ATI-Style PN Comprehensive Predictor
Practice Exam (Original) – Set 1
1. A nurse is caring for a client who has heart failure and reports increasing
shortness of breath. Which finding requires immediate intervention?
A) Bilateral ankle edema
B) Weight gain of 1 lb (0.45 kg) in 24 hr
C) Oxygen saturation of 86% on room air
D) Fatigue with activity
💡 RATIONALE – An oxygen saturation of 86% indicates impaired oxygenation and requires
immediate action according to ABC priorities.
✔️ ANSWER – C) Oxygen saturation of 86% on room air
2. A nurse is preparing to administer regular insulin at 0730. The client’s
breakfast tray has not arrived. What should the nurse do?
A) Administer the insulin as prescribed
B) Hold the insulin until the meal is available
C) Double the insulin dose later
D) Ask the provider to discontinue the insulin
💡 RATIONALE – Regular insulin can cause hypoglycemia if administered without food
available. The nurse should ensure the client can eat soon after administration.
✔️ ANSWER – B) Hold the insulin until the meal is available
3. A nurse is assessing a client who is experiencing hypoglycemia. Which finding
should the nurse expect?
A) Warm, dry skin
B) Bradycardia
C) Tremors and diaphoresis
D) Decreased hunger
💡 RATIONALE – Hypoglycemia activates the sympathetic nervous system, causing tremors,
diaphoresis, tachycardia, and hunger.
,✔️ ANSWER – C) Tremors and diaphoresis
4. A nurse is caring for a client receiving a blood transfusion. The client develops
chills and low back pain. What is the nurse’s first action?
A) Notify the provider
B) Stop the transfusion
C) Administer acetaminophen
D) Obtain a urine specimen
💡 RATIONALE – These findings suggest a transfusion reaction. The priority action is to stop
the transfusion immediately.
✔️ ANSWER – B) Stop the transfusion
5. A nurse is caring for a client who had a stroke and has dysphagia. Which
intervention is appropriate?
A) Offer thin liquids frequently
B) Place food on the unaffected side of the mouth
C) Encourage use of a straw
D) Position supine after meals
💡 RATIONALE – Food should be placed on the stronger, unaffected side to reduce aspiration
risk.
✔️ ANSWER – B) Place food on the unaffected side of the mouth
6. A nurse is caring for a client with chronic kidney disease. Which laboratory
value should the nurse report immediately?
A) Hemoglobin 10 g/dL
B) Potassium 6.2 mEq/L
C) Calcium 8.2 mg/dL
D) BUN 30 mg/dL
💡 RATIONALE – Hyperkalemia can cause life-threatening cardiac dysrhythmias and requires
immediate intervention.
,✔️ ANSWER – B) Potassium 6.2 mEq/L
7. A nurse is teaching a client about nitroglycerin tablets. Which statement by
the client indicates understanding?
A) “I will swallow the tablet with water.”
B) “I will take the tablet only at bedtime.”
C) “I will place the tablet under my tongue.”
D) “I will chew the tablet before swallowing.”
💡 RATIONALE – Sublingual nitroglycerin should be placed under the tongue for rapid
absorption.
✔️ ANSWER – C) “I will place the tablet under my tongue.”
8. A nurse is caring for a client who is 1 day postoperative. Which finding
requires immediate follow-up?
A) Pain rating of 6/10
B) Temperature 37.4°C (99.3°F)
C) Absent bowel sounds
D) Calf pain when dorsiflexing the foot
💡 RATIONALE – Calf pain may indicate deep vein thrombosis, a potentially life-threatening
complication.
✔️ ANSWER – D) Calf pain when dorsiflexing the foot
9. A nurse is caring for a client with COPD who is receiving oxygen. Which
oxygen flow rate is generally appropriate unless otherwise prescribed?
A) 1–2 L/min via nasal cannula
B) 8–10 L/min via face mask
C) 12–15 L/min via nonrebreather mask
D) 6–8 L/min via simple mask
💡 RATIONALE – Clients with COPD often require low-flow oxygen to avoid suppressing
respiratory drive.
, ✔️ ANSWER – A) 1–2 L/min via nasal cannula
10. A nurse is caring for a client with a chest tube after a lobectomy. The
drainage system accidentally falls over and cracks. What should the nurse do
first?
A) Clamp the chest tube near the client’s chest
B) Place the end of the chest tube in a bottle of sterile water
C) Replace the drainage system with a new one
D) Notify the provider immediately
💡 RATIONALE – If the drainage system is cracked, the priority is to submerge the chest tube
end in sterile water to maintain the water seal and prevent air from entering the pleural space.
✔️ ANSWER – B) Place the end of the chest tube in a bottle of sterile water
11. A nurse is assessing a newborn 2 hr after birth. Which finding should be
reported immediately?
A) Acrocyanosis
B) Respiratory rate 68/min with grunting
C) Heart rate 140/min
D) Sleeping between feedings
💡 RATIONALE – Grunting and tachypnea indicate respiratory distress and require prompt
evaluation.
✔️ ANSWER – B) Respiratory rate 68/min with grunting
12. A nurse is caring for a client receiving heparin. Which laboratory value is
most important to monitor?
