ATI RN Comprehensive Predictor Practice
Exam Questions And Answers Plus
Rationales 2026 | Instant Pdf Download
1. A nurse is caring for four clients. Which client should the nurse
see first?
A. A client with COPD and SpO₂ 89% on 2 L/min oxygen via nasal
cannula
B. A client post-appendectomy day 2 with a temperature of 38.3°C
(101°F)
C. A client with heart failure and 3+ pitting edema
D. A client with new-onset confusion and a bounding pulse
Answer: D
Rationale: New-onset confusion with a bounding pulse suggests
hypercapnia or fluid overload affecting cerebral perfusion. This acute
change in neurological status is always the priority, even over stable vital
sign abnormalities.
2. A charge nurse is making client assignments on a medical-surgical
unit. Which client should be assigned to the Licensed Practical Nurse
(LPN)?
A. A client 1 hour post-cardiac catheterization with bleeding at the
insertion site
,B. A client with stable diabetes mellitus requiring insulin administration
and foot care
C. A client newly admitted with a stroke and altered mental status
D. A client receiving IV heparin with a PTT of 98 seconds
Answer: B
Rationale: LPNs can administer insulin, perform stable wound care, and
monitor stable clients. Options A, C, and D require RN assessment
(bleeding, neurological changes, critical lab monitoring).
3. A nurse is caring for a client with heart failure who reports
sudden shortness of breath, cough with pink, frothy sputum, and
anxiety. Vital signs: BP 168/94, HR 118, RR 32, SpO₂ 84% on 2 L/min
via nasal cannula. Which of the following actions should the nurse
take first? (Select all that apply.)
A. Place the client in high-Fowler’s position
B. Increase oxygen to 100% via non-rebreather mask
C. Administer IV furosemide as prescribed
D. Prepare for endotracheal intubation
E. Notify the healthcare provider
F. Start a second IV line
Answer: A, B, C
Rationale: High-Fowler’s position improves lung expansion and reduces
venous return (A). The client is severely hypoxemic at 84% SpO₂, so
high-flow oxygen via non-rebreather mask is essential (B). IV furosemide
,reduces preload and pulmonary congestion (C). Intubation is not a first
action unless non-invasive measures fail.
4. A nurse is preparing to administer a blood transfusion to a client.
Which IV solution is compatible with packed red blood cells?
A. Lactated Ringer’s solution
B. 5% Dextrose in water (D5W)
C. 0.9% Normal saline
D. 0.45% Normal saline
Answer: C
Rationale: Only 0.9% normal saline is compatible with blood products.
Dextrose solutions can cause hemolysis, and Lactated Ringer’s contains
calcium that can cause clotting.
5. A nurse is caring for a client with a new prescription for
enoxaparin (Lovenox). Which route of administration is correct?
A. Intramuscular
B. Subcutaneous
C. Intravenous push
D. Oral
Answer: B
Rationale: Enoxaparin is a low-molecular-weight heparin administered
subcutaneously, typically in the abdomen. The air bubble in the prefilled
syringe should not be expelled.
, 6. A client with a history of atrial fibrillation is taking warfarin. The
nurse notes an INR of 4.8. The client has no signs of bleeding. What
should the nurse anticipate?
A. Administer vitamin K orally
B. Hold the next dose of warfarin
C. Transfuse fresh frozen plasma
D. Increase the warfarin dose
Answer: B
Rationale: For an asymptomatic client with an INR of 4.8, the standard
of care is to hold the next dose of warfarin and monitor the INR. Vitamin
K is typically reserved for INR >5.0 or active bleeding.
7. A nurse is assessing a client with suspected appendicitis. Which
finding is most specific?
A. Rebound tenderness in the left lower quadrant
B. Pain that starts in the epigastrium and migrates to the right lower
quadrant
C. Fever and chills
D. Nausea and vomiting before the onset of pain
Answer: B
Rationale: Classic appendicitis presents with periumbilical or epigastric
pain that later localizes to McBurney’s point (right lower quadrant). This
migratory pain pattern is highly specific.
