ATI RN COMPREHENSIVE PREDICTOR PRACTICE EXAM
Original Practice Questions with Correct Answer✓s & Rationales
150+ Questions for Student Test Preparation
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with diabetes mellitus who has a blood glucose level of 180 mg/dL
B. A client who is 2 hours postoperative from a thoracotomy and reports sudden shortness of breath
C. A client with hypertension who requests pain medication for a headache
D. A client with chronic kidney disease who has a scheduled dialysis treatment in 1 hour
Correct Answer✓: B
Rationale: The client who is 2 hours postoperative from a thoracotomy reporting sudden shortness of
breath is at highest risk for life-threatening complications such as pulmonary embolism,
pneumothorax, or atelectasis. Using the ABC (Airway, Breathing, Circulation) priority framework,
breathing difficulties take precedence. Option A: A blood glucose of 180 mg/dL is elevated but not
immediately life-threatening. Option C: A headache in a hypertensive client requires assessment but is
not the priority over respiratory distress. Option D: A scheduled dialysis treatment is important but
not emergent if the client is stable.
2. A charge nurse is delegating tasks to a licensed practical nurse (LPN) and an assistive personnel
(AP). Which task is appropriate for the LPN to perform?
A. Administering a subcutaneous insulin injection to a client with type 1 diabetes
B. Developing a discharge teaching plan for a client newly diagnosed with heart failure
C. Performing an initial admission assessment on a client admitted with pneumonia
D. Evaluating the effectiveness of a new antihypertensive medication
Correct Answer✓: A
Rationale: Administering subcutaneous insulin injections is within the scope of practice for an
LPN/LVN in most jurisdictions. LPNs can perform routine medication administration under RN
,supervision. Option B: Developing discharge teaching plans requires the assessment, planning, and
evaluation skills of an RN. Option C: Initial admission assessments require the comprehensive
assessment skills and clinical judgment of an RN. Option D: Evaluating medication effectiveness
involves complex clinical judgment and is an RN responsibility.
3. A nurse is reviewing the medical record of a client who has signed an informed consent form for
surgery. Which finding indicates the consent may not be valid?
A. The client signed the form 24 hours before the scheduled procedure
B. The client's signature was witnessed by the nurse
C. The provider explained the procedure using medical terminology the client did not understand
D. The client asked questions about alternatives to the procedure
Correct Answer✓: C
Rationale: For informed consent to be valid, the client must receive information in a manner they can
understand. Using medical terminology that the client does not comprehend violates the principle of
informed consent, as the client cannot make an educated decision. Option A: Signing 24 hours in
advance is acceptable if the client's condition hasn't changed. Option B: A nurse can witness a
signature, confirming the client signed voluntarily. Option D: Asking questions demonstrates the client
is engaged in the decision-making process.
4. A nurse manager is implementing a new electronic health record (EHR) system. Which action best
supports staff adaptation to the change?
A. Requiring all staff to complete training modules before the go-live date
B. Assigning super-users to provide real-time support during the transition
C. Sending an email with the implementation timeline 1 week prior
D. Allowing staff to opt out of using the new system for non-urgent documentation
Correct Answer✓: B
Rationale: Assigning super-users (staff members with advanced training) to provide real-time, bedside
support during EHR implementation reduces anxiety, addresses immediate questions, and promotes
,successful adoption. This is a best practice in change management. Option A: While training is
important, requiring completion without ongoing support may not address real-time challenges.
Option C: One week's notice is insufficient for major system changes. Option D: Allowing opt-outs
creates inconsistency and compromises data integrity.
5. A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The provider
insists the transfusion is life-saving. What is the nurse's priority action?
A. Administer the transfusion as ordered because it is life-saving
B. Contact the hospital ethics committee for consultation
C. Respect the client's refusal and document the discussion
D. Ask the family to convince the client to accept the transfusion
Correct Answer✓: C
Rationale: A competent adult has the legal and ethical right to refuse any medical treatment, even if
life-saving, based on autonomy and informed consent principles. The nurse's priority is to respect the
client's decision, ensure the refusal is informed, and thoroughly document the discussion. Option A:
Administering against the client's wishes constitutes battery. Option B: While ethics consultation may
be helpful, it does not override a competent client's right to refuse. Option D: Pressuring the client
through family undermines autonomy.
