Fall Semester 2026–2027 ATI Comprehensive Predictor
Updated 2026 | 190+ Questions and Answers | ATI
Comprehensive Predictor Comprehensive Study Guide,
Practice Exam, Exam Prep Test Bank, NCLEX-RN
Readiness, Fundamentals of Nursing, Medical-Surgical
Nursing, Pharmacology, Maternal-Newborn, Pediatrics,
Mental Health, Leadership & Management, Community
Health, Next Generation NCLEX (NGN), Detailed
Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who has a new diagnosis of type 1
diabetes mellitus. Which of the following findings indicates a therapeutic
response to insulin therapy?
A. Weight loss of 5 pounds in one week
B. Fasting blood glucose level of 95 mg/dL
C. Presence of ketones in the urine
D. A 1-hour postprandial glucose of 220 mg/dL
CORRECT ANSWER: B. Fasting blood glucose level of 95 mg/dL
Rationale: A therapeutic response to insulin therapy is indicated by blood glucose levels
within the target range. A fasting blood glucose of 95 mg/dL is within the recommended
range of 80-130 mg/dL for adults with diabetes, demonstrating effective glycemic
control. Weight loss, ketones, and elevated postprandial glucose indicate poor control.
Question 2: A nurse is preparing to administer a blood transfusion to a client.
Which of the following IV solutions should the nurse use to prime the blood
administration tubing?
A. 0.9% Sodium Chloride
B. 5% Dextrose in Water
C. Lactated Ringer's
D. 0.45% Sodium Chloride
CORRECT ANSWER: A. 0.9% Sodium Chloride
Rationale: Only 0.9% sodium chloride (normal saline) is compatible with blood products.
Dextrose solutions and Lactated Ringer's can cause hemolysis or clotting due to
changes in pH or calcium content. Hypotonic solutions can cause red blood cell lysis.
Question 3: A nurse is assessing a client who is 12 hours post-operative
following a total hip arthroplasty. Which of the following findings should the
nurse report to the provider immediately?
A. Heart rate of 88/min
B. Pain level of 4 on a scale of 0 to 10
C. Swelling of the operative extremity
D. Oxygen saturation of 89%
CORRECT ANSWER: D. Oxygen saturation of 89%
Rationale: An oxygen saturation of 89% indicates hypoxemia, which is a critical finding
,that requires immediate intervention. This could signify a pulmonary embolism, a major
risk following hip surgery, and must be reported to the provider stat.
Question 4: A nurse is performing a neurological assessment on a client.
Which of the following cranial nerves is the nurse testing when asking the
client to shrug their shoulders against resistance?
A. Cranial Nerve IX (Glossopharyngeal)
B. Cranial Nerve X (Vagus)
C. Cranial Nerve XI (Accessory)
D. Cranial Nerve XII (Hypoglossal)
CORRECT ANSWER: C. Cranial Nerve XI (Accessory)
Rationale: The accessory nerve (CN XI) innervates the sternocleidomastoid and
trapezius muscles, which are responsible for shoulder shrugging and head turning. CN
IX is for taste and swallowing, CN X is for parasympathetic functions, and CN XII is for
tongue movement.
Question 5: A nurse is providing discharge teaching to a client with heart
failure. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I will weigh myself once a week."
B. "I can skip my diuretic if I feel dizzy."
C. "I should limit my daily sodium intake to 2 grams."
D. "I will notify my doctor if I gain 2 pounds in a day."
CORRECT ANSWER: D. I will notify my doctor if I gain 2 pounds in a day.
Rationale: A weight gain of 2-3 pounds in a day or 5 pounds in a week indicates fluid
retention and worsening heart failure, requiring immediate notification of the provider.
Daily, not weekly, weight monitoring is standard.
Question 6: A nurse is caring for a client with a chest tube attached to a water
seal drainage system. Which of the following actions is appropriate if the
drainage system is accidentally knocked over and the water seal is broken?
A. Clamp the chest tube immediately.
B. Place the end of the chest tube in a bottle of sterile water.
C. Reconnect the system to suction.
D. Notify the provider immediately.
CORRECT ANSWER: B. Place the end of the chest tube in a bottle of sterile
water.
Rationale: If the water seal is broken, the priority is to prevent air from entering the
pleural space. Placing the end of the tube in sterile water re-establishes the water seal.
Clamping the tube is avoided to prevent tension pneumothorax, though it may be briefly
done if necessary.
