ATI Comprehensive Predictor Exam Versions 1-3
Actual Exam 2026/2027 – Complete Exam-Style
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[SECTION 1: Safe & Effective Care Environment — Questions 1-35]
Q1: A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an assistive
personnel (AP). Which of the following tasks should the charge nurse assign to the AP?
A. Administering a tap water enema to a client with constipation.
B. Measuring the output of a client who just returned from hemodialysis.
C. Recording the intake and output of a client with congestive heart failure.
D. Ambulating a client who is postoperative day 1 following a total knee replacement.
[CORRECT]
Correct Answer: D
Rationale: Ambulating a stable postoperative client is within the scope of practice for assistive
personnel (AP) as it involves routine care and does not require sterile technique or complex
clinical judgment. Administering an enema (A) is a nursing task often delegated to LPNs, but
measuring specific outputs like dialysis return (B) requires assessment skills for complications.
Recording intake and output (C) can sometimes be delegated, but in a client with heart failure,
the accuracy is critical for fluid management; however, ambulation is the safest and most
standard delegation for AP. The RN retains responsibility for supervision and evaluation.
Q2: A nurse is caring for a client who has a new prescription for wrist restraints. Which of the
following actions should the nurse take?
A. Secure the restraints to the side rails of the bed.
B. Apply the restraints so that the client's hand is restrained in a neutral position.
C. Tie the restraints with a quick-release knot. [CORRECT]
D. Check the client's skin integrity every 4 hours.
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Correct Answer: C
Rationale: Restraints must be tied with a quick-release knot to ensure they can be removed
immediately in an emergency, such as cardiac arrest or a fire. Securing restraints to side rails (A)
is dangerous because if the side rails are lowered, the restraints can tighten and cause injury or
strangulation. The hands should be restrained in a slightly flexed, anatomical position, not
necessarily neutral, to prevent contracture (B), though positioning varies by protocol; the quick-
release is universal. Skin integrity and circulation must be checked at least every 15 to 30
minutes (D), not every 4 hours, to prevent neurovascular compromise.
Q3: A nurse is triaging clients in the emergency department following a mass casualty incident
involving an explosion. Which of the following clients should the nurse tag as "black"
(expectant)?
A. A client with a 2-inch laceration on the forearm who is ambulatory.
B. A client with a partial-thickness burn on the face and airway difficulty.
C. A client with an open head injury and fixed, dilated pupils, no spontaneous breathing.
[CORRECT]
D. A client with a fractured femur and a pedal pulse of 2+.
Correct Answer: C
Rationale: In disaster triage using the START method, clients tagged "black" are those with
injuries that are so extensive that survival is unlikely given available resources. A client with
fixed, dilated pupils and apnea indicates severe brain death or imminent death, fitting the
expectant category. The ambulatory client (A) is "green" (minor). The client with airway burns
(B) is "red" (immediate). The client with the femur fracture (D) is "yellow" (delayed) as they are
stable but need urgent treatment.
Q4: A nurse manager is reviewing incident reports. Which of the following situations requires
completion of an incident report?
A. A client refuses to take a prescribed medication.
B. A client falls out of bed while reaching for water.
C. A client verbally threatens a nursing assistant.
D. A client receives an incorrect dose of medication but shows no adverse effects. [CORRECT]
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Correct Answer: D
Rationale: An incident report (variance report) is required for any unexpected event that could
have or did result in injury to a client, including medication errors, regardless of whether an
adverse effect occurred. This allows for quality improvement and risk management. Medication
refusal (A) is a client right documented in the medical record, not necessarily an incident report
unless there are specific protocol requirements. Verbal threats (C) should be documented in the
chart and security may be notified, but a fall (B) or medication error (D) are the primary safety
events requiring an incident report. Between B and D, both are reportable, but D represents a
specific systems failure. Note: In practice, falls also require reports. However, medication errors
are strict compliance events.
Q5: A nurse is delegating client care to the LPN. Which of the following statements by the nurse
demonstrates appropriate delegation?
A. "You need to check the client's telemetry monitor and interpret the rhythms."
B. "Please administer the blood transfusion and monitor for a reaction."
C. "Administer the enema and report the client's response to me." [CORRECT]
D. "Perform the initial admission assessment for the new client in room 302."
Correct Answer: C
Rationale: LPNs can perform tasks such as administering enemas and collecting data on client
response, provided the RN supervises and evaluates the outcome. Interpreting telemetry rhythms
(A) and initial admission assessments (D) are complex tasks that require the scope of practice
and clinical judgment of a registered nurse (RN). While some states allow LPNs to monitor
blood transfusions (B), it is often considered a high-risk task requiring RN supervision, and
enemas are a more standard delegation for LPN scope in most ATI scenarios.
Q6: A nurse is caring for a client who is on contact precautions due to Clostridioides difficile
infection. Which of the following actions should the nurse take?
A. Place the client in a negative-pressure room.
B. Don a gown and gloves before entering the room. [CORRECT]
C. Wear a mask when within 3 feet of the client.
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D. Use alcohol-based hand rub before leaving the client's room.
Correct Answer: B
Rationale: Contact precautions require the use of a gown and gloves for any contact with the
client or the client's environment to prevent the spread of pathogens like C. diff. A negative-
pressure room (A) is used for airborne precautions. A mask (C) is required for droplet
precautions. Alcohol-based hand rub (D) is ineffective against C. diff spores; the nurse must
wash hands with soap and water.
Q7: A nurse is caring for a client who has a sealed radiation implant for cervical cancer. Which of
the following instructions should the nurse include in the teaching plan for visitors?
A. Visitors may stand at the bedside for up to 30 minutes.
B. Visitors must maintain a distance of at least 6 feet from the client. [CORRECT]
C. Pregnant nurses are permitted to provide care for this client.
D. Visitors are allowed to hold the client's hand for comfort.
Correct Answer: B
Rationale: For clients with sealed radiation implants, time, distance, and shielding are the safety
principles. Visitors should maintain a distance of at least 6 feet from the source to minimize
radiation exposure. Standing at the bedside (A) or holding hands (D) violates the principle of
distance. Pregnant nurses and visitors (C) should not be in the room due to the risk of fetal harm.
Q8: A nurse on a medical-surgical unit is receiving shift report. Which of the following clients
should the nurse assess first?
A. A client who is postoperative day 2 after a laparoscopic cholecystectomy requesting pain
medication.
B. A client with type 2 diabetes mellitus reporting a blood glucose level of 120 mg/dL.
C. A client with heart failure who reports coughing up pink-tinged frothy sputum.
D. A client with a deep vein thrombosis (DVT) reporting calf pain. [CORRECT]