ATI COMPREHENSIVE PREDICTOR EXAM
1. The nurse is providing perineal care to an uncircumcised male patient. Which action will
the nurse take?
A. Leave the foreskin alone because there is little chance of infection.
B. Retract the foreskin for cleansing and allow it to return on its own.
C. Retract the foreskin and return it to its natural position when done.
D. Leave the foreskin retracted.
Answer: C
Rationale:
Return the foreskin to its natural position. Keeping the foreskin retracted leads to tightening
of the foreskin around the shaft of the penis, causing local edema and discomfort. The
foreskin may not return to its natural position on its own. Patients at greatest risk for infection
are uncircumcised males.
2. Which instruction will the nurse provide to the nursing assistive personnel when providing
foot care for a patient with diabetes?
A. Do not place slippers on the patient’s feet.
B. Trim the patient’s toenails daily.
C. Report sores on the patient’s toes.
D. Check the brachial artery.
Answer: C
Rationale:
Report any changes that may indicate inflammation or injury to tissue. Do not allow the
diabetic patient to go barefoot; injury can lead to amputations. Clipping toenails is not
allowed. Patients with peripheral vascular disease or diabetes mellitus often require nail care
from a specialist to reduce the risk of infection. When assessing the patient’s feet, the nurse
palpates the dorsalis pedis of the foot, not the brachial artery.
3. The debilitated patient is resisting attempts by the nurse to provide oral hygiene. Which
action will the nurse take next?
A. Insert an oral airway.
B. Place the patient in a flat, supine position.
C. Use undiluted hydrogen peroxide as a cleaner.
D. Quickly proceed while not talking to the patient.
Answer: A
Rationale:
If the patient is uncooperative, or is having difficulty keeping the mouth open, insert an oral
airway. Insert it upside down, and then turn the airway sideways and over the tongue to keep
the teeth apart. Do not use force. Position the patient on his or her side or turn the head to
allow for drainage. Placing the patient in a flat, supine position could lead to aspiration.
Hydrogen peroxide is irritating to mucosa. Even though the patient is debilitated, explain the
steps of mouth care and the sensations that he or she will feel. Also tell the patient when the
procedure is completed.
4. A nurse is providing oral care to a patient with stomatitis. Which technique will the nurse
use?
A. Avoid commercial mouthwashes.
B. Avoid normal saline rinses.
C. Brush with a hard toothbrush.
D. Brush with an alcohol-based toothpaste.
Answer: A
Rationale:
Stomatitis causes burning, pain, and change in food and fluid tolerance. Advise patients to
avoid alcohol and commercial mouthwash and stop smoking. When caring for patients with
stomatitis, brush with a soft toothbrush and floss gently to prevent bleeding of the gums. In
some cases, flossing needs to be temporarily omitted from oral care. Normal saline rinses
(approximately 30 mL) on awaking in the morning, after each meal, and at bedtime help
clean the oral cavity.
5. The nurse is teaching a patient about contact lens care. Which instructions will the nurse
include in the teaching session?
A. Use tap water to clean soft lenses.
B. Wash and rinse lens storage case daily.
C. Reuse storage solution for up to a week.
D. Keep the lenses is a cool dry place when not being used.
Answer: B
Rationale:
Thoroughly wash and rinse lens storage case on a daily basis. Clean periodically with soap or
liquid detergent, rinse thoroughly with warm water, and air-dry. Do not use tap water to clean
soft lenses. Lenses should be kept moist or wet when not worn. Use fresh solution daily when
storing and disinfecting lenses.
6. The patient reports to the nurse about a perceived decrease in hearing. When the nurse
examines the patient’s ear, a large amount of cerumen buildup at the entrance to the ear canal
is observed. Which action will the nurse take next?
A. Teach the patient how to use cotton-tipped applicators.
B. Tell the patient to use a bobby pin to extract earwax.
C. Apply gentle, downward retraction of the ear canal.
D. Instill hot water into the ear canal to melt the wax.
Answer: C
Rationale:
When cerumen is visible, gentle, downward retraction at the entrance to the ear canal causes
the wax to loosen and slip out. Instruct the patient never to use sharp objects such as bobby
pins or paper clips to remove earwax. Use of such objects can traumatize the ear canal and
ruptures the tympanic membrane. Avoid the use of cotton-tipped applicators as well because
they cause earwax to become impacted within the canal. Instilling cold or hot water causes
nausea or vomiting.
7. The patient is being fitted with a hearing aid. In teaching the patient how to care for the
hearing aid, which instructions will the nurse provide?
A. Change the battery every day or as needed.
B. Adjust the volume for a talking distance of 1 yard.
C. Wear the hearing aid 24 hours per day except when sleeping.
D. Avoid the use of hairspray, but aerosol perfumes are allowed.
Answer: B
Rationale:
Adjust volume to a comfortable level for talking at a distance of 1 yard. Initially, wear a
hearing aid for 15 to 20 minutes; then gradually increase wear time to 10 to 12 hours per day.
Batteries last 1 week with daily wearing of 10 to 12 hours. Avoid the use of hairspray and
perfume while wearing hearing aids. Residue from the spray can cause the aid to become oily
and greasy.
8. The patient is reporting an inability to clear nasal passages. Which action will the nurse
take?
A. Use gentle suction to prevent tissue damage.
B. Instruct patient to blow nose forcefully to clear the passage.
C. Place a dry washcloth under the nose to absorb secretions.
D. Insert a cotton-tipped applicator to the back of the nose.
Answer: A
Rationale:
Excessive nasal secretions can be removed using gentle suctioning. However, patients usually
remove secretions from the nose by gentle blowing into a soft tissue. Caution the patient
against harsh blowing that creates pressure capable of injuring the eardrum, the nasal mucosa,
and even sensitive eye structures. If the patient is unable to remove nasal secretions, assist by
using a wet washcloth or a cotton-tipped applicator moistened in water or saline. Never insert
the applicator beyond the length of the cotton tip.
9. A patient uses an in-the-canal hearing aid. Which assessment is a priority?
A. Eyeglass usage
B. Cerumen buildup
C. Type of physical exercise
D. Excessive moisture problems
Answer: B
Rationale:
With this type of model (in-the-canal), cerumen tends to plug this model more than others.
There are three popular types of hearing aids. An in-the-canal (ITC) aid is the newest,
smallest, and least visible and fits entirely in the ear canal. It has cosmetic appeal, is easy to
manipulate and place in the ear, and does not interfere with wearing eyeglasses or using the
telephone, and the patient can wear it during most physical exercise. An in-the-ear aid (ITE,
or intra-aural) is more noticeable than the ITC aid and is not for people with moisture or skin
problems in the ear canal. The larger size of this type of aid (behind-the-ear, BTE, or postaural) can make use of eyeglasses and phones difficult; it is more difficult to keep in place
during physical exercise.
