ATI RN Comprehensive Predictor Exam
Practice Questions & Rationales
MEDICAL-SURGICAL NURSING
Question 1
A nurse is caring for a client who has heart failure and is receiving furosemide. Which of the
following laboratory values should the nurse monitor closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes excretion of potassium, leading to
hypokalemia. Hypokalemia can increase the risk of cardiac dysrhythmias, especially in clients
taking digitalis preparations. Serum sodium, calcium, and magnesium may also be affected but
potassium is the priority.
Question 2
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following
actions should the nurse take?
A. Massage the injection site after administration
B. Administer the medication in the deltoid muscle
C. Use a 25-gauge, 1-inch needle
D. Aspirate before injecting the medication
Correct Answer: C
Rationale: Heparin should be administered subcutaneously using a 25-gauge, 1-inch (or 5/8
inch) needle in the abdomen. The site should not be massaged after administration as this can
,cause hematoma formation. Aspiration is not recommended as it can cause tissue damage. The
deltoid is not used for subcutaneous heparin.
Question 3
A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of
the following findings should the nurse expect?
A. Clubbing of the fingers
B. Bradycardia
C. Hypoxemia with hypercapnia
D. Barrel-shaped chest
Correct Answer: D
Rationale: A barrel-shaped chest is a classic finding in COPD due to hyperinflation of the lungs.
Clubbing occurs with chronic hypoxemia but is more common in cystic fibrosis. Tachycardia, not
bradycardia, is expected. COPD clients may have hypercapnia but this is an advanced finding.
Question 4
A nurse is teaching a client who has hypertension about dietary modifications. Which of the
following statements by the client indicates an understanding of the teaching?
A. "I should limit my sodium intake to 3,000 mg per day"
B. "I can eat canned vegetables as long as I rinse them"
C. "I should avoid processed meats like bacon and deli turkey"
D. "I can use salt substitutes freely without any concerns"
Correct Answer: C
Rationale: Processed meats are high in sodium and should be avoided. The recommended
sodium limit for hypertension is 1,500-2,300 mg/day, not 3,000 mg. Canned vegetables, even
rinsed, contain significant sodium. Salt substitutes contain potassium and should be used
cautiously, especially in clients with renal impairment or those taking potassium-sparing
diuretics.
Question 5
,A nurse is caring for a client who is postoperative following a total hip arthroplasty. Which of the
following actions should the nurse take to prevent dislocation?
A. Place a pillow between the client's legs when turning
B. Position the client in high Fowler's position
C. Encourage crossing the legs at the ankle
D. Keep the operative leg adducted
Correct Answer: A
Rationale: Placing a pillow between the client's legs when turning maintains abduction and
prevents adduction, which can cause dislocation. High Fowler's position does not specifically
prevent dislocation. Leg crossing and adduction are contraindicated as they increase the risk of
dislocation.
Question 6
A nurse is assessing a client who has diabetes mellitus and reports feeling shaky and weak. The
client's blood glucose level is 60 mg/dL. Which of the following actions should the nurse take
first?
A. Administer glucagon IM
B. Provide 15 g of fast-acting carbohydrate
C. Check the client's blood glucose again in 15 minutes
D. Notify the provider
Correct Answer: B
Rationale: The client is experiencing hypoglycemia. The initial treatment is to provide 15 g of
fast-acting carbohydrate (e.g., 4 oz juice, glucose tablets). Glucagon is used for severe
hypoglycemia when the client cannot swallow. Rechecking glucose in 15 minutes is appropriate
after intervention.
Question 7
A nurse is caring for a client who has chronic kidney disease and is receiving hemodialysis.
Which of the following laboratory values should the nurse report to the provider?
A. Serum potassium 5.2 mEq/L
B. Serum calcium 9.5 mg/dL
, C. Serum phosphorus 3.5 mg/dL
D. Serum albumin 4.0 g/dL
Correct Answer: A
Rationale: A potassium level of 5.2 mEq/L is elevated (normal 3.5-5.0 mEq/L) and places the
client at risk for cardiac dysrhythmias. This should be reported immediately. Calcium,
phosphorus, and albumin are within normal limits.
Question 8
A nurse is teaching a client who has angina pectoris about nitroglycerin sublingual tablets.
Which of the following statements by the client indicates understanding?
A. "I should take one tablet every 15 minutes until the pain subsides"
B. "I should call 911 if the pain is not relieved after three tablets"
C. "I can swallow the tablet with a glass of water"
D. "I should take the tablet with food to prevent stomach upset"
Correct Answer: B
Rationale: If chest pain is not relieved after three sublingual nitroglycerin tablets (5 minutes
apart), the client should call 911 immediately as this may indicate an acute myocardial
infarction. Tablets should be placed under the tongue, not swallowed. They should be taken at
the onset of pain, not with food.
Question 9
A nurse is assessing a client who has a closed head injury. Which of the following findings
indicates increased intracranial pressure?
A. Widening pulse pressure
B. Decreased systolic blood pressure
C. Tachycardia
D. Decreased respirations
Correct Answer: A
Rationale: Cushing's triad includes widening pulse pressure, bradycardia, and irregular
respirations. Increased ICP causes hypertension with a widening pulse pressure. Bradycardia,
not tachycardia, is a late sign.
