ATI RN VATI COMPREHENSIVE PREDICTOR 2026/2027 |
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Section 1: Management of Care - Legal, Ethical & Delegation
(Questions 1-25)
Q1. A nurse is caring for four clients on a medical-surgical unit. Which client should
the nurse assess FIRST?
A. A client with pneumonia who has an oxygen saturation of 92% on 2L nasal cannula
B. A client with a new colostomy who reports incisional pain rated 4/10
C. A client with heart failure who has 2+ pitting edema in bilateral lower extremities
D. A client with type 2 diabetes whose blood glucose is 248 mg/dL
Rationale: The pneumonia client has compromised oxygenation (SpO2 92%), which
is an airway/breathing priority per the ABC framework. Pain (B), edema (C), and
hyperglycemia (D) are important but not immediately life-threatening. [CORRECT]
Correct Answer: A
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP) on a busy
unit. Which task is MOST APPROPRIATE to delegate to the UAP?
A. Assessing a postoperative client for signs of hemorrhage
B. Feeding a client with dysphagia who requires thickened liquids
C. Reinforcing discharge teaching about wound care
D. Evaluating the effectiveness of a client's pain medication
Rationale: Feeding a stable client with dysphagia (with clear instructions on
thickened liquids) is within UAP scope. Assessment (A), teaching (C), and evaluation
(D) are RN responsibilities and cannot be delegated. [CORRECT]
,Correct Answer: B
Q3. [Bowtie] A nurse is reviewing the assignment for the shift. Which client situation
requires the nurse to seek clarification from the charge nurse before accepting the
assignment?
A. A client with a new tracheostomy requiring suctioning every 2 hours
B. A client with a PICC line requiring IV antibiotic administration
C. A client in the first 24 hours post-op from gastric bypass surgery
D. A client receiving chemotherapy via peripheral IV
Rationale: The first 24 hours post-gastric bypass requires specialized monitoring for
anastomotic leaks, bleeding, and fluid shifts that may exceed the nurse's scope or
competency without proper training/assignment. This requires clarification.
[CORRECT]
Correct Answer: C
Q4. A nurse receives a telephone order from a provider for morphine sulfate 10mg IV
push for a client reporting severe pain. What is the nurse's FIRST action?
A. Administer the medication immediately to provide pain relief
B. Repeat the order back to the provider for verification
C. Document the order in the electronic health record
D. Check the client's allergy history and current vital signs
Rationale: Per safe medication practices and the Joint Commission National Patient
Safety Goals, telephone orders must be read back for verification before any other
action. [CORRECT]
Correct Answer: B
,Q5. A nurse is caring for a client who requires restraints for safety. Which action by
the nurse demonstrates appropriate restraint management?
A. Applying four-point restraints to a client who is pulling at IV lines
B. Securing restraints to the bed frame with a quick-release knot
C. Checking circulation every 4 hours while the client is in restraints
D. Removing restraints only when the charge nurse is present
Rationale: Restraints must be secured with quick-release knots to the bed frame (not
side rails) to allow rapid release in emergencies. Four-point restraints require
provider order and are last resort (A). Circulation checks are every 15-30 minutes (C).
[CORRECT]
Correct Answer: B
Q6. A nurse is reviewing the plan of care for a client with a stage 3 pressure injury on
the coccyx. Which intervention is MOST appropriate for the nurse to include in the
plan?
A. Massage the area with moisturizing lotion twice daily
B. Position the client with a donut-shaped cushion under the sacrum
C. Reposition the client at least every 2 hours and use a pressure-redistributing
mattress
D. Apply a heating pad to the area for 20 minutes every 4 hours
Rationale: Repositioning every 2 hours and using pressure-redistributing surfaces
are evidence-based interventions for pressure injury prevention and healing.
Massage (A) can damage tissue; donut cushions (B) cause pressure ring injuries; heat
(D) is contraindicated. [CORRECT]
Correct Answer: C
Q7. A nurse is caring for a client with a do-not-resuscitate (DNR) order. The client
becomes unresponsive and apneic. What is the nurse's MOST appropriate action?
, A. Initiate cardiopulmonary resuscitation (CPR) immediately
B. Call for the rapid response team and provide comfort measures
C. Begin rescue breathing but do not perform chest compressions
D. Check the client's pulse and if absent, begin CPR
Rationale: A DNR order means no resuscitation efforts (CPR, intubation,
defibrillation) should be initiated. The nurse should ensure comfort, notify the
provider, and support the family. [CORRECT]
Correct Answer: B
Q8. A nurse is reviewing the medication administration record for a client with heart
failure. Which order should the nurse question?
A. Furosemide 40mg PO daily
B. Digoxin 0.25mg PO daily
C. Metoprolol 25mg PO BID
D. Potassium chloride 20mEq PO daily
Rationale: The standard maintenance dose of digoxin is 0.125mg daily for clients
with heart failure; 0.25mg is the loading dose or higher maintenance dose and
increases toxicity risk, especially in older adults. The nurse should verify this order.
[CORRECT]
Correct Answer: B
Q9. A nurse is caring for a client with a nasogastric (NG) tube connected to low
intermittent suction. The nurse notes that the client has not had any drainage in the
collection container for the past 4 hours. What is the nurse's FIRST action?
