ATI RN COMPREHENSIVE PREDICTOR - SET 1 EXAM
QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. A client with suspected fat embolism syndrome has respiratory distress, neurologic changes, and
petechiae after long-bone fracture. Which action should occur next?
A. support oxygenation and stabilize fracture
B. titrate oxygen to prescribed target and give bronchodilators
C. give rapid bronchodilation and assess response
D. lung-protective ventilation and treat underlying cause
Correct Answer: A. support oxygenation and stabilize fracture
Rationale: The priority for fat embolism syndrome is to support oxygenation and stabilize fracture. This
addresses the immediate pathophysiology and reduces the risk of ARDS.
2. Which finding most strongly supports borderline personality disorder with escalating self-harm threats?
A. intense fear of abandonment, unstable relationships, affective instability, and recurrent self-harm behavior
B. decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity
C. time-consuming intrusive thoughts and repetitive rituals performed to reduce anxiety
D. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe
Correct Answer: A. intense fear of abandonment, unstable relationships, affective instability, and recurrent
self-harm behavior
Rationale: intense fear of abandonment, unstable relationships, affective instability, and recurrent self-harm
behavior is characteristic of borderline personality disorder with escalating self-harm threats.
3. A client is being transferred from intensive care to a medical unit. Which information is essential in the
handoff?
A. Current condition, recent changes, code status, lines/drains, high-risk medications, pending tests, and
anticipated concerns
B. Only the client's room number
C. Only the admission diagnosis
D. Only the names of family members
Correct Answer: A. Current condition, recent changes, code status, lines/drains, high-risk medications, pending
tests, and anticipated concerns
Rationale: A safe transfer handoff communicates current risks, therapies, pending work, and contingency plans.
4. A client with upper GI bleed has hematemesis or melena with possible orthostasis. Which complication is
the nurse most concerned about detecting early? upper GI bleed Condition hematemesis or melena with
possible orthostasis Initial cue Trend change and recognize risk early Nursing focus
A. infection and organ injury
B. hemorrhagic shock
C. spontaneous bacterial peritonitis or variceal bleeding
D. hypocalcemia, shock, or organ failure
Correct Answer: B. hemorrhagic shock
Rationale: A recognized serious complication of upper GI bleed is hemorrhagic shock. Focused surveillance
supports early escalation and treatment.
5. Which transmission-based precaution is most appropriate for a client with a client with suspected Ebola
virus disease and epidemiologic risk?
A. Place the client in the general waiting room
B. Immediately isolate and follow the facility/public-health high-consequence pathogen protocol with
recommended PPE
C. Use standard precautions only until laboratory confirmation
D. Send the client home without notifying infection prevention
Correct Answer: B. Immediately isolate and follow the facility/public-health high-consequence pathogen
protocol with recommended PPE
Rationale: Suspected high-consequence viral hemorrhagic fever requires immediate isolation,
infection-prevention escalation, and public-health coordination.
6. The nurse is caring for a client taking empagliflozin. Which parameter is most important to monitor for
safe ongoing therapy?
A. respiratory rate, sedation, pain
,B. drug level, renal function, blood pressure
C. pulse and respiratory symptoms
D. renal function, volume status, and glucose
Correct Answer: D. renal function, volume status, and glucose
Rationale: empagliflozin is a SGLT2 inhibitor. Its relevant priority monitoring parameter is renal function,
volume status, and glucose; safe nursing care requires connecting the medication class with its expected effects,
monitoring needs, and major risks.
7. An adult client asks which oral-health habit supports prevention. Which teaching is appropriate?
A. Use sugar-sweetened drinks to strengthen enamel
B. Brush with fluoride toothpaste and obtain regular dental care based on individual risk
C. Stop brushing if gums bleed once
D. Replace brushing with mouthwash alone
Correct Answer: B. Brush with fluoride toothpaste and obtain regular dental care based on individual risk
Rationale: Regular fluoride toothpaste use, interdental cleaning, and dental care support oral-health prevention.
