ATI CRITICAL THINKING PRACTICE EXAMINATION
2026–2027 — STUDY GUIDE | LATEST UPDATE
2026/2027 | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS | ALREADY GRADED A+
1. A nurse is caring for a client who develops sudden shortness of breath,
chest pain, and tachycardia. Which action should the nurse take first?
A) Administer prescribed pain medication
B) Obtain a full set of vital signs
C) Elevate the head of the bed and apply oxygen
D) Document the findings
Correct Answer: C
Airway and breathing are priorities in sudden respiratory distress. Elevating the
head of the bed and applying oxygen address hypoxemia immediately. Pain
medication and documentation are secondary. Vital signs are important but do not
replace oxygen administration.
2. A client with heart failure reports a weight gain of 3 kg in 2 days and
increasing dyspnea. Which nursing action is most appropriate?
A) Restrict fluids and notify the provider
B) Encourage the client to ambulate
C) Administer a prescribed diuretic
D) Document the findings and reassess in 24 hours
Correct Answer: A
Weight gain and worsening dyspnea indicate fluid retention and possible
decompensation. The nurse should restrict fluids as appropriate and notify the
provider. Ambulation may worsen dyspnea. A diuretic may be prescribed but
requires an order. Documenting and waiting is unsafe.
, 3. A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate?
A) Administering an oral medication
B) Performing a sterile dressing change
C) Ambulating a stable client in the hallway
D) Teaching a client about wound care
Correct Answer: C
UAPs can ambulate stable clients. Medication administration, sterile dressing
changes, and patient teaching require licensed nursing judgment and are not
within UAP scope.
4. A client with diabetes reports feeling shaky and diaphoretic. The nurse
checks a capillary blood glucose and finds it is 55 mg/dL. The client is alert
and able to swallow. What should the nurse do first?
A) Administer glucagon
B) Give 15 grams of fast-acting carbohydrate
C) Call a code blue
D) Provide a meal with complex carbohydrates
Correct Answer: B
For hypoglycemia in a conscious client who can swallow, give 15 grams of fast-
acting carbohydrate (e.g., 4 oz juice) and recheck in 15 minutes. Glucagon is for
unconscious clients. A code blue is unnecessary. Complex carbohydrates follow
stabilization.
5. A nurse is preparing to administer digoxin to a client. The apical pulse is 54
beats per minute. Which action should the nurse take?
A) Administer the digoxin as prescribed
B) Hold the digoxin and notify the provider
C) Give half the prescribed dose
D) Administer the digoxin with an antacid
Correct Answer: B
Digoxin should be held if the apical pulse is below 60 beats per minute, and the
,provider notified. Administering may cause bradycardia. The nurse cannot
independently change the dose. Antacids interfere with absorption.
6. A client is scheduled for a barium enema. Which instruction is most
important after the procedure?
A) Eat a heavy meal immediately
B) Take a laxative to remove barium
C) Restrict fluids for 24 hours
D) Avoid all activity
Correct Answer: B
After a barium enema, a laxative is often used to evacuate barium and prevent
impaction. Heavy meals and fluid restriction are not appropriate. Activity may be
resumed as tolerated.
7. A nurse is assessing a client with a suspected deep vein thrombosis. The left
calf is swollen, warm, and tender. Which action is most appropriate?
A) Massage the calf
B) Elevate the leg and notify the provider
C) Ambulate the client frequently
D) Apply a heating pad to the calf
Correct Answer: B
Elevation and provider notification are appropriate; massage and ambulation can
dislodge the clot. A heating pad may be used after the diagnosis is confirmed but
is not the first action.
8. A client with chronic obstructive pulmonary disease is receiving oxygen at 2
L/min via nasal cannula. The client's respirations decrease to 8 breaths per
minute, and the client is drowsy. What should the nurse do?
A) Increase oxygen to 4 L/min
B) Decrease oxygen to 1 L/min and notify the provider
C) Administer a bronchodilator
D) Place the client flat
, Correct Answer: B
In COPD with chronic CO₂ retention, excessive oxygen can suppress the hypoxic
drive. Reduce oxygen to the minimum needed to maintain SpO₂ 88–92% and notify
the provider. Increasing oxygen worsens hypoventilation.
9. A nurse is preparing to administer a blood transfusion. Which IV solution is
compatible for co-administration?
A) Dextrose 5% in water
B) Lactated Ringer’s
C) 0.9% sodium chloride
D) Dextrose 5% in 0.45% sodium chloride
Correct Answer: C
Only 0.9% sodium chloride is compatible with blood products. Dextrose solutions
cause hemolysis. Lactated Ringer’s contains calcium, which can cause clotting with
citrate in blood.
10.A client with a new colostomy is being taught about stoma care. Which
observation indicates a healthy stoma?
A) Dark purple and dry
B) Beefy red and moist
C) Pale pink and dry
D) Blue-tinged and cool
Correct Answer: B
A healthy stoma is moist and beefy red due to adequate blood supply. Dark purple
or blue-tinged indicates ischemia. Pale and dry suggests poor perfusion.
11.A nurse is caring for a client who is NPO for surgery and asks for a sip of
water. What is the best response?
A) “You may have a few ice chips.”
B) “You must remain NPO to prevent aspiration during anesthesia.”
C) “A small sip is safe.”
D) “You can drink clear liquids until 2 hours before surgery.”
