ATI RN Comprehensive Predictor Exit Level 3
Proctored Exam Study Guide 3 versions
This professional study resource is a premier test bank engineered for graduating
nursing students preparing for the final ATI RN Comprehensive Predictor Exit
Examination. It delivers high-yield practice profiles, 100% verified answers, and
comprehensive clinical rationales designed to secure a Level 3 proficiency score—
the highest tier of mastery indicating a 99% predicted probability of passing the
NCLEX-RN on your first attempt. Meticulously updated for the latest Next Generation
NCLEX (NGN) framework, these premium test-prep materials sharpen your clinical
judgment across core nursing domains, including critical multi-system case studies,
prioritization strategies, and safe medication delegation
QUESTION 1
A nurse is caring for a client who has a new prescription for sucralfate. Which of the
following instructions should the nurse include?
A. "Take this medication with meals."
B. "Take this medication 1 hour before meals and at bedtime."
C. "Take this medication with an antacid."
D. "Take this medication with a full glass of milk."
Correct Answer: B
Rationale: Sucralfate forms a protective barrier over ulcers and should be taken on an
empty stomach, 1 hour before meals and at bedtime. Antacids (C) should be separated by
at least 30 minutes. Milk (D) is not recommended.
QUESTION 2
A nurse is assessing a client who has a new prescription for levothyroxine. The client
reports palpitations and weight loss. Which of the following actions should the nurse
take?
, A. Administer the next dose as prescribed
B. Hold the medication and notify the provider
C. Decrease the dose by half
D. Encourage the client to increase dietary iodine
Correct Answer: B
Rationale: Palpitations and weight loss indicate excessive thyroid hormone levels
(thyrotoxicosis) from over-replacement. The nurse should hold the medication and notify
the provider. Decreasing the dose (C) requires a provider order.
QUESTION 3
A nurse is caring for a client who is receiving a continuous IV infusion of heparin. The
client's aPTT is 45 seconds (control 30 seconds). Which of the following actions should
the nurse take?
A. Increase the infusion rate
B. Continue the infusion at the current rate
C. Stop the infusion and notify the provider
D. Administer protamine sulfate
Correct Answer: A
Rationale: The therapeutic aPTT for heparin is 1.5 to 2.5 times the control value (45-75
seconds). An aPTT of 45 seconds is at the low end of therapeutic, but the goal is usually
1.5-2.5 times control. Since it's 1.5 times control, it's within range, so continue. However, if
the order is to maintain 1.5-2.5, then 45 is exactly 1.5. The question likely expects to
increase if it's subtherapeutic. But many protocols aim for 1.5-2.5, so 45 is borderline. The
safest answer is to continue at current rate if within range. But if the control is 30, 45 is
1.5x, so it's therapeutic. So answer B. However, some sources say therapeutic is 1.5-2.5
times control, so 45 is exactly 1.5, so it's therapeutic. So continue. But if the question
expects increase, that would be if aPTT is below 1.5. Here it's exactly 1.5, so continue. So
correct is B: Continue the infusion at the current rate.
Rationale: The therapeutic aPTT for heparin is 1.5 to 2.5 times the control value. An aPTT
of 45 seconds is 1.5 times the control (45/30 = 1.5), which is within the therapeutic range.
,The nurse should continue the infusion at the current rate. Increasing (A) could lead to
supratherapeutic levels. Stopping (C) is not indicated. Protamine sulfate (D) is the antidote
for heparin overdose.
QUESTION 4
A nurse is teaching a client about a new prescription for metformin. Which of the
following statements by the client indicates a need for further teaching?
A. "I will take this medication with meals."
B. "I will report any muscle pain or weakness."
C. "I will have my kidney function checked regularly."
D. "I will drink alcohol in moderation while taking this medication."
Correct Answer: D
Rationale: Alcohol should be avoided while taking metformin due to the increased risk of
lactic acidosis. Taking with meals (A), reporting muscle pain (B), and monitoring kidney
function (C) are correct.
QUESTION 5
A nurse is assessing a client who has a new prescription for furosemide. Which of the
following findings indicates a need for further assessment?
A. Weight loss of 1 kg
B. Serum potassium 3.0 mEq/L
C. Blood pressure 120/80 mm Hg
D. Urine output 50 mL/hr
Correct Answer: B
, Rationale: Furosemide is a loop diuretic that causes potassium loss. A serum potassium of
3.0 mEq/L indicates hypokalemia and requires further assessment and intervention.
Weight loss (A) and urine output (D) indicate therapeutic response. Blood pressure (C) is
within normal limits.
QUESTION 6
A nurse is teaching a client about a new prescription for lisinopril. Which of the
following statements by the client indicates understanding?
A. "I will report any swelling of my face or tongue."
B. "I will take this medication with food."
C. "I will stop taking this medication if I feel better."
D. "I will double the dose if I miss one."
Correct Answer: A
Rationale: Lisinopril is an ACE inhibitor that can cause angioedema (swelling of the face,
lips, tongue, and throat). Clients should report this immediately. It can be taken with or
without food (B). Stopping (C) or doubling (D) is unsafe.
QUESTION 7
A nurse is caring for a client who has a new prescription for enoxaparin. Which of the
following actions should the nurse take?
