ATI RN COMPREHENSIVE PREDICTOR - SET 5 EXAM
QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. The nurse prepares a room for a client with pulmonary tuberculosis?
A. Contact precautions with gown and gloves only
B. Airborne precautions in an airborne infection isolation room with a fit-tested respirator
C. Droplet precautions with a standard surgical mask
D. Protective environment with positive pressure
Correct Answer: B. Airborne precautions in an airborne infection isolation room with a fit-tested respirator
Rationale: Pulmonary tuberculosis spreads through airborne particles and requires airborne isolation and
respiratory protection.
2. For a client with Guillain-Barre syndrome, which measurement or study is most important to include in
focused surveillance?
A. neurologic status and vascular imaging
B. neurologic examination and ICP when monitored
C. vital capacity and neurologic exam
D. serial neuro checks and CT
Correct Answer: C. vital capacity and neurologic exam
Rationale: For Guillain-Barre syndrome, focused monitoring includes vital capacity and neurologic exam.
Trending the most relevant data helps identify deterioration or treatment complications before they become
irreversible.
3. Which nursing action best addresses sleep disturbance in the hospital?
A. administer prescribed antiemetic, minimize triggering odors, and advance oral intake as tolerated
B. establish scheduled toileting, assess contributing factors, and protect skin
C. cluster nighttime care when possible, reduce noise/light, control symptoms, and support the client's normal
sleep routine
D. pause feeding when aspiration or intolerance is suspected, assess the client, verify the plan, and resume only
when safe
Correct Answer: C. cluster nighttime care when possible, reduce noise/light, control symptoms, and support the
client's normal sleep routine
Rationale: Environmental and behavioral sleep measures can improve rest without automatically relying on
sedatives.
4. Which description best explains the therapeutic action of morphine?
A. activates mu-opioid receptors
B. replaces thyroxine
C. inhibits osteoclast-mediated bone resorption
D. enhances GABA-A receptor activity
Correct Answer: A. activates mu-opioid receptors
Rationale: morphine is a opioid agonist. Its relevant mechanism of action is activates mu-opioid receptors; safe
nursing care requires connecting the medication class with its expected effects, monitoring needs, and major risks.
5. The nurse is caring for four clients receiving medications. Which client should the nurse assess first?
A. a client taking metformin who reports mild diarrhea
B. a client taking digoxin who has nausea, a pulse of 48/min, and yellow-green vision
C. a client taking amlodipine with ankle edema at the end of the day
D. a client taking prednisone who reports increased appetite
Correct Answer: B. a client taking digoxin who has nausea, a pulse of 48/min, and yellow-green vision
Rationale: Bradycardia, GI symptoms, and visual changes are classic findings of potentially serious digoxin
toxicity.
6. A hospitalized client develops hypotension with signs of poor perfusion and pulmonary congestion after
cardiac injury, suggesting cardiogenic shock. Which action best addresses the immediate physiologic
threat?
A. support perfusion and treat the cardiac cause
B. avoid massaging the leg and begin prescribed anticoagulation
C. activate the acute coronary syndrome pathway and obtain rapid reperfusion evaluation
D. avoid sudden preload reduction and refer for valve evaluation when severe
,Correct Answer: A. support perfusion and treat the cardiac cause
Rationale: The priority for cardiogenic shock is to support perfusion and treat the cardiac cause. This addresses
the immediate pathophysiology and reduces the risk of multiorgan failure.
7. Which finding most strongly supports acute mania?
A. intrusive memories, avoidance, hyperarousal, and exaggerated startle after trauma
B. decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity
C. acute fluctuating attention and cognition with altered level of consciousness
D. intense fear of abandonment, unstable relationships, affective instability, and recurrent self-harm behavior
Correct Answer: B. decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity
Rationale: decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity is
characteristic of acute mania.
8. A parent asks which car-seat direction is safest for a young child. Which teaching is appropriate?
A. Turn forward-facing at the first birthday regardless of size
B. Place a rear-facing seat in front of an active airbag
C. Keep the child rear-facing as long as possible within the manufacturer's height and weight limits
D. Use an adult lap belt for infants
Correct Answer: C. Keep the child rear-facing as long as possible within the manufacturer's height and weight
limits
Rationale: Rear-facing restraints provide superior support for the head, neck, and spine and should be used
within seat limits.
9. During ongoing care for hypovolemic shock, the nurse reviews the original finding of tachycardia,
hypotension, cool skin, low urine output. Which parameter should be trended most closely?