8. Which description best explains the therapeutic action of trimethoprim-sulfamethoxazole?
A. binds bacterial 30S ribosome causing faulty protein synthesis
B. competitively blocks opioid receptors
C. reduces central prostaglandin synthesis
D. inhibits sequential folate synthesis steps
Correct Answer: D. inhibits sequential folate synthesis steps
Rationale: trimethoprim-sulfamethoxazole is a folate antagonist combination. Its relevant mechanism of action is
inhibits sequential folate synthesis steps; safe nursing care requires connecting the medication class with its
expected effects, monitoring needs, and major risks.
9. A client is experiencing postoperative pain. Which finding is most consistent with this care need?
A. incisional pain that worsens with movement but is accompanied by stable vital signs and a benign wound
assessment
B. air hunger in a client receiving comfort-focused end-of-life care
C. coughing or wet voice during meals and food pocketing
D. frequent loose stools with moist erythematous perineal skin
Correct Answer: A. incisional pain that worsens with movement but is accompanied by stable vital signs and a
benign wound assessment
Rationale: incisional pain that worsens with movement but is accompanied by stable vital signs and a benign
wound assessment is a common cue when caring for postoperative pain.
10. The emergency nurse recognizes central adiposity, proximal weakness, bruising, and hyperglycemia as
Cushing syndrome. Which treatment or nursing action has the highest priority?
A. replace fluids and give desmopressin for central DI when ordered
B. start isotonic fluids then insulin with close potassium monitoring
C. identify source and reduce excess glucocorticoid exposure safely
D. aggressive fluid replacement then insulin and electrolyte management
Correct Answer: C. identify source and reduce excess glucocorticoid exposure safely
Rationale: The priority for Cushing syndrome is to identify source and reduce excess glucocorticoid exposure
safely. This addresses the immediate pathophysiology and reduces the risk of infection, diabetes, osteoporosis.
11. Which nurse response is most therapeutic for a client experiencing borderline personality disorder with
escalating self-harm threats?
A. Use calm orientation and explain that symptoms are being monitored and treated
B. Validate the emotion while setting clear boundaries, such as, "I can see you are overwhelmed; we will work
with you using the same safety plan."
C. After stabilization, use nonjudgmental language and offer overdose-prevention and treatment resources
D. Say, "Tell me what you miss most about your spouse," and allow silence
Correct Answer: B. Validate the emotion while setting clear boundaries, such as, "I can see you are
overwhelmed; we will work with you using the same safety plan."
Rationale: Consistent boundaries and direct risk assessment reduce splitting and support safety without
reinforcing maladaptive behavior.
12. The nurse is caring for four postpartum clients. Which client should the nurse assess first?
, A. a client 1 hour after vaginal birth with a boggy uterus and rapidly saturating a perineal pad
B. a client with afterpains while breastfeeding
C. a client requesting help with newborn swaddling
D. a client with perineal edema relieved by an ice pack
Correct Answer: A. a client 1 hour after vaginal birth with a boggy uterus and rapidly saturating a perineal pad
Rationale: A boggy uterus with heavy bleeding suggests uterine atony and postpartum hemorrhage.
13. Which cluster of findings is most consistent with cirrhosis with ascites?
A. hematemesis or melena with possible orthostasis
B. surgical wound opens with visible tissue or organs
C. periumbilical pain migrating to right lower quadrant with anorexia
D. portal hypertension with edema/ascites and synthetic dysfunction
Correct Answer: D. portal hypertension with edema/ascites and synthetic dysfunction
Rationale: portal hypertension with edema/ascites and synthetic dysfunction is a characteristic presentation of
cirrhosis with ascites; recognizing this pattern reduces delay in evaluation and management.
