ATI RN Comprehensive Predictor 2026 –
Version 1 | Practice Exam & Detailed
Rationales
1. A nurse is caring for a client who suddenly develops chest
pain and dyspnea. Which action should the nurse take first?
A. Obtain a 12-lead ECG
B. Administer oxygen at 2 L/min via nasal cannula
C. Notify the healthcare provider
D. Draw cardiac enzymes
Answer: B. Administer oxygen at 2 L/min via nasal cannula
Rationale: Airway and breathing take priority in acute
distress. Oxygen improves myocardial oxygenation
immediately and is the first action before diagnostics or
provider notification.
2. A client with heart failure is prescribed furosemide.
Which lab value requires immediate intervention?
A. Potassium 3.1 mEq/L
B. Sodium 136 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 1.8 mg/dL
Answer: A. Potassium 3.1 mEq/L
,Rationale: Furosemide causes potassium loss. Hypokalemia
increases risk of dysrhythmias and requires prompt
correction.
3. A nurse is assessing a client with suspected stroke. Which
finding requires immediate action?
A. Unilateral facial droop
B. Slurred speech
C. Blood glucose 58 mg/dL
D. Weak grip on left hand
Answer: C. Blood glucose 58 mg/dL
Rationale: Hypoglycemia can mimic stroke symptoms and
must be corrected immediately to prevent neurologic
damage.
4. Which client should the nurse assess first?
A. Postoperative client reporting pain 6/10
B. Client with COPD reporting mild dyspnea while eating
C. Client with diabetes and blood glucose 250 mg/dL
D. Client scheduled for discharge in 1 hour
Answer: B. Client with COPD reporting mild dyspnea while
eating
Rationale: Respiratory compromise is highest priority,
especially in COPD clients at risk for rapid deterioration.
,5. A nurse is teaching a client about warfarin therapy. Which
statement indicates understanding?
A. “I will eat more leafy greens.”
B. “I will take aspirin for headaches.”
C. “I will have my INR checked regularly.”
D. “I will double my dose if I miss one.”
Answer: C. “I will have my INR checked regularly.”
Rationale: Warfarin requires INR monitoring to ensure
therapeutic anticoagulation and prevent bleeding
complications.
6. A postoperative client has shallow respirations and
oxygen saturation of 88%. What is the nurse’s priority
action?
A. Encourage coughing and deep breathing
B. Apply oxygen via face mask
C. Administer pain medication
D. Assess lung sounds
Answer: B. Apply oxygen via face mask
Rationale: Oxygen saturation below 90% requires immediate
oxygen delivery to prevent hypoxia.
7. Which finding is most concerning in a client receiving
morphine?
, A. Respiratory rate 10/min
B. Blood pressure 110/70 mmHg
C. Pupils 3 mm equal
D. Drowsiness
Answer: A. Respiratory rate 10/min
Rationale: Opioids can cause respiratory depression; a low
respiratory rate is life-threatening.
8. A nurse is caring for a client with suspected sepsis. Which
action is priority?
A. Obtain blood cultures
B. Start broad-spectrum antibiotics
C. Administer IV fluids
D. Monitor urine output
Answer: C. Administer IV fluids
Rationale: Fluid resuscitation is essential to maintain
perfusion in septic shock.
9. Which electrolyte imbalance is associated with tetany and
positive Chvostek’s sign?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypophosphatemia
Answer: B. Hypocalcemia
Version 1 | Practice Exam & Detailed
Rationales
1. A nurse is caring for a client who suddenly develops chest
pain and dyspnea. Which action should the nurse take first?
A. Obtain a 12-lead ECG
B. Administer oxygen at 2 L/min via nasal cannula
C. Notify the healthcare provider
D. Draw cardiac enzymes
Answer: B. Administer oxygen at 2 L/min via nasal cannula
Rationale: Airway and breathing take priority in acute
distress. Oxygen improves myocardial oxygenation
immediately and is the first action before diagnostics or
provider notification.
2. A client with heart failure is prescribed furosemide.
Which lab value requires immediate intervention?
A. Potassium 3.1 mEq/L
B. Sodium 136 mEq/L
C. Calcium 9.2 mg/dL
D. Magnesium 1.8 mg/dL
Answer: A. Potassium 3.1 mEq/L
,Rationale: Furosemide causes potassium loss. Hypokalemia
increases risk of dysrhythmias and requires prompt
correction.
3. A nurse is assessing a client with suspected stroke. Which
finding requires immediate action?
A. Unilateral facial droop
B. Slurred speech
C. Blood glucose 58 mg/dL
D. Weak grip on left hand
Answer: C. Blood glucose 58 mg/dL
Rationale: Hypoglycemia can mimic stroke symptoms and
must be corrected immediately to prevent neurologic
damage.
4. Which client should the nurse assess first?
A. Postoperative client reporting pain 6/10
B. Client with COPD reporting mild dyspnea while eating
C. Client with diabetes and blood glucose 250 mg/dL
D. Client scheduled for discharge in 1 hour
Answer: B. Client with COPD reporting mild dyspnea while
eating
Rationale: Respiratory compromise is highest priority,
especially in COPD clients at risk for rapid deterioration.
,5. A nurse is teaching a client about warfarin therapy. Which
statement indicates understanding?
A. “I will eat more leafy greens.”
B. “I will take aspirin for headaches.”
C. “I will have my INR checked regularly.”
D. “I will double my dose if I miss one.”
Answer: C. “I will have my INR checked regularly.”
Rationale: Warfarin requires INR monitoring to ensure
therapeutic anticoagulation and prevent bleeding
complications.
6. A postoperative client has shallow respirations and
oxygen saturation of 88%. What is the nurse’s priority
action?
A. Encourage coughing and deep breathing
B. Apply oxygen via face mask
C. Administer pain medication
D. Assess lung sounds
Answer: B. Apply oxygen via face mask
Rationale: Oxygen saturation below 90% requires immediate
oxygen delivery to prevent hypoxia.
7. Which finding is most concerning in a client receiving
morphine?
, A. Respiratory rate 10/min
B. Blood pressure 110/70 mmHg
C. Pupils 3 mm equal
D. Drowsiness
Answer: A. Respiratory rate 10/min
Rationale: Opioids can cause respiratory depression; a low
respiratory rate is life-threatening.
8. A nurse is caring for a client with suspected sepsis. Which
action is priority?
A. Obtain blood cultures
B. Start broad-spectrum antibiotics
C. Administer IV fluids
D. Monitor urine output
Answer: C. Administer IV fluids
Rationale: Fluid resuscitation is essential to maintain
perfusion in septic shock.
9. Which electrolyte imbalance is associated with tetany and
positive Chvostek’s sign?
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypophosphatemia
Answer: B. Hypocalcemia