Question 7: A nurse is assessing a client who is receiving a continuous enteral
feeding via a nasogastric tube. Which of the following findings indicates a
complication of the feeding?
A. Gastric residual volume of 50 mL
,B. Blood glucose of 150 mg/dL
C. Bowel sounds present in all four quadrants
D. Respiratory rate of 28/min with crackles
CORRECT ANSWER: D. Respiratory rate of 28/min with crackles
Rationale: An increased respiratory rate with crackles indicates possible aspiration
pneumonia, a serious complication of enteral feeding. The other options are within
normal or acceptable ranges and do not indicate an immediate complication.
Question 8: A nurse is preparing a client for an intravenous pyelogram (IVP).
Which of the following client statements should the nurse report to the
provider?
A. "I am allergic to shellfish."
B. "I had a cup of coffee this morning."
C. "I took my blood pressure medication."
D. "I am feeling anxious about the test."
CORRECT ANSWER: A. I am allergic to shellfish.
Rationale: An allergy to shellfish is a contraindication for IVP due to the iodine-based
contrast media used. The contrast can cause a severe allergic reaction, including
anaphylaxis. The provider should be notified to consider alternative imaging or pre-
medication.
Question 9: A nurse is caring for a client who has a new prescription for
haloperidol. Which of the following adverse effects is the priority for the nurse
to monitor?
A. Sedation
B. Constipation
C. Extrapyramidal symptoms
D. Dry mouth
CORRECT ANSWER: C. Extrapyramidal symptoms
Rationale: Extrapyramidal symptoms (EPS), such as acute dystonia, parkinsonism, and
tardive dyskinesia, are serious and potentially irreversible adverse effects of haloperidol.
They require prompt assessment and intervention. While sedation, constipation, and
dry mouth are side effects, EPS is the priority due to its severity.
Question 10: A nurse is assessing a client who has a suspected diagnosis of
meningitis. Which of the following findings is an indication of meningeal
irritation?
A. Brudzinski's sign
B. Babinski's sign
C. Chvostek's sign
D. Kernig's sign
CORRECT ANSWER: A. Brudzinski's sign
Rationale: Brudzinski's sign (involuntary flexion of the hips and knees when the neck is
flexed) and Kernig's sign are classic indicators of meningeal irritation, often seen in
meningitis. Babinski's sign indicates upper motor neuron damage, and Chvostek's sign
indicates hypocalcemia.
, Question 11: A nurse is providing education about a low-cholesterol diet to a
client with hyperlipidemia. Which of the following food choices by the client
indicates a need for further teaching?
A. Baked salmon
B. Oatmeal with fresh fruit
C. Scrambled eggs with cheese
D. Whole-grain toast with avocado
CORRECT ANSWER: C. Scrambled eggs with cheese
Rationale: Egg yolks and cheese are high in cholesterol and saturated fats, which should
be limited in a low-cholesterol diet. Salmon, oatmeal, and avocados are heart-healthy
choices that contain beneficial fats and fiber.
Question 12: A nurse is caring for a client who is receiving a heparin infusion
for a deep vein thrombosis. Which of the following laboratory values should
the nurse monitor to evaluate the effectiveness of the therapy?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
CORRECT ANSWER: C. Activated partial thromboplastin time (aPTT)
Rationale: Heparin's therapeutic effect is monitored using the aPTT. The target aPTT is
typically 1.5 to 2.5 times the control value. PT and INR monitor warfarin therapy, and
platelet count monitors for heparin-induced thrombocytopenia.
Question 13: A nurse is assessing a client who is 2 days post-operative
following a mastectomy. Which of the following findings should the nurse
report to the provider?
A. Serous drainage on the dressing
B. A temperature of 99.2°F (37.3°C)
C. Numbness in the upper arm
D. Pain of 3 on a 0-10 scale
CORRECT ANSWER: C. Numbness in the upper arm
Rationale: Numbness in the upper arm following a mastectomy could indicate nerve
damage, specifically injury to the brachial plexus or intercostobrachial nerve. This is a
significant finding that should be reported to the provider for further evaluation.
Question 14: A nurse is preparing to administer enoxaparin subcutaneously to
a client. Which of the following actions is correct?
A. Administer the medication into the deltoid muscle.
B. Massage the injection site after administration.
C. Administer the medication in the anterolateral abdominal wall.
D. Aspirate before injecting the medication.
CORRECT ANSWER: C. Administer the medication in the anterolateral
abdominal wall.
