ATI RN Comprehensive Predictor (NGN-STYLE QUESTIONS & CASE
SCENARIOS) Set 2 Exam
1. The nurse reviews the situation of a 24-year-old client: competent adult refuses a recommended blood
transfusion after receiving information. Which nursing action would require correction?
A. administering the transfusion because it is clinically indicated
B. begin interdisciplinary discharge planning early and assess equipment, caregiver, and follow-up needs
C. notify the provider performing the procedure so questions can be answered before consent is finalized
D. assess the client, obtain needed care, notify the provider as indicated, and complete the safety report per policy
Correct Answer: A. administering the transfusion because it is clinically indicated
Rationale: Administering the transfusion because it is clinically indicated would require correction because it conflicts
with autonomy and informed refusal and could increase risk. The safer approach is to follow the evidence-based action
appropriate to the client's current status.
2. In a rehabilitation setting, a 24-year-old client has the following concern: client taking an antipsychotic
develops high fever, severe rigidity, and altered mental status. What should the nurse do next?
A. review potassium and volume status and report significant abnormalities
B. stop the antipsychotic and seek emergency treatment for neuroleptic malignant syndrome
C. stop the medication and seek urgent evaluation for angioedema
D. verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before administration
Correct Answer: B. stop the antipsychotic and seek emergency treatment for neuroleptic malignant syndrome
Rationale: The next step is to stop the antipsychotic and seek emergency treatment for neuroleptic malignant syndrome.
This action follows the priorities implied by NMS recognition and addresses the most time-sensitive risk before
lower-priority interventions.
3. The nurse reviews the situation of a 68-year-old client: nurse discovers that a medication entry from two
hours earlier was omitted. Which principle best explains the nurse's clinical decision-making in this
situation?
A. continuity of care
B. post-event assessment and quality improvement
C. ABCs and acute change
D. legal documentation
Correct Answer: D. legal documentation
Rationale: The central principle is legal documentation. It links the client cues to the safest nursing response and helps
distinguish the best option from alternatives that may be reasonable in other contexts.
,4. During discharge teaching, the nurse is caring for a 81-year-old client. Client has been taking high-dose
corticosteroids for several weeks. Which finding best indicates that the plan of care is effective?
A. the offending drug is stopped and complications are treated
B. ventilation improves and sedation decreases
C. toxicity is reversed before respiratory arrest
D. adrenal crisis is avoided during dose reduction
Correct Answer: D. adrenal crisis is avoided during dose reduction
Rationale: An effective plan should produce this result: adrenal crisis is avoided during dose reduction. That outcome
directly demonstrates improvement in the problem targeted by corticosteroid safety.
5. In a long-term care facility, a 68-year-old client has the following concern: stable client requiring a sterile
dressing change and scheduled oral medications. Which principle best explains the nurse's clinical
decision-making in this situation?
A. disaster ethics and triage
B. scope of practice and client stability
C. scope and predictability
D. post-event assessment and quality improvement
Correct Answer: C. scope and predictability
Rationale: The central principle is scope and predictability. It links the client cues to the safest nursing response and
helps distinguish the best option from alternatives that may be reasonable in other contexts.
6. In a long-term care facility, the nurse is caring for a 74-year-old client. Client develops chills, back pain,
and dyspnea shortly after a blood transfusion begins. What should the nurse do next?
A. hold and report the finding and assess renal function and drug monitoring as ordered
B. assess for bleeding and review INR and interacting medications or diet changes
C. take it consistently as directed, commonly on an empty stomach, and separate it from interfering supplements such
as iron or calcium
D. stop the transfusion, keep IV access with appropriate fluid per protocol, assess the client, and notify the provider and
blood bank
Correct Answer: D. stop the transfusion, keep IV access with appropriate fluid per protocol, assess the client, and
notify the provider and blood bank
Rationale: The next step is to stop the transfusion, keep IV access with appropriate fluid per protocol, assess the client,
and notify the provider and blood bank. This action follows the priorities implied by transfusion reaction and addresses
the most time-sensitive risk before lower-priority interventions.