A. CBC/liver tests with DMARDs and disease activity
B. pain/function assessment
C. serial neurovascular assessment
D. MAP, urine output, lactate
Correct Answer: D. MAP, urine output, lactate
Rationale: For hypovolemic shock, focused monitoring includes MAP, urine output, lactate. Trending the most
relevant data helps identify deterioration or treatment complications before they become irreversible.
10. A nurse sees a coworker recapping a used needle with two hands. Which correction is most
appropriate?
A. Break the needle before disposal
B. Activate the safety device and dispose of the needle directly in a sharps container without two-handed
recapping
C. Carry the uncapped needle to another room
D. Place the used needle in regular trash
Correct Answer: B. Activate the safety device and dispose of the needle directly in a sharps container without
two-handed recapping
Rationale: Needle safety devices and immediate sharps disposal reduce percutaneous injury; routine two-handed
recapping is unsafe.
11. Which description best explains the therapeutic action of ceftriaxone?
A. inhibits norepinephrine and dopamine reuptake
B. reduces central prostaglandin synthesis
C. disrupts microtubule-mediated neutrophil activity
D. inhibits bacterial cell-wall synthesis
Correct Answer: D. inhibits bacterial cell-wall synthesis
Rationale: ceftriaxone is a third-generation cephalosporin. Its relevant mechanism of action is inhibits bacterial
cell-wall synthesis; safe nursing care requires connecting the medication class with its expected effects,
monitoring needs, and major risks.
12. A client requests a second opinion before a major procedure. Which response by the nurse is
appropriate?
A. Support the request and help the client understand how to obtain another qualified opinion
B. Tell the client the request is disloyal to the provider
C. Cancel all treatment permanently
, D. Ask the family to decide whether a second opinion is allowed
Correct Answer: A. Support the request and help the client understand how to obtain another qualified opinion
Rationale: Clients may seek additional information and opinions as part of informed decision-making.
13. A client is experiencing pressure injury prevention. Which finding is most consistent with this care
need?
A. incisional pain that worsens with movement but is accompanied by stable vital signs and a benign wound
assessment
B. nonblanchable erythema over a pressure point in an immobile client
C. abdominal bloating, nausea, or repeated coughing during tube feeding
D. air hunger in a client receiving comfort-focused end-of-life care
Correct Answer: B. nonblanchable erythema over a pressure point in an immobile client
Rationale: nonblanchable erythema over a pressure point in an immobile client is a common cue when caring for
pressure injury prevention.
14. A postpartum client asks how to reduce the risk of sudden unexpected infant death during sleep. Which
teaching is correct?
A. Place the infant prone after every feeding
B. Use pillows to keep the infant on the side
C. Share the adult bed to improve observation
D. Place the infant supine on a firm, flat sleep surface without loose bedding
Correct Answer: D. Place the infant supine on a firm, flat sleep surface without loose bedding
Rationale: Safe-sleep guidance recommends supine positioning on a firm, flat surface with the sleep area free of
soft objects and loose bedding.
15. The emergency nurse recognizes hyperglycemia, ketones, metabolic acidosis, and dehydration as DKA.
Which treatment or nursing action has the highest priority?
A. rapid IV fluids and stress-dose glucocorticoids
B. start isotonic fluids then insulin with close potassium monitoring
C. aggressive fluid replacement then insulin and electrolyte management
D. replace fluids and give desmopressin for central DI when ordered
Correct Answer: B. start isotonic fluids then insulin with close potassium monitoring
Rationale: The priority for DKA is to start isotonic fluids then insulin with close potassium monitoring. This
addresses the immediate pathophysiology and reduces the risk of cerebral edema or dangerous potassium shifts.
16. Which finding most strongly supports schizophrenia with command hallucinations?
A. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe
B. a report that voices are telling the client to harm someone
C. acute fluctuating attention and cognition with altered level of consciousness
D. tremor, autonomic hyperactivity, insomnia, agitation, hallucinations, or seizures after reducing heavy alcohol
use
Correct Answer: B. a report that voices are telling the client to harm someone
Rationale: a report that voices are telling the client to harm someone is characteristic of schizophrenia with
command hallucinations.
17. A nurse identifies a pattern of delayed antibiotic administration on the unit. What quality-improvement
step is most appropriate after confirming the data?
A. Publicly blame the slowest nurse
B. Stop tracking administration times
C. Analyze process causes with the interprofessional team and test a targeted workflow improvement
D. Change every medication schedule without reviewing causes
Correct Answer: C. Analyze process causes with the interprofessional team and test a targeted workflow
improvement
Rationale: Quality improvement uses data and process analysis to identify modifiable system causes and test
interventions.
18. The nurse is planning surveillance for a client with COPD exacerbation. Which complication can cause
major deterioration and warrants focused monitoring?
