2026 UPDATED QUESTIONS DOWNLOAD
ATI RN Comprehensive Predictor 2026-2027 | 300-Question Practice Set: Med-Surg,
Pharmacology, Pediatrics, OB, Mental Health, & Lead Management with Detailed
Rationales
Achieve a 90% or higher predictability score on your nursing exit exam with this
meticulously updated 300-question practice set for the 2026-2027 cycle. Each
question is designed to test high-level clinical judgment, focusing on the most "must-
know" topics like electrolyte imbalances, acid-base disorders, and emergency
interventions. Every answer includes a detailed italicized rationale to bridge the gap
between knowing a fact and applying it to complex patient scenarios.
A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take to prevent
deep vein thrombosis (DVT)?
A. Place a pillow under the client's knees.
B. Apply sequential compression devices (SCDs) to the client's legs.
C. Massage the client's calves daily.
D. Maintain the client on strict bed rest.
Rationale: SCDs promote venous return and prevent blood stasis. Placing pillows
under knees or massaging calves can actually cause or dislodge a clot.
A nurse is reviewing the laboratory results of a client who is taking spironolactone.
Which of the following values should the nurse report to the provider?
A. Sodium 140 mEq/L
B. Potassium 5.8 mEq/L
C. Chloride 100 mEq/L
D. Magnesium 2.0 mEq/L
Rationale: Spironolactone is a potassium-sparing diuretic. A level of 5.8 mEq/L
indicates hyperkalemia (normal is 3.5–5.0 mEq/L), which carries a risk for cardiac
dysrhythmias.
,2026 UPDATED QUESTIONS DOWNLOAD
A nurse is preparing to administer digoxin to a client. Which of the following findings
is a manifestation of digoxin toxicity?
A. Hypertension
B. Visual disturbances (yellow-green halos)
C. Polyuria
D. Tachycardia
Rationale: Classic signs of digoxin toxicity include GI upset (anorexia, nausea),
bradycardia, and visual changes such as halos or blurred vision.
A nurse is caring for a client in the manic phase of bipolar disorder. Which of the
following snacks is most appropriate?
A. A bowl of chicken noodle soup
B. A banana and a turkey wrap
C. A side salad with dressing
D. Spaghetti and meatballs
Rationale: Clients in a manic phase have high energy and difficulty sitting still; "finger
foods" allow them to maintain caloric intake while moving.
Which of the following is the priority action for a nurse who discovers a small fire in
a client's trash can?
A. Pull the fire alarm.
B. Extinguish the fire.
C. Remove the client from the room.
D. Close the door to the room.
Rationale: Following the RACE mnemonic (Rescue, Alarm, Confine, Extinguish), the
first priority is always to rescue/remove the client from immediate danger.
A nurse is assessing a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. What does this indicate?
A. The system is functioning normally.
B. There is an air leak in the system.
C. The lung has fully re-expanded.
,2026 UPDATED QUESTIONS DOWNLOAD
D. The suction pressure is too high.
Rationale: Intermittent bubbling is normal during expiration/coughing, but continuous
bubbling in the water seal chamber signifies a leak.
A client is receiving a blood transfusion and reports low back pain and chills. What
is the nurse's first action?
A. Notify the healthcare provider.
B. Stop the transfusion immediately.
C. Check the client's temperature.
D. Slow the rate of the infusion.
Rationale: Low back pain and chills are signs of a hemolytic reaction. The
transfusion must be stopped immediately to prevent further damage.
A nurse is teaching a client about a low-purine diet to manage gout. Which food
should the nurse tell the client to avoid?
A. Whole grain bread
B. Organ meats (liver)
C. Fresh blueberries
D. Skim milk
Rationale: Purines break down into uric acid. High-purine foods like organ meats,
shellfish, and certain oily fish should be avoided.
Which of the following findings should a nurse expect in a client with hypocalcemia?
A. Negative Chvostek's sign
B. Positive Trousseau's sign
C. Constipation
D. Hyporeflexia
Rationale: Hypocalcemia causes neuromuscular irritability. A positive Trousseau's
(carpal spasm with BP cuff) or Chvostek's sign is an expected finding.
A nurse is assessing a client with preeclampsia who is receiving magnesium sulfate.
Which finding indicates toxicity?
A. Respiratory rate of 10/min
, 2026 UPDATED QUESTIONS DOWNLOAD
B. Hyperreflexia (+4)
C. Increased urine output
D. Blood pressure 150/95 mm Hg
Rationale: Magnesium sulfate is a CNS depressant. Signs of toxicity include
bradypnea (RR <12), absent deep tendon reflexes, and decreased urine output.
A nurse is caring for a client with a newly placed ileostomy. Which statement by the
client indicates a need for further teaching?
A. "I will empty my pouch when it is one-third full."
B. "I will take enteric-coated aspirin for my headaches."
C. "I will drink at least 2 liters of fluid daily."
D. "I will avoid high-fiber foods for the first few weeks."
Rationale: Enteric-coated or sustained-release medications may not be absorbed
properly in the shortened GI tract of a client with an ileostomy.
A nurse is teaching a parent of a child with pediculosis capitis (head lice). Which
instruction should the nurse include?
A. "Soak combs and brushes in cold water for 5 minutes."
B. "Seal non-washable items in a plastic bag for 14 days."
C. "Apply mayonnaise to the hair for 24 hours."
D. "Wash bed linens in cold water."
Rationale: Items that cannot be laundered in hot water should be sealed in plastic
bags for 2 weeks to ensure any remaining lice or nits are dead.
A nurse is preparing to administer an IM injection to a 2-month-old infant. Which site
should the nurse use?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
Rationale: The vastus lateralis is the preferred site for IM injections in infants
because it is the most developed muscle.