14. Which infection-control plan is appropriate for a client with measles?
A. Airborne precautions with appropriate respiratory protection
B. Standard precautions only
C. Contact precautions only
D. Droplet precautions only
Correct Answer: A. Airborne precautions with appropriate respiratory protection
Rationale: Measles is highly contagious through airborne transmission and requires airborne precautions.
15. A client with a new stroke has dysphagia and difficulty communicating. Which interdisciplinary
referral should the nurse prioritize?
A. Speech-language pathology
B. Dermatology
C. Podiatry
D. Ophthalmic surgery
Correct Answer: A. Speech-language pathology
Rationale: Speech-language pathologists evaluate swallowing safety and communication after stroke.
16. A 16-year-old asks about preventing sexually transmitted infections. Which teaching is most
appropriate?
A. Rely on appearance to determine whether a partner has an infection
B. Use antibiotics after every sexual encounter
C. Use condoms consistently and correctly and obtain recommended screening/vaccination based on risk
D. Avoid vaccination because it increases infection risk
Correct Answer: C. Use condoms consistently and correctly and obtain recommended screening/vaccination
based on risk
Rationale: Barrier protection, appropriate screening, and vaccination such as HPV vaccination reduce STI risk.
17. Which description best explains the therapeutic action of filgrastim?
A. relaxes arterial smooth muscle
B. reduces aqueous humor production
C. blocks muscarinic bronchoconstriction
D. stimulates neutrophil production
Correct Answer: D. stimulates neutrophil production
Rationale: filgrastim is a G-CSF. Its relevant mechanism of action is stimulates neutrophil production; safe
nursing care requires connecting the medication class with its expected effects, monitoring needs, and major risks.
18. A client is experiencing diarrhea with perineal irritation. Which finding is most consistent with this
care need?
A. nonblanchable erythema over a pressure point in an immobile client
B. difficulty repositioning with intact cognition and stable cardiopulmonary status
C. coughing or wet voice during meals and food pocketing
D. frequent loose stools with moist erythematous perineal skin
Correct Answer: D. frequent loose stools with moist erythematous perineal skin
QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. A client with suspected fat embolism syndrome has respiratory distress, neurologic changes, and
petechiae after long-bone fracture. Which action should occur next?
A. support oxygenation and stabilize fracture
B. titrate oxygen to prescribed target and give bronchodilators
C. give rapid bronchodilation and assess response
D. lung-protective ventilation and treat underlying cause
Correct Answer: A. support oxygenation and stabilize fracture
Rationale: The priority for fat embolism syndrome is to support oxygenation and stabilize fracture. This
addresses the immediate pathophysiology and reduces the risk of ARDS.
2. Which finding most strongly supports borderline personality disorder with escalating self-harm threats?
A. intense fear of abandonment, unstable relationships, affective instability, and recurrent self-harm behavior
B. decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity
C. time-consuming intrusive thoughts and repetitive rituals performed to reduce anxiety
D. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe
Correct Answer: A. intense fear of abandonment, unstable relationships, affective instability, and recurrent
self-harm behavior
Rationale: intense fear of abandonment, unstable relationships, affective instability, and recurrent self-harm
behavior is characteristic of borderline personality disorder with escalating self-harm threats.
3. A client is being transferred from intensive care to a medical unit. Which information is essential in the
handoff?
A. Current condition, recent changes, code status, lines/drains, high-risk medications, pending tests, and
anticipated concerns
B. Only the client's room number
C. Only the admission diagnosis
D. Only the names of family members
Correct Answer: A. Current condition, recent changes, code status, lines/drains, high-risk medications, pending
tests, and anticipated concerns
Rationale: A safe transfer handoff communicates current risks, therapies, pending work, and contingency plans.
