ATI RN Comprehensive Predictor 2023

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Free ATI RN Comprehensive Predictor 2023 Questions

1. A nurse is assessing a client's pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?
  • A. Hypotension
  • B. Hypovolemia
  • C. Cardiogenic shock
  • D. Left ventricular failure

Explanation

Pulmonary artery wedge pressure (PAWP) reflects left atrial pressure and indirectly measures left ventricular end-diastolic pressure (LVEDP) — the pressure in the left side of the heart at the end of filling. An elevated PAWP (greater than 12 mm Hg) indicates increased left ventricular preload, which occurs in left ventricular failure or fluid overload. This leads to pulmonary congestion, dyspnea, and decreased cardiac output.
2. 127. A nurse is caring for an adolescent client who is pregnant with their second child and is experiencing anxiety. Which of the following statements should the nurse make?
  • A. "Tell me more about how you are feeling about this pregnancy."
  • B. "Clients are usually happy about a second pregnancy."
  • C. "You will feel better when you have your first ultrasound."
  • D. "Let's focus on how you are feeling physically."

Explanation

This response demonstrates therapeutic communication, allowing the adolescent to express emotions and concerns about the pregnancy in a supportive, nonjudgmental way. Open-ended questions encourage dialogue, helping the nurse assess the client’s emotional state and provide appropriate support.
3. A nurse in a clinic is caring for an adolescent client who is at 24 weeks of gestation and showing signs of preeclampsia. Which of the following findings should the nurse expect?
  • A. Increased platelet count
  • B. Increased protein in urine
  • C. Decreased BUN
  • D. Decreased serum uric acid

Explanation

Preeclampsia is a hypertensive disorder of pregnancy characterized by elevated blood pressure and proteinuria (protein in the urine) after 20 weeks of gestation. The presence of protein in the urine indicates glomerular damage due to endothelial dysfunction, which allows protein to leak into the urine. Other typical findings include elevated liver enzymes, decreased platelet count, and increased serum uric acid and BUN due to impaired renal perfusion.
4.

A community health nurse is planning to make home visits to several clients. Which of the following clients should the nurse plan to visit first?

  • A. A client who has multiple sclerosis who is due for a monthly assessment and requires their indwelling catheter to be changed​
  • B. A child who has terminal cancer and requires daily dressing changes​
  • C. A client who has diabetes mellitus and requires their feet to be examined​
  • D. A child who has a new diagnosis of heart disease and requires education about medication

Explanation

Explanation
A newly diagnosed child with heart disease needs immediate education on medication management to prevent complications such as heart failure, arrhythmias, or poor adherence. Early teaching ensures the family understands dosing, adverse effects, and when to seek emergency care. New or unstable conditions take priority because they pose a higher risk for rapid deterioration without immediate intervention.
5. 93. A newly licensed nurse is caring for a client who requires tracheal suctioning, which is a procedure the nurse has not performed in practice. Which of the following actions should the nurse take?
  • A. Ask an experienced nurse to assist with the procedure.
  • B. Delegate the task to an assistive personnel.
  • C. Refuse to take the assignment.
  • D. Identify that the task is in the scope of RN practice and perform the suctioning.

Explanation

Tracheal suctioning is within the scope of practice for a registered nurse, but since the newly licensed nurse has not yet performed the procedure independently, it is appropriate to seek assistance and supervision from an experienced nurse. This ensures client safety while allowing the new nurse to gain competence and confidence under proper guidance.
6. A nurse is reviewing home care with a client who has multiple sclerosis. Which of the following precautions should the nurse recommend to promote client safety?
  • A. Use a cane for support while walking.
  • B. Avoid the use of orthotics.
  • C. Implement a rigorous range-of-motion exercise plan.
  • D. Walk with feet close together for stability.

Explanation

Clients with multiple sclerosis (MS) often experience muscle weakness, impaired coordination, and balance difficulties due to demyelination of the nervous system. Using a cane or assistive device provides added support, helps prevent falls, and promotes independence in ambulation. The nurse should also recommend removing home hazards, such as loose rugs, and ensuring adequate lighting.
7.