A. Irrigate the NG tube with 30mL of normal saline
B. Check the tube for kinks and verify suction settings
C. Notify the provider that the tube is not functioning
D. Reposition the client to promote drainage
Green Light Study Set | A+ Graded | NCLEX-RN Test Plan |
Pass Guaranteed - A+ Graded
Section 1: Management of Care - Legal, Ethical & Delegation
(Questions 1-25)
Q1. A nurse is caring for four clients on a medical-surgical unit. Which client should
the nurse assess FIRST?
A. A client with pneumonia who has an oxygen saturation of 92% on 2L nasal cannula
B. A client with a new colostomy who reports incisional pain rated 4/10
C. A client with heart failure who has 2+ pitting edema in bilateral lower extremities
D. A client with type 2 diabetes whose blood glucose is 248 mg/dL
Rationale: The pneumonia client has compromised oxygenation (SpO2 92%), which
is an airway/breathing priority per the ABC framework. Pain (B), edema (C), and
hyperglycemia (D) are important but not immediately life-threatening. [CORRECT]
Correct Answer: A
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP) on a busy
unit. Which task is MOST APPROPRIATE to delegate to the UAP?
A. Assessing a postoperative client for signs of hemorrhage
B. Feeding a client with dysphagia who requires thickened liquids
C. Reinforcing discharge teaching about wound care
D. Evaluating the effectiveness of a client's pain medication
Rationale: Feeding a stable client with dysphagia (with clear instructions on
thickened liquids) is within UAP scope. Assessment (A), teaching (C), and evaluation
(D) are RN responsibilities and cannot be delegated. [CORRECT]
,Correct Answer: B
Q3. [Bowtie] A nurse is reviewing the assignment for the shift. Which client situation
requires the nurse to seek clarification from the charge nurse before accepting the
assignment?
A. A client with a new tracheostomy requiring suctioning every 2 hours
B. A client with a PICC line requiring IV antibiotic administration
C. A client in the first 24 hours post-op from gastric bypass surgery
D. A client receiving chemotherapy via peripheral IV
Rationale: The first 24 hours post-gastric bypass requires specialized monitoring for
anastomotic leaks, bleeding, and fluid shifts that may exceed the nurse's scope or
competency without proper training/assignment. This requires clarification.
[CORRECT]
Correct Answer: C
Q4. A nurse receives a telephone order from a provider for morphine sulfate 10mg IV
push for a client reporting severe pain. What is the nurse's FIRST action?
A. Administer the medication immediately to provide pain relief
B. Repeat the order back to the provider for verification
C. Document the order in the electronic health record
D. Check the client's allergy history and current vital signs
Rationale: Per safe medication practices and the Joint Commission National Patient
Safety Goals, telephone orders must be read back for verification before any other
action. [CORRECT]
Correct Answer: B
,Q5. A nurse is caring for a client who requires restraints for safety. Which action by
the nurse demonstrates appropriate restraint management?
A. Applying four-point restraints to a client who is pulling at IV lines
B. Securing restraints to the bed frame with a quick-release knot
C. Checking circulation every 4 hours while the client is in restraints
D. Removing restraints only when the charge nurse is present
Rationale: Restraints must be secured with quick-release knots to the bed frame (not
side rails) to allow rapid release in emergencies. Four-point restraints require
provider order and are last resort (A). Circulation checks are every 15-30 minutes (C).
[CORRECT]
Correct Answer: B
Q6. A nurse is reviewing the plan of care for a client with a stage 3 pressure injury on
the coccyx. Which intervention is MOST appropriate for the nurse to include in the
plan?
A. Massage the area with moisturizing lotion twice daily
B. Position the client with a donut-shaped cushion under the sacrum
C. Reposition the client at least every 2 hours and use a pressure-redistributing
mattress
D. Apply a heating pad to the area for 20 minutes every 4 hours
Rationale: Repositioning every 2 hours and using pressure-redistributing surfaces
are evidence-based interventions for pressure injury prevention and healing.
Massage (A) can damage tissue; donut cushions (B) cause pressure ring injuries; heat
(D) is contraindicated. [CORRECT]
Correct Answer: C
Q7. A nurse is caring for a client with a do-not-resuscitate (DNR) order. The client
becomes unresponsive and apneic. What is the nurse's MOST appropriate action?
, A. Initiate cardiopulmonary resuscitation (CPR) immediately
B. Call for the rapid response team and provide comfort measures
C. Begin rescue breathing but do not perform chest compressions
D. Check the client's pulse and if absent, begin CPR
Rationale: A DNR order means no resuscitation efforts (CPR, intubation,
defibrillation) should be initiated. The nurse should ensure comfort, notify the
provider, and support the family. [CORRECT]
Correct Answer: B
Q8. A nurse is reviewing the medication administration record for a client with heart
failure. Which order should the nurse question?
A. Furosemide 40mg PO daily
B. Digoxin 0.25mg PO daily
C. Metoprolol 25mg PO BID
D. Potassium chloride 20mEq PO daily
Rationale: The standard maintenance dose of digoxin is 0.125mg daily for clients
with heart failure; 0.25mg is the loading dose or higher maintenance dose and
increases toxicity risk, especially in older adults. The nurse should verify this order.
[CORRECT]
Correct Answer: B
Q9. A nurse is caring for a client with a nasogastric (NG) tube connected to low
intermittent suction. The nurse notes that the client has not had any drainage in the
collection container for the past 4 hours. What is the nurse's FIRST action?
A. Irrigate the NG tube with 30mL of normal saline
B. Check the tube for kinks and verify suction settings
C. Notify the provider that the tube is not functioning
D. Reposition the client to promote drainage