,7. During a telephone triage call, the nurse is reviewing the case of a 81-year-old client. Client with a valid
advance directive that conflicts with a family request. Which complication or safety concern is the nurse
primarily trying to prevent?
A. privacy and minimum necessary disclosure
B. continuity of care
C. autonomy and self-determination
D. advocacy and escalation
Correct Answer: C. autonomy and self-determination
Rationale: The major safety concern is tied to autonomy and self-determination. The cue pattern makes that risk more
immediate than the unrelated complications represented by the distractors.
8. Cameron is a 34-year-old client and is being assessed by the nurse. Client receiving magnesium sulfate for
severe preeclampsia develops absent reflexes and slow respirations. What should the nurse do next?
A. assess for bleeding and review INR and interacting medications or diet changes
B. stop the infusion and prepare to administer calcium gluconate as prescribed
C. stop or slow the infusion as ordered, assess the client, and notify the provider
D. dilute and infuse with a controlled pump according to policy; never give IV potassium by direct push
Correct Answer: B. stop the infusion and prepare to administer calcium gluconate as prescribed
Rationale: The next step is to stop the infusion and prepare to administer calcium gluconate as prescribed. This action
follows the priorities implied by magnesium toxicity and addresses the most time-sensitive risk before lower-priority
interventions.
9. During morning rounds, the nurse is reviewing the case of a 55-year-old client. Nurse believes a
prescription places a client at serious risk and the prescriber dismisses the concern. Which complication or
safety concern is the nurse primarily trying to prevent?
A. disaster ethics and triage
B. advocacy and escalation
C. scope and predictability
D. occupational safety and assignment
Correct Answer: B. advocacy and escalation
Rationale: The major safety concern is tied to advocacy and escalation. The cue pattern makes that risk more immediate
than the unrelated complications represented by the distractors.
, 10. The nurse reviews the situation of a 29-year-old client: client with suspected infection has hypotension,
tachypnea, confusion, and elevated lactate. Which nursing action would require correction?
A. waiting for all culture results before starting indicated antibiotics
B. keep the child calm, assess airway severity, and provide prescribed humidified oxygen/epinephrine or steroid
therapy as indicated
C. begin prescribed isotonic fluid resuscitation, insulin therapy, and close potassium monitoring
D. assess airway and circulation, establish large-bore IV access, obtain labs/type and screen, and prepare for urgent
management
Correct Answer: A. waiting for all culture results before starting indicated antibiotics
Rationale: Waiting for all culture results before starting indicated antibiotics would require correction because it
conflicts with sepsis and shock and could increase risk. The safer approach is to follow the evidence-based action
appropriate to the client's current status.
11. At change of shift, after the nurse implements the plan for a 74-year-old client with competent adult
refuses a recommended blood transfusion after receiving information, which evaluation finding should be
documented as the best evidence of improvement?
A. staff exposure remains within regulated limits
B. the client makes an informed voluntary decision
C. care respects autonomy while continuing supportive treatment
D. care aligns with the client's legally recognized preferences
Correct Answer: C. care respects autonomy while continuing supportive treatment
Rationale: Care respects autonomy while continuing supportive treatment is the clearest evidence that the intervention
worked. Evaluation should compare observed results with the expected outcome for autonomy and informed refusal.
12. On a medical-surgical unit, the nurse is reviewing the case of a 62-year-old client. Client on
unfractionated heparin has a sharp platelet-count drop. Which complication or safety concern is the nurse
primarily trying to prevent?
A. electrolyte replacement
B. heparin complications
C. magnesium toxicity
D. digoxin safety
Correct Answer: B. heparin complications
Rationale: The major safety concern is tied to heparin complications. The cue pattern makes that risk more immediate
than the unrelated complications represented by the distractors.
