ACTUAL ATI PN COMPREHENSIVE
PREDICTOR EXIT LEVEL 3 EXAM
QUESTIONS AND ANSWERS WITH
RATIONALES LATEST EXAM UPDATE
GRADED A+
Questions 1–30: Management of Care (Delegation, Assignment, Legal, Ethics, Case Management)
1. A nurse is preparing to transfer a client to a long-term care facility. Which of the following
information must the nurse include in the handoff report?
A. The client’s full address and social security number
B. The client’s diagnosis, current medications, and code status
C. The client’s family’s employment details
D. The name of the client’s primary care provider’s spouse
B
Rationale: Handoff communication must include essential clinical data: diagnosis, treatments,
medications, allergies, code status, and pending results. Personal identifiers beyond name and
age are not needed and violate confidentiality.
2. A client with end-stage renal disease decides to stop dialysis. The client is alert and
oriented. What is the nurse’s priority action? A. Encourage the client to reconsider
B. Notify the provider of the client’s decision
C. Call the ethics committee immediately
D. Administer antidepressants without consent
Answer: B
,Rationale: The nurse must notify the provider so the client’s decision can be honored and
palliative care arranged. The nurse supports autonomy; coercion or unrequested medication is
unethical.
3. A charge nurse is making assignments. Which client should be assigned to an experienced
LPN?
A. Client receiving IV heparin infusion with aPTT monitoring
B. Client with new colostomy requiring stoma teaching
C. Client on continuous BiPAP with O2 saturation 88%
D. Client with a fractured hip who needs pain medication every 4 hours
Answer: D
*Rationale: Administering scheduled pain medication (e.g., oral or IV push in stable client) is
appropriate for LPN. Heparin infusion requires RN titration based on lab results. New colostomy
teaching is RN/enterostomal therapist. BiPAP with low O2 sat requires RN assessment.*
4. A nurse observes another nurse taking a photo of a client’s wound on a personal cell phone.
What should the nurse do first? A. Report the nurse to the nursing supervisor
B. Ignore it because no names were shown
C. Ask the nurse to delete the photo immediately
D. Take a photo of the nurse and send to HR
Answer: A
Rationale: Taking photos of a client on a personal device violates HIPAA. The nurse must report
the breach to a supervisor. Asking to delete does not resolve the violation; reporting is the first
step per facility policy.
5. A nurse is caring for a client who is on suicide precautions. The client asks the nurse to keep a
secret about a plan to harm self. What should the nurse do?
A. Promise to keep the secret to maintain trust
B. Tell the client that secrets cannot be kept if safety is at risk
C. Document the request but take no action
,Answer:
D. Transfer the client to another nurse
Answer: B
Rationale: Safety overrides confidentiality. The nurse must inform the treatment team of any
suicidal ideation or plan. Making a promise of secrecy is dangerous and unethical.
6. A client is being discharged but does not have insurance to pay for prescribed medications.
Which action demonstrates advocacy?
A. Telling the client to skip doses to save money
B. Notifying the provider to request generic or lower-cost alternatives
C. Discharging the client without medications
D. Billing the client’s family without consent
Answer: B
Rationale: The nurse advocates by collaborating with the provider and social worker to find
affordable options. Skipping doses is unsafe. Advocacy is a key RN/LPN role in discharge
planning.
7. A charge nurse is delegating tasks to a licensed practical nurse (LPN) and an assistive
personnel (AP). Which of the following tasks should the charge nurse assign to the LPN?
A. Bathing a client with dementia
B. Feeding a client with dysphagia
C. Administering a tube feeding to a client with a gastrostomy tube
D. Ambulating a client who has a history of falls
Answer: C
Rationale: Administering a tube feeding requires assessment and monitoring for complications
(e.g., aspiration, residual volume), which is within the LPN scope in many states. Bathing,
feeding stable clients with dysphagia (if no active complications), and ambulating are
appropriate for AP after training.
, 8. A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
client’s family asks the nurse to persuade the client. Which of the following actions should the
nurse take?
A. Respect the client’s decision and document refusal
B. Explain the risks of refusing transfusion to the family only
C. Ask the family to sign a consent for transfusion
D. Notify the ethics committee to override the refusal
Answer: A
Rationale: A competent adult has the legal and ethical right to refuse treatment, even if it may
lead to death. The nurse must respect autonomy and document the refusal. The family cannot
override a competent client’s decision.
9. A nurse manager is reviewing informed consent with a new LPN. Which statement by the LPN
indicates understanding?
A. “The LPN can witness the client’s signature on the consent form.”
B. “The LPN is responsible for explaining the procedure’s risks.”
C. “Informed consent is only required for surgical procedures.”
D. “A minor can consent for their own appendectomy without a parent.”
Answer: A
Rationale: LPNs may witness a signed consent form, but the provider (physician, surgeon) is
responsible for explaining risks, benefits, and alternatives. Consent is required for many invasive
procedures, not just surgery. Minors generally require parent/guardian consent except in specific
situations (e.g., emancipated minor).
10. A nurse on a medical-surgical unit is planning care for four clients. Which client should the
nurse assign to the LPN?
