ATI RN COMPREHENSIVE PREDICTOR - SET 2 EXAM
QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. The nurse is caring for a client taking lactulose. Which parameter is most important to monitor for safe
ongoing therapy?
A. stool frequency and mental status in encephalopathy
B. blood pressure and edema
C. serum lithium, renal function, thyroid function, sodium
D. mood and seizure risk factors
Correct Answer: A. stool frequency and mental status in encephalopathy
Rationale: lactulose is a osmotic laxative. Its relevant priority monitoring parameter is stool frequency and
mental status in encephalopathy; safe nursing care requires connecting the medication class with its expected
effects, monitoring needs, and major risks.
2. Which transmission-based precaution is most appropriate for a client with localized herpes zoster in an
immunocompetent adult with lesions that can be covered?
A. Standard precautions with lesions completely covered
B. Airborne precautions for every encounter until pain resolves
C. Droplet precautions until fever ends
D. Protective isolation
Correct Answer: A. Standard precautions with lesions completely covered
Rationale: Localized zoster in an immunocompetent client can generally be managed with standard precautions
when lesions are fully covered; disseminated disease requires airborne and contact precautions.
3. Which adverse clinical development is a recognized major complication of HHS?
A. respiratory failure
B. thrombosis and neurologic injury
C. cerebral edema or dangerous potassium shifts
D. seizure and cerebral edema
Correct Answer: B. thrombosis and neurologic injury
Rationale: A recognized serious complication of HHS is thrombosis and neurologic injury. Focused surveillance
supports early escalation and treatment.
4. The emergency nurse recognizes thirst and neurologic changes from water deficit as hypernatremia.
Which treatment or nursing action has the highest priority?
A. cardiac monitoring and urgent membrane stabilization/shifting/removal when severe
B. replace potassium safely and correct cause
C. replace free water gradually and treat cause
D. identify reversible causes and manage fluid/electrolyte threats
Correct Answer: C. replace free water gradually and treat cause
Rationale: The priority for hypernatremia is to replace free water gradually and treat cause. This addresses the
immediate pathophysiology and reduces the risk of cerebral edema if corrected too rapidly.
5. A pregnant client asks about Tdap. Which teaching is correct?
A. Tdap is given only after delivery
B. Tdap is contraindicated after 20 weeks
C. A prior Tdap means it should never be repeated in pregnancy
D. Tdap is recommended during each pregnancy, preferably during 27 to 36 weeks
Correct Answer: D. Tdap is recommended during each pregnancy, preferably during 27 to 36 weeks
Rationale: Tdap during each pregnancy, ideally at 27 to 36 weeks, maximizes passive antibody transfer to the
newborn.
6. Which finding most strongly supports anorexia nervosa with medical instability?
A. time-consuming intrusive thoughts and repetitive rituals performed to reduce anxiety
B. injuries with fearful behavior and a partner who controls the conversation or access to care
C. tremor, autonomic hyperactivity, insomnia, agitation, hallucinations, or seizures after reducing heavy alcohol
use
D. severe restriction with bradycardia, orthostasis, electrolyte abnormalities, or very low weight
Correct Answer: D. severe restriction with bradycardia, orthostasis, electrolyte abnormalities, or very low
weight
,Rationale: severe restriction with bradycardia, orthostasis, electrolyte abnormalities, or very low weight is
characteristic of anorexia nervosa with medical instability.
7. A nurse learns that a competent client has designated a durable power of attorney for health care. When
does that surrogate generally make health decisions?
A. Whenever the surrogate disagrees with the client
B. When the client lacks decision-making capacity according to applicable law and the document
C. Only after the client dies
D. Whenever the client is hospitalized
Correct Answer: B. When the client lacks decision-making capacity according to applicable law and the
document
Rationale: A health-care surrogate generally acts when the client cannot make decisions, subject to the directive
and applicable law.
8. A client is experiencing enteral nutrition tolerance. Which finding is most consistent with this care need?
A. involuntary urine loss associated with urgency but no urinary retention
B. abdominal bloating, nausea, or repeated coughing during tube feeding
C. queasiness and reduced oral intake without abdominal rigidity or hemodynamic instability
D. frequent loose stools with moist erythematous perineal skin
Correct Answer: B. abdominal bloating, nausea, or repeated coughing during tube feeding
Rationale: abdominal bloating, nausea, or repeated coughing during tube feeding is a common cue when caring
for enteral nutrition tolerance.
9. The charge nurse is assigning morning care. Which task is appropriate to delegate to trained assistive
personnel for a stable client who needs a routine nonsterile stool specimen collected?
A. Interpret a positive occult-blood result
B. Explain why the provider ordered the test
C. Collect and label the specimen according to policy
D. Determine whether gastrointestinal bleeding is occurring
Correct Answer: C. Collect and label the specimen according to policy
Rationale: Specimen collection can be delegated when routine; interpretation and education are nursing
responsibilities.
