ATI RN Comprehensive Predictor 2026 –
Version 2 Practice Exam | NGN-Style
Questions & Detailed Rationales
1. A nurse is caring for a client with acute asthma
exacerbation. Which medication should the nurse
administer first?
A. Fluticasone inhaler
B. Montelukast oral tablet
C. Albuterol inhaler
D. Prednisone oral tablet
Rationale: Albuterol is a short-acting beta-2 agonist that
provides rapid bronchodilation and is the first-line rescue
medication in acute asthma attacks. Fluticasone and
prednisone reduce inflammation but do not provide
immediate relief. Montelukast is for long-term control and not
acute management.
2. A client receiving heparin therapy has an aPTT of 110
seconds. What is the nurse’s priority action?
A. Continue infusion at current rate
B. Increase heparin dose
C. Administer vitamin K
D. Stop the heparin infusion and notify the provider
,Rationale: An aPTT significantly above therapeutic range
indicates high bleeding risk. Heparin must be stopped
immediately. Vitamin K reverses warfarin, not heparin.
3. Which finding indicates effective treatment of heart
failure?
A. Increased peripheral edema
B. Weight gain of 2 kg in 24 hours
C. Decreased crackles in lungs
D. Jugular vein distention
Rationale: Decreased pulmonary crackles indicate reduced
fluid overload and improved cardiac function. Weight gain,
edema, and JVD indicate worsening heart failure.
4. A nurse is assessing a client with suspected stroke. Which
finding requires immediate intervention?
A. Headache
B. Slurred speech
C. Weak grip on right hand
D. Airway obstruction and inability to swallow secretions
Rationale: Airway compromise is the priority under ABCs.
Neurologic deficits are expected in stroke, but airway
obstruction is immediately life-threatening.
5. Which action is appropriate when administering
potassium IV?
,A. Administer IV push over 1 minute
B. Use an infusion pump for controlled administration
C. Give undiluted for rapid correction
D. Administer intramuscularly
Rationale: IV potassium must always be diluted and infused
via pump to prevent cardiac dysrhythmias. IV push is fatal.
6. A client with diabetes has a blood glucose of 52 mg/dL.
What is the nurse’s first action?
A. Administer glucagon IM
B. Notify provider
C. Give long-acting insulin
D. Give 15 g of fast-acting carbohydrate orally
Rationale: The client is conscious and hypoglycemic. Oral
glucose is first-line. Glucagon is for unconscious patients.
7. Which assessment finding indicates digoxin toxicity?
A. Hypertension
B. Tachycardia
C. Yellow-green halos around lights
D. Dry cough
Rationale: Visual disturbances such as yellow-green halos are
classic signs of digoxin toxicity. Bradycardia, not tachycardia,
is also common.
, 8. A postoperative client reports sudden chest pain and
dyspnea. What is the nurse’s priority action?
A. Administer pain medication
B. Obtain vital signs
C. Assess oxygen saturation and apply oxygen
D. Encourage deep breathing
Rationale: Sudden chest pain and dyspnea may indicate
pulmonary embolism. Oxygenation is the priority.
9. Which isolation precaution is required for a client with
active tuberculosis?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Protective isolation
Rationale: TB spreads via airborne particles requiring
negative pressure room and N95 respirator.
10. A nurse is caring for a client receiving furosemide. Which
lab value requires immediate action?
A. Sodium 140 mEq/L
B. Potassium 3.0 mEq/L
C. Calcium 9.0 mg/dL
D. Chloride 100 mEq/L
Rationale: Furosemide causes potassium loss; hypokalemia
increases risk for dysrhythmias.
Version 2 Practice Exam | NGN-Style
Questions & Detailed Rationales
1. A nurse is caring for a client with acute asthma
exacerbation. Which medication should the nurse
administer first?
A. Fluticasone inhaler
B. Montelukast oral tablet
C. Albuterol inhaler
D. Prednisone oral tablet
Rationale: Albuterol is a short-acting beta-2 agonist that
provides rapid bronchodilation and is the first-line rescue
medication in acute asthma attacks. Fluticasone and
prednisone reduce inflammation but do not provide
immediate relief. Montelukast is for long-term control and not
acute management.
2. A client receiving heparin therapy has an aPTT of 110
seconds. What is the nurse’s priority action?
A. Continue infusion at current rate
B. Increase heparin dose
C. Administer vitamin K
D. Stop the heparin infusion and notify the provider
,Rationale: An aPTT significantly above therapeutic range
indicates high bleeding risk. Heparin must be stopped
immediately. Vitamin K reverses warfarin, not heparin.
3. Which finding indicates effective treatment of heart
failure?
A. Increased peripheral edema
B. Weight gain of 2 kg in 24 hours
C. Decreased crackles in lungs
D. Jugular vein distention
Rationale: Decreased pulmonary crackles indicate reduced
fluid overload and improved cardiac function. Weight gain,
edema, and JVD indicate worsening heart failure.
4. A nurse is assessing a client with suspected stroke. Which
finding requires immediate intervention?
A. Headache
B. Slurred speech
C. Weak grip on right hand
D. Airway obstruction and inability to swallow secretions
Rationale: Airway compromise is the priority under ABCs.
Neurologic deficits are expected in stroke, but airway
obstruction is immediately life-threatening.
5. Which action is appropriate when administering
potassium IV?
,A. Administer IV push over 1 minute
B. Use an infusion pump for controlled administration
C. Give undiluted for rapid correction
D. Administer intramuscularly
Rationale: IV potassium must always be diluted and infused
via pump to prevent cardiac dysrhythmias. IV push is fatal.
6. A client with diabetes has a blood glucose of 52 mg/dL.
What is the nurse’s first action?
A. Administer glucagon IM
B. Notify provider
C. Give long-acting insulin
D. Give 15 g of fast-acting carbohydrate orally
Rationale: The client is conscious and hypoglycemic. Oral
glucose is first-line. Glucagon is for unconscious patients.
7. Which assessment finding indicates digoxin toxicity?
A. Hypertension
B. Tachycardia
C. Yellow-green halos around lights
D. Dry cough
Rationale: Visual disturbances such as yellow-green halos are
classic signs of digoxin toxicity. Bradycardia, not tachycardia,
is also common.
, 8. A postoperative client reports sudden chest pain and
dyspnea. What is the nurse’s priority action?
A. Administer pain medication
B. Obtain vital signs
C. Assess oxygen saturation and apply oxygen
D. Encourage deep breathing
Rationale: Sudden chest pain and dyspnea may indicate
pulmonary embolism. Oxygenation is the priority.
9. Which isolation precaution is required for a client with
active tuberculosis?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Protective isolation
Rationale: TB spreads via airborne particles requiring
negative pressure room and N95 respirator.
10. A nurse is caring for a client receiving furosemide. Which
lab value requires immediate action?
A. Sodium 140 mEq/L
B. Potassium 3.0 mEq/L
C. Calcium 9.0 mg/dL
D. Chloride 100 mEq/L
Rationale: Furosemide causes potassium loss; hypokalemia
increases risk for dysrhythmias.