Exam Questions And Answers Plus
Rationales 2026 | Instant Pdf Download
1. A nurse is caring for four clients. Which client should the nurse
see first?
A. A client with COPD and SpO₂ 89% on 2 L/min oxygen via nasal
cannula
B. A client post-appendectomy day 2 with a temperature of 38.3°C
(101°F)
C. A client with heart failure and 3+ pitting edema
D. A client with new-onset confusion and a bounding pulse
Answer: D
Rationale: New-onset confusion with a bounding pulse suggests
hypercapnia or fluid overload affecting cerebral perfusion. This acute
change in neurological status is always the priority, even over stable vital
sign abnormalities.
2. A charge nurse is making client assignments on a medical-surgical
unit. Which client should be assigned to the Licensed Practical Nurse
(LPN)?
A. A client 1 hour post-cardiac catheterization with bleeding at the
insertion site
,B. A client with stable diabetes mellitus requiring insulin administration
and foot care
C. A client newly admitted with a stroke and altered mental status
D. A client receiving IV heparin with a PTT of 98 seconds
Answer: B
Rationale: LPNs can administer insulin, perform stable wound care, and
monitor stable clients. Options A, C, and D require RN assessment
(bleeding, neurological changes, critical lab monitoring).
3. A nurse is caring for a client with heart failure who reports
sudden shortness of breath, cough with pink, frothy sputum, and
anxiety. Vital signs: BP 168/94, HR 118, RR 32, SpO₂ 84% on 2 L/min
via nasal cannula. Which of the following actions should the nurse
take first? (Select all that apply.)
A. Place the client in high-Fowler’s position
B. Increase oxygen to 100% via non-rebreather mask
C. Administer IV furosemide as prescribed
D. Prepare for endotracheal intubation
E. Notify the healthcare provider
F. Start a second IV line
Answer: A, B, C
Rationale: High-Fowler’s position improves lung expansion and reduces
venous return (A). The client is severely hypoxemic at 84% SpO₂, so
high-flow oxygen via non-rebreather mask is essential (B). IV furosemide
,reduces preload and pulmonary congestion (C). Intubation is not a first
action unless non-invasive measures fail.
4. A nurse is preparing to administer a blood transfusion to a client.
Which IV solution is compatible with packed red blood cells?
A. Lactated Ringer’s solution
B. 5% Dextrose in water (D5W)
C. 0.9% Normal saline
D. 0.45% Normal saline
Answer: C
Rationale: Only 0.9% normal saline is compatible with blood products.
Dextrose solutions can cause hemolysis, and Lactated Ringer’s contains
calcium that can cause clotting.
5. A nurse is caring for a client with a new prescription for
enoxaparin (Lovenox). Which route of administration is correct?
A. Intramuscular
B. Subcutaneous
C. Intravenous push
D. Oral
Answer: B
Rationale: Enoxaparin is a low-molecular-weight heparin administered
subcutaneously, typically in the abdomen. The air bubble in the prefilled
syringe should not be expelled.
, 6. A client with a history of atrial fibrillation is taking warfarin. The
nurse notes an INR of 4.8. The client has no signs of bleeding. What
should the nurse anticipate?
A. Administer vitamin K orally
B. Hold the next dose of warfarin
C. Transfuse fresh frozen plasma
D. Increase the warfarin dose
Answer: B
Rationale: For an asymptomatic client with an INR of 4.8, the standard
of care is to hold the next dose of warfarin and monitor the INR. Vitamin
K is typically reserved for INR >5.0 or active bleeding.
7. A nurse is assessing a client with suspected appendicitis. Which
finding is most specific?
A. Rebound tenderness in the left lower quadrant
B. Pain that starts in the epigastrium and migrates to the right lower
quadrant
C. Fever and chills
D. Nausea and vomiting before the onset of pain
Answer: B
Rationale: Classic appendicitis presents with periumbilical or epigastric
pain that later localizes to McBurney’s point (right lower quadrant). This
migratory pain pattern is highly specific.
