ATI RN Comprehensive Predictor (NGN-STYLE QUESTIONS & CASE
SCENARIOS) Set 3 Exam
1. During a medication pass, a 29-year-old client has the following concern: stable postoperative client
needing bathing and ambulation. Which principle best explains the nurse's clinical decision-making in this
situation?
A. continuity of care
B. ABCs and acute change
C. advocacy and escalation
D. scope of practice and client stability
Correct Answer: D. scope of practice and client stability
Rationale: The central principle is scope of practice and client stability. 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.
2. The nurse reviews the situation of a 34-year-old client: client taking isoniazid, rifampin, pyrazinamide,
and ethambutol reports vision changes. What should the nurse do next?
A. verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before administration
B. do not stop abruptly; taper only as prescribed and monitor for infection and hyperglycemia
C. report the vision change promptly and assess for medication toxicity
D. check blood glucose promptly and treat hypoglycemia with rapid carbohydrate if the client can safely swallow
Correct Answer: C. report the vision change promptly and assess for medication toxicity
Rationale: The next step is to report the vision change promptly and assess for medication toxicity. This action follows
the priorities implied by tuberculosis pharmacotherapy and addresses the most time-sensitive risk before lower-priority
interventions.
3. During a postoperative assessment, the nurse is reviewing the case of a 41-year-old client. Client scheduled
for an invasive procedure who says the risks are not understood. Which complication or safety concern is the
nurse primarily trying to prevent?
A. informed consent responsibilities
B. occupational safety and assignment
C. privacy and minimum necessary disclosure
D. scope of practice and client stability
Correct Answer: A. informed consent responsibilities
Rationale: The major safety concern is tied to informed consent responsibilities. The cue pattern makes that risk more
immediate than the unrelated complications represented by the distractors.
,4. Avery is a 74-year-old client and is being assessed by the nurse. Client with possible ischemic stroke is
being evaluated for thrombolytic therapy. What should the nurse do next?
A. hold lithium and obtain urgent evaluation, including serum level and fluid-electrolyte status
B. verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before administration
C. stop the antipsychotic and seek emergency treatment for neuroleptic malignant syndrome
D. dilute and infuse with a controlled pump according to policy; never give IV potassium by direct push
Correct Answer: B. verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before
administration
Rationale: The next step is to verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before
administration. This action follows the priorities implied by thrombolytic safety and addresses the most time-sensitive
risk before lower-priority interventions.
5. At change of shift, the nurse is reviewing the case of a 62-year-old client. Client falls without apparent
injury after attempting to toilet independently. Which complication or safety concern is the nurse primarily
trying to prevent?
A. scope of practice and client stability
B. disaster ethics and triage
C. occupational safety and assignment
D. post-event assessment and quality improvement
Correct Answer: D. post-event assessment and quality improvement
Rationale: The major safety concern is tied to post-event assessment and quality improvement. The cue pattern makes
that risk more immediate than the unrelated complications represented by the distractors.
6. In a long-term care facility, after the nurse implements the plan for a 24-year-old client with client taking
warfarin develops unusual bruising, which evaluation finding should be documented as the best evidence of
improvement?
A. serotonergic toxicity is treated promptly
B. toxicity is reversed before respiratory arrest
C. drug-related toxicity is recognized early
D. anticoagulation remains therapeutic without bleeding
Correct Answer: D. anticoagulation remains therapeutic without bleeding
Rationale: Anticoagulation remains therapeutic without bleeding is the clearest evidence that the intervention worked.
Evaluation should compare observed results with the expected outcome for warfarin monitoring.
,7. In the emergency department, the nurse is caring for a 68-year-old client. Older adult with new mobility
limits and limited home support. Which information is most important to include in handoff to the next
nurse?
A. a complete retelling of the entire hospitalization without prioritization
B. ability to perform self-care and access prescribed services, the action taken, and the client's response
C. nonurgent social details that do not affect current care
D. tasks already completed that have no relevance to ongoing safety
Correct Answer: B. ability to perform self-care and access prescribed services, the action taken, and the client's
response
Rationale: Handoff should emphasize current risk, ability to perform self-care and access prescribed services, actions
taken, and the client's response so care can continue safely. Irrelevant or unprioritized details can obscure time-sensitive
concerns.
8. In a community clinic, after the nurse implements the plan for a 55-year-old client with postoperative
client receiving IV opioid is difficult to arouse with slow respirations, which evaluation finding should be
documented as the best evidence of improvement?
A. HIT is recognized and heparin exposure stops
B. ventilation improves and sedation decreases
C. thyroid replacement reaches a stable therapeutic effect
D. serotonergic toxicity is treated promptly
Correct Answer: B. ventilation improves and sedation decreases
Rationale: Ventilation improves and sedation decreases is the clearest evidence that the intervention worked. Evaluation
should compare observed results with the expected outcome for opioid adverse effects.
9. During a telephone triage call, a 62-year-old client has the following concern: pregnant nurse asks about
caring for a client receiving a sealed radiation implant. Which information is most important to include in
handoff to the next nurse?