4. A client with upper GI bleed has hematemesis or melena with possible orthostasis. Which complication is
the nurse most concerned about detecting early? upper GI bleed Condition hematemesis or melena with
possible orthostasis Initial cue Trend change and recognize risk early Nursing focus
A. infection and organ injury
B. hemorrhagic shock
C. spontaneous bacterial peritonitis or variceal bleeding
D. hypocalcemia, shock, or organ failure
Correct Answer: B. hemorrhagic shock
Rationale: A recognized serious complication of upper GI bleed is hemorrhagic shock. Focused surveillance
supports early escalation and treatment.
5. Which transmission-based precaution is most appropriate for a client with a client with suspected Ebola
virus disease and epidemiologic risk?
A. Place the client in the general waiting room
B. Immediately isolate and follow the facility/public-health high-consequence pathogen protocol with
recommended PPE
C. Use standard precautions only until laboratory confirmation
D. Send the client home without notifying infection prevention
Correct Answer: B. Immediately isolate and follow the facility/public-health high-consequence pathogen
protocol with recommended PPE
Rationale: Suspected high-consequence viral hemorrhagic fever requires immediate isolation,
infection-prevention escalation, and public-health coordination.
6. The nurse is caring for a client taking empagliflozin. Which parameter is most important to monitor for
safe ongoing therapy?
A. respiratory rate, sedation, pain
,B. drug level, renal function, blood pressure
C. pulse and respiratory symptoms
D. renal function, volume status, and glucose
Correct Answer: D. renal function, volume status, and glucose
Rationale: empagliflozin is a SGLT2 inhibitor. Its relevant priority monitoring parameter is renal function,
volume status, and glucose; safe nursing care requires connecting the medication class with its expected effects,
monitoring needs, and major risks.
7. An adult client asks which oral-health habit supports prevention. Which teaching is appropriate?
A. Use sugar-sweetened drinks to strengthen enamel
B. Brush with fluoride toothpaste and obtain regular dental care based on individual risk
C. Stop brushing if gums bleed once
D. Replace brushing with mouthwash alone
Correct Answer: B. Brush with fluoride toothpaste and obtain regular dental care based on individual risk
Rationale: Regular fluoride toothpaste use, interdental cleaning, and dental care support oral-health prevention.
8. Which description best explains the therapeutic action of trimethoprim-sulfamethoxazole?
A. binds bacterial 30S ribosome causing faulty protein synthesis
B. competitively blocks opioid receptors
C. reduces central prostaglandin synthesis
D. inhibits sequential folate synthesis steps
Correct Answer: D. inhibits sequential folate synthesis steps
Rationale: trimethoprim-sulfamethoxazole is a folate antagonist combination. Its relevant mechanism of action is
inhibits sequential folate synthesis steps; safe nursing care requires connecting the medication class with its
expected effects, monitoring needs, and major risks.
9. A client is experiencing postoperative pain. Which finding is most consistent with this care need?
A. incisional pain that worsens with movement but is accompanied by stable vital signs and a benign wound
assessment
B. air hunger in a client receiving comfort-focused end-of-life care
C. coughing or wet voice during meals and food pocketing
D. frequent loose stools with moist erythematous perineal skin
Correct Answer: A. incisional pain that worsens with movement but is accompanied by stable vital signs and a
benign wound assessment
Rationale: incisional pain that worsens with movement but is accompanied by stable vital signs and a benign
wound assessment is a common cue when caring for postoperative pain.
10. The emergency nurse recognizes central adiposity, proximal weakness, bruising, and hyperglycemia as
Cushing syndrome. Which treatment or nursing action has the highest priority?
A. replace fluids and give desmopressin for central DI when ordered
B. start isotonic fluids then insulin with close potassium monitoring
C. identify source and reduce excess glucocorticoid exposure safely
D. aggressive fluid replacement then insulin and electrolyte management
Correct Answer: C. identify source and reduce excess glucocorticoid exposure safely
Rationale: The priority for Cushing syndrome is to identify source and reduce excess glucocorticoid exposure
safely. This addresses the immediate pathophysiology and reduces the risk of infection, diabetes, osteoporosis.
