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ATI PN COMPREHENSIVE PREDICTOR EXAM
(Detail Solutions)
1. Which patient statement is the most reliable indicator that an older adult has the correct
understanding of health promotion activities?
a. “I need to increase my fat intake and limit protein.”
“I still keep my dentist appointments even though I have partials
b. now.”
c. “I should discontinue my fitness club membership for safety reasons.” “I’m up-todate on my
immunizations, but at my age, I don’t need the
d. influenza vaccine.”
Answer: B
Rationale:
General preventive measures for the nurse to recommend to older adults include keeping
regular dental appointments to promote good oral hygiene, eating a lowfat, well-balanced diet,
exercising regularly, and maintaining immunizations for seasonal influenza, tetanus, diphtheria
and pertussis, shingles, and pneumococcal disease.
2. A 72-year-old woman was recently widowed. She worked as a teller at a bank for 40 years
and has been retired for the past 5 years. She never learned how to drive. She lives in a rural
area that does not have public transportation. Which psychosocial change does the nurse focus
on as a priority?
a. Sexuality
b. Retirement
c. Environment
d. Social isolation
Answer: D
Rationale:
The highest priority at this time is the potential for social isolation. This woman does not know
how to drive and lives in a rural community that does not have public transportation. All of
these factors contribute to her social isolation. Other possible changes she may be going
through right now include sexuality related to her advanced age and recent death of her spouse;
however, this is not the priority at this time. She has been retired for 5 years, so this is also not

an immediate need. She may eventually experience needs related to environment, but the data
do not support this as an issue at this time.
MULTIPLE RESPONSE
1. A recently widowed older-adult patient is dehydrated and is admitted to the hospital for
intravenous fluid replacement. During the evening shift, the patient becomes acutely confused.
Which possible reversible causes will the nurse consider when assessing this patient? (Select all
that apply.)
a. Electrolyte imbalance
b. Sensory deprivation
c. Hypoglycemia
d. Drug effects
e. Dementia
Answer: A, B, C, D
Rationale:
Delirium, or acute confusional state, is a potentially reversible cognitive impairment that is
often due to a physiological event. Physiological causes include electrolyte imbalances,
untreated pain, infection, cerebral anoxia, hypoglycemia, medication effects, tumors, subdural
hematomas, and cerebrovascular infarction or hemorrhage. Sometimes it is also caused by
environmental factors such as sensory deprivation or overstimulation, unfamiliar surroundings,
or sleep deprivation or psychosocial factors such as emotional distress. Dementia is a gradual,
progressive, and irreversible cerebral dysfunction.
MATCHING
A nurse is using different strategies to meet older patients’ psychosocial needs.
Match the strategy the nurse is using to its description.
1. Body image a. Respecting the older adult’s uniqueness
2.Validation therapy b. Improving level of awareness
3. Therapeutic communication c. Listening to the patient’s past recollections
4. Reality orientation d. Accepting describing of patient’s perspective
5. Reminiscence e. Offering help with grooming and hygiene
Answers: 1. E
2. D
3. A

4. B
5. C
MULTIPLE CHOICE
1. Which types of nurses make the best communicators with patients?
a. Those who learn effective psychomotor skills
b. Those who develop critical thinking skills
c. Those who like different kinds of people
d. Those who maintain perceptual biases
Answer: B
Rationale:
Nurses who develop critical thinking skills make the best communicators. Just liking people
does not make an effective communicator because it is important to apply critical thinking
standards to ensure sound effective communication. Just learning psychomotor skills does not
ensure that the nurse will use those techniques, and communication involves more than
psychomotor skills.Critical thinking helps the nurse overcome perceptual biases or human
tendencies that interfere with accurately perceiving and interpreting messages from others.
Nurses who maintain perceptual biases do not make good communicators.
2. A nurse believes that the nurse-patient relationship is a partnership and that both are equal
participants. Which term should the nurse use to describe this belief?
a. Critical thinking
b. Authentic
d. Attend
Answer: C
Rationale:
Effective interpersonal communication requires a sense of mutuality, a belief that the nursepatient relationship is a partnership and that both are equal participants. Critical thinking in
nursing, based on established standards of nursing care and ethical standards, promotes
effective communication and uses standards such as humility, self-confidence, independent
attitude, and fairness. To be authentic (one’s self) and to respond appropriately to the other
person are important for interpersonal relationships but do not mean mutuality. Attending is
giving all of your attention to the patient.