Rationale: Enoxaparin is administered subcutaneously into the anterolateral or
Updated 2026 | 190+ Questions and Answers | ATI
Comprehensive Predictor Comprehensive Study Guide,
Practice Exam, Exam Prep Test Bank, NCLEX-RN
Readiness, Fundamentals of Nursing, Medical-Surgical
Nursing, Pharmacology, Maternal-Newborn, Pediatrics,
Mental Health, Leadership & Management, Community
Health, Next Generation NCLEX (NGN), Detailed
Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who has a new diagnosis of type 1
diabetes mellitus. Which of the following findings indicates a therapeutic
response to insulin therapy?
A. Weight loss of 5 pounds in one week
B. Fasting blood glucose level of 95 mg/dL
C. Presence of ketones in the urine
D. A 1-hour postprandial glucose of 220 mg/dL
CORRECT ANSWER: B. Fasting blood glucose level of 95 mg/dL
Rationale: A therapeutic response to insulin therapy is indicated by blood glucose levels
within the target range. A fasting blood glucose of 95 mg/dL is within the recommended
range of 80-130 mg/dL for adults with diabetes, demonstrating effective glycemic
control. Weight loss, ketones, and elevated postprandial glucose indicate poor control.
Question 2: A nurse is preparing to administer a blood transfusion to a client.
Which of the following IV solutions should the nurse use to prime the blood
administration tubing?
A. 0.9% Sodium Chloride
B. 5% Dextrose in Water
C. Lactated Ringer's
D. 0.45% Sodium Chloride
CORRECT ANSWER: A. 0.9% Sodium Chloride
Rationale: Only 0.9% sodium chloride (normal saline) is compatible with blood products.
Dextrose solutions and Lactated Ringer's can cause hemolysis or clotting due to
changes in pH or calcium content. Hypotonic solutions can cause red blood cell lysis.
Question 3: A nurse is assessing a client who is 12 hours post-operative
following a total hip arthroplasty. Which of the following findings should the
nurse report to the provider immediately?
A. Heart rate of 88/min
B. Pain level of 4 on a scale of 0 to 10
C. Swelling of the operative extremity
D. Oxygen saturation of 89%
CORRECT ANSWER: D. Oxygen saturation of 89%
Rationale: An oxygen saturation of 89% indicates hypoxemia, which is a critical finding
,that requires immediate intervention. This could signify a pulmonary embolism, a major
risk following hip surgery, and must be reported to the provider stat.
Question 4: A nurse is performing a neurological assessment on a client.
Which of the following cranial nerves is the nurse testing when asking the
client to shrug their shoulders against resistance?
A. Cranial Nerve IX (Glossopharyngeal)
B. Cranial Nerve X (Vagus)
C. Cranial Nerve XI (Accessory)
D. Cranial Nerve XII (Hypoglossal)
CORRECT ANSWER: C. Cranial Nerve XI (Accessory)
Rationale: The accessory nerve (CN XI) innervates the sternocleidomastoid and
trapezius muscles, which are responsible for shoulder shrugging and head turning. CN
IX is for taste and swallowing, CN X is for parasympathetic functions, and CN XII is for
tongue movement.
Question 5: A nurse is providing discharge teaching to a client with heart
failure. Which of the following statements by the client indicates an
understanding of the teaching?
A. "I will weigh myself once a week."
B. "I can skip my diuretic if I feel dizzy."
C. "I should limit my daily sodium intake to 2 grams."
D. "I will notify my doctor if I gain 2 pounds in a day."
CORRECT ANSWER: D. I will notify my doctor if I gain 2 pounds in a day.
Rationale: A weight gain of 2-3 pounds in a day or 5 pounds in a week indicates fluid
retention and worsening heart failure, requiring immediate notification of the provider.
Daily, not weekly, weight monitoring is standard.
Question 6: A nurse is caring for a client with a chest tube attached to a water
seal drainage system. Which of the following actions is appropriate if the
drainage system is accidentally knocked over and the water seal is broken?
A. Clamp the chest tube immediately.
B. Place the end of the chest tube in a bottle of sterile water.
C. Reconnect the system to suction.
D. Notify the provider immediately.
CORRECT ANSWER: B. Place the end of the chest tube in a bottle of sterile
water.
Rationale: If the water seal is broken, the priority is to prevent air from entering the
pleural space. Placing the end of the tube in sterile water re-establishes the water seal.
Clamping the tube is avoided to prevent tension pneumothorax, though it may be briefly
done if necessary.
Question 7: A nurse is assessing a client who is receiving a continuous enteral
feeding via a nasogastric tube. Which of the following findings indicates a
complication of the feeding?
