ATI RN COMPREHENSIVE PREDICTOR NGN-STYLE SET 4
EXAM QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. During morning coordination rounds, a client asks the nurse to explain a surgical procedure
immediately before signing consent. Which response is appropriate?
A. Explain all surgical risks and obtain the signature
B. Have a family member explain the procedure
C. Sign the consent as the client's surrogate
D. Notify the provider because the provider performing the procedure is responsible for explaining risks, benefits,
and alternatives
Correct Answer: D. Notify the provider because the provider performing the procedure is responsible for
explaining risks, benefits, and alternatives
Rationale: The procedural provider obtains informed consent; the nurse may witness the signature and reinforce
information but should not substitute for the provider's explanation.
2. On a medical-surgical unit, a client with heart failure exacerbation has the expected presentation of
dyspnea, crackles, orthopnea, and rapid weight gain. Which worsening development should the nurse
anticipate as a major complication?
A. thrombosis and neurologic injury
B. pulmonary edema
C. arrhythmia and heart failure
D. venous thrombosis
Correct Answer: B. pulmonary edema
Rationale: A major complication of heart failure exacerbation is pulmonary edema.
3. During a preventive-care visit, a client plans international travel. Which health-promotion step should
occur early?
A. Wait until returning to discuss travel health
B. Review destination-specific vaccines, medications, and health risks several weeks before travel
C. Stop routine medications during travel
D. Assume all destinations have identical vaccine requirements
Correct Answer: B. Review destination-specific vaccines, medications, and health risks several weeks before
travel
Rationale: Travel recommendations depend on destination, itinerary, health status, and time available before
departure.
4. During a home-health medication check, which client condition most commonly explains a prescription
for hydroxychloroquine?
A. rheumatoid arthritis and lupus
B. serious susceptible bacterial infections
C. type 2 diabetes
D. arthritis pain and inflammation
Correct Answer: A. rheumatoid arthritis and lupus
Rationale: hydroxychloroquine, a DMARD/antimalarial, is commonly used for rheumatoid arthritis and lupus.
5. During a comfort and mobility assessment, which nursing action best addresses dysphagia after stroke?
A. use multimodal pain control, position for comfort, and reassess response after intervention
B. establish scheduled toileting, assess contributing factors, and protect skin
C. keep the client upright, follow the prescribed texture/feeding plan, and use swallowing precautions
D. provide frequent oral care and water-based moisturizers while assessing hydration
Correct Answer: C. keep the client upright, follow the prescribed texture/feeding plan, and use swallowing
precautions
Rationale: Dysphagia increases aspiration risk; positioning and the individualized swallowing plan are key safety
measures.
6. During a focused safety round, a nurse enters a contact-precaution room wearing gown and gloves.
Which PPE should generally be removed first when leaving?
A. Mask before touching anything else
,B. Clean shoe covers after leaving the unit
C. Eyeglasses before gloves
D. Gloves because they are usually the most contaminated item
Correct Answer: D. Gloves because they are usually the most contaminated item
Rationale: Gloves are typically most contaminated and are removed early in the doffing sequence while avoiding
contamination.
7. A client with untreated hyperthyroidism develops temperature 40.2 C, HR 154/min, agitation, and
vomiting. Which condition should the nurse suspect?
40. 2 C T 154/min HR Marked agitation Behavior Hyperthyroidism History
A. Myxedema coma
B. Thyroid storm
C. Addisonian crisis
D. Diabetic ketoacidosis
Correct Answer: B. Thyroid storm
Rationale: Extreme fever, tachycardia, GI symptoms, and agitation in hyperthyroidism are classic for thyroid
storm.
8. While planning comfort-focused bedside care, which client statement demonstrates correct teaching
about nausea after surgery?
A. comfort medications are titrated to relieve suffering rather than to hasten death
B. shift weight frequently and avoid prolonged pressure on vulnerable areas
C. take small frequent sips and foods as tolerated and report persistent vomiting
D. increase dietary fiber gradually and maintain hydration unless restricted
Correct Answer: C. take small frequent sips and foods as tolerated and report persistent vomiting
Rationale: Symptom control and gradual intake help prevent dehydration while the nurse remains alert for signs
of complications.
9. While assessing coping and safety, a client is experiencing moderate dementia. Which nursing action is
the priority?
