ATI COMPREHENSIVE PRACTICE EXAM 2026/2027| Questions
with Detailed Rationales & Teaching Points| Actual ATI-Style
Questions | Comprehensive Content Review | Pass Guarantee
1. Multiple Choice (Single Answer) – Management of Care
A charge nurse is reviewing the assignments for the shift. Which client should be
assigned to the most experienced nurse?
A. A 55-year-old client admitted with pneumonia and stable vital signs
B. A 2-day postoperative client who requires wound irrigation
C. A client admitted with chest pain and a history of myocardial infarction
D. A client scheduled for discharge after laparoscopic surgery
Correct Answer: C
Rationale: The client with chest pain and a history of MI is at high risk for complications
such as reinfarction or arrhythmias. This assignment requires the most experienced
nurse to recognize subtle changes and intervene quickly.
Teaching Point: High-acuity clients are prioritized for experienced nurses to ensure
patient safety and optimal outcomes.
2. Multiple Response – Safety and Infection Control
,The nurse is caring for a client with Clostridioides difficile. Which actions are
appropriate? (Select all that apply.)
A. Place the client on contact precautions
B. Use alcohol-based hand sanitizer before and after care
C. Clean equipment with bleach solution
D. Provide a private room
E. Wear gloves only when handling stool
Correct Answers: A, C, D
Rationale: Contact precautions and a private room are required. Bleach is sporicidal and
effective against C. diff. Alcohol does not kill spores. Gloves are worn for all contact
with the client and environment, not just stool.
Teaching Point: Always use soap and water for hand hygiene with C. diff and prioritize
sporicidal cleaning agents.
3. Fill-in-the-Blank – Pharmacological and Parenteral Therapies
A client is prescribed 500 mL of 0.9 % saline to run over 4 hours. The drop factor is 15
gtt/mL. Calculate the infusion rate in gtt/min. Round to the nearest whole number.
Correct Answer: 31 gtt/min
Rationale:
Total volume = 500 mL
Time = 4 hours × 60 = 240 min
,Drop factor = 15 gtt/mL
(500 × 15) ÷ 240 = 31.25 ≈ 31 gtt/min
Teaching Point: Always verify drop factor and convert hours to minutes for accurate
calculations.
4. Ordered Response – Basic Care and Comfort
Place the steps in order for performing a sterile dressing change:
A. Remove old dressing
B. Perform hand hygiene
C. Apply sterile gloves
D. Clean wound with sterile solution
E. Apply new sterile dressing
Correct Order: B → A → B → C → D → E
Rationale: Hand hygiene is always first and between steps. Old dressing is removed,
hands cleaned again, sterile gloves applied, wound cleaned, and new dressing applied.
Teaching Point: Sterile technique requires strict sequencing to prevent contamination.
5. Hot Spot – Health Promotion and Maintenance
The nurse is assessing a 6-month-old infant during a well-baby visit. Where should the
nurse place the stethoscope to best auscultate the apical pulse? (Describe anatomical
location)
, Correct Answer: Left mid-clavicular line, 4th intercostal space
Rationale: In infants, the heart is more horizontal; the apex is located at the 4th ICS, L
MCL.
Teaching Point: Anatomical landmarks differ with age—always adjust assessment
technique accordingly.
6. Multiple Choice – Psychosocial Integrity
A client with depression tells the nurse, “I don’t think I’ll ever feel better.” Which response
by the nurse is most therapeutic?
A. “You have a lot to live for.”
B. “Tell me more about how you’re feeling.”
C. “Everyone feels this way sometimes.”
D. “You should try to stay positive.”
Correct Answer: B
Rationale: Open-ended, empathetic responses encourage the client to express feelings
and build trust.
Teaching Point: Avoid minimizing or offering false reassurance; therapeutic
communication fosters rapport.
