1
ATI RN Comprehensive Predictor 2026–2027 Latest Update | Comprehensive
Practice Questions, Detailed Answer Explanations, Complete Study Review &
NCLEXRN® Exam Preparation Guide PDF
Exam Coverage Summary
This comprehensive NCLEXRN® examination covers all essential nursing domains including: safe and effective care
environment (management of care, safety and infection control); health promotion and maintenance (developmental stages,
disease prevention, prenatal care); psychosocial integrity (mental health disorders, therapeutic communication, crisis
intervention); physiological integrity (basic care and comfort, pharmacological therapies, reduction of risk potential,
physiological adaptation); medicalsurgical nursing (cardiovascular, respiratory, neurological, endocrine, gastrointestinal, renal
disorders); maternalnewborn nursing (antepartum, intrapartum, postpartum, neonatal care); pediatric nursing (growth and
development, childhood illnesses, pediatric emergencies); psychiatricmental health nursing (mood disorders, psychotic disorders,
anxiety disorders, personality disorders); pharmacology (medication administration, adverse effects, therapeutic levels, drug
interactions); nutrition (dietary modifications, enteral and parenteral nutrition); and legal/ethical issues (informed consent,
advance directives, client advocacy, documentation).
250 Multiple Choice Questions
1. A nurse is caring for a client who has a blood glucose level of 45 mg/dL. Which of the following manifestations should the
nurse expect?
A. Polyuria and polydipsia
B. Jitteriness and diaphoresis
C. Kussmaul respirations
D. Bradycardia and hypertension
Hypoglycemia presents with adrenergic symptoms including jitteriness, diaphoresis, tachycardia, and confusion. Blood glucose
below 70 mg/dL requires immediate intervention. Polyuria and polydipsia indicate hyperglycemia. Kussmaul respirations occur
in diabetic ketoacidosis.
2. A nurse is preparing to administer a feeding via gastrostomy tube. Which of the following actions should the nurse take to
prevent aspiration?
A. Place the client in a supine position
B. Administer the feeding over 15 minutes
C. Position the client in semiFowler's position
D. Flush the tube with cold water
, 2
SemiFowler's position (3045 degrees) prevents reflux and aspiration during tube feeding. Supine position increases aspiration
risk. Feedings should be administered over 30 minutes. Room temperature water should be used for flushes.
3. A nurse is assessing a client who has sickle cell anemia and reports chest pain. Which of the following findings indicates acute
chest syndrome?
A. Substernal retractions
B. Bradycardia
C. Hyperglycemia
D. Peripheral edema
Substernal retractions indicate respiratory distress and acute chest syndrome, a serious complication of sickle cell anemia. Other
findings include fever, cough, hypoxia, and infiltrates on chest xray. This is a medical emergency requiring immediate
intervention.
4. A nurse is caring for a client who is 1 day postoperative following a hip arthroplasty. Which of the following actions should the
nurse take?
A. Position the client in a low Fowler's position
B. Maintain the client's hips in an adducted position
C. Place an abduction pillow between the client's legs
D. Ambulate the client four times daily
Abduction pillow prevents hip dislocation postoperatively. Hips should be maintained in abduction, not adduction. Ambulation
frequency depends on the client's condition. Low Fowler's position is not specifically indicated for hip arthroplasty.
5. A nurse is caring for a client who has a new prescription for digoxin. Which of the following findings should the nurse identify
as a contraindication to administering this medication?
A. Apical pulse of 58/min
B. Potassium level of 4.2 mEq/L
C. Blood pressure of 118/78 mm Hg
D. Respiratory rate of 18/min
Digoxin is contraindicated with heart rate below 60/min due to risk of bradycardia. Hypokalemia increases digoxin toxicity risk.
Normal potassium is 3.55.0 mEq/L. The apical pulse must be counted for 1 full minute before administration.
6. A nurse is preparing a client for discharge following a subtotal thyroidectomy. Which of the following instructions should the
nurse include?
, 3
A. Restrict calcium intake
B. Report tingling around the mouth
C. Avoid iodine supplements
D. Limit fluid intake
Tingling around the mouth indicates hypocalcemia, a complication of thyroidectomy due to accidental parathyroid gland
removal. Calcium supplements may be needed. Iodine supplementation is not typically restricted. Adequate hydration is
encouraged.
7. A nurse is caring for a client who has rheumatoid arthritis. Which of the following laboratory findings should the nurse
anticipate?
A. Elevated erythrocyte sedimentation rate
B. Decreased platelet count
C. Low serum calcium
D. Increased potassium level
ESR is elevated in inflammatory conditions like rheumatoid arthritis. Platelet count may be normal or elevated. Calcium and
potassium levels are not specifically affected by RA. Creactive protein is also typically elevated.
8. A nurse is caring for a client who has petechiae and a platelet count of 50,000/mm³. Which of the following actions should the
nurse take?