A. Gastric residual volume of 50 mL
,B. Blood glucose of 150 mg/dL
C. Bowel sounds present in all four quadrants
D. Respiratory rate of 28/min with crackles
CORRECT ANSWER: D. Respiratory rate of 28/min with crackles
Rationale: An increased respiratory rate with crackles indicates possible aspiration
pneumonia, a serious complication of enteral feeding. The other options are within
normal or acceptable ranges and do not indicate an immediate complication.
Question 8: A nurse is preparing a client for an intravenous pyelogram (IVP).
Which of the following client statements should the nurse report to the
provider?
A. "I am allergic to shellfish."
B. "I had a cup of coffee this morning."
C. "I took my blood pressure medication."
D. "I am feeling anxious about the test."
CORRECT ANSWER: A. I am allergic to shellfish.
Rationale: An allergy to shellfish is a contraindication for IVP due to the iodine-based
contrast media used. The contrast can cause a severe allergic reaction, including
anaphylaxis. The provider should be notified to consider alternative imaging or pre-
medication.
Question 9: A nurse is caring for a client who has a new prescription for
haloperidol. Which of the following adverse effects is the priority for the nurse
to monitor?
A. Sedation
B. Constipation
C. Extrapyramidal symptoms
D. Dry mouth
CORRECT ANSWER: C. Extrapyramidal symptoms
Rationale: Extrapyramidal symptoms (EPS), such as acute dystonia, parkinsonism, and
tardive dyskinesia, are serious and potentially irreversible adverse effects of haloperidol.
They require prompt assessment and intervention. While sedation, constipation, and
dry mouth are side effects, EPS is the priority due to its severity.
Question 10: A nurse is assessing a client who has a suspected diagnosis of
meningitis. Which of the following findings is an indication of meningeal
irritation?
A. Brudzinski's sign
B. Babinski's sign
C. Chvostek's sign
D. Kernig's sign
CORRECT ANSWER: A. Brudzinski's sign
Rationale: Brudzinski's sign (involuntary flexion of the hips and knees when the neck is
flexed) and Kernig's sign are classic indicators of meningeal irritation, often seen in
meningitis. Babinski's sign indicates upper motor neuron damage, and Chvostek's sign
indicates hypocalcemia.
, Question 11: A nurse is providing education about a low-cholesterol diet to a
client with hyperlipidemia. Which of the following food choices by the client
indicates a need for further teaching?
A. Baked salmon
B. Oatmeal with fresh fruit
C. Scrambled eggs with cheese
D. Whole-grain toast with avocado
CORRECT ANSWER: C. Scrambled eggs with cheese
Rationale: Egg yolks and cheese are high in cholesterol and saturated fats, which should
be limited in a low-cholesterol diet. Salmon, oatmeal, and avocados are heart-healthy
choices that contain beneficial fats and fiber.
Question 12: A nurse is caring for a client who is receiving a heparin infusion
for a deep vein thrombosis. Which of the following laboratory values should
the nurse monitor to evaluate the effectiveness of the therapy?
A. Prothrombin time (PT)
B. International normalized ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
CORRECT ANSWER: C. Activated partial thromboplastin time (aPTT)
Rationale: Heparin's therapeutic effect is monitored using the aPTT. The target aPTT is
typically 1.5 to 2.5 times the control value. PT and INR monitor warfarin therapy, and
platelet count monitors for heparin-induced thrombocytopenia.
Question 13: A nurse is assessing a client who is 2 days post-operative
following a mastectomy. Which of the following findings should the nurse
report to the provider?
A. Serous drainage on the dressing
B. A temperature of 99.2°F (37.3°C)
C. Numbness in the upper arm
D. Pain of 3 on a 0-10 scale
CORRECT ANSWER: C. Numbness in the upper arm
Rationale: Numbness in the upper arm following a mastectomy could indicate nerve
damage, specifically injury to the brachial plexus or intercostobrachial nerve. This is a
significant finding that should be reported to the provider for further evaluation.
Question 14: A nurse is preparing to administer enoxaparin subcutaneously to
a client. Which of the following actions is correct?
A. Administer the medication into the deltoid muscle.
B. Massage the injection site after administration.
C. Administer the medication in the anterolateral abdominal wall.
D. Aspirate before injecting the medication.
CORRECT ANSWER: C. Administer the medication in the anterolateral
abdominal wall.
Rationale: Enoxaparin is administered subcutaneously into the anterolateral or