10. Which description best explains the therapeutic action of lorazepam?
A. enhances GABA-A receptor activity
B. stimulates erythroid progenitor cells
C. blocks dopamine and enhances upper GI motility
D. promotes cellular glucose uptake
Correct Answer: A. enhances GABA-A receptor activity
Rationale: lorazepam is a benzodiazepine. Its relevant mechanism of action is enhances GABA-A receptor
activity; safe nursing care requires connecting the medication class with its expected effects, monitoring needs,
and major risks.
11. A nurse is entering a sterile field and notices the sterile glove touches the bedrail. What should the
nurse do?
A. Continue because only the fingertips matter
B. Wipe the glove with alcohol
C. Replace the contaminated glove before continuing the sterile procedure
D. Ask the client not to look at the glove
Correct Answer: C. Replace the contaminated glove before continuing the sterile procedure
Rationale: Contact with a nonsterile surface contaminates the glove; sterile technique requires replacement
before continuing.
12. A client with suspected aplastic anemia has pancytopenia from marrow failure. Which action should
occur next?
A. give intramuscular epinephrine immediately
B. obtain cultures and give prompt broad-spectrum antipseudomonal antibiotics
C. avoid IM injections/trauma and treat cause
D. protect from bleeding/infection and treat cause
Correct Answer: D. protect from bleeding/infection and treat cause
, Rationale: The priority for aplastic anemia is to protect from bleeding/infection and treat cause. This addresses
the immediate pathophysiology and reduces the risk of sepsis or hemorrhage.
13. Which finding pattern best matches the expected presentation of aplastic anemia?
A. severe pain from microvascular occlusion
B. fever in a patient with severe neutropenia
C. pancytopenia from marrow failure
D. low platelet count with petechiae or mucosal bleeding
Correct Answer: C. pancytopenia from marrow failure
Rationale: pancytopenia from marrow failure is a characteristic presentation of aplastic anemia; recognizing this
pattern reduces delay in evaluation and management.
14. An older adult asks how to prevent constipation. Which advice is appropriate if not contraindicated?
A. Use stimulant laxatives every day without evaluation
B. Restrict fluids
C. Increase fluid, dietary fiber, and physical activity gradually
D. Avoid fruits and vegetables
Correct Answer: C. Increase fluid, dietary fiber, and physical activity gradually
Rationale: Hydration, fiber, and activity promote bowel regularity for many older adults.
15. Which finding most strongly supports opioid overdose?
A. a report that voices are telling the client to harm someone
B. marked respiratory depression with decreased consciousness and pinpoint pupils
C. decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity
D. acute fluctuating attention and cognition with altered level of consciousness
Correct Answer: B. marked respiratory depression with decreased consciousness and pinpoint pupils
Rationale: marked respiratory depression with decreased consciousness and pinpoint pupils is characteristic of
opioid overdose.
16. A hospitalized client wants a spiritual-care visit. Which nursing action is appropriate?
A. Facilitate access to the client's preferred spiritual support without imposing the nurse's beliefs
B. Explain that spiritual needs are outside nursing care
C. Choose a faith representative for the client
D. Discuss only the nurse's own beliefs
Correct Answer: A. Facilitate access to the client's preferred spiritual support without imposing the nurse's
beliefs
Rationale: Nursing care can support spiritual needs by respecting client preferences and arranging appropriate
resources.
17. A client is experiencing end-of-life dyspnea. Which finding is most consistent with this care need?
A. frequent nighttime awakening related to noise, pain, and repeated interruptions
B. dry oral mucosa with inability to perform self-care
C. coughing or wet voice during meals and food pocketing
D. air hunger in a client receiving comfort-focused end-of-life care
Correct Answer: D. air hunger in a client receiving comfort-focused end-of-life care
Rationale: air hunger in a client receiving comfort-focused end-of-life care is a common cue when caring for
end-of-life dyspnea.
18. A client is experiencing anorexia nervosa with medical instability. Which nursing action is the priority?
A. provide a low-stimulation environment, set concise limits, and offer portable high-calorie foods and fluids
B. avoid abruptly blocking rituals initially; support structured treatment such as exposure and response prevention
C. assess safety and functioning, normalize varied grief responses, and offer support/resources
D. prioritize medical stabilization, monitored nutrition restoration, and assessment for refeeding complications
Correct Answer: D. prioritize medical stabilization, monitored nutrition restoration, and assessment for
refeeding complications
Rationale: Severe eating disorders can cause life-threatening cardiac and electrolyte complications; refeeding
must be monitored.
