-release formulations must NOT be crushed, chewed, or opened, as this
destroys the release mechanism and can cause dose dumping (rapid release of the entire dose),
leading to toxicity. Administering the whole tablet with a soft food like applesauce helps with
swallowing. Juices can interfere with the absorption of some medications.
, 8. A nurse is assessing a Jewish client's adherence to a kosher diet. Which behavior should the
nurse expect?
A. Eating leavened bread during Passover
B. Frequently eating shellfish
C. Separating meat and dairy products
D. Fasting from meat during Hanukkah
Correct Answer: C
Rationale: Kosher dietary laws require strict separation of meat and dairy products — they
cannot be eaten together or prepared with the same utensils. Shellfish is not kosher. Leavened
bread is prohibited during Passover. Hanukkah does not require fasting from meat.
9. A nurse is assessing a client who was in a motor vehicle crash and sustained minor injuries.
The client appears agitated and anxious. The nurse recognizes the client is in the alarm stage
of general adaptation syndrome (GAS). Which finding should the nurse expect?
A. Bradycardia
B. Tachycardia
C. Hypothermia
D. Hypoglycemia
Correct Answer: B
Rationale: The alarm stage is the "fight-or-flight" response, mediated by sympathetic
nervous system activation. This causes tachycardia, increased blood pressure, increased blood
glucose, and increased respiratory rate. Bradycardia, hypothermia, and hypoglycemia are
opposite to the expected findings.
10. A nurse is caring for a client on bed rest with Buck's traction following a femur fracture.
Which action should the nurse take?
A. Check the skin under the traction device every 8 hours.
B. Loosen the traction every 2 hours.
C. Place additional weights on the traction rope.
D. Position the client in semi-Fowler's position.
Correct Answer: A