6. A nurse is preparing to transfer a stable client from the ICU to a medical-surgical unit. Which
information is most important to include in the handoff report?
A. The client's favorite foods and activity preferences
B. The client's code status and advance directive information
C. The name of the client's primary care provider
D. The client's insurance information
Correct Answer✓: B
Rationale: Code status and advance directive information are critical for continuity of care and
ensuring the client's wishes are respected in emergencies. This is a priority in handoff communication
, per SBAR and joint commission standards. Options A, C, D: While potentially useful, these are not
immediately critical for safe care transition compared to life-sustaining treatment preferences.
7. A nurse is supervising a newly licensed nurse who is preparing to administer medications. Which
action by the newly licensed nurse requires intervention?
A. Checking the client's allergy band before administering penicillin
B. Using two patient identifiers before administering medications
C. Preparing medications for multiple clients at the same time to save time
D. Verifying the medication order against the MAR before administration
Correct Answer✓: C
Rationale: Preparing medications for multiple clients simultaneously increases the risk of medication
errors (wrong client, wrong medication). Medications should be prepared for one client at a time.
Options A, B, D: These are all correct medication administration practices that promote safety.
8. A nurse is caring for a client who is experiencing acute pain. The provider prescribes morphine 4 mg
IV. The nurse notes the usual dose is 2-4 mg IV. What should the nurse do first?
A. Administer the 4 mg dose as prescribed
B. Hold the medication and contact the provider to clarify the order
C. Administer 2 mg and document the rationale
D. Ask another nurse to verify the order before administration
Correct Answer✓: A
Rationale: The prescribed dose of 4 mg IV is within the usual therapeutic range (2-4 mg IV) noted by
the nurse. Since the order is clear, complete, and within standard parameters, the nurse should
administer the medication as prescribed after performing standard safety checks. Option B:
Clarification is needed for doses outside the usual range, unclear orders, or potential interactions—
not for doses within the expected range. Option C: The nurse should not alter a valid provider order
without consultation. Option D: While double-checking high-alert medications is good practice, it is
not required first for a standard dose within range.
Original Practice Questions with Correct Answer✓s & Rationales
150+ Questions for Student Test Preparation
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with diabetes mellitus who has a blood glucose level of 180 mg/dL
B. A client who is 2 hours postoperative from a thoracotomy and reports sudden shortness of breath
C. A client with hypertension who requests pain medication for a headache
D. A client with chronic kidney disease who has a scheduled dialysis treatment in 1 hour
Correct Answer✓: B
Rationale: The client who is 2 hours postoperative from a thoracotomy reporting sudden shortness of
breath is at highest risk for life-threatening complications such as pulmonary embolism,
pneumothorax, or atelectasis. Using the ABC (Airway, Breathing, Circulation) priority framework,
breathing difficulties take precedence. Option A: A blood glucose of 180 mg/dL is elevated but not
immediately life-threatening. Option C: A headache in a hypertensive client requires assessment but is
not the priority over respiratory distress. Option D: A scheduled dialysis treatment is important but
not emergent if the client is stable.
2. A charge nurse is delegating tasks to a licensed practical nurse (LPN) and an assistive personnel
(AP). Which task is appropriate for the LPN to perform?
A. Administering a subcutaneous insulin injection to a client with type 1 diabetes
B. Developing a discharge teaching plan for a client newly diagnosed with heart failure
C. Performing an initial admission assessment on a client admitted with pneumonia
D. Evaluating the effectiveness of a new antihypertensive medication
Correct Answer✓: A
Rationale: Administering subcutaneous insulin injections is within the scope of practice for an
LPN/LVN in most jurisdictions. LPNs can perform routine medication administration under RN
,supervision. Option B: Developing discharge teaching plans requires the assessment, planning, and
evaluation skills of an RN. Option C: Initial admission assessments require the comprehensive
assessment skills and clinical judgment of an RN. Option D: Evaluating medication effectiveness
involves complex clinical judgment and is an RN responsibility.
3. A nurse is reviewing the medical record of a client who has signed an informed consent form for
surgery. Which finding indicates the consent may not be valid?