A. Administer aspirin for fever
B. Monitor for signs of bleeding
C. Encourage vigorous oral hygiene
D. Apply ice packs to bruised areas
Thrombocytopenia (platelet count below 150,000) increases bleeding risk. Monitor for petechiae, ecchymosis, bleeding gums,
and internal bleeding. Aspirin should be avoided as it further impairs platelet function. Soft toothbrushes are recommended.
9. A nurse is caring for a client who has a living will. Which of the following actions should the nurse take?
A. Follow the client's documented wishes
B. Consult the ethics committee only
C. Notify the provider immediately
D. Honor the family's request only
, 4
Living will documents the client's healthcare treatment preferences. The nurse should respect and follow these documented
wishes. The ethics committee and family may be involved but the client's directive takes precedence when clear.
10. A nurse is caring for a client who requires contact precautions. Which of the following actions should the nurse take?
A. Place the client in a negative pressure room
B. Wear an N95 respirator when entering the room
C. Don a gown and gloves before entering the room
D. Limit visitors to 15 minutes per day
Contact precautions require gown and gloves for all interactions. Negative pressure is for airborne precautions. N95 is needed for
airborne and some droplet precautions. Visitor restrictions depend on the specific infectious agent and facility policy.
11. A nurse is caring for a client who had a myocardial infarction and is participating in cardiac rehabilitation. Which of the
following is the primary goal of this program?
A. Return the client to his previous level of activity
B. Maintain bed rest for 6 weeks
C. Restrict all physical activity
D. Monitor for arrhythmias only
Cardiac rehabilitation aims to safely return clients to optimal functioning and reduce future cardiac events. Bed rest is not
appropriate. Program includes graded exercise, risk factor modification, and education.
12. A nurse is providing teaching to a client who is starting combination oral contraceptives. Which of the following adverse
effects should the nurse include?
A. Decreased risk of hypertension
B. Increased risk of thrombophlebitis
C. Reduced incidence of migraines
D. Lower cholesterol levels
Combination oral contraceptives increase the risk of thromboembolic events including thrombophlebitis. They may increase
blood pressure, not decrease it. Estrogen can increase triglycerides and LDL cholesterol.
13. A nurse is caring for a client who is comatose. Which of the following interventions should the nurse implement to prevent
corneal abrasion?
A. Apply artificial tears every 2 hours
B. Tape the client's eyelids open
ATI RN Comprehensive Predictor 2026–2027 Latest Update | Comprehensive
Practice Questions, Detailed Answer Explanations, Complete Study Review &
NCLEXRN® Exam Preparation Guide PDF
Exam Coverage Summary
This comprehensive NCLEXRN® examination covers all essential nursing domains including: safe and effective care
environment (management of care, safety and infection control); health promotion and maintenance (developmental stages,
disease prevention, prenatal care); psychosocial integrity (mental health disorders, therapeutic communication, crisis
intervention); physiological integrity (basic care and comfort, pharmacological therapies, reduction of risk potential,
physiological adaptation); medicalsurgical nursing (cardiovascular, respiratory, neurological, endocrine, gastrointestinal, renal
disorders); maternalnewborn nursing (antepartum, intrapartum, postpartum, neonatal care); pediatric nursing (growth and
development, childhood illnesses, pediatric emergencies); psychiatricmental health nursing (mood disorders, psychotic disorders,
anxiety disorders, personality disorders); pharmacology (medication administration, adverse effects, therapeutic levels, drug
interactions); nutrition (dietary modifications, enteral and parenteral nutrition); and legal/ethical issues (informed consent,
advance directives, client advocacy, documentation).
250 Multiple Choice Questions
1. A nurse is caring for a client who has a blood glucose level of 45 mg/dL. Which of the following manifestations should the
nurse expect?
A. Polyuria and polydipsia
B. Jitteriness and diaphoresis
C. Kussmaul respirations
D. Bradycardia and hypertension
Hypoglycemia presents with adrenergic symptoms including jitteriness, diaphoresis, tachycardia, and confusion. Blood glucose
below 70 mg/dL requires immediate intervention. Polyuria and polydipsia indicate hyperglycemia. Kussmaul respirations occur
in diabetic ketoacidosis.
2. A nurse is preparing to administer a feeding via gastrostomy tube. Which of the following actions should the nurse take to
prevent aspiration?
A. Place the client in a supine position
B. Administer the feeding over 15 minutes
C. Position the client in semiFowler's position
D. Flush the tube with cold water
, 2
SemiFowler's position (3045 degrees) prevents reflux and aspiration during tube feeding. Supine position increases aspiration
risk. Feedings should be administered over 30 minutes. Room temperature water should be used for flushes.
3. A nurse is assessing a client who has sickle cell anemia and reports chest pain. Which of the following findings indicates acute
chest syndrome?
