ATI COMPREHENSIVE PRACTICE EXAM 2026/2027| Questions
with Detailed Rationales & Teaching Points| Actual ATI-Style
Questions | Comprehensive Content Review | Pass Guarantee
1. (Management of Care - Prioritization)
The charge nurse on a medical-surgical unit receives report on four patients. Which
patient requires the nurse's immediate assessment?
A. A 68-year-old with heart failure who reports increased shortness of breath when
ambulating to the bathroom
B. A 42-year-old post-appendectomy who is requesting pain medication for an incisional
pain rated 6/10
C. A 55-year-old with diabetes whose blood glucose is 185 mg/dL before lunch
D. A 79-year-old with pneumonia whose oxygen saturation dropped from 94% to 88% on
room air
Correct Answer: D
Rationale: A drop in oxygen saturation to 88% indicates severe hypoxemia and potential
respiratory failure. This patient requires immediate intervention (oxygen therapy,
assessment, possible respiratory distress protocol). Option A indicates worsening
condition but not immediate life threat. Option B is expected post-op pain. Option C is
elevated but not critical.
Teaching Point: Always prioritize airway, breathing, and circulation (ABC) changes,
especially acute drops in oxygen saturation.
,2. (Safety and Infection Control)
A nurse is preparing to administer chemotherapy to a patient. Which action
demonstrates proper safety protocol?
A. Wearing a disposable gown with the opening in the front for easy removal
B. Crushing the oral chemotherapy tablets to mix with applesauce
C. Double-gloving with chemotherapy-tested nitrile gloves
D. Disposing of the empty chemotherapy vial in the regular trash
Correct Answer: C
Rationale: Chemotherapy requires double-gloving with tested nitrile gloves to prevent
skin exposure. Gowns should have openings in the back (A). Chemotherapy tablets
should never be crushed (B) due to aerosolization risk. Empty vials require hazardous
waste disposal (D).
Teaching Point: Chemotherapy is a hazardous drug requiring special PPE (double
gloves, non-permeable gown with back closure, eye protection) and disposal
procedures.
3. (Pharmacological and Parenteral Therapies - Calculation)
A patient is prescribed heparin 5,000 units subcutaneously every 12 hours for DVT
prophylaxis. The vial concentration is 10,000 units/mL. How many mL should the nurse
administer? (Round to the nearest tenth)
Correct Answer: 0.5 mL
,Rationale: Desired dose (5,000 units) ÷ Available concentration (10,000 units/mL) = 0.5
mL.
Teaching Point: Always verify the concentration on the vial and use the formula:
Desired/Have = Amount to administer.
4. (Health Promotion and Maintenance)
A nurse is teaching a group of older adults about fall prevention in the home. Which
statement by a participant indicates understanding of the teaching?
A. "I should keep my throw rugs down to provide traction on my hardwood floors"
B. "I need to install nightlights in the bathroom and hallway"
C. "Taking my diuretic at bedtime will help me sleep better"
D. "I can skip my eye doctor appointments if my vision seems fine"
Correct Answer: B
Rationale: Nightlights reduce fall risk by improving visibility. Throw rugs (A) are a
tripping hazard. Diuretics at bedtime (C) cause nocturia and fall risk. Regular eye exams
(D) are essential for detecting vision changes that increase fall risk.
Teaching Point: Fall prevention includes removing environmental hazards (rugs, clutter),
adequate lighting, medication timing adjustments, and regular vision checks.
5. (Psychosocial Integrity)
, A patient newly diagnosed with multiple sclerosis tells the nurse, "I don't see the point in
physical therapy. I'll never walk normally again anyway." Which response demonstrates
therapeutic communication?
A. "Don't give up hope. Many people with MS live full lives"
B. "Physical therapy will help you walk normally if you try hard enough"
C. "You feel discouraged about your prognosis right now"
D. "Let's talk about something more positive to cheer you up"
Correct Answer: C
Rationale: This response uses reflection to acknowledge the patient's feelings without
false reassurance (A, B) or blocking communication (D). It validates emotions and
encourages further expression.
Teaching Point: Therapeutic communication techniques include reflection, clarification,
and focusing. Avoid false reassurance, changing the subject, or giving advice.
6. (Basic Care and Comfort)
A patient is receiving hospice care for end-stage lung cancer. The family asks about
providing oral care as the patient becomes less responsive. Which instruction is most
appropriate?