19. A healthy 50-year-old asks about shingles prevention. Which vaccine teaching is appropriate?
A. Recombinant zoster vaccine is recommended beginning at age 50 for immunocompetent adults
QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. The nurse is caring for a client taking lactulose. Which parameter is most important to monitor for safe
ongoing therapy?
A. stool frequency and mental status in encephalopathy
B. blood pressure and edema
C. serum lithium, renal function, thyroid function, sodium
D. mood and seizure risk factors
Correct Answer: A. stool frequency and mental status in encephalopathy
Rationale: lactulose is a osmotic laxative. Its relevant priority monitoring parameter is stool frequency and
mental status in encephalopathy; safe nursing care requires connecting the medication class with its expected
effects, monitoring needs, and major risks.
2. Which transmission-based precaution is most appropriate for a client with localized herpes zoster in an
immunocompetent adult with lesions that can be covered?
A. Standard precautions with lesions completely covered
B. Airborne precautions for every encounter until pain resolves
C. Droplet precautions until fever ends
D. Protective isolation
Correct Answer: A. Standard precautions with lesions completely covered
Rationale: Localized zoster in an immunocompetent client can generally be managed with standard precautions
when lesions are fully covered; disseminated disease requires airborne and contact precautions.
3. Which adverse clinical development is a recognized major complication of HHS?
A. respiratory failure
B. thrombosis and neurologic injury
C. cerebral edema or dangerous potassium shifts
D. seizure and cerebral edema
Correct Answer: B. thrombosis and neurologic injury
Rationale: A recognized serious complication of HHS is thrombosis and neurologic injury. Focused surveillance
supports early escalation and treatment.
4. The emergency nurse recognizes thirst and neurologic changes from water deficit as hypernatremia.
Which treatment or nursing action has the highest priority?
A. cardiac monitoring and urgent membrane stabilization/shifting/removal when severe
B. replace potassium safely and correct cause
C. replace free water gradually and treat cause
D. identify reversible causes and manage fluid/electrolyte threats
Correct Answer: C. replace free water gradually and treat cause
Rationale: The priority for hypernatremia is to replace free water gradually and treat cause. This addresses the
immediate pathophysiology and reduces the risk of cerebral edema if corrected too rapidly.
5. A pregnant client asks about Tdap. Which teaching is correct?
A. Tdap is given only after delivery
B. Tdap is contraindicated after 20 weeks
C. A prior Tdap means it should never be repeated in pregnancy
D. Tdap is recommended during each pregnancy, preferably during 27 to 36 weeks
Correct Answer: D. Tdap is recommended during each pregnancy, preferably during 27 to 36 weeks
Rationale: Tdap during each pregnancy, ideally at 27 to 36 weeks, maximizes passive antibody transfer to the
newborn.
6. Which finding most strongly supports anorexia nervosa with medical instability?
A. time-consuming intrusive thoughts and repetitive rituals performed to reduce anxiety
B. injuries with fearful behavior and a partner who controls the conversation or access to care
C. tremor, autonomic hyperactivity, insomnia, agitation, hallucinations, or seizures after reducing heavy alcohol
use
D. severe restriction with bradycardia, orthostasis, electrolyte abnormalities, or very low weight
Correct Answer: D. severe restriction with bradycardia, orthostasis, electrolyte abnormalities, or very low
weight
,Rationale: severe restriction with bradycardia, orthostasis, electrolyte abnormalities, or very low weight is
characteristic of anorexia nervosa with medical instability.
7. A nurse learns that a competent client has designated a durable power of attorney for health care. When
does that surrogate generally make health decisions?
A. Whenever the surrogate disagrees with the client
B. When the client lacks decision-making capacity according to applicable law and the document
C. Only after the client dies
D. Whenever the client is hospitalized
Correct Answer: B. When the client lacks decision-making capacity according to applicable law and the
document
Rationale: A health-care surrogate generally acts when the client cannot make decisions, subject to the directive
and applicable law.
8. A client is experiencing enteral nutrition tolerance. Which finding is most consistent with this care need?
A. involuntary urine loss associated with urgency but no urinary retention
B. abdominal bloating, nausea, or repeated coughing during tube feeding
C. queasiness and reduced oral intake without abdominal rigidity or hemodynamic instability
D. frequent loose stools with moist erythematous perineal skin
Correct Answer: B. abdominal bloating, nausea, or repeated coughing during tube feeding
Rationale: abdominal bloating, nausea, or repeated coughing during tube feeding is a common cue when caring
for enteral nutrition tolerance.
9. The charge nurse is assigning morning care. Which task is appropriate to delegate to trained assistive
personnel for a stable client who needs a routine nonsterile stool specimen collected?
A. Interpret a positive occult-blood result
B. Explain why the provider ordered the test
C. Collect and label the specimen according to policy
D. Determine whether gastrointestinal bleeding is occurring
Correct Answer: C. Collect and label the specimen according to policy
Rationale: Specimen collection can be delegated when routine; interpretation and education are nursing
responsibilities.