2026–2027 — STUDY GUIDE | LATEST UPDATE
2026/2027 | PRACTICE QUESTIONS AND ANSWERS |
EXAM REVIEW | 100% CORRECT ANSWERS |
VERIFIED SOLUTIONS | ALREADY GRADED A+
1. A nurse is caring for a client who develops sudden shortness of breath,
chest pain, and tachycardia. Which action should the nurse take first?
A) Administer prescribed pain medication
B) Obtain a full set of vital signs
C) Elevate the head of the bed and apply oxygen
D) Document the findings
Correct Answer: C
Airway and breathing are priorities in sudden respiratory distress. Elevating the
head of the bed and applying oxygen address hypoxemia immediately. Pain
medication and documentation are secondary. Vital signs are important but do not
replace oxygen administration.
2. A client with heart failure reports a weight gain of 3 kg in 2 days and
increasing dyspnea. Which nursing action is most appropriate?
A) Restrict fluids and notify the provider
B) Encourage the client to ambulate
C) Administer a prescribed diuretic
D) Document the findings and reassess in 24 hours
Correct Answer: A
Weight gain and worsening dyspnea indicate fluid retention and possible
decompensation. The nurse should restrict fluids as appropriate and notify the
provider. Ambulation may worsen dyspnea. A diuretic may be prescribed but
requires an order. Documenting and waiting is unsafe.
, 3. A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task is appropriate?
A) Administering an oral medication
B) Performing a sterile dressing change
C) Ambulating a stable client in the hallway
D) Teaching a client about wound care
Correct Answer: C
UAPs can ambulate stable clients. Medication administration, sterile dressing
changes, and patient teaching require licensed nursing judgment and are not
within UAP scope.
4. A client with diabetes reports feeling shaky and diaphoretic. The nurse
checks a capillary blood glucose and finds it is 55 mg/dL. The client is alert
and able to swallow. What should the nurse do first?
A) Administer glucagon
B) Give 15 grams of fast-acting carbohydrate
C) Call a code blue
D) Provide a meal with complex carbohydrates
Correct Answer: B
For hypoglycemia in a conscious client who can swallow, give 15 grams of fast-
acting carbohydrate (e.g., 4 oz juice) and recheck in 15 minutes. Glucagon is for
unconscious clients. A code blue is unnecessary. Complex carbohydrates follow
stabilization.
5. A nurse is preparing to administer digoxin to a client. The apical pulse is 54
beats per minute. Which action should the nurse take?
A) Administer the digoxin as prescribed
B) Hold the digoxin and notify the provider
C) Give half the prescribed dose
D) Administer the digoxin with an antacid
Correct Answer: B
Digoxin should be held if the apical pulse is below 60 beats per minute, and the
,provider notified. Administering may cause bradycardia. The nurse cannot
independently change the dose. Antacids interfere with absorption.
6. A client is scheduled for a barium enema. Which instruction is most
important after the procedure?
A) Eat a heavy meal immediately
B) Take a laxative to remove barium
C) Restrict fluids for 24 hours
D) Avoid all activity
Correct Answer: B
After a barium enema, a laxative is often used to evacuate barium and prevent
impaction. Heavy meals and fluid restriction are not appropriate. Activity may be
resumed as tolerated.
7. A nurse is assessing a client with a suspected deep vein thrombosis. The left
calf is swollen, warm, and tender. Which action is most appropriate?
A) Massage the calf
B) Elevate the leg and notify the provider
C) Ambulate the client frequently
D) Apply a heating pad to the calf
Correct Answer: B
Elevation and provider notification are appropriate; massage and ambulation can
dislodge the clot. A heating pad may be used after the diagnosis is confirmed but
is not the first action.
8. A client with chronic obstructive pulmonary disease is receiving oxygen at 2
L/min via nasal cannula. The client's respirations decrease to 8 breaths per
minute, and the client is drowsy. What should the nurse do?
A) Increase oxygen to 4 L/min
B) Decrease oxygen to 1 L/min and notify the provider
C) Administer a bronchodilator
D) Place the client flat
, Correct Answer: B
In COPD with chronic CO₂ retention, excessive oxygen can suppress the hypoxic
drive. Reduce oxygen to the minimum needed to maintain SpO₂ 88–92% and notify
the provider. Increasing oxygen worsens hypoventilation.
9. A nurse is preparing to administer a blood transfusion. Which IV solution is
compatible for co-administration?
A) Dextrose 5% in water
B) Lactated Ringer’s
C) 0.9% sodium chloride
D) Dextrose 5% in 0.45% sodium chloride
Correct Answer: C
Only 0.9% sodium chloride is compatible with blood products. Dextrose solutions
cause hemolysis. Lactated Ringer’s contains calcium, which can cause clotting with
citrate in blood.
10.A client with a new colostomy is being taught about stoma care. Which
observation indicates a healthy stoma?
A) Dark purple and dry
B) Beefy red and moist
C) Pale pink and dry
D) Blue-tinged and cool
Correct Answer: B
A healthy stoma is moist and beefy red due to adequate blood supply. Dark purple
or blue-tinged indicates ischemia. Pale and dry suggests poor perfusion.
11.A nurse is caring for a client who is NPO for surgery and asks for a sip of
water. What is the best response?
A) “You may have a few ice chips.”
B) “You must remain NPO to prevent aspiration during anesthesia.”
C) “A small sip is safe.”
D) “You can drink clear liquids until 2 hours before surgery.”