A. obstructive shock
B. hypercapnic respiratory failure
QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. The nurse prepares a room for a client with pulmonary tuberculosis?
A. Contact precautions with gown and gloves only
B. Airborne precautions in an airborne infection isolation room with a fit-tested respirator
C. Droplet precautions with a standard surgical mask
D. Protective environment with positive pressure
Correct Answer: B. Airborne precautions in an airborne infection isolation room with a fit-tested respirator
Rationale: Pulmonary tuberculosis spreads through airborne particles and requires airborne isolation and
respiratory protection.
2. For a client with Guillain-Barre syndrome, which measurement or study is most important to include in
focused surveillance?
A. neurologic status and vascular imaging
B. neurologic examination and ICP when monitored
C. vital capacity and neurologic exam
D. serial neuro checks and CT
Correct Answer: C. vital capacity and neurologic exam
Rationale: For Guillain-Barre syndrome, focused monitoring includes vital capacity and neurologic exam.
Trending the most relevant data helps identify deterioration or treatment complications before they become
irreversible.
3. Which nursing action best addresses sleep disturbance in the hospital?
A. administer prescribed antiemetic, minimize triggering odors, and advance oral intake as tolerated
B. establish scheduled toileting, assess contributing factors, and protect skin
C. cluster nighttime care when possible, reduce noise/light, control symptoms, and support the client's normal
sleep routine
D. pause feeding when aspiration or intolerance is suspected, assess the client, verify the plan, and resume only
when safe
Correct Answer: C. cluster nighttime care when possible, reduce noise/light, control symptoms, and support the
client's normal sleep routine
Rationale: Environmental and behavioral sleep measures can improve rest without automatically relying on
sedatives.
4. Which description best explains the therapeutic action of morphine?
A. activates mu-opioid receptors
B. replaces thyroxine
C. inhibits osteoclast-mediated bone resorption
D. enhances GABA-A receptor activity
Correct Answer: A. activates mu-opioid receptors
Rationale: morphine is a opioid agonist. Its relevant mechanism of action is activates mu-opioid receptors; safe
nursing care requires connecting the medication class with its expected effects, monitoring needs, and major risks.
5. The nurse is caring for four clients receiving medications. Which client should the nurse assess first?
A. a client taking metformin who reports mild diarrhea
B. a client taking digoxin who has nausea, a pulse of 48/min, and yellow-green vision
C. a client taking amlodipine with ankle edema at the end of the day
D. a client taking prednisone who reports increased appetite
Correct Answer: B. a client taking digoxin who has nausea, a pulse of 48/min, and yellow-green vision
Rationale: Bradycardia, GI symptoms, and visual changes are classic findings of potentially serious digoxin
toxicity.
6. A hospitalized client develops hypotension with signs of poor perfusion and pulmonary congestion after
cardiac injury, suggesting cardiogenic shock. Which action best addresses the immediate physiologic
threat?
A. support perfusion and treat the cardiac cause
B. avoid massaging the leg and begin prescribed anticoagulation
C. activate the acute coronary syndrome pathway and obtain rapid reperfusion evaluation
D. avoid sudden preload reduction and refer for valve evaluation when severe
,Correct Answer: A. support perfusion and treat the cardiac cause
Rationale: The priority for cardiogenic shock is to support perfusion and treat the cardiac cause. This addresses
the immediate pathophysiology and reduces the risk of multiorgan failure.
7. Which finding most strongly supports acute mania?
A. intrusive memories, avoidance, hyperarousal, and exaggerated startle after trauma
B. decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity
C. acute fluctuating attention and cognition with altered level of consciousness
D. intense fear of abandonment, unstable relationships, affective instability, and recurrent self-harm behavior
Correct Answer: B. decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity
Rationale: decreased need for sleep, pressured speech, grandiosity, and escalating goal-directed activity is
characteristic of acute mania.
8. A parent asks which car-seat direction is safest for a young child. Which teaching is appropriate?
A. Turn forward-facing at the first birthday regardless of size
B. Place a rear-facing seat in front of an active airbag
C. Keep the child rear-facing as long as possible within the manufacturer's height and weight limits
D. Use an adult lap belt for infants
Correct Answer: C. Keep the child rear-facing as long as possible within the manufacturer's height and weight
limits
Rationale: Rear-facing restraints provide superior support for the head, neck, and spine and should be used
within seat limits.
9. During ongoing care for hypovolemic shock, the nurse reviews the original finding of tachycardia,
hypotension, cool skin, low urine output. Which parameter should be trended most closely?