10. Which description best explains the therapeutic action of lorazepam?
A. enhances GABA-A receptor activity
B. stimulates erythroid progenitor cells
C. blocks dopamine and enhances upper GI motility
D. promotes cellular glucose uptake
Correct Answer: A. enhances GABA-A receptor activity
Rationale: lorazepam is a benzodiazepine. Its relevant mechanism of action is enhances GABA-A receptor
activity; safe nursing care requires connecting the medication class with its expected effects, monitoring needs,
and major risks.
11. A nurse is entering a sterile field and notices the sterile glove touches the bedrail. What should the
nurse do?
A. Continue because only the fingertips matter
B. Wipe the glove with alcohol
C. Replace the contaminated glove before continuing the sterile procedure
D. Ask the client not to look at the glove
Correct Answer: C. Replace the contaminated glove before continuing the sterile procedure
Rationale: Contact with a nonsterile surface contaminates the glove; sterile technique requires replacement
before continuing.
12. A client with suspected aplastic anemia has pancytopenia from marrow failure. Which action should
occur next?
A. give intramuscular epinephrine immediately
B. obtain cultures and give prompt broad-spectrum antipseudomonal antibiotics
C. avoid IM injections/trauma and treat cause
D. protect from bleeding/infection and treat cause
Correct Answer: D. protect from bleeding/infection and treat cause
, Rationale: The priority for aplastic anemia is to protect from bleeding/infection and treat cause. This addresses
the immediate pathophysiology and reduces the risk of sepsis or hemorrhage.
13. Which finding pattern best matches the expected presentation of aplastic anemia?
A. severe pain from microvascular occlusion
B. fever in a patient with severe neutropenia
C. pancytopenia from marrow failure
D. low platelet count with petechiae or mucosal bleeding
Correct Answer: C. pancytopenia from marrow failure
Rationale: pancytopenia from marrow failure is a characteristic presentation of aplastic anemia; recognizing this
pattern reduces delay in evaluation and management.
14. An older adult asks how to prevent constipation. Which advice is appropriate if not contraindicated?
A. Use stimulant laxatives every day without evaluation
B. Restrict fluids
C. Increase fluid, dietary fiber, and physical activity gradually
D. Avoid fruits and vegetables
Correct Answer: C. Increase fluid, dietary fiber, and physical activity gradually
Rationale: Hydration, fiber, and activity promote bowel regularity for many older adults.
15. Which finding most strongly supports opioid overdose?
A. a report that voices are telling the client to harm someone
B. marked respiratory depression with decreased consciousness and pinpoint pupils
C. decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity
D. acute fluctuating attention and cognition with altered level of consciousness
Correct Answer: B. marked respiratory depression with decreased consciousness and pinpoint pupils
Rationale: marked respiratory depression with decreased consciousness and pinpoint pupils is characteristic of
opioid overdose.
16. A hospitalized client wants a spiritual-care visit. Which nursing action is appropriate?
A. Facilitate access to the client's preferred spiritual support without imposing the nurse's beliefs
B. Explain that spiritual needs are outside nursing care
C. Choose a faith representative for the client
D. Discuss only the nurse's own beliefs
Correct Answer: A. Facilitate access to the client's preferred spiritual support without imposing the nurse's
beliefs
Rationale: Nursing care can support spiritual needs by respecting client preferences and arranging appropriate
resources.
17. A client is experiencing end-of-life dyspnea. Which finding is most consistent with this care need?
A. frequent nighttime awakening related to noise, pain, and repeated interruptions
B. dry oral mucosa with inability to perform self-care
C. coughing or wet voice during meals and food pocketing
D. air hunger in a client receiving comfort-focused end-of-life care
Correct Answer: D. air hunger in a client receiving comfort-focused end-of-life care
Rationale: air hunger in a client receiving comfort-focused end-of-life care is a common cue when caring for
end-of-life dyspnea.
18. A client is experiencing anorexia nervosa with medical instability. Which nursing action is the priority?
A. provide a low-stimulation environment, set concise limits, and offer portable high-calorie foods and fluids
B. avoid abruptly blocking rituals initially; support structured treatment such as exposure and response prevention
C. assess safety and functioning, normalize varied grief responses, and offer support/resources
D. prioritize medical stabilization, monitored nutrition restoration, and assessment for refeeding complications
Correct Answer: D. prioritize medical stabilization, monitored nutrition restoration, and assessment for
refeeding complications
Rationale: Severe eating disorders can cause life-threatening cardiac and electrolyte complications; refeeding
must be monitored.
19. A healthy 50-year-old asks about shingles prevention. Which vaccine teaching is appropriate?
A. Recombinant zoster vaccine is recommended beginning at age 50 for immunocompetent adults