A. only the client's room number and diagnosis
B. exposure controls and dosimetry requirements, the action taken, and the client's response
C. tasks already completed that have no relevance to ongoing safety
D. nonurgent social details that do not affect current care
Correct Answer: B. exposure controls and dosimetry requirements, the action taken, and the client's response
Rationale: Handoff should emphasize current risk, exposure controls and dosimetry requirements, actions taken, and the
client's response so care can continue safely. Irrelevant or unprioritized details can obscure time-sensitive concerns.
, 10. At change of shift, the nurse is caring for a pregnant or postpartum client. Pregnant client has severe
hypertension, headache, visual changes, and right upper quadrant pain. Which principle best explains the
nurse's clinical decision-making in this situation?
A. inhalation injury
B. diabetic ketoacidosis
C. severe preeclampsia
D. heart failure decompensation
Correct Answer: C. severe preeclampsia
Rationale: The central principle is severe preeclampsia. 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.
11. The nurse reviews the situation of a 74-year-old client: stable postoperative client needing bathing and
ambulation. Which response by the nurse best promotes immediate client safety?
A. assess and intervene for the client with stridor first
B. begin interdisciplinary discharge planning early and assess equipment, caregiver, and follow-up needs
C. respect the refusal, assess understanding, notify the provider, and document the decision
D. delegate routine bathing and ambulation to assistive personnel after the RN assesses the client
Correct Answer: D. delegate routine bathing and ambulation to assistive personnel after the RN assesses the client
Rationale: The safest response is to delegate routine bathing and ambulation to assistive personnel after the RN assesses
the client. The decision is supported by scope of practice and client stability, which places prevention of immediate harm
ahead of less urgent tasks.
12. In a community clinic, a 29-year-old client has the following concern: client taking lithium develops
coarse tremor, vomiting, and ataxia. Which information is most important to include in handoff to the next
nurse?
A. lithium level, renal function, sodium, hydration, and neurologic status, the action taken, and the client's response
B. a complete retelling of the entire hospitalization without prioritization
C. only the client's room number and diagnosis
D. tasks already completed that have no relevance to ongoing safety
Correct Answer: A. lithium level, renal function, sodium, hydration, and neurologic status, the action taken, and the
client's response
Rationale: Handoff should emphasize current risk, lithium level, renal function, sodium, hydration, and neurologic
status, actions taken, and the client's response so care can continue safely. Irrelevant or unprioritized details can obscure
time-sensitive concerns.
SCENARIOS) Set 3 Exam
1. During a medication pass, a 29-year-old client has the following concern: stable postoperative client
needing bathing and ambulation. Which principle best explains the nurse's clinical decision-making in this
situation?
A. continuity of care
B. ABCs and acute change
C. advocacy and escalation
D. scope of practice and client stability
Correct Answer: D. scope of practice and client stability
Rationale: The central principle is scope of practice and client stability. 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.
2. The nurse reviews the situation of a 34-year-old client: client taking isoniazid, rifampin, pyrazinamide,
and ethambutol reports vision changes. What should the nurse do next?
A. verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before administration
B. do not stop abruptly; taper only as prescribed and monitor for infection and hyperglycemia
C. report the vision change promptly and assess for medication toxicity
D. check blood glucose promptly and treat hypoglycemia with rapid carbohydrate if the client can safely swallow
Correct Answer: C. report the vision change promptly and assess for medication toxicity
Rationale: The next step is to report the vision change promptly and assess for medication toxicity. This action follows
the priorities implied by tuberculosis pharmacotherapy and addresses the most time-sensitive risk before lower-priority
interventions.
3. During a postoperative assessment, the nurse is reviewing the case of a 41-year-old client. Client scheduled
for an invasive procedure who says the risks are not understood. Which complication or safety concern is the
nurse primarily trying to prevent?
A. informed consent responsibilities
B. occupational safety and assignment
C. privacy and minimum necessary disclosure
D. scope of practice and client stability
Correct Answer: A. informed consent responsibilities
Rationale: The major safety concern is tied to informed consent responsibilities. The cue pattern makes that risk more
immediate than the unrelated complications represented by the distractors.
,4. Avery is a 74-year-old client and is being assessed by the nurse. Client with possible ischemic stroke is
being evaluated for thrombolytic therapy. What should the nurse do next?
A. hold lithium and obtain urgent evaluation, including serum level and fluid-electrolyte status
B. verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before administration
C. stop the antipsychotic and seek emergency treatment for neuroleptic malignant syndrome
D. dilute and infuse with a controlled pump according to policy; never give IV potassium by direct push
Correct Answer: B. verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before
administration
Rationale: The next step is to verify eligibility, bleeding risk, timing, imaging results, and blood pressure criteria before
administration. This action follows the priorities implied by thrombolytic safety and addresses the most time-sensitive
risk before lower-priority interventions.
