ATI RN Comprehensive Predictor 2026 — Original
Prac ce Ques ons & Detailed Ra onales
1. Fundamentals — Infection Control
A nurse is caring for a client who has Clostridioides difficile infection. Which action should the
nurse take?
A. Use alcohol-based hand sanitizer after removing gloves.
B. Place the client in a negative-pressure room.
C. Wash hands with soap and water after removing gloves.
D. Wear an N95 respirator when entering the room.
Answer: C
Rationale: C. difficile spores are not reliably removed by alcohol-based hand sanitizer. Soap
and water should be used after caring for a client with C. difficile. Negative-pressure rooms and
N95 respirators are associated with airborne precautions, not routine C. difficile care.
2. Fundamentals — Safety
A nurse enters a client's room and finds the client lying on the floor. What should the nurse do
first?
A. Notify the provider.
B. Assess the client for injury.
C. Complete an incident report.
D. Help the client back into bed.
Answer: B
Rationale: The nurse's priority is assessment of the client for injury, including airway, breathing,
circulation, neurologic status, and possible musculoskeletal injury. Moving the client before
assessment could worsen an injury.
3. Pharmacology — Digoxin
,A nurse is preparing to administer digoxin to an adult client. Which finding requires the nurse to
withhold the medication?
A. Apical pulse 56/min
B. Respiratory rate 18/min
C. Blood pressure 128/76 mm Hg
D. Potassium 4.2 mEq/L
Answer: A
Rationale: Digoxin can cause bradycardia. An adult client's apical pulse should generally be at
least 60/min before administration unless otherwise prescribed. A pulse of 56/min requires
withholding the medication and notifying the provider.
4. Adult Medical-Surgical — Heart Failure
A client with heart failure reports increasing shortness of breath and has bilateral crackles.
Which action should the nurse take first?
A. Encourage oral fluids.
B. Place the client in high-Fowler's position.
C. Obtain the client's daily weight.
D. Restrict dietary sodium.
Answer: B
Rationale: High-Fowler's positioning improves lung expansion and decreases venous return,
which can reduce pulmonary congestion and improve breathing. Airway and breathing take
priority over routine monitoring or dietary interventions.
5. Maternal-Newborn — Fetal Monitoring
A pregnant client receiving oxytocin has recurrent late fetal heart rate decelerations. Which
action should the nurse take first?
A. Increase the oxytocin infusion.
B. Place the client supine.
C. Stop the oxytocin infusion.
D. Encourage the client to push.
Answer: C
,Rationale: Oxytocin can increase uterine contractions and worsen uteroplacental insufficiency.
The nurse should stop the infusion and initiate appropriate intrauterine resuscitation measures.
6. Pediatrics — Respiratory
A child with suspected epiglottitis is sitting upright, drooling, and experiencing respiratory
distress. Which action should the nurse take?
A. Inspect the throat with a tongue blade.
B. Place the child supine.
C. Keep the child calm and prepare for airway management.
D. Obtain a throat culture immediately.
Answer: C
Rationale: Epiglottitis can cause sudden, life-threatening airway obstruction. The child should
be kept calm and airway equipment and experienced personnel should be prepared. Throat
inspection can trigger complete airway obstruction.
7. Mental Health — Therapeutic Communication
A client says, "Nobody cares about me anymore." Which response is most therapeutic?
A. "You shouldn't feel that way."
B. "Why do you think nobody cares?"
C. "Tell me more about what makes you feel that way."
D. "Your family probably cares about you."
Answer: C
Rationale: This response encourages the client to explore feelings without judgment. The other
responses minimize feelings, ask a potentially challenging "why" question, or provide
reassurance without addressing the client's concerns.
8. Pharmacology — Warfarin
Which laboratory value is most important for a nurse to monitor for a client receiving warfarin?
A. aPTT
B. INR
, C. Platelet count only
D. Serum sodium
Answer: B
Rationale: INR is used to monitor the therapeutic effect of warfarin and guide dosing. aPTT is
primarily used for unfractionated heparin therapy.
9. Leadership — Delegation
Which task is appropriate for the nurse to delegate to an assistive personnel (AP)?
A. Assessing a client with new chest pain
B. Teaching a client how to use an incentive spirometer
C. Obtaining vital signs for a stable client
D. Evaluating a client's response to medication
Answer: C
Rationale: Obtaining routine vital signs for a stable client is within the typical role of AP
personnel. Assessment, teaching, and evaluation require nursing judgment.
10. Adult Medical-Surgical — COPD
A client with COPD is receiving oxygen. Which oxygen prescription should the nurse question?
A. Oxygen at 1 L/min by nasal cannula
B. Oxygen at 2 L/min by nasal cannula
C. Oxygen titrated according to prescribed target saturation
D. Oxygen at 10 L/min by nonrebreather mask for a stable client without acute distress
Answer: D
Rationale: A high-flow nonrebreather mask is not a routine oxygen delivery method for a stable
client with COPD. Oxygen therapy should be carefully titrated according to the client's
condition and prescribed target.
11. Fundamentals — Pressure Injury Prevention
Which intervention is most appropriate for preventing pressure injuries in an immobile client?
Prac ce Ques ons & Detailed Ra onales
1. Fundamentals — Infection Control
A nurse is caring for a client who has Clostridioides difficile infection. Which action should the
nurