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ATI RN Comprehensive Predictor Practice Exam: 100 Questions with Answers
Section 1: Management of Care & Prioritization (Questions 1–20)
Q1. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A. Client with COPD reporting anxiety
B. Client 2 days post-op reporting calf pain and swelling
C. Client with a fractured femur requesting pain medication
D. Client awaiting discharge teaching
Answer: B
Rationale: Calf pain with swelling after surgery suggests DVT, which can embolize to the
lungs (PE) — a life-threatening emergency. ABCDE and acute-change priority frameworks
place potential pulmonary embolism above comfort or teaching needs .
Q2. A nurse is receiving a change-of-shift report on four clients. Which client should the
nurse assess first?
A. A client who is 1 day postoperative with a pain rating of 6/10
B. A client with COPD who has an oxygen saturation of 88% on room air
C. A client who is waiting for discharge teaching
D. A client with stable diabetes who is requesting a snack
Answer: B
Rationale: Prioritization follows the ABC (Airway, Breathing, Circulation) framework. An
oxygen saturation of 88% indicates respiratory compromise, which takes priority over pain
management, discharge teaching, or non-urgent requests .
Q3. A charge nurse is making client assignments on a medical-surgical unit. Which client
should be assigned to the most experienced RN?
A. A client with diabetes mellitus requiring insulin administration
B. A client with pneumonia requiring q4h vital signs
C. A client with chest tubes and new onset of respiratory distress
D. A client with a urinary tract infection requiring IV antibiotics
Answer: C
Rationale: The client with chest tubes and respiratory distress is unstable and requires
complex assessment and intervention. This client should be assigned to the most
experienced RN .
Q4. 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 the risks
B. Document the refusal
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C. Administer the transfusion if Hgb is critical
D. Notify the provider
E. Ask the family to override the decision
Answer: A, B, D
Rationale: A competent adult has the right to autonomy and to refuse any treatment. The
nurse's role is to ensure informed refusal, document the refusal, and notify the provider. The
client's decision cannot be overridden by family or the nurse .
Q5. Which task is appropriate to delegate to a UAP?
A. Administering a PRN analgesic
B. Measuring and recording intake and output
C. Teaching a client about a new medication
D. Assessing a client's wound for signs of infection
Answer: B
Rationale: UAPs can perform tasks that are routine, predictable, and require no clinical
judgment. I&O measurement fits this. Assessment, teaching, and medication administration
require an RN license .
Q6. A charge nurse is delegating client care to assistive personnel (AP). Which task should
the nurse delegate to the AP?
A. Administering enteral feedings via gastrostomy tube
B. Obtaining a sterile urine specimen from an indwelling catheter
C. Measuring a client's intake and output
D. Assessing a client's wound for signs of infection
Answer: C
Rationale: Measurement of intake and output is within the scope of practice for assistive
personnel. Tasks requiring clinical judgment (tube feedings, sterile specimen collection,
wound assessment) must be performed by a licensed nurse .
Q7. A nurse is delegating vital signs to an assistive personnel (AP). Which client should the
AP NOT be assigned to?
A. Client with pneumonia on room air
B. Client post-op day 3 with stable vitals
C. Client with frequent loose stools and orthostatic hypotension
D. Client with hypertension controlled on lisinopril
Answer: C
Rationale: Orthostatic hypotension requires skilled assessment (measuring lying, sitting,
standing). APs can take routine vital signs but should not perform orthostatic checks on
unstable clients .
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Q8. A charge nurse is evaluating a newly licensed nurse's understanding of delegation.
Which statement indicates correct understanding?
A. "I can delegate assessment tasks to the LPN"
B. "Delegation means I am no longer responsible for the task"
C. "The RN retains accountability for delegated tasks"
D. "I can delegate any task if the person is willing"
Answer: C
Rationale: The RN retains accountability for delegated tasks. Assessment, evaluation, and
nursing judgment cannot be delegated .
Q9. A nurse manager is reviewing incident reports. Which situation requires immediate
follow-up?
A. A nurse documenting a late entry
B. A nurse removing a client's restraints without a new order
C. A nurse using a translator phone for discharge teaching
D. A nurse administering a medication 15 minutes late
Answer: B
Rationale: Removing restraints without a new order violates safety protocols and regulatory
requirements. This requires immediate follow-up .
Q10. A nurse is preparing to discharge a client. Which statement indicates understanding of
fall precautions?
A. "I will keep my walker close to my bed at night."
B. "I will wear socks without grippers to bed."
C. "I will dim the lights to reduce glare."
D. "I will remove my bed alarm since I feel safe now."
Answer: A
Rationale: Keeping assistive devices close to the bed prevents falls during transfers. Socks
should have non-skid grips, lights should be bright enough for safety, and bed alarms should
remain in place per provider order .
Q11. A nurse is preparing to administer medication to a client. Which action is most
important for preventing medication errors?
A. Verify the client's identity using two identifiers
B. Ask the client to state their name only
C. Check the medication once at the nursing station
D. Administer the medication without checking the order
Answer: A
Rationale: Using two client identifiers is the standard for safe medication administration .