SCENARIOS) Set 2 Exam
1. The nurse reviews the situation of a 24-year-old client: competent adult refuses a recommended blood
transfusion after receiving information. Which nursing action would require correction?
A. administering the transfusion because it is clinically indicated
B. begin interdisciplinary discharge planning early and assess equipment, caregiver, and follow-up needs
C. notify the provider performing the procedure so questions can be answered before consent is finalized
D. assess the client, obtain needed care, notify the provider as indicated, and complete the safety report per policy
Correct Answer: A. administering the transfusion because it is clinically indicated
Rationale: Administering the transfusion because it is clinically indicated would require correction because it conflicts
with autonomy and informed refusal and could increase risk. The safer approach is to follow the evidence-based action
appropriate to the client's current status.
2. In a rehabilitation setting, a 24-year-old client has the following concern: client taking an antipsychotic
develops high fever, severe rigidity, and altered mental status. What should the nurse do next?
A. review potassium and volume status and report significant abnormalities
B. stop the antipsychotic and seek emergency treatment for neuroleptic malignant syndrome
C. stop the medication and seek urgent evaluation for angioedema
D. verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before administration
Correct Answer: B. stop the antipsychotic and seek emergency treatment for neuroleptic malignant syndrome
Rationale: The next step is to stop the antipsychotic and seek emergency treatment for neuroleptic malignant syndrome.
This action follows the priorities implied by NMS recognition and addresses the most time-sensitive risk before
lower-priority interventions.
3. The nurse reviews the situation of a 68-year-old client: nurse discovers that a medication entry from two
hours earlier was omitted. Which principle best explains the nurse's clinical decision-making in this
situation?
A. continuity of care
B. post-event assessment and quality improvement
C. ABCs and acute change
D. legal documentation
Correct Answer: D. legal documentation
Rationale: The central principle is legal documentation. It links the client cues to the safest nursing response and helps
distinguish the best option from alternatives that may be reasonable in other contexts.
,4. During discharge teaching, the nurse is caring for a 81-year-old client. Client has been taking high-dose
corticosteroids for several weeks. Which finding best indicates that the plan of care is effective?
A. the offending drug is stopped and complications are treated
B. ventilation improves and sedation decreases
C. toxicity is reversed before respiratory arrest
D. adrenal crisis is avoided during dose reduction
Correct Answer: D. adrenal crisis is avoided during dose reduction
Rationale: An effective plan should produce this result: adrenal crisis is avoided during dose reduction. That outcome
directly demonstrates improvement in the problem targeted by corticosteroid safety.
5. In a long-term care facility, a 68-year-old client has the following concern: stable client requiring a sterile
dressing change and scheduled oral medications. Which principle best explains the nurse's clinical
decision-making in this situation?
A. disaster ethics and triage
B. scope of practice and client stability
C. scope and predictability
D. post-event assessment and quality improvement
Correct Answer: C. scope and predictability
Rationale: The central principle is scope and predictability. It links the client cues to the safest nursing response and
helps distinguish the best option from alternatives that may be reasonable in other contexts.
6. In a long-term care facility, the nurse is caring for a 74-year-old client. Client develops chills, back pain,
and dyspnea shortly after a blood transfusion begins. What should the nurse do next?
A. hold and report the finding and assess renal function and drug monitoring as ordered
B. assess for bleeding and review INR and interacting medications or diet changes
C. take it consistently as directed, commonly on an empty stomach, and separate it from interfering supplements such
as iron or calcium
D. stop the transfusion, keep IV access with appropriate fluid per protocol, assess the client, and notify the provider and
blood bank
Correct Answer: D. stop the transfusion, keep IV access with appropriate fluid per protocol, assess the client, and
notify the provider and blood bank
Rationale: The next step is to stop the transfusion, keep IV access with appropriate fluid per protocol, assess the client,
and notify the provider and blood bank. This action follows the priorities implied by transfusion reaction and addresses
the most time-sensitive risk before lower-priority interventions.