A nurse is caring for a 9-year-old child at a clinic.​

Exhibit 1
Nurses' Notes
1000
Child has been brought to the clinic by their parent due to a report of right arm pain. The parent states that several hours ago the child tripped and fell onto the sidewalk while playing outside.​
The child states, "I was running when we were playing, and i tripped over a curb." Child is supporting their arm across their body. Exhibit 2​
Assessment
1000:
Child is alert and appears developmentally appropriate for their age and well nourished.​
Respirations easy and unlabored. Abdomen nondistended. Right forearm and fingers are edematous.Ecchymotic area noted on outer aspect of the forearm. Radial pulse +2. Fingers slightly cool to touch. Child can move fingers and reports a mild "tingling" sensation. Child verbalizes a pain level of 4 on a scale of 0 to 10. Abrasion noted on right knee. No active bleeding. Multiple areas of bruising noted on lower extremities in various stages of healing.​
Exhibit 3
Vital Signs
1000
Temperature 36.8° C (98.2* F)
Heart rate 102/min
Respiratory rate 22/min
BP 100/60 mm Hg
Oxygen saturation 98% on room air

Which condition is MOST consistent with all four assessment findings listed in the table (sensation changes, edema, ecchymosis, and pain) based on the child's injury and clinical presentation?

  • A. Sprain​
  • B. Fracture​
  • C. Dislocation​
  • D. None of the above

Explanation

Explanation
A fracture best explains the combination of edema, ecchymosis, altered sensation (tingling), and pain following a fall onto the arm. This child’s forearm shows swelling, bruising, and mild neurovascular changes—typical signs of a bone injury. Supporting the arm across the body and reporting localized pain are also common behavioral indicators of a fracture rather than a soft-tissue or joint injury. Together, these findings strongly align with a fracture diagnosis.
8. 71. A nurse is providing teaching to the guardians of a toddler about discipline techniques. Which of the following statements by the guardian indicates an understanding of the teaching?
  • A. "I will set a timer for 10 minutes for each timeout session."
  • B. "My child will learn rules through physical punishment."
  • C. "I will remind my child of their misbehavior to reinforce discipline."
  • D. "A timeout session should begin once my child is quiet."

Explanation

A timeout is an effective, age-appropriate discipline technique for toddlers that teaches self-control. The timeout should begin when the child becomes quiet, not while they are still crying or yelling. This helps reinforce calm behavior as the expected response. The general guideline is 1 minute per year of age (e.g., 2 minutes for a 2-year-old). The guardian should calmly explain the reason for the timeout and resume positive interaction afterward.
9. A nurse is caring for a client who has been on hemodialysis for the past 5 years. The client is refusing hemodialysis and says, "I'm tired of wasting my life; I would rather die." Which of the following statements should the nurse make?
  • A. "You are feeling anxious now; why don't you give it some time before making a final decision?"
  • B. "You should talk with your family members before making this decision."
  • C. "I will discuss this with your primary health care provider, and we can discuss this more tomorrow."
  • D. "Let me refer you to talk to someone regarding your treatment options."

Explanation

When a client expresses a desire to stop life-sustaining treatment, the nurse should respond with empathy and provide access to supportive resources, such as a social worker, counselor, or palliative care specialist. This ensures the client receives emotional support and has an opportunity to explore treatment options, end-of-life preferences, and coping strategies in a nonjudgmental setting.
10.

A nurse is conducting a health promotion class about the use of oral contraceptives. Which of the following disorders is a contraindication for oral contraceptive use?

  • A. Hypertension​
  • B. Fibromyalgia​
  • C. Asthma​
  • D. Fibrocystic breast condition

Explanation

Explanation
Hypertension is a contraindication to oral contraceptive use because estrogen-containing contraceptives increase the risk of thromboembolic events, stroke, and myocardial infarction. In clients with hypertension, these risks are significantly higher. Estrogen can also raise blood pressure further. Therefore, clients with hypertension should use alternative contraceptive methods that do not contain estrogen.

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