ATI RN Comprehensive Predictor 2026
– Version B Practice Exam | Verified
Questions & Detailed Rationales
1. A nurse is caring for a client with heart failure. Which
finding indicates worsening fluid overload?
A. Weight loss of 1 kg in 24 hr
B. Dry mucous membranes
C. Crackles in both lung bases
D. Decreased jugular vein distention
Rationale: Crackles indicate pulmonary congestion caused by
excess fluid accumulation in the lungs. This is a common
manifestation of worsening heart failure and fluid overload.
Weight loss, dry mucous membranes, and decreased JVD
suggest reduced fluid volume rather than overload.
2. A nurse is assessing a client experiencing hypoglycemia.
Which manifestation should the nurse expect?
A. Bradycardia
B. Warm, dry skin
C. Diaphoresis
D. Polyuria
,Rationale: Hypoglycemia activates the sympathetic nervous
system, causing diaphoresis, tremors, tachycardia, and
anxiety. Polyuria is associated with hyperglycemia.
3. A nurse is caring for a client receiving heparin therapy.
Which laboratory value should the nurse monitor?
A. INR
B. Platelet count only
C. Hemoglobin A1C
D. Activated partial thromboplastin time (aPTT)
Rationale: aPTT evaluates the therapeutic effectiveness of
heparin. INR is primarily monitored for warfarin therapy.
4. Which action should a nurse take first when a client
develops sudden shortness of breath following surgery?
A. Notify the provider
B. Obtain arterial blood gases
C. Assess oxygen saturation and respiratory status
D. Prepare for chest x-ray
Rationale: Assessment is the priority. Determining airway and
breathing status guides further interventions and aligns with
the nursing process.
5. A client with chronic kidney disease has a potassium level
of 6.2 mEq/L. Which finding is the priority?
,A. Peripheral edema
B. Nausea
C. Peaked T waves on ECG
D. Fatigue
Rationale: Hyperkalemia can cause life-threatening cardiac
dysrhythmias. Peaked T waves indicate significant cardiac
involvement requiring immediate intervention.
6. A nurse is teaching a client about nitroglycerin tablets.
Which statement by the client indicates understanding?
A. "I will swallow the tablet immediately."
B. "I can take unlimited doses if pain continues."
C. "I will place the tablet under my tongue."
D. "I should store the tablets in a weekly pill organizer."
Rationale: Sublingual administration allows rapid absorption.
Nitroglycerin should remain in its original dark container and
dosage limits must be followed.
7. A nurse is caring for a client with a chest tube. Which
finding requires immediate intervention?
A. Gentle bubbling in suction chamber
B. Drainage of 50 mL in 8 hr
C. Chest tube disconnected from drainage system
D. Tidaling in water seal chamber
, Rationale: Disconnection can allow air to enter the pleural
space, potentially causing a tension pneumothorax. This is an
emergency.
8. Which client should the nurse assess first?
A. Client with osteoarthritis reporting pain 6/10
B. Client with pneumonia and temperature of 38°C (100.4°F)
C. Client with asthma who has wheezing and difficulty
speaking
D. Client with diabetes requesting a snack
Rationale: Airway and breathing take priority. Difficulty
speaking indicates significant respiratory compromise.
9. A nurse is evaluating a newborn. Which finding requires
immediate reporting?
A. Acrocyanosis
B. Heart rate 140/min
C. Central cyanosis
D. Respiratory rate 45/min
Rationale: Central cyanosis suggests inadequate oxygenation
and is abnormal in a newborn.
10. A nurse is caring for a client receiving morphine IV.
Which adverse effect is the priority?
– Version B Practice Exam | Verified
Questions & Detailed Rationales
1. A nurse is caring for a client with heart failure. Which
finding indicates worsening fluid overload?
A. Weight loss of 1 kg in 24 hr
B. Dry mucous membranes
C. Crackles in both lung bases
D. Decreased jugular vein distention
Rationale: Crackles indicate pulmonary congestion caused by
excess fluid accumulation in the lungs. This is a common
manifestation of worsening heart failure and fluid overload.
Weight loss, dry mucous membranes, and decreased JVD
suggest reduced fluid volume rather than overload.
2. A nurse is assessing a client experiencing hypoglycemia.
Which manifestation should the nurse expect?
A. Bradycardia
B. Warm, dry skin
C. Diaphoresis
D. Polyuria
,Rationale: Hypoglycemia activates the sympathetic nervous
system, causing diaphoresis, tremors, tachycardia, and
anxiety. Polyuria is associated with hyperglycemia.
3. A nurse is caring for a client receiving heparin therapy.
Which laboratory value should the nurse monitor?
A. INR
B. Platelet count only
C. Hemoglobin A1C
D. Activated partial thromboplastin time (aPTT)
Rationale: aPTT evaluates the therapeutic effectiveness of
heparin. INR is primarily monitored for warfarin therapy.
4. Which action should a nurse take first when a client
develops sudden shortness of breath following surgery?
A. Notify the provider
B. Obtain arterial blood gases
C. Assess oxygen saturation and respiratory status
D. Prepare for chest x-ray
Rationale: Assessment is the priority. Determining airway and
breathing status guides further interventions and aligns with
the nursing process.
5. A client with chronic kidney disease has a potassium level
of 6.2 mEq/L. Which finding is the priority?
,A. Peripheral edema
B. Nausea
C. Peaked T waves on ECG
D. Fatigue
Rationale: Hyperkalemia can cause life-threatening cardiac
dysrhythmias. Peaked T waves indicate significant cardiac
involvement requiring immediate intervention.
6. A nurse is teaching a client about nitroglycerin tablets.
Which statement by the client indicates understanding?
A. "I will swallow the tablet immediately."
B. "I can take unlimited doses if pain continues."
C. "I will place the tablet under my tongue."
D. "I should store the tablets in a weekly pill organizer."
Rationale: Sublingual administration allows rapid absorption.
Nitroglycerin should remain in its original dark container and
dosage limits must be followed.
7. A nurse is caring for a client with a chest tube. Which
finding requires immediate intervention?
A. Gentle bubbling in suction chamber
B. Drainage of 50 mL in 8 hr
C. Chest tube disconnected from drainage system
D. Tidaling in water seal chamber
, Rationale: Disconnection can allow air to enter the pleural
space, potentially causing a tension pneumothorax. This is an
emergency.
8. Which client should the nurse assess first?
A. Client with osteoarthritis reporting pain 6/10
B. Client with pneumonia and temperature of 38°C (100.4°F)
C. Client with asthma who has wheezing and difficulty
speaking
D. Client with diabetes requesting a snack
Rationale: Airway and breathing take priority. Difficulty
speaking indicates significant respiratory compromise.
9. A nurse is evaluating a newborn. Which finding requires
immediate reporting?
A. Acrocyanosis
B. Heart rate 140/min
C. Central cyanosis
D. Respiratory rate 45/min
Rationale: Central cyanosis suggests inadequate oxygenation
and is abnormal in a newborn.
10. A nurse is caring for a client receiving morphine IV.
Which adverse effect is the priority?