,7. During a telephone triage call, the nurse is reviewing the case of a 81-year-old client. Client with a valid
advance directive that conflicts with a family request. Which complication or safety concern is the nurse
primarily trying to prevent?
A. privacy and minimum necessary disclosure
B. continuity of care
C. autonomy and self-determination
D. advocacy and escalation
Correct Answer: C. autonomy and self-determination
Rationale: The major safety concern is tied to autonomy and self-determination. The cue pattern makes that risk more
immediate than the unrelated complications represented by the distractors.
8. Cameron is a 34-year-old client and is being assessed by the nurse. Client receiving magnesium sulfate for
severe preeclampsia develops absent reflexes and slow respirations. What should the nurse do next?
A. assess for bleeding and review INR and interacting medications or diet changes
B. stop the infusion and prepare to administer calcium gluconate as prescribed
C. stop or slow the infusion as ordered, assess the client, and notify the provider
D. dilute and infuse with a controlled pump according to policy; never give IV potassium by direct push
Correct Answer: B. stop the infusion and prepare to administer calcium gluconate as prescribed
Rationale: The next step is to stop the infusion and prepare to administer calcium gluconate as prescribed. This action
follows the priorities implied by magnesium toxicity and addresses the most time-sensitive risk before lower-priority
interventions.
9. During morning rounds, the nurse is reviewing the case of a 55-year-old client. Nurse believes a
prescription places a client at serious risk and the prescriber dismisses the concern. Which complication or
safety concern is the nurse primarily trying to prevent?
A. disaster ethics and triage
B. advocacy and escalation
C. scope and predictability
D. occupational safety and assignment
Correct Answer: B. advocacy and escalation
Rationale: The major safety concern is tied to advocacy and escalation. The cue pattern makes that risk more immediate
than the unrelated complications represented by the distractors.
, 10. The nurse reviews the situation of a 29-year-old client: client with suspected infection has hypotension,
tachypnea, confusion, and elevated lactate. Which nursing action would require correction?
A. waiting for all culture results before starting indicated antibiotics
B. keep the child calm, assess airway severity, and provide prescribed humidified oxygen/epinephrine or steroid
therapy as indicated
C. begin prescribed isotonic fluid resuscitation, insulin therapy, and close potassium monitoring
D. assess airway and circulation, establish large-bore IV access, obtain labs/type and screen, and prepare for urgent
management
Correct Answer: A. waiting for all culture results before starting indicated antibiotics
Rationale: Waiting for all culture results before starting indicated antibiotics would require correction because it
conflicts with sepsis and shock and could increase risk. The safer approach is to follow the evidence-based action
appropriate to the client's current status.
11. At change of shift, after the nurse implements the plan for a 74-year-old client with competent adult
refuses a recommended blood transfusion after receiving information, which evaluation finding should be
documented as the best evidence of improvement?
A. staff exposure remains within regulated limits
B. the client makes an informed voluntary decision
C. care respects autonomy while continuing supportive treatment
D. care aligns with the client's legally recognized preferences
Correct Answer: C. care respects autonomy while continuing supportive treatment
Rationale: Care respects autonomy while continuing supportive treatment is the clearest evidence that the intervention
worked. Evaluation should compare observed results with the expected outcome for autonomy and informed refusal.
12. On a medical-surgical unit, the nurse is reviewing the case of a 62-year-old client. Client on
unfractionated heparin has a sharp platelet-count drop. Which complication or safety concern is the nurse
primarily trying to prevent?
A. electrolyte replacement
B. heparin complications
C. magnesium toxicity
D. digoxin safety
Correct Answer: B. heparin complications
Rationale: The major safety concern is tied to heparin complications. The cue pattern makes that risk more immediate
than the unrelated complications represented by the distractors.