A) INR
B) aPTT
C) Hemoglobin A1c
D) Creatinine kinase
Practice Exam (Original) – Set 1
1. A nurse is caring for a client who has heart failure and reports increasing
shortness of breath. Which finding requires immediate intervention?
A) Bilateral ankle edema
B) Weight gain of 1 lb (0.45 kg) in 24 hr
C) Oxygen saturation of 86% on room air
D) Fatigue with activity
💡 RATIONALE – An oxygen saturation of 86% indicates impaired oxygenation and requires
immediate action according to ABC priorities.
✔️ ANSWER – C) Oxygen saturation of 86% on room air
2. A nurse is preparing to administer regular insulin at 0730. The client’s
breakfast tray has not arrived. What should the nurse do?
A) Administer the insulin as prescribed
B) Hold the insulin until the meal is available
C) Double the insulin dose later
D) Ask the provider to discontinue the insulin
💡 RATIONALE – Regular insulin can cause hypoglycemia if administered without food
available. The nurse should ensure the client can eat soon after administration.
✔️ ANSWER – B) Hold the insulin until the meal is available
3. A nurse is assessing a client who is experiencing hypoglycemia. Which finding
should the nurse expect?
A) Warm, dry skin
B) Bradycardia
C) Tremors and diaphoresis
D) Decreased hunger
💡 RATIONALE – Hypoglycemia activates the sympathetic nervous system, causing tremors,
diaphoresis, tachycardia, and hunger.
,✔️ ANSWER – C) Tremors and diaphoresis
4. A nurse is caring for a client receiving a blood transfusion. The client develops
chills and low back pain. What is the nurse’s first action?
A) Notify the provider
B) Stop the transfusion
C) Administer acetaminophen
D) Obtain a urine specimen
💡 RATIONALE – These findings suggest a transfusion reaction. The priority action is to stop
the transfusion immediately.
✔️ ANSWER – B) Stop the transfusion
5. A nurse is caring for a client who had a stroke and has dysphagia. Which
intervention is appropriate?
A) Offer thin liquids frequently
B) Place food on the unaffected side of the mouth
C) Encourage use of a straw
D) Position supine after meals
💡 RATIONALE – Food should be placed on the stronger, unaffected side to reduce aspiration
risk.
✔️ ANSWER – B) Place food on the unaffected side of the mouth
6. A nurse is caring for a client with chronic kidney disease. Which laboratory
value should the nurse report immediately?
A) Hemoglobin 10 g/dL
B) Potassium 6.2 mEq/L
C) Calcium 8.2 mg/dL
D) BUN 30 mg/dL
💡 RATIONALE – Hyperkalemia can cause life-threatening cardiac dysrhythmias and requires
immediate intervention.
,✔️ ANSWER – B) Potassium 6.2 mEq/L
7. A nurse is teaching a client about nitroglycerin tablets. Which statement by
the client indicates understanding?
A) “I will swallow the tablet with water.”
B) “I will take the tablet only at bedtime.”
C) “I will place the tablet under my tongue.”
D) “I will chew the tablet before swallowing.”
💡 RATIONALE – Sublingual nitroglycerin should be placed under the tongue for rapid
absorption.
✔️ ANSWER – C) “I will place the tablet under my tongue.”
8. A nurse is caring for a client who is 1 day postoperative. Which finding
requires immediate follow-up?
A) Pain rating of 6/10
B) Temperature 37.4°C (99.3°F)
C) Absent bowel sounds
D) Calf pain when dorsiflexing the foot
💡 RATIONALE – Calf pain may indicate deep vein thrombosis, a potentially life-threatening
complication.
✔️ ANSWER – D) Calf pain when dorsiflexing the foot
9. A nurse is caring for a client with COPD who is receiving oxygen. Which
oxygen flow rate is generally appropriate unless otherwise prescribed?
A) 1–2 L/min via nasal cannula
B) 8–10 L/min via face mask
C) 12–15 L/min via nonrebreather mask
D) 6–8 L/min via simple mask
💡 RATIONALE – Clients with COPD often require low-flow oxygen to avoid suppressing
respiratory drive.
, ✔️ ANSWER – A) 1–2 L/min via nasal cannula
10. A nurse is caring for a client with a chest tube after a lobectomy. The
drainage system accidentally falls over and cracks. What should the nurse do
first?
A) Clamp the chest tube near the client’s chest
B) Place the end of the chest tube in a bottle of sterile water
C) Replace the drainage system with a new one
D) Notify the provider immediately
💡 RATIONALE – If the drainage system is cracked, the priority is to submerge the chest tube
end in sterile water to maintain the water seal and prevent air from entering the pleural space.
✔️ ANSWER – B) Place the end of the chest tube in a bottle of sterile water
11. A nurse is assessing a newborn 2 hr after birth. Which finding should be
reported immediately?
A) Acrocyanosis
B) Respiratory rate 68/min with grunting
C) Heart rate 140/min
D) Sleeping between feedings
💡 RATIONALE – Grunting and tachypnea indicate respiratory distress and require prompt
evaluation.
✔️ ANSWER – B) Respiratory rate 68/min with grunting
12. A nurse is caring for a client receiving heparin. Which laboratory value is
most important to monitor?
A) INR
B) aPTT
C) Hemoglobin A1c
D) Creatinine kinase
