Virtual ATI Green Light Comprehensive
Predictor 2026 Practice Questions &
Answers PDF | ATI NCLEX Predictor Study
Guide with Verified Solutions & Rationales
• This comprehensive ATI NCLEX Predictor practice set features 200 exam-style
questions with verified answers and detailed EXPERT RATIONALE designed to
mirror the Virtual ATI Green Light Comprehensive Predictor 2026 format.
• Study strategically by working through all questions under timed conditions,
reviewing every EXPERT RATIONALE carefully — especially for missed items — to
reinforce clinical reasoning across all core NCLEX content areas.
1. A nurse is caring for a client who has heart failure and a prescription for
digoxin 0.125 mg PO daily. The client's apical pulse is 54 beats/min. Which of
the following actions should the nurse take?
A. Administer the medication and document the finding
B. Administer the medication and notify the provider after giving the dose
C. Hold the medication and notify the provider
D. Hold the medication and recheck the pulse in 30 minutes
E. Administer a half dose and monitor the client closely
Correct Answer: C. Hold the medication and notify the provider
EXPERT RATIONALE: Digoxin is held when the apical pulse is below 60 beats/min in
adults. Bradycardia is a sign of digoxin toxicity risk, and the provider must be
notified before administration to prevent further cardiac depression.
2. A nurse is assessing a client who is 24 hours postoperative following a
bowel resection. Which of the following findings should the nurse report to
the provider?
A. Hypoactive bowel sounds in all four quadrants
B. Scant serosanguineous drainage on the surgical dressing
,C. Oral temperature of 38.8°C (101.8°F)
D. Urine output of 40 mL/hr
E. Pain rated 5/10 at the incision site
Correct Answer: C. Oral temperature of 38.8°C (101.8°F)
EXPERT RATIONALE: A temperature above 38.5°C (101.3°F) at 24 hours
postoperatively suggests infection or a serious complication beyond the expected
atelectasis-related fever. This requires prompt provider notification for evaluation.
3. A nurse is preparing to administer medications to a client who has chronic
kidney disease. Which of the following medications should the nurse
question?
A. Calcium carbonate 500 mg PO with meals
B. Erythropoietin 4,000 units subcutaneously
C. Ibuprofen 400 mg PO every 6 hours PRN pain
D. Sodium bicarbonate 650 mg PO daily
E. Ferrous sulfate 325 mg PO daily
Correct Answer: C. Ibuprofen 400 mg PO every 6 hours PRN pain
EXPERT RATIONALE: NSAIDs such as ibuprofen are contraindicated in chronic
kidney disease because they reduce renal blood flow by inhibiting prostaglandins,
further impairing already compromised kidney function and risking acute kidney
injury.
4. A nurse is caring for a client who has been prescribed lithium for bipolar
disorder. Which of the following laboratory values requires immediate
intervention?
A. Serum lithium level 0.8 mEq/L
B. Serum lithium level 1.8 mEq/L
,C. WBC count 6,500/mm³
D. Serum creatinine 0.9 mg/dL
E. Serum sodium 138 mEq/L
Correct Answer: B. Serum lithium level 1.8 mEq/L
EXPERT RATIONALE: The therapeutic range for lithium is 0.6–1.2 mEq/L for
maintenance. A level of 1.8 mEq/L indicates toxicity. Signs include tremors, nausea,
ataxia, and confusion. Levels above 1.5 mEq/L require immediate provider
notification and possible dose adjustment or discontinuation.
5. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following statements by the client
indicates understanding?
A. "I can take ibuprofen for my arthritis pain while on this medication."
B. "I should eat consistent amounts of leafy green vegetables."
C. "I will stop taking the medication if I notice any bruising."
D. "I need to take this medication only when I feel my blood is too thick."
E. "I should double the dose if I miss one."
Correct Answer: B. "I should eat consistent amounts of leafy green
vegetables."
EXPERT RATIONALE: Vitamin K found in leafy greens antagonizes warfarin. Clients
do not need to eliminate these foods but must keep intake consistent to maintain a
stable INR. Abrupt changes in vitamin K intake cause unpredictable fluctuations in
anticoagulation levels.
6. A nurse is assessing a newborn 1 hour after birth. Which of the following
findings requires immediate intervention?
A. Respiratory rate of 48 breaths/min
, B. Acrocyanosis of the hands and feet
C. Grunting with each expiration
D. Molding of the skull
E. Heart rate of 148 beats/min
Correct Answer: C. Grunting with each expiration
EXPERT RATIONALE: Expiratory grunting in a newborn is a sign of respiratory
distress. The newborn is attempting to maintain positive end-expiratory pressure to
keep alveoli open. This finding warrants immediate assessment and intervention to
prevent respiratory failure.
7. A nurse is caring for a client who has been in labor for 14 hours. The fetal
monitor shows late decelerations with each contraction. Which of the
following is the priority nursing action?
A. Increase the rate of the oxytocin infusion
B. Prepare for immediate cesarean delivery
C. Reposition the client to the left lateral position
D. Administer oxygen via face mask at 2 L/min
E. Notify the provider and document the findings
Correct Answer: C. Reposition the client to the left lateral position
EXPERT RATIONALE: Late decelerations indicate uteroplacental insufficiency. The
first priority intervention is to reposition the client to the left lateral position to
relieve aortic and caval compression, improving placental blood flow. Oxygen, IV
fluid bolus, and provider notification follow.
8. A nurse is caring for a client who has been admitted with suspected
meningitis. Which of the following actions should the nurse take first?