ATI RN Comprehensive Predictor Practice Exam: 100 Questions with Answers
Section 1: Management of Care & Prioritization (Questions 1–20)
Q1. A nurse is caring for four clients. Which client should the nurse assess FIRST?
A. Client with COPD reporting anxiety
B. Client 2 days post-op reporting calf pain and swelling
C. Client with a fractured femur requesting pain medication
D. Client awaiting discharge teaching
Answer: B
Rationale: Calf pain with swelling after surgery suggests DVT, which can embolize to the
lungs (PE) — a life-threatening emergency. ABCDE and acute-change priority frameworks
place potential pulmonary embolism above comfort or teaching needs .
Q2. A nurse is receiving a change-of-shift report on four clients. Which client should the
nurse assess first?
A. A client who is 1 day postoperative with a pain rating of 6/10
B. A client with COPD who has an oxygen saturation of 88% on room air
C. A client who is waiting for discharge teaching
D. A client with stable diabetes who is requesting a snack
Answer: B
Rationale: Prioritization follows the ABC (Airway, Breathing, Circulation) framework. An
oxygen saturation of 88% indicates respiratory compromise, which takes priority over pain
management, discharge teaching, or non-urgent requests .
Q3. A charge nurse is making client assignments on a medical-surgical unit. Which client
should be assigned to the most experienced RN?
A. A client with diabetes mellitus requiring insulin administration
B. A client with pneumonia requiring q4h vital signs
C. A client with chest tubes and new onset of respiratory distress
D. A client with a urinary tract infection requiring IV antibiotics
Answer: C
Rationale: The client with chest tubes and respiratory distress is unstable and requires
complex assessment and intervention. This client should be assigned to the most
experienced RN .
Q4. 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 the risks
B. Document the refusal
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C. Administer the transfusion if Hgb is critical
D. Notify the provider
E. Ask the family to override the decision
Answer: A, B, D
Rationale: A competent adult has the right to autonomy and to refuse any treatment. The
nurse's role is to ensure informed refusal, document the refusal, and notify the provider. The
client's decision cannot be overridden by family or the nurse .
Q5. Which task is appropriate to delegate to a UAP?
A. Administering a PRN analgesic
B. Measuring and recording intake and output
C. Teaching a client about a new medication
D. Assessing a client's wound for signs of infection
Answer: B
Rationale: UAPs can perform tasks that are routine, predictable, and require no clinical
judgment. I&O measurement fits this. Assessment, teaching, and medication administration
require an RN license .
Q6. A charge nurse is delegating client care to assistive personnel (AP). Which task should
the nurse delegate to the AP?
A. Administering enteral feedings via gastrostomy tube
B. Obtaining a sterile urine specimen from an indwelling catheter
C. Measuring a client's intake and output
D. Assessing a client's wound for signs of infection
Answer: C
Rationale: Measurement of intake and output is within the scope of practice for assistive
personnel. Tasks requiring clinical judgment (tube feedings, sterile specimen collection,
wound assessment) must be performed by a licensed nurse .
Q7. A nurse is delegating vital signs to an assistive personnel (AP). Which client should the
AP NOT be assigned to?
A. Client with pneumonia on room air
B. Client post-op day 3 with stable vitals
C. Client with frequent loose stools and orthostatic hypotension
D. Client with hypertension controlled on lisinopril
Answer: C
Rationale: Orthostatic hypotension requires skilled assessment (measuring lying, sitting,
standing). APs can take routine vital signs but should not perform orthostatic checks on
unstable clients .
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Q8. A charge nurse is evaluating a newly licensed nurse's understanding of delegation.
Which statement indicates correct understanding?
A. "I can delegate assessment tasks to the LPN"
B. "Delegation means I am no longer responsible for the task"
C. "The RN retains accountability for delegated tasks"
D. "I can delegate any task if the person is willing"
Answer: C
Rationale: The RN retains accountability for delegated tasks. Assessment, evaluation, and
nursing judgment cannot be delegated .
Q9. A nurse manager is reviewing incident reports. Which situation requires immediate
follow-up?
A. A nurse documenting a late entry
B. A nurse removing a client's restraints without a new order
C. A nurse using a translator phone for discharge teaching
D. A nurse administering a medication 15 minutes late
Answer: B
Rationale: Removing restraints without a new order violates safety protocols and regulatory
requirements. This requires immediate follow-up .
Q10. A nurse is preparing to discharge a client. Which statement indicates understanding of
fall precautions?
A. "I will keep my walker close to my bed at night."
B. "I will wear socks without grippers to bed."
C. "I will dim the lights to reduce glare."
D. "I will remove my bed alarm since I feel safe now."
Answer: A
Rationale: Keeping assistive devices close to the bed prevents falls during transfers. Socks
should have non-skid grips, lights should be bright enough for safety, and bed alarms should
remain in place per provider order .
Q11. A nurse is preparing to administer medication to a client. Which action is most
important for preventing medication errors?
A. Verify the client's identity using two identifiers
B. Ask the client to state their name only
C. Check the medication once at the nursing station
D. Administer the medication without checking the order
Answer: A
Rationale: Using two client identifiers is the standard for safe medication administration .