A. use routines, environmental cues, safety planning, and caregiver support while assessing reversible
contributors to decline
B. use a validated withdrawal scale and administer symptom-triggered benzodiazepine therapy as prescribed
while monitoring for seizures and delirium
C. promote safety, identify triggers, and support evidence-based trauma-focused treatment
D. initiate the prescribed high-level suicide precautions, remove hazards, and maintain direct safety observation
as indicated
Correct Answer: A. use routines, environmental cues, safety planning, and caregiver support while assessing
reversible contributors to decline
Rationale: Dementia care emphasizes function, predictability, dignity, and safety; confrontation can increase
distress.
10. During morning coordination rounds, during assignment planning, which activity can the RN safely
delegate for a stable client with heart failure who requires the morning daily weight?
A. Obtain and record the morning weight using the same scale
B. Interpret a 1.8-kg overnight weight gain and change the plan of care
C. Teach the client how sodium affects fluid retention
D. Evaluate the response to a newly started loop diuretic
Correct Answer: A. Obtain and record the morning weight using the same scale
Rationale: Obtaining routine measurements is delegable; assessment, teaching, and evaluation remain RN
responsibilities.
11. During a preventive-care visit, a client with no contraindications asks how much sleep most adults need.
Which response is reasonable?
A. Most adults benefit from about 7 or more hours of sleep per night on a regular basis
B. Two to three hours is adequate for adults
C. Adults should avoid regular sleep schedules
D. Sleep needs disappear after age 65
Correct Answer: A. Most adults benefit from about 7 or more hours of sleep per night on a regular basis
, Rationale: Most adults need at least about 7 hours of regular sleep, though individual needs vary.
12. During an interprofessional safety huddle, a nurse documents care in the electronic health record.
Which entry is appropriate?
A. A note blaming the client for nonadherence
B. An altered entry that hides a medication error
C. An unapproved abbreviation that could be misread
D. Objective, timely documentation of assessments, interventions, and the client response
Correct Answer: D. Objective, timely documentation of assessments, interventions, and the client response
Rationale: Health records should be accurate, objective, timely, and consistent with professional and
organizational standards.
13. At a chronic-care clinic visit, a medication order for metoclopramide is added to the chart. Which
clinical purpose best fits this drug?
A. serious susceptible bacterial infections
B. rheumatoid arthritis and lupus
C. gastroparesis and selected nausea
D. type 2 diabetes
Correct Answer: C. gastroparesis and selected nausea
Rationale: metoclopramide, a dopamine antagonist/prokinetic, is commonly used for gastroparesis and selected
nausea.
14. A client with SIADH has sodium values of 128, 124, and 119 mEq/L over 8 hours and becomes
increasingly confused. Which complication is the nurse most concerned about? 128 mEq/L 0800 Na 124
mEq/L 1200 Na 119 mEq/L; confusion worsening 1600 Na
A. Cerebral edema and seizure from worsening hyponatremia
B. Hypercalcemic crisis
C. Iron overload
D. Metabolic alkalosis from potassium excess
Correct Answer: A. Cerebral edema and seizure from worsening hyponatremia
Rationale: Rapidly worsening severe hyponatremia can cause cerebral edema, confusion, and seizures.
15. While preparing care for a high-risk client, which transmission-based precaution is best for a client
with rubella?
A. Airborne precautions
B. Droplet precautions
C. Contact precautions only
D. Protective isolation
Correct Answer: B. Droplet precautions
Rationale: Rubella is spread through respiratory droplets and requires droplet precautions.
16. A client with a known bowel obstruction develops constant severe abdominal pain, fever, tachycardia,
and a rigid abdomen. What should the nurse suspect? Intermittent cramping pain Earlier Constant severe
pain; fever; rigid abdomen Now
A. Resolution of the obstruction
B. Simple constipation
C. Bowel ischemia or perforation requiring urgent surgical evaluation
D. Expected response to nasogastric decompression
Correct Answer: C. Bowel ischemia or perforation requiring urgent surgical evaluation
Rationale: A change from colicky to constant severe pain with peritoneal signs suggests strangulation, ischemia,
or perforation.
17. While planning comfort-focused bedside care, a client is experiencing dysphagia after stroke. Which
assessment finding is most consistent with this care need?
A. air hunger in a client receiving comfort-focused end-of-life care
B. coughing or wet voice during meals and food pocketing
C. difficulty locating objects and navigating an unfamiliar room
D. dry oral mucosa with inability to perform self-care
Correct Answer: B. coughing or wet voice during meals and food pocketing
EXAM QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. During morning coordination rounds, a client asks the nurse to explain a surgical procedure
immediately before signing consent. Which response is appropriate?