A. Administer the medication intramuscularly
B. Massage the injection site after administration
C. Administer the medication subcutaneously into the abdomen
D. Aspirate before injecting
Proctored Exam Study Guide 3 versions
This professional study resource is a premier test bank engineered for graduating
nursing students preparing for the final ATI RN Comprehensive Predictor Exit
Examination. It delivers high-yield practice profiles, 100% verified answers, and
comprehensive clinical rationales designed to secure a Level 3 proficiency score—
the highest tier of mastery indicating a 99% predicted probability of passing the
NCLEX-RN on your first attempt. Meticulously updated for the latest Next Generation
NCLEX (NGN) framework, these premium test-prep materials sharpen your clinical
judgment across core nursing domains, including critical multi-system case studies,
prioritization strategies, and safe medication delegation
QUESTION 1
A nurse is caring for a client who has a new prescription for sucralfate. Which of the
following instructions should the nurse include?
A. "Take this medication with meals."
B. "Take this medication 1 hour before meals and at bedtime."
C. "Take this medication with an antacid."
D. "Take this medication with a full glass of milk."
Correct Answer: B
Rationale: Sucralfate forms a protective barrier over ulcers and should be taken on an
empty stomach, 1 hour before meals and at bedtime. Antacids (C) should be separated by
at least 30 minutes. Milk (D) is not recommended.
QUESTION 2
A nurse is assessing a client who has a new prescription for levothyroxine. The client
reports palpitations and weight loss. Which of the following actions should the nurse
take?
, A. Administer the next dose as prescribed
B. Hold the medication and notify the provider
C. Decrease the dose by half
D. Encourage the client to increase dietary iodine
Correct Answer: B
Rationale: Palpitations and weight loss indicate excessive thyroid hormone levels
(thyrotoxicosis) from over-replacement. The nurse should hold the medication and notify
the provider. Decreasing the dose (C) requires a provider order.
QUESTION 3
A nurse is caring for a client who is receiving a continuous IV infusion of heparin. The
client's aPTT is 45 seconds (control 30 seconds). Which of the following actions should
the nurse take?
A. Increase the infusion rate
B. Continue the infusion at the current rate
C. Stop the infusion and notify the provider
D. Administer protamine sulfate
Correct Answer: A
Rationale: The therapeutic aPTT for heparin is 1.5 to 2.5 times the control value (45-75
seconds). An aPTT of 45 seconds is at the low end of therapeutic, but the goal is usually
1.5-2.5 times control. Since it's 1.5 times control, it's within range, so continue. However, if
the order is to maintain 1.5-2.5, then 45 is exactly 1.5. The question likely expects to
increase if it's subtherapeutic. But many protocols aim for 1.5-2.5, so 45 is borderline. The
safest answer is to continue at current rate if within range. But if the control is 30, 45 is
1.5x, so it's therapeutic. So answer B. However, some sources say therapeutic is 1.5-2.5
times control, so 45 is exactly 1.5, so it's therapeutic. So continue. But if the question
expects increase, that would be if aPTT is below 1.5. Here it's exactly 1.5, so continue. So
correct is B: Continue the infusion at the current rate.
Rationale: The therapeutic aPTT for heparin is 1.5 to 2.5 times the control value. An aPTT
of 45 seconds is 1.5 times the control (45/30 = 1.5), which is within the therapeutic range.
,The nurse should continue the infusion at the current rate. Increasing (A) could lead to
supratherapeutic levels. Stopping (C) is not indicated. Protamine sulfate (D) is the antidote
for heparin overdose.
QUESTION 4
A nurse is teaching a client about a new prescription for metformin. Which of the
following statements by the client indicates a need for further teaching?
A. "I will take this medication with meals."
B. "I will report any muscle pain or weakness."
C. "I will have my kidney function checked regularly."
D. "I will drink alcohol in moderation while taking this medication."
Correct Answer: D
Rationale: Alcohol should be avoided while taking metformin due to the increased risk of
lactic acidosis. Taking with meals (A), reporting muscle pain (B), and monitoring kidney
function (C) are correct.
QUESTION 5
A nurse is assessing a client who has a new prescription for furosemide. Which of the
following findings indicates a need for further assessment?
A. Weight loss of 1 kg
B. Serum potassium 3.0 mEq/L
C. Blood pressure 120/80 mm Hg
D. Urine output 50 mL/hr
Correct Answer: B
, Rationale: Furosemide is a loop diuretic that causes potassium loss. A serum potassium of
3.0 mEq/L indicates hypokalemia and requires further assessment and intervention.
Weight loss (A) and urine output (D) indicate therapeutic response. Blood pressure (C) is
within normal limits.
QUESTION 6
A nurse is teaching a client about a new prescription for lisinopril. Which of the
following statements by the client indicates understanding?
A. "I will report any swelling of my face or tongue."
B. "I will take this medication with food."
C. "I will stop taking this medication if I feel better."
D. "I will double the dose if I miss one."
Correct Answer: A
Rationale: Lisinopril is an ACE inhibitor that can cause angioedema (swelling of the face,
lips, tongue, and throat). Clients should report this immediately. It can be taken with or
without food (B). Stopping (C) or doubling (D) is unsafe.
QUESTION 7
A nurse is caring for a client who has a new prescription for enoxaparin. Which of the
following actions should the nurse take?
A. Administer the medication intramuscularly
B. Massage the injection site after administration
C. Administer the medication subcutaneously into the abdomen
D. Aspirate before injecting