A. Client 1 hour post-lobectomy with chest tube drainage 150 mL/hr
B. Client with newly inserted tracheostomy requiring frequent suctioning
C. Client with stable type 2 diabetes mellitus requiring insulin glargine
PREDICTOR EXIT LEVEL 3 EXAM
QUESTIONS AND ANSWERS WITH
RATIONALES LATEST EXAM UPDATE
GRADED A+
Questions 1–30: Management of Care (Delegation, Assignment, Legal, Ethics, Case Management)
1. A nurse is preparing to transfer a client to a long-term care facility. Which of the following
information must the nurse include in the handoff report?
A. The client’s full address and social security number
B. The client’s diagnosis, current medications, and code status
C. The client’s family’s employment details
D. The name of the client’s primary care provider’s spouse
B
Rationale: Handoff communication must include essential clinical data: diagnosis, treatments,
medications, allergies, code status, and pending results. Personal identifiers beyond name and
age are not needed and violate confidentiality.
2. A client with end-stage renal disease decides to stop dialysis. The client is alert and
oriented. What is the nurse’s priority action? A. Encourage the client to reconsider
B. Notify the provider of the client’s decision
C. Call the ethics committee immediately
D. Administer antidepressants without consent
Answer: B
,Rationale: The nurse must notify the provider so the client’s decision can be honored and
palliative care arranged. The nurse supports autonomy; coercion or unrequested medication is
unethical.
3. A charge nurse is making assignments. Which client should be assigned to an experienced
LPN?
A. Client receiving IV heparin infusion with aPTT monitoring
B. Client with new colostomy requiring stoma teaching
C. Client on continuous BiPAP with O2 saturation 88%
D. Client with a fractured hip who needs pain medication every 4 hours
Answer: D
*Rationale: Administering scheduled pain medication (e.g., oral or IV push in stable client) is
appropriate for LPN. Heparin infusion requires RN titration based on lab results. New colostomy
teaching is RN/enterostomal therapist. BiPAP with low O2 sat requires RN assessment.*
4. A nurse observes another nurse taking a photo of a client’s wound on a personal cell phone.
What should the nurse do first? A. Report the nurse to the nursing supervisor
B. Ignore it because no names were shown
C. Ask the nurse to delete the photo immediately
D. Take a photo of the nurse and send to HR
Answer: A
Rationale: Taking photos of a client on a personal device violates HIPAA. The nurse must report
the breach to a supervisor. Asking to delete does not resolve the violation; reporting is the first
step per facility policy.
5. A nurse is caring for a client who is on suicide precautions. The client asks the nurse to keep a
secret about a plan to harm self. What should the nurse do?
A. Promise to keep the secret to maintain trust
B. Tell the client that secrets cannot be kept if safety is at risk
C. Document the request but take no action
,Answer:
D. Transfer the client to another nurse
Answer: B
Rationale: Safety overrides confidentiality. The nurse must inform the treatment team of any
suicidal ideation or plan. Making a promise of secrecy is dangerous and unethical.
6. A client is being discharged but does not have insurance to pay for prescribed medications.
Which action demonstrates advocacy?
A. Telling the client to skip doses to save money
B. Notifying the provider to request generic or lower-cost alternatives
C. Discharging the client without medications
D. Billing the client’s family without consent
Answer: B
Rationale: The nurse advocates by collaborating with the provider and social worker to find
affordable options. Skipping doses is unsafe. Advocacy is a key RN/LPN role in discharge
planning.
7. A charge nurse is delegating tasks to a licensed practical nurse (LPN) and an assistive
personnel (AP). Which of the following tasks should the charge nurse assign to the LPN?
A. Bathing a client with dementia
B. Feeding a client with dysphagia
C. Administering a tube feeding to a client with a gastrostomy tube
D. Ambulating a client who has a history of falls
Answer: C
Rationale: Administering a tube feeding requires assessment and monitoring for complications
(e.g., aspiration, residual volume), which is within the LPN scope in many states. Bathing,
feeding stable clients with dysphagia (if no active complications), and ambulating are
appropriate for AP after training.
, 8. A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
client’s family asks the nurse to persuade the client. Which of the following actions should the
nurse take?
A. Respect the client’s decision and document refusal
B. Explain the risks of refusing transfusion to the family only
C. Ask the family to sign a consent for transfusion
D. Notify the ethics committee to override the refusal
Answer: A
Rationale: A competent adult has the legal and ethical right to refuse treatment, even if it may
lead to death. The nurse must respect autonomy and document the refusal. The family cannot
override a competent client’s decision.
9. A nurse manager is reviewing informed consent with a new LPN. Which statement by the LPN
indicates understanding?
A. “The LPN can witness the client’s signature on the consent form.”
B. “The LPN is responsible for explaining the procedure’s risks.”
C. “Informed consent is only required for surgical procedures.”
D. “A minor can consent for their own appendectomy without a parent.”
Answer: A
Rationale: LPNs may witness a signed consent form, but the provider (physician, surgeon) is
responsible for explaining risks, benefits, and alternatives. Consent is required for many invasive
procedures, not just surgery. Minors generally require parent/guardian consent except in specific
situations (e.g., emancipated minor).
10. A nurse on a medical-surgical unit is planning care for four clients. Which client should the
nurse assign to the LPN?
A. Client 1 hour post-lobectomy with chest tube drainage 150 mL/hr
B. Client with newly inserted tracheostomy requiring frequent suctioning
C. Client with stable type 2 diabetes mellitus requiring insulin glargine