A. Explain all surgical risks and obtain the signature
B. Have a family member explain the procedure
C. Sign the consent as the client's surrogate
D. Notify the provider because the provider performing the procedure is responsible for explaining risks, benefits,
and alternatives
Correct Answer: D. Notify the provider because the provider performing the procedure is responsible for
explaining risks, benefits, and alternatives
Rationale: The procedural provider obtains informed consent; the nurse may witness the signature and reinforce
information but should not substitute for the provider's explanation.
2. On a medical-surgical unit, a client with heart failure exacerbation has the expected presentation of
dyspnea, crackles, orthopnea, and rapid weight gain. Which worsening development should the nurse
anticipate as a major complication?
A. thrombosis and neurologic injury
B. pulmonary edema
C. arrhythmia and heart failure
D. venous thrombosis
Correct Answer: B. pulmonary edema
Rationale: A major complication of heart failure exacerbation is pulmonary edema.
3. During a preventive-care visit, a client plans international travel. Which health-promotion step should
occur early?
A. Wait until returning to discuss travel health
B. Review destination-specific vaccines, medications, and health risks several weeks before travel
C. Stop routine medications during travel
D. Assume all destinations have identical vaccine requirements
Correct Answer: B. Review destination-specific vaccines, medications, and health risks several weeks before
travel
Rationale: Travel recommendations depend on destination, itinerary, health status, and time available before
departure.
4. During a home-health medication check, which client condition most commonly explains a prescription
for hydroxychloroquine?
A. rheumatoid arthritis and lupus
B. serious susceptible bacterial infections
C. type 2 diabetes
D. arthritis pain and inflammation
Correct Answer: A. rheumatoid arthritis and lupus
Rationale: hydroxychloroquine, a DMARD/antimalarial, is commonly used for rheumatoid arthritis and lupus.
5. During a comfort and mobility assessment, which nursing action best addresses dysphagia after stroke?
A. use multimodal pain control, position for comfort, and reassess response after intervention
B. establish scheduled toileting, assess contributing factors, and protect skin
C. keep the client upright, follow the prescribed texture/feeding plan, and use swallowing precautions
D. provide frequent oral care and water-based moisturizers while assessing hydration
Correct Answer: C. keep the client upright, follow the prescribed texture/feeding plan, and use swallowing
precautions
Rationale: Dysphagia increases aspiration risk; positioning and the individualized swallowing plan are key safety
measures.
6. During a focused safety round, a nurse enters a contact-precaution room wearing gown and gloves.
Which PPE should generally be removed first when leaving?
A. Mask before touching anything else
,B. Clean shoe covers after leaving the unit
C. Eyeglasses before gloves
D. Gloves because they are usually the most contaminated item
Correct Answer: D. Gloves because they are usually the most contaminated item
Rationale: Gloves are typically most contaminated and are removed early in the doffing sequence while avoiding
contamination.
7. A client with untreated hyperthyroidism develops temperature 40.2 C, HR 154/min, agitation, and
vomiting. Which condition should the nurse suspect?
40. 2 C T 154/min HR Marked agitation Behavior Hyperthyroidism History
A. Myxedema coma
B. Thyroid storm
C. Addisonian crisis
D. Diabetic ketoacidosis
Correct Answer: B. Thyroid storm
Rationale: Extreme fever, tachycardia, GI symptoms, and agitation in hyperthyroidism are classic for thyroid
storm.
8. While planning comfort-focused bedside care, which client statement demonstrates correct teaching
about nausea after surgery?
A. comfort medications are titrated to relieve suffering rather than to hasten death
B. shift weight frequently and avoid prolonged pressure on vulnerable areas
C. take small frequent sips and foods as tolerated and report persistent vomiting
D. increase dietary fiber gradually and maintain hydration unless restricted
Correct Answer: C. take small frequent sips and foods as tolerated and report persistent vomiting
Rationale: Symptom control and gradual intake help prevent dehydration while the nurse remains alert for signs
of complications.
9. While assessing coping and safety, a client is experiencing moderate dementia. Which nursing action is
the priority?