3. A nurse wants to present information about flu immunizations to the older adults in the
community. Which type of communication should the nurse use?
a. Public
b. Small group
c. Interpersonal
d. Intrapersonal
Answer: A
Rationale:
Public communication is interaction with an audience. Nurses have opportunities to speak with
groups of consumers about health-related topics, present scholarly work to colleagues at
conferences, or lead classroom discussions with peers or students. When nurses work on
committees or participate in patient care conferences, they use a small group communication
process. Interpersonal communication is one-on-one interaction between a nurse and another
person that often occurs face to face. Intrapersonal communication is a powerful form of
communication that you use as a professional nurse. This level of communication is also called
self- talk.
4. A nurse is using therapeutic communication with a patient. Which technique will the nurse
use to ensure effective communication?
a. Interpersonal communication to change negative self-talk to positive a. self-talk
b. Small group communication to present information to an audience
c. Electronic communication to assess a patient in another city
d. Intrapersonal communication to build strong teams
Answer: C
Rationale:
Electronic communication is the use of technology to create ongoing relationships with patients
and their health care team. Intrapersonal communication is self-talk. Interpersonal
communication is one-on-one interaction between a nurse and another person that often occurs
face to face. Public communication is used to present information to an audience. Small group
communication is interaction that occurs when a small number of persons meet. When nurses
work on committees or participate in patient care conferences, they use a small group
communication process.
5. A nurse is standing beside the patient’s bed.

Nurse: How are you doing? Patient: I don’t feel good.
Which element will the nurse identify as feedback?
a. Nurse
b. Patient
c. How are you doing?
d. I don’t feel good.
Answer: D
Rationale:
“I don’t feel good” is the feedback because the feedback is the message the receiver returns.
The sender is the person who encodes and delivers the message, and the receiver is the person
who receives and decodes the message. The nurse is the sender. The patient is the receiver.
“How are you doing?” is the message.
6. A nurse is sitting at the patient’s bedside taking a nursing history. Which zone of personal
space is the nurse using?
a. Socio-consultative
b. Personal
c. Intimate
d. Public
Answer: B
Rationale:
Personal space is 18 inches to 4 feet and involves things such as sitting at a patient’s bedside,
taking a patient’s nursing history, or teaching an individual patient. Intimate space is 0 to 18
inches and involves things such as performing a physical assessment, bathing, grooming,
dressing, feeding, and toileting a patient. The socioconsultative zone is 9 to 12 feet and
involves things such as giving directions to visitors in the hallway and giving verbal report to a
group of nurses. The public zone is 12 feet and greater and involves things such as speaking at
a community forum, testifying at a legislative hearing, or lecturing.
7. A smiling patient angrily states, “I will not cough and deep breathe.” How will the nurse
interpret this finding?
a. The patient’s denotative meaning is wrong.
b. The patient’s personal space was violated.
c. The patient’s affect is inappropriate.

d. The patient’s vocabulary is poor.
Answer: C
Rationale:
An inappropriate affect is a facial expression that does not match the content of a verbal
message (e.g., smiling when describing a sad situation). The patient is smiling but is angry,
which indicates an inappropriate affect.
The patient’s personal space was not violated. The patient’s vocabulary is not poor. Individuals
who use a common language share denotative meaning: baseball has the same meaning for
everyone who speaks English, but code denotes cardiac arrest primarily to health care
providers. The patient’s denotative meaning is correct for cough and deep breathe.

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