A. The client signed the form 24 hours before the scheduled procedure
B. The client's signature was witnessed by the nurse
C. The provider explained the procedure using medical terminology the client did not understand
D. The client asked questions about alternatives to the procedure
Correct Answer✓: C
Rationale: For informed consent to be valid, the client must receive information in a manner they can
understand. Using medical terminology that the client does not comprehend violates the principle of
informed consent, as the client cannot make an educated decision. Option A: Signing 24 hours in
advance is acceptable if the client's condition hasn't changed. Option B: A nurse can witness a
signature, confirming the client signed voluntarily. Option D: Asking questions demonstrates the client
is engaged in the decision-making process.
4. A nurse manager is implementing a new electronic health record (EHR) system. Which action best
supports staff adaptation to the change?
A. Requiring all staff to complete training modules before the go-live date
B. Assigning super-users to provide real-time support during the transition
C. Sending an email with the implementation timeline 1 week prior
D. Allowing staff to opt out of using the new system for non-urgent documentation
Correct Answer✓: B
Rationale: Assigning super-users (staff members with advanced training) to provide real-time, bedside
support during EHR implementation reduces anxiety, addresses immediate questions, and promotes
,successful adoption. This is a best practice in change management. Option A: While training is
important, requiring completion without ongoing support may not address real-time challenges.
Option C: One week's notice is insufficient for major system changes. Option D: Allowing opt-outs
creates inconsistency and compromises data integrity.
5. A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The provider
insists the transfusion is life-saving. What is the nurse's priority action?
A. Administer the transfusion as ordered because it is life-saving
B. Contact the hospital ethics committee for consultation
C. Respect the client's refusal and document the discussion
D. Ask the family to convince the client to accept the transfusion
Correct Answer✓: C
Rationale: A competent adult has the legal and ethical right to refuse any medical treatment, even if
life-saving, based on autonomy and informed consent principles. The nurse's priority is to respect the
client's decision, ensure the refusal is informed, and thoroughly document the discussion. Option A:
Administering against the client's wishes constitutes battery. Option B: While ethics consultation may
be helpful, it does not override a competent client's right to refuse. Option D: Pressuring the client
through family undermines autonomy.
6. A nurse is preparing to transfer a stable client from the ICU to a medical-surgical unit. Which
information is most important to include in the handoff report?
A. The client's favorite foods and activity preferences
B. The client's code status and advance directive information
C. The name of the client's primary care provider
D. The client's insurance information
Correct Answer✓: B
Rationale: Code status and advance directive information are critical for continuity of care and
ensuring the client's wishes are respected in emergencies. This is a priority in handoff communication
, per SBAR and joint commission standards. Options A, C, D: While potentially useful, these are not
immediately critical for safe care transition compared to life-sustaining treatment preferences.
7. A nurse is supervising a newly licensed nurse who is preparing to administer medications. Which
action by the newly licensed nurse requires intervention?
A. Checking the client's allergy band before administering penicillin
B. Using two patient identifiers before administering medications
C. Preparing medications for multiple clients at the same time to save time
D. Verifying the medication order against the MAR before administration
Correct Answer✓: C
Rationale: Preparing medications for multiple clients simultaneously increases the risk of medication
errors (wrong client, wrong medication). Medications should be prepared for one client at a time.
Options A, B, D: These are all correct medication administration practices that promote safety.
8. A nurse is caring for a client who is experiencing acute pain. The provider prescribes morphine 4 mg
IV. The nurse notes the usual dose is 2-4 mg IV. What should the nurse do first?
A. Administer the 4 mg dose as prescribed
B. Hold the medication and contact the provider to clarify the order
C. Administer 2 mg and document the rationale
D. Ask another nurse to verify the order before administration
Correct Answer✓: A
Rationale: The prescribed dose of 4 mg IV is within the usual therapeutic range (2-4 mg IV) noted by
the nurse. Since the order is clear, complete, and within standard parameters, the nurse should
administer the medication as prescribed after performing standard safety checks. Option B:
Clarification is needed for doses outside the usual range, unclear orders, or potential interactions—
not for doses within the expected range. Option C: The nurse should not alter a valid provider order
without consultation. Option D: While double-checking high-alert medications is good practice, it is
not required first for a standard dose within range.