A. use routines, environmental cues, safety planning, and caregiver support while assessing reversible
contributors to decline
B. use a validated withdrawal scale and administer symptom-triggered benzodiazepine therapy as prescribed
while monitoring for seizures and delirium
C. promote safety, identify triggers, and support evidence-based trauma-focused treatment
D. initiate the prescribed high-level suicide precautions, remove hazards, and maintain direct safety observation
as indicated
Correct Answer: A. use routines, environmental cues, safety planning, and caregiver support while assessing
reversible contributors to decline
Rationale: Dementia care emphasizes function, predictability, dignity, and safety; confrontation can increase
distress.
10. During morning coordination rounds, during assignment planning, which activity can the RN safely
delegate for a stable client with heart failure who requires the morning daily weight?
A. Obtain and record the morning weight using the same scale
B. Interpret a 1.8-kg overnight weight gain and change the plan of care
C. Teach the client how sodium affects fluid retention
D. Evaluate the response to a newly started loop diuretic
Correct Answer: A. Obtain and record the morning weight using the same scale
Rationale: Obtaining routine measurements is delegable; assessment, teaching, and evaluation remain RN
responsibilities.
11. During a preventive-care visit, a client with no contraindications asks how much sleep most adults need.
Which response is reasonable?
A. Most adults benefit from about 7 or more hours of sleep per night on a regular basis
B. Two to three hours is adequate for adults
C. Adults should avoid regular sleep schedules
D. Sleep needs disappear after age 65
Correct Answer: A. Most adults benefit from about 7 or more hours of sleep per night on a regular basis
, Rationale: Most adults need at least about 7 hours of regular sleep, though individual needs vary.
12. During an interprofessional safety huddle, a nurse documents care in the electronic health record.
Which entry is appropriate?
A. A note blaming the client for nonadherence
B. An altered entry that hides a medication error
C. An unapproved abbreviation that could be misread
D. Objective, timely documentation of assessments, interventions, and the client response
Correct Answer: D. Objective, timely documentation of assessments, interventions, and the client response
Rationale: Health records should be accurate, objective, timely, and consistent with professional and
organizational standards.
13. At a chronic-care clinic visit, a medication order for metoclopramide is added to the chart. Which
clinical purpose best fits this drug?
A. serious susceptible bacterial infections
B. rheumatoid arthritis and lupus
C. gastroparesis and selected nausea
D. type 2 diabetes
Correct Answer: C. gastroparesis and selected nausea
Rationale: metoclopramide, a dopamine antagonist/prokinetic, is commonly used for gastroparesis and selected
nausea.
14. A client with SIADH has sodium values of 128, 124, and 119 mEq/L over 8 hours and becomes
increasingly confused. Which complication is the nurse most concerned about? 128 mEq/L 0800 Na 124
mEq/L 1200 Na 119 mEq/L; confusion worsening 1600 Na
A. Cerebral edema and seizure from worsening hyponatremia
B. Hypercalcemic crisis
C. Iron overload
D. Metabolic alkalosis from potassium excess
Correct Answer: A. Cerebral edema and seizure from worsening hyponatremia
Rationale: Rapidly worsening severe hyponatremia can cause cerebral edema, confusion, and seizures.
15. While preparing care for a high-risk client, which transmission-based precaution is best for a client
with rubella?
A. Airborne precautions
B. Droplet precautions
C. Contact precautions only
D. Protective isolation
Correct Answer: B. Droplet precautions
Rationale: Rubella is spread through respiratory droplets and requires droplet precautions.
16. A client with a known bowel obstruction develops constant severe abdominal pain, fever, tachycardia,
and a rigid abdomen. What should the nurse suspect? Intermittent cramping pain Earlier Constant severe
pain; fever; rigid abdomen Now
A. Resolution of the obstruction
B. Simple constipation
C. Bowel ischemia or perforation requiring urgent surgical evaluation
D. Expected response to nasogastric decompression
Correct Answer: C. Bowel ischemia or perforation requiring urgent surgical evaluation
Rationale: A change from colicky to constant severe pain with peritoneal signs suggests strangulation, ischemia,
or perforation.
17. While planning comfort-focused bedside care, a client is experiencing dysphagia after stroke. Which
assessment finding is most consistent with this care need?
A. air hunger in a client receiving comfort-focused end-of-life care
B. coughing or wet voice during meals and food pocketing
C. difficulty locating objects and navigating an unfamiliar room
D. dry oral mucosa with inability to perform self-care
Correct Answer: B. coughing or wet voice during meals and food pocketing