A. Administer acetaminophen for fever
Predictor 2026 Practice Questions &
Answers PDF | ATI NCLEX Predictor Study
Guide with Verified Solutions & Rationales
• This comprehensive ATI NCLEX Predictor practice set features 200 exam-style
questions with verified answers and detailed EXPERT RATIONALE designed to
mirror the Virtual ATI Green Light Comprehensive Predictor 2026 format.
• Study strategically by working through all questions under timed conditions,
reviewing every EXPERT RATIONALE carefully — especially for missed items — to
reinforce clinical reasoning across all core NCLEX content areas.
1. A nurse is caring for a client who has heart failure and a prescription for
digoxin 0.125 mg PO daily. The client's apical pulse is 54 beats/min. Which of
the following actions should the nurse take?
A. Administer the medication and document the finding
B. Administer the medication and notify the provider after giving the dose
C. Hold the medication and notify the provider
D. Hold the medication and recheck the pulse in 30 minutes
E. Administer a half dose and monitor the client closely
Correct Answer: C. Hold the medication and notify the provider
EXPERT RATIONALE: Digoxin is held when the apical pulse is below 60 beats/min in
adults. Bradycardia is a sign of digoxin toxicity risk, and the provider must be
notified before administration to prevent further cardiac depression.
2. A nurse is assessing a client who is 24 hours postoperative following a
bowel resection. Which of the following findings should the nurse report to
the provider?
A. Hypoactive bowel sounds in all four quadrants
B. Scant serosanguineous drainage on the surgical dressing
,C. Oral temperature of 38.8°C (101.8°F)
D. Urine output of 40 mL/hr
E. Pain rated 5/10 at the incision site
Correct Answer: C. Oral temperature of 38.8°C (101.8°F)
EXPERT RATIONALE: A temperature above 38.5°C (101.3°F) at 24 hours
postoperatively suggests infection or a serious complication beyond the expected
atelectasis-related fever. This requires prompt provider notification for evaluation.
3. A nurse is preparing to administer medications to a client who has chronic
kidney disease. Which of the following medications should the nurse
question?
A. Calcium carbonate 500 mg PO with meals
B. Erythropoietin 4,000 units subcutaneously
C. Ibuprofen 400 mg PO every 6 hours PRN pain
D. Sodium bicarbonate 650 mg PO daily
E. Ferrous sulfate 325 mg PO daily
Correct Answer: C. Ibuprofen 400 mg PO every 6 hours PRN pain
EXPERT RATIONALE: NSAIDs such as ibuprofen are contraindicated in chronic
kidney disease because they reduce renal blood flow by inhibiting prostaglandins,
further impairing already compromised kidney function and risking acute kidney
injury.
4. A nurse is caring for a client who has been prescribed lithium for bipolar
disorder. Which of the following laboratory values requires immediate
intervention?
A. Serum lithium level 0.8 mEq/L
B. Serum lithium level 1.8 mEq/L
,C. WBC count 6,500/mm³
D. Serum creatinine 0.9 mg/dL
E. Serum sodium 138 mEq/L
Correct Answer: B. Serum lithium level 1.8 mEq/L
EXPERT RATIONALE: The therapeutic range for lithium is 0.6–1.2 mEq/L for
maintenance. A level of 1.8 mEq/L indicates toxicity. Signs include tremors, nausea,
ataxia, and confusion. Levels above 1.5 mEq/L require immediate provider
notification and possible dose adjustment or discontinuation.
5. A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following statements by the client
indicates understanding?
A. "I can take ibuprofen for my arthritis pain while on this medication."
B. "I should eat consistent amounts of leafy green vegetables."
C. "I will stop taking the medication if I notice any bruising."
D. "I need to take this medication only when I feel my blood is too thick."
E. "I should double the dose if I miss one."
Correct Answer: B. "I should eat consistent amounts of leafy green
vegetables."
EXPERT RATIONALE: Vitamin K found in leafy greens antagonizes warfarin. Clients
do not need to eliminate these foods but must keep intake consistent to maintain a
stable INR. Abrupt changes in vitamin K intake cause unpredictable fluctuations in
anticoagulation levels.
6. A nurse is assessing a newborn 1 hour after birth. Which of the following
findings requires immediate intervention?
A. Respiratory rate of 48 breaths/min
, B. Acrocyanosis of the hands and feet
C. Grunting with each expiration
D. Molding of the skull
E. Heart rate of 148 beats/min
Correct Answer: C. Grunting with each expiration
EXPERT RATIONALE: Expiratory grunting in a newborn is a sign of respiratory
distress. The newborn is attempting to maintain positive end-expiratory pressure to
keep alveoli open. This finding warrants immediate assessment and intervention to
prevent respiratory failure.
7. A nurse is caring for a client who has been in labor for 14 hours. The fetal
monitor shows late decelerations with each contraction. Which of the
following is the priority nursing action?
A. Increase the rate of the oxytocin infusion
B. Prepare for immediate cesarean delivery
C. Reposition the client to the left lateral position
D. Administer oxygen via face mask at 2 L/min
E. Notify the provider and document the findings
Correct Answer: C. Reposition the client to the left lateral position
EXPERT RATIONALE: Late decelerations indicate uteroplacental insufficiency. The
first priority intervention is to reposition the client to the left lateral position to
relieve aortic and caval compression, improving placental blood flow. Oxygen, IV
fluid bolus, and provider notification follow.
8. A nurse is caring for a client who has been admitted with suspected
meningitis. Which of the following actions should the nurse take first?
A. Administer acetaminophen for fever