Practice Questions & Rationales
MEDICAL-SURGICAL NURSING
Question 1
A nurse is caring for a client who has heart failure and is receiving furosemide. Which of the
following laboratory values should the nurse monitor closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes excretion of potassium, leading to
hypokalemia. Hypokalemia can increase the risk of cardiac dysrhythmias, especially in clients
taking digitalis preparations. Serum sodium, calcium, and magnesium may also be affected but
potassium is the priority.
Question 2
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following
actions should the nurse take?
A. Massage the injection site after administration
B. Administer the medication in the deltoid muscle
C. Use a 25-gauge, 1-inch needle
D. Aspirate before injecting the medication
Correct Answer: C
Rationale: Heparin should be administered subcutaneously using a 25-gauge, 1-inch (or 5/8
inch) needle in the abdomen. The site should not be massaged after administration as this can
,cause hematoma formation. Aspiration is not recommended as it can cause tissue damage. The
deltoid is not used for subcutaneous heparin.
Question 3
A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of
the following findings should the nurse expect?
A. Clubbing of the fingers
B. Bradycardia
C. Hypoxemia with hypercapnia
D. Barrel-shaped chest
Correct Answer: D
Rationale: A barrel-shaped chest is a classic finding in COPD due to hyperinflation of the lungs.
Clubbing occurs with chronic hypoxemia but is more common in cystic fibrosis. Tachycardia, not
bradycardia, is expected. COPD clients may have hypercapnia but this is an advanced finding.
Question 4
A nurse is teaching a client who has hypertension about dietary modifications. Which of the
following statements by the client indicates an understanding of the teaching?
A. "I should limit my sodium intake to 3,000 mg per day"
B. "I can eat canned vegetables as long as I rinse them"
C. "I should avoid processed meats like bacon and deli turkey"
D. "I can use salt substitutes freely without any concerns"
Correct Answer: C
Rationale: Processed meats are high in sodium and should be avoided. The recommended
sodium limit for hypertension is 1,500-2,300 mg/day, not 3,000 mg. Canned vegetables, even
rinsed, contain significant sodium. Salt substitutes contain potassium and should be used
cautiously, especially in clients with renal impairment or those taking potassium-sparing
diuretics.
Question 5
,A nurse is caring for a client who is postoperative following a total hip arthroplasty. Which of the
following actions should the nurse take to prevent dislocation?
A. Place a pillow between the client's legs when turning
B. Position the client in high Fowler's position
C. Encourage crossing the legs at the ankle
D. Keep the operative leg adducted
Correct Answer: A
Rationale: Placing a pillow between the client's legs when turning maintains abduction and
prevents adduction, which can cause dislocation. High Fowler's position does not specifically
prevent dislocation. Leg crossing and adduction are contraindicated as they increase the risk of
dislocation.
Question 6
A nurse is assessing a client who has diabetes mellitus and reports feeling shaky and weak. The
client's blood glucose level is 60 mg/dL. Which of the following actions should the nurse take
first?
A. Administer glucagon IM
B. Provide 15 g of fast-acting carbohydrate
C. Check the client's blood glucose again in 15 minutes
D. Notify the provider
Correct Answer: B
Rationale: The client is experiencing hypoglycemia. The initial treatment is to provide 15 g of
fast-acting carbohydrate (e.g., 4 oz juice, glucose tablets). Glucagon is used for severe
hypoglycemia when the client cannot swallow. Rechecking glucose in 15 minutes is appropriate
after intervention.
Question 7
A nurse is caring for a client who has chronic kidney disease and is receiving hemodialysis.
Which of the following laboratory values should the nurse report to the provider?
A. Serum potassium 5.2 mEq/L
B. Serum calcium 9.5 mg/dL
, C. Serum phosphorus 3.5 mg/dL
D. Serum albumin 4.0 g/dL
Correct Answer: A
Rationale: A potassium level of 5.2 mEq/L is elevated (normal 3.5-5.0 mEq/L) and places the
client at risk for cardiac dysrhythmias. This should be reported immediately. Calcium,
phosphorus, and albumin are within normal limits.
Question 8
A nurse is teaching a client who has angina pectoris about nitroglycerin sublingual tablets.
Which of the following statements by the client indicates understanding?
A. "I should take one tablet every 15 minutes until the pain subsides"
B. "I should call 911 if the pain is not relieved after three tablets"
C. "I can swallow the tablet with a glass of water"
D. "I should take the tablet with food to prevent stomach upset"
Correct Answer: B
Rationale: If chest pain is not relieved after three sublingual nitroglycerin tablets (5 minutes
apart), the client should call 911 immediately as this may indicate an acute myocardial
infarction. Tablets should be placed under the tongue, not swallowed. They should be taken at
the onset of pain, not with food.
Question 9
A nurse is assessing a client who has a closed head injury. Which of the following findings
indicates increased intracranial pressure?
A. Widening pulse pressure
B. Decreased systolic blood pressure
C. Tachycardia
D. Decreased respirations
Correct Answer: A
Rationale: Cushing's triad includes widening pulse pressure, bradycardia, and irregular
respirations. Increased ICP causes hypertension with a widening pulse pressure. Bradycardia,
not tachycardia, is a late sign.