11. Which nurse response is most therapeutic for a client experiencing borderline personality disorder with
escalating self-harm threats?
A. Use calm orientation and explain that symptoms are being monitored and treated
B. Validate the emotion while setting clear boundaries, such as, "I can see you are overwhelmed; we will work
with you using the same safety plan."
C. After stabilization, use nonjudgmental language and offer overdose-prevention and treatment resources
D. Say, "Tell me what you miss most about your spouse," and allow silence
Correct Answer: B. Validate the emotion while setting clear boundaries, such as, "I can see you are
overwhelmed; we will work with you using the same safety plan."
Rationale: Consistent boundaries and direct risk assessment reduce splitting and support safety without
reinforcing maladaptive behavior.
12. The nurse is caring for four postpartum clients. Which client should the nurse assess first?
, A. a client 1 hour after vaginal birth with a boggy uterus and rapidly saturating a perineal pad
B. a client with afterpains while breastfeeding
C. a client requesting help with newborn swaddling
D. a client with perineal edema relieved by an ice pack
Correct Answer: A. a client 1 hour after vaginal birth with a boggy uterus and rapidly saturating a perineal pad
Rationale: A boggy uterus with heavy bleeding suggests uterine atony and postpartum hemorrhage.
13. Which cluster of findings is most consistent with cirrhosis with ascites?
A. hematemesis or melena with possible orthostasis
B. surgical wound opens with visible tissue or organs
C. periumbilical pain migrating to right lower quadrant with anorexia
D. portal hypertension with edema/ascites and synthetic dysfunction
Correct Answer: D. portal hypertension with edema/ascites and synthetic dysfunction
Rationale: portal hypertension with edema/ascites and synthetic dysfunction is a characteristic presentation of
cirrhosis with ascites; recognizing this pattern reduces delay in evaluation and management.
14. Which infection-control plan is appropriate for a client with measles?
A. Airborne precautions with appropriate respiratory protection
B. Standard precautions only
C. Contact precautions only
D. Droplet precautions only
Correct Answer: A. Airborne precautions with appropriate respiratory protection
Rationale: Measles is highly contagious through airborne transmission and requires airborne precautions.
15. A client with a new stroke has dysphagia and difficulty communicating. Which interdisciplinary
referral should the nurse prioritize?
A. Speech-language pathology
B. Dermatology
C. Podiatry
D. Ophthalmic surgery
Correct Answer: A. Speech-language pathology
Rationale: Speech-language pathologists evaluate swallowing safety and communication after stroke.
16. A 16-year-old asks about preventing sexually transmitted infections. Which teaching is most
appropriate?
A. Rely on appearance to determine whether a partner has an infection
B. Use antibiotics after every sexual encounter
C. Use condoms consistently and correctly and obtain recommended screening/vaccination based on risk
D. Avoid vaccination because it increases infection risk
Correct Answer: C. Use condoms consistently and correctly and obtain recommended screening/vaccination
based on risk
Rationale: Barrier protection, appropriate screening, and vaccination such as HPV vaccination reduce STI risk.
17. Which description best explains the therapeutic action of filgrastim?
A. relaxes arterial smooth muscle
B. reduces aqueous humor production
C. blocks muscarinic bronchoconstriction
D. stimulates neutrophil production
Correct Answer: D. stimulates neutrophil production
Rationale: filgrastim is a G-CSF. Its relevant mechanism of action is stimulates neutrophil production; safe
nursing care requires connecting the medication class with its expected effects, monitoring needs, and major risks.
18. A client is experiencing diarrhea with perineal irritation. Which finding is most consistent with this
care need?
A. nonblanchable erythema over a pressure point in an immobile client
B. difficulty repositioning with intact cognition and stable cardiopulmonary status
C. coughing or wet voice during meals and food pocketing
D. frequent loose stools with moist erythematous perineal skin
Correct Answer: D. frequent loose stools with moist erythematous perineal skin