A. "Use a firm toothbrush to remove plaque effectively"
B. "Apply petroleum jelly to the lips to prevent dryness"
C. "Give frequent large gulps of water to keep the mouth moist"
with Detailed Rationales & Teaching Points| Actual ATI-Style
Questions | Comprehensive Content Review | Pass Guarantee
1. (Management of Care - Prioritization)
The charge nurse on a medical-surgical unit receives report on four patients. Which
patient requires the nurse's immediate assessment?
A. A 68-year-old with heart failure who reports increased shortness of breath when
ambulating to the bathroom
B. A 42-year-old post-appendectomy who is requesting pain medication for an incisional
pain rated 6/10
C. A 55-year-old with diabetes whose blood glucose is 185 mg/dL before lunch
D. A 79-year-old with pneumonia whose oxygen saturation dropped from 94% to 88% on
room air
Correct Answer: D
Rationale: A drop in oxygen saturation to 88% indicates severe hypoxemia and potential
respiratory failure. This patient requires immediate intervention (oxygen therapy,
assessment, possible respiratory distress protocol). Option A indicates worsening
condition but not immediate life threat. Option B is expected post-op pain. Option C is
elevated but not critical.
Teaching Point: Always prioritize airway, breathing, and circulation (ABC) changes,
especially acute drops in oxygen saturation.
,2. (Safety and Infection Control)
A nurse is preparing to administer chemotherapy to a patient. Which action
demonstrates proper safety protocol?
A. Wearing a disposable gown with the opening in the front for easy removal
B. Crushing the oral chemotherapy tablets to mix with applesauce
C. Double-gloving with chemotherapy-tested nitrile gloves
D. Disposing of the empty chemotherapy vial in the regular trash
Correct Answer: C
Rationale: Chemotherapy requires double-gloving with tested nitrile gloves to prevent
skin exposure. Gowns should have openings in the back (A). Chemotherapy tablets
should never be crushed (B) due to aerosolization risk. Empty vials require hazardous
waste disposal (D).
Teaching Point: Chemotherapy is a hazardous drug requiring special PPE (double
gloves, non-permeable gown with back closure, eye protection) and disposal
procedures.
3. (Pharmacological and Parenteral Therapies - Calculation)
A patient is prescribed heparin 5,000 units subcutaneously every 12 hours for DVT
prophylaxis. The vial concentration is 10,000 units/mL. How many mL should the nurse
administer? (Round to the nearest tenth)
Correct Answer: 0.5 mL
,Rationale: Desired dose (5,000 units) ÷ Available concentration (10,000 units/mL) = 0.5
mL.
Teaching Point: Always verify the concentration on the vial and use the formula:
Desired/Have = Amount to administer.
4. (Health Promotion and Maintenance)
A nurse is teaching a group of older adults about fall prevention in the home. Which
statement by a participant indicates understanding of the teaching?
A. "I should keep my throw rugs down to provide traction on my hardwood floors"
B. "I need to install nightlights in the bathroom and hallway"
C. "Taking my diuretic at bedtime will help me sleep better"
D. "I can skip my eye doctor appointments if my vision seems fine"
Correct Answer: B
Rationale: Nightlights reduce fall risk by improving visibility. Throw rugs (A) are a
tripping hazard. Diuretics at bedtime (C) cause nocturia and fall risk. Regular eye exams
(D) are essential for detecting vision changes that increase fall risk.
Teaching Point: Fall prevention includes removing environmental hazards (rugs, clutter),
adequate lighting, medication timing adjustments, and regular vision checks.
5. (Psychosocial Integrity)
, A patient newly diagnosed with multiple sclerosis tells the nurse, "I don't see the point in
physical therapy. I'll never walk normally again anyway." Which response demonstrates
therapeutic communication?
A. "Don't give up hope. Many people with MS live full lives"
B. "Physical therapy will help you walk normally if you try hard enough"
C. "You feel discouraged about your prognosis right now"
D. "Let's talk about something more positive to cheer you up"
Correct Answer: C
Rationale: This response uses reflection to acknowledge the patient's feelings without
false reassurance (A, B) or blocking communication (D). It validates emotions and
encourages further expression.
Teaching Point: Therapeutic communication techniques include reflection, clarification,
and focusing. Avoid false reassurance, changing the subject, or giving advice.
6. (Basic Care and Comfort)
A patient is receiving hospice care for end-stage lung cancer. The family asks about
providing oral care as the patient becomes less responsive. Which instruction is most
appropriate?
A. "Use a firm toothbrush to remove plaque effectively"
B. "Apply petroleum jelly to the lips to prevent dryness"
C. "Give frequent large gulps of water to keep the mouth moist"