ATI RN Comprehensive Predictor 2026-2027 | 300-Question Practice Set: Med-Surg,
Pharmacology, Pediatrics, OB, Mental Health, & Lead Management with Detailed
Rationales
Achieve a 90% or higher predictability score on your nursing exit exam with this
meticulously updated 300-question practice set for the 2026-2027 cycle. Each
question is designed to test high-level clinical judgment, focusing on the most "must-
know" topics like electrolyte imbalances, acid-base disorders, and emergency
interventions. Every answer includes a detailed italicized rationale to bridge the gap
between knowing a fact and applying it to complex patient scenarios.
A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take to prevent
deep vein thrombosis (DVT)?
A. Place a pillow under the client's knees.
B. Apply sequential compression devices (SCDs) to the client's legs.
C. Massage the client's calves daily.
D. Maintain the client on strict bed rest.
Rationale: SCDs promote venous return and prevent blood stasis. Placing pillows
under knees or massaging calves can actually cause or dislodge a clot.
A nurse is reviewing the laboratory results of a client who is taking spironolactone.
Which of the following values should the nurse report to the provider?
A. Sodium 140 mEq/L
B. Potassium 5.8 mEq/L
C. Chloride 100 mEq/L
D. Magnesium 2.0 mEq/L
Rationale: Spironolactone is a potassium-sparing diuretic. A level of 5.8 mEq/L
indicates hyperkalemia (normal is 3.5–5.0 mEq/L), which carries a risk for cardiac
dysrhythmias.
,2026 UPDATED QUESTIONS DOWNLOAD
A nurse is preparing to administer digoxin to a client. Which of the following findings
is a manifestation of digoxin toxicity?
A. Hypertension
B. Visual disturbances (yellow-green halos)
C. Polyuria
D. Tachycardia
Rationale: Classic signs of digoxin toxicity include GI upset (anorexia, nausea),
bradycardia, and visual changes such as halos or blurred vision.
A nurse is caring for a client in the manic phase of bipolar disorder. Which of the
following snacks is most appropriate?
A. A bowl of chicken noodle soup
B. A banana and a turkey wrap
C. A side salad with dressing
D. Spaghetti and meatballs
Rationale: Clients in a manic phase have high energy and difficulty sitting still; "finger
foods" allow them to maintain caloric intake while moving.
Which of the following is the priority action for a nurse who discovers a small fire in
a client's trash can?
A. Pull the fire alarm.
B. Extinguish the fire.
C. Remove the client from the room.
D. Close the door to the room.
Rationale: Following the RACE mnemonic (Rescue, Alarm, Confine, Extinguish), the
first priority is always to rescue/remove the client from immediate danger.
A nurse is assessing a client with a chest tube. The nurse notes continuous
bubbling in the water seal chamber. What does this indicate?
A. The system is functioning normally.
B. There is an air leak in the system.
C. The lung has fully re-expanded.
,2026 UPDATED QUESTIONS DOWNLOAD
D. The suction pressure is too high.
Rationale: Intermittent bubbling is normal during expiration/coughing, but continuous
bubbling in the water seal chamber signifies a leak.
A client is receiving a blood transfusion and reports low back pain and chills. What
is the nurse's first action?
A. Notify the healthcare provider.
B. Stop the transfusion immediately.
C. Check the client's temperature.
D. Slow the rate of the infusion.
Rationale: Low back pain and chills are signs of a hemolytic reaction. The
transfusion must be stopped immediately to prevent further damage.
A nurse is teaching a client about a low-purine diet to manage gout. Which food
should the nurse tell the client to avoid?
A. Whole grain bread
B. Organ meats (liver)
C. Fresh blueberries
D. Skim milk
Rationale: Purines break down into uric acid. High-purine foods like organ meats,
shellfish, and certain oily fish should be avoided.
Which of the following findings should a nurse expect in a client with hypocalcemia?
A. Negative Chvostek's sign
B. Positive Trousseau's sign
C. Constipation
D. Hyporeflexia
Rationale: Hypocalcemia causes neuromuscular irritability. A positive Trousseau's
(carpal spasm with BP cuff) or Chvostek's sign is an expected finding.
A nurse is assessing a client with preeclampsia who is receiving magnesium sulfate.
Which finding indicates toxicity?
A. Respiratory rate of 10/min
, 2026 UPDATED QUESTIONS DOWNLOAD
B. Hyperreflexia (+4)
C. Increased urine output
D. Blood pressure 150/95 mm Hg
Rationale: Magnesium sulfate is a CNS depressant. Signs of toxicity include
bradypnea (RR <12), absent deep tendon reflexes, and decreased urine output.
A nurse is caring for a client with a newly placed ileostomy. Which statement by the
client indicates a need for further teaching?
A. "I will empty my pouch when it is one-third full."
B. "I will take enteric-coated aspirin for my headaches."
C. "I will drink at least 2 liters of fluid daily."
D. "I will avoid high-fiber foods for the first few weeks."
Rationale: Enteric-coated or sustained-release medications may not be absorbed
properly in the shortened GI tract of a client with an ileostomy.
A nurse is teaching a parent of a child with pediculosis capitis (head lice). Which
instruction should the nurse include?
A. "Soak combs and brushes in cold water for 5 minutes."
B. "Seal non-washable items in a plastic bag for 14 days."
C. "Apply mayonnaise to the hair for 24 hours."
D. "Wash bed linens in cold water."
Rationale: Items that cannot be laundered in hot water should be sealed in plastic
bags for 2 weeks to ensure any remaining lice or nits are dead.
A nurse is preparing to administer an IM injection to a 2-month-old infant. Which site
should the nurse use?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
Rationale: The vastus lateralis is the preferred site for IM injections in infants
because it is the most developed muscle.