A. CBC/liver tests with DMARDs and disease activity
B. pain/function assessment
C. serial neurovascular assessment
D. MAP, urine output, lactate
Correct Answer: D. MAP, urine output, lactate
Rationale: For hypovolemic shock, focused monitoring includes MAP, urine output, lactate. Trending the most
relevant data helps identify deterioration or treatment complications before they become irreversible.
10. A nurse sees a coworker recapping a used needle with two hands. Which correction is most
appropriate?
A. Break the needle before disposal
B. Activate the safety device and dispose of the needle directly in a sharps container without two-handed
recapping
C. Carry the uncapped needle to another room
D. Place the used needle in regular trash
Correct Answer: B. Activate the safety device and dispose of the needle directly in a sharps container without
two-handed recapping
Rationale: Needle safety devices and immediate sharps disposal reduce percutaneous injury; routine two-handed
recapping is unsafe.
11. Which description best explains the therapeutic action of ceftriaxone?
A. inhibits norepinephrine and dopamine reuptake
B. reduces central prostaglandin synthesis
C. disrupts microtubule-mediated neutrophil activity
D. inhibits bacterial cell-wall synthesis
Correct Answer: D. inhibits bacterial cell-wall synthesis
Rationale: ceftriaxone is a third-generation cephalosporin. Its relevant mechanism of action is inhibits bacterial
cell-wall synthesis; safe nursing care requires connecting the medication class with its expected effects,
monitoring needs, and major risks.
12. A client requests a second opinion before a major procedure. Which response by the nurse is
appropriate?
A. Support the request and help the client understand how to obtain another qualified opinion
B. Tell the client the request is disloyal to the provider
C. Cancel all treatment permanently
, D. Ask the family to decide whether a second opinion is allowed
Correct Answer: A. Support the request and help the client understand how to obtain another qualified opinion
Rationale: Clients may seek additional information and opinions as part of informed decision-making.
13. A client is experiencing pressure injury prevention. Which finding is most consistent with this care
need?
A. incisional pain that worsens with movement but is accompanied by stable vital signs and a benign wound
assessment
B. nonblanchable erythema over a pressure point in an immobile client
C. abdominal bloating, nausea, or repeated coughing during tube feeding
D. air hunger in a client receiving comfort-focused end-of-life care
Correct Answer: B. nonblanchable erythema over a pressure point in an immobile client
Rationale: nonblanchable erythema over a pressure point in an immobile client is a common cue when caring for
pressure injury prevention.
14. A postpartum client asks how to reduce the risk of sudden unexpected infant death during sleep. Which
teaching is correct?
A. Place the infant prone after every feeding
B. Use pillows to keep the infant on the side
C. Share the adult bed to improve observation
D. Place the infant supine on a firm, flat sleep surface without loose bedding
Correct Answer: D. Place the infant supine on a firm, flat sleep surface without loose bedding
Rationale: Safe-sleep guidance recommends supine positioning on a firm, flat surface with the sleep area free of
soft objects and loose bedding.
15. The emergency nurse recognizes hyperglycemia, ketones, metabolic acidosis, and dehydration as DKA.
Which treatment or nursing action has the highest priority?
A. rapid IV fluids and stress-dose glucocorticoids
B. start isotonic fluids then insulin with close potassium monitoring
C. aggressive fluid replacement then insulin and electrolyte management
D. replace fluids and give desmopressin for central DI when ordered
Correct Answer: B. start isotonic fluids then insulin with close potassium monitoring
Rationale: The priority for DKA is to start isotonic fluids then insulin with close potassium monitoring. This
addresses the immediate pathophysiology and reduces the risk of cerebral edema or dangerous potassium shifts.
16. Which finding most strongly supports schizophrenia with command hallucinations?
A. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe
B. a report that voices are telling the client to harm someone
C. acute fluctuating attention and cognition with altered level of consciousness
D. tremor, autonomic hyperactivity, insomnia, agitation, hallucinations, or seizures after reducing heavy alcohol
use
Correct Answer: B. a report that voices are telling the client to harm someone
Rationale: a report that voices are telling the client to harm someone is characteristic of schizophrenia with
command hallucinations.
17. A nurse identifies a pattern of delayed antibiotic administration on the unit. What quality-improvement
step is most appropriate after confirming the data?
A. Publicly blame the slowest nurse
B. Stop tracking administration times
C. Analyze process causes with the interprofessional team and test a targeted workflow improvement
D. Change every medication schedule without reviewing causes
Correct Answer: C. Analyze process causes with the interprofessional team and test a targeted workflow
improvement
Rationale: Quality improvement uses data and process analysis to identify modifiable system causes and test
interventions.
18. The nurse is planning surveillance for a client with COPD exacerbation. Which complication can cause
major deterioration and warrants focused monitoring?
A. obstructive shock
B. hypercapnic respiratory failure