5. At change of shift, the nurse is reviewing the case of a 62-year-old client. Client falls without apparent
injury after attempting to toilet independently. Which complication or safety concern is the nurse primarily
trying to prevent?
A. scope of practice and client stability
B. disaster ethics and triage
C. occupational safety and assignment
D. post-event assessment and quality improvement
Correct Answer: D. post-event assessment and quality improvement
Rationale: The major safety concern is tied to post-event assessment and quality improvement. The cue pattern makes
that risk more immediate than the unrelated complications represented by the distractors.
6. In a long-term care facility, after the nurse implements the plan for a 24-year-old client with client taking
warfarin develops unusual bruising, which evaluation finding should be documented as the best evidence of
improvement?
A. serotonergic toxicity is treated promptly
B. toxicity is reversed before respiratory arrest
C. drug-related toxicity is recognized early
D. anticoagulation remains therapeutic without bleeding
Correct Answer: D. anticoagulation remains therapeutic without bleeding
Rationale: Anticoagulation remains therapeutic without bleeding is the clearest evidence that the intervention worked.
Evaluation should compare observed results with the expected outcome for warfarin monitoring.
,7. In the emergency department, the nurse is caring for a 68-year-old client. Older adult with new mobility
limits and limited home support. Which information is most important to include in handoff to the next
nurse?
A. a complete retelling of the entire hospitalization without prioritization
B. ability to perform self-care and access prescribed services, the action taken, and the client's response
C. nonurgent social details that do not affect current care
D. tasks already completed that have no relevance to ongoing safety
Correct Answer: B. ability to perform self-care and access prescribed services, the action taken, and the client's
response
Rationale: Handoff should emphasize current risk, ability to perform self-care and access prescribed services, actions
taken, and the client's response so care can continue safely. Irrelevant or unprioritized details can obscure time-sensitive
concerns.
8. In a community clinic, after the nurse implements the plan for a 55-year-old client with postoperative
client receiving IV opioid is difficult to arouse with slow respirations, which evaluation finding should be
documented as the best evidence of improvement?
A. HIT is recognized and heparin exposure stops
B. ventilation improves and sedation decreases
C. thyroid replacement reaches a stable therapeutic effect
D. serotonergic toxicity is treated promptly
Correct Answer: B. ventilation improves and sedation decreases
Rationale: Ventilation improves and sedation decreases is the clearest evidence that the intervention worked. Evaluation
should compare observed results with the expected outcome for opioid adverse effects.
9. During a telephone triage call, a 62-year-old client has the following concern: pregnant nurse asks about
caring for a client receiving a sealed radiation implant. Which information is most important to include in
handoff to the next nurse?
A. only the client's room number and diagnosis
B. exposure controls and dosimetry requirements, the action taken, and the client's response
C. tasks already completed that have no relevance to ongoing safety
D. nonurgent social details that do not affect current care
Correct Answer: B. exposure controls and dosimetry requirements, the action taken, and the client's response
Rationale: Handoff should emphasize current risk, exposure controls and dosimetry requirements, actions taken, and the
client's response so care can continue safely. Irrelevant or unprioritized details can obscure time-sensitive concerns.
, 10. At change of shift, the nurse is caring for a pregnant or postpartum client. Pregnant client has severe
hypertension, headache, visual changes, and right upper quadrant pain. Which principle best explains the
nurse's clinical decision-making in this situation?
A. inhalation injury
B. diabetic ketoacidosis
C. severe preeclampsia
D. heart failure decompensation
Correct Answer: C. severe preeclampsia
Rationale: The central principle is severe preeclampsia. 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.
11. The nurse reviews the situation of a 74-year-old client: stable postoperative client needing bathing and
ambulation. Which response by the nurse best promotes immediate client safety?
A. assess and intervene for the client with stridor first
B. begin interdisciplinary discharge planning early and assess equipment, caregiver, and follow-up needs
C. respect the refusal, assess understanding, notify the provider, and document the decision
D. delegate routine bathing and ambulation to assistive personnel after the RN assesses the client
Correct Answer: D. delegate routine bathing and ambulation to assistive personnel after the RN assesses the client
Rationale: The safest response is to delegate routine bathing and ambulation to assistive personnel after the RN assesses
the client. The decision is supported by scope of practice and client stability, which places prevention of immediate harm
ahead of less urgent tasks.
12. In a community clinic, a 29-year-old client has the following concern: client taking lithium develops
coarse tremor, vomiting, and ataxia. Which information is most important to include in handoff to the next
nurse?
A. lithium level, renal function, sodium, hydration, and neurologic status, the action taken, and the client's response
B. a complete retelling of the entire hospitalization without prioritization
C. only the client's room number and diagnosis
D. tasks already completed that have no relevance to ongoing safety
Correct Answer: A. lithium level, renal function, sodium, hydration, and neurologic status, the action taken, and the
client's response
Rationale: Handoff should emphasize current risk, lithium level, renal function, sodium, hydration, and neurologic
status, actions taken, and the client's response so care can continue safely. Irrelevant or unprioritized details can obscure
time-sensitive concerns.