7. Multiple Choice – Reduction of Risk Potential
A client with diabetes has a blood glucose of 48 mg/dL. The client is conscious and
alert. What should the nurse administer first?
with Detailed Rationales & Teaching Points| Actual ATI-Style
Questions | Comprehensive Content Review | Pass Guarantee
1. Multiple Choice (Single Answer) – Management of Care
A charge nurse is reviewing the assignments for the shift. Which client should be
assigned to the most experienced nurse?
A. A 55-year-old client admitted with pneumonia and stable vital signs
B. A 2-day postoperative client who requires wound irrigation
C. A client admitted with chest pain and a history of myocardial infarction
D. A client scheduled for discharge after laparoscopic surgery
Correct Answer: C
Rationale: The client with chest pain and a history of MI is at high risk for complications
such as reinfarction or arrhythmias. This assignment requires the most experienced
nurse to recognize subtle changes and intervene quickly.
Teaching Point: High-acuity clients are prioritized for experienced nurses to ensure
patient safety and optimal outcomes.
2. Multiple Response – Safety and Infection Control
,The nurse is caring for a client with Clostridioides difficile. Which actions are
appropriate? (Select all that apply.)
A. Place the client on contact precautions
B. Use alcohol-based hand sanitizer before and after care
C. Clean equipment with bleach solution
D. Provide a private room
E. Wear gloves only when handling stool
Correct Answers: A, C, D
Rationale: Contact precautions and a private room are required. Bleach is sporicidal and
effective against C. diff. Alcohol does not kill spores. Gloves are worn for all contact
with the client and environment, not just stool.
Teaching Point: Always use soap and water for hand hygiene with C. diff and prioritize
sporicidal cleaning agents.
3. Fill-in-the-Blank – Pharmacological and Parenteral Therapies
A client is prescribed 500 mL of 0.9 % saline to run over 4 hours. The drop factor is 15
gtt/mL. Calculate the infusion rate in gtt/min. Round to the nearest whole number.
Correct Answer: 31 gtt/min
Rationale:
Total volume = 500 mL
Time = 4 hours × 60 = 240 min
,Drop factor = 15 gtt/mL
(500 × 15) ÷ 240 = 31.25 ≈ 31 gtt/min
Teaching Point: Always verify drop factor and convert hours to minutes for accurate
calculations.
4. Ordered Response – Basic Care and Comfort
Place the steps in order for performing a sterile dressing change:
A. Remove old dressing
B. Perform hand hygiene
C. Apply sterile gloves
D. Clean wound with sterile solution
E. Apply new sterile dressing
Correct Order: B → A → B → C → D → E
Rationale: Hand hygiene is always first and between steps. Old dressing is removed,
hands cleaned again, sterile gloves applied, wound cleaned, and new dressing applied.
Teaching Point: Sterile technique requires strict sequencing to prevent contamination.
5. Hot Spot – Health Promotion and Maintenance
The nurse is assessing a 6-month-old infant during a well-baby visit. Where should the
nurse place the stethoscope to best auscultate the apical pulse? (Describe anatomical
location)
, Correct Answer: Left mid-clavicular line, 4th intercostal space
Rationale: In infants, the heart is more horizontal; the apex is located at the 4th ICS, L
MCL.
Teaching Point: Anatomical landmarks differ with age—always adjust assessment
technique accordingly.
6. Multiple Choice – Psychosocial Integrity
A client with depression tells the nurse, “I don’t think I’ll ever feel better.” Which response
by the nurse is most therapeutic?
A. “You have a lot to live for.”
B. “Tell me more about how you’re feeling.”
C. “Everyone feels this way sometimes.”
D. “You should try to stay positive.”
Correct Answer: B
Rationale: Open-ended, empathetic responses encourage the client to express feelings
and build trust.
Teaching Point: Avoid minimizing or offering false reassurance; therapeutic
communication fosters rapport.
7. Multiple Choice – Reduction of Risk Potential
A client with diabetes has a blood glucose of 48 mg/dL. The client is conscious and
alert. What should the nurse administer first?