A. Substernal retractions
B. Bradycardia
C. Hyperglycemia
D. Peripheral edema
Substernal retractions indicate respiratory distress and acute chest syndrome, a serious complication of sickle cell anemia. Other
findings include fever, cough, hypoxia, and infiltrates on chest xray. This is a medical emergency requiring immediate
intervention.
4. A nurse is caring for a client who is 1 day postoperative following a hip arthroplasty. Which of the following actions should the
nurse take?
A. Position the client in a low Fowler's position
B. Maintain the client's hips in an adducted position
C. Place an abduction pillow between the client's legs
D. Ambulate the client four times daily
Abduction pillow prevents hip dislocation postoperatively. Hips should be maintained in abduction, not adduction. Ambulation
frequency depends on the client's condition. Low Fowler's position is not specifically indicated for hip arthroplasty.
5. A nurse is caring for a client who has a new prescription for digoxin. Which of the following findings should the nurse identify
as a contraindication to administering this medication?
A. Apical pulse of 58/min
B. Potassium level of 4.2 mEq/L
C. Blood pressure of 118/78 mm Hg
D. Respiratory rate of 18/min
Digoxin is contraindicated with heart rate below 60/min due to risk of bradycardia. Hypokalemia increases digoxin toxicity risk.
Normal potassium is 3.55.0 mEq/L. The apical pulse must be counted for 1 full minute before administration.
6. A nurse is preparing a client for discharge following a subtotal thyroidectomy. Which of the following instructions should the
nurse include?
, 3
A. Restrict calcium intake
B. Report tingling around the mouth
C. Avoid iodine supplements
D. Limit fluid intake
Tingling around the mouth indicates hypocalcemia, a complication of thyroidectomy due to accidental parathyroid gland
removal. Calcium supplements may be needed. Iodine supplementation is not typically restricted. Adequate hydration is
encouraged.
7. A nurse is caring for a client who has rheumatoid arthritis. Which of the following laboratory findings should the nurse
anticipate?
A. Elevated erythrocyte sedimentation rate
B. Decreased platelet count
C. Low serum calcium
D. Increased potassium level
ESR is elevated in inflammatory conditions like rheumatoid arthritis. Platelet count may be normal or elevated. Calcium and
potassium levels are not specifically affected by RA. Creactive protein is also typically elevated.
8. A nurse is caring for a client who has petechiae and a platelet count of 50,000/mm³. Which of the following actions should the
nurse take?
A. Administer aspirin for fever
B. Monitor for signs of bleeding
C. Encourage vigorous oral hygiene
D. Apply ice packs to bruised areas
Thrombocytopenia (platelet count below 150,000) increases bleeding risk. Monitor for petechiae, ecchymosis, bleeding gums,
and internal bleeding. Aspirin should be avoided as it further impairs platelet function. Soft toothbrushes are recommended.
9. A nurse is caring for a client who has a living will. Which of the following actions should the nurse take?
A. Follow the client's documented wishes
B. Consult the ethics committee only
C. Notify the provider immediately
D. Honor the family's request only
, 4
Living will documents the client's healthcare treatment preferences. The nurse should respect and follow these documented
wishes. The ethics committee and family may be involved but the client's directive takes precedence when clear.
10. A nurse is caring for a client who requires contact precautions. Which of the following actions should the nurse take?
A. Place the client in a negative pressure room
B. Wear an N95 respirator when entering the room
C. Don a gown and gloves before entering the room
D. Limit visitors to 15 minutes per day
Contact precautions require gown and gloves for all interactions. Negative pressure is for airborne precautions. N95 is needed for
airborne and some droplet precautions. Visitor restrictions depend on the specific infectious agent and facility policy.
11. A nurse is caring for a client who had a myocardial infarction and is participating in cardiac rehabilitation. Which of the
following is the primary goal of this program?
A. Return the client to his previous level of activity
B. Maintain bed rest for 6 weeks
C. Restrict all physical activity
D. Monitor for arrhythmias only
Cardiac rehabilitation aims to safely return clients to optimal functioning and reduce future cardiac events. Bed rest is not
appropriate. Program includes graded exercise, risk factor modification, and education.
12. A nurse is providing teaching to a client who is starting combination oral contraceptives. Which of the following adverse
effects should the nurse include?
A. Decreased risk of hypertension
B. Increased risk of thrombophlebitis
C. Reduced incidence of migraines
D. Lower cholesterol levels
Combination oral contraceptives increase the risk of thromboembolic events including thrombophlebitis. They may increase
blood pressure, not decrease it. Estrogen can increase triglycerides and LDL cholesterol.
13. A nurse is caring for a client who is comatose. Which of the following interventions should the nurse implement to prevent
corneal abrasion?
A. Apply artificial tears every 2 hours
B. Tape the client's eyelids open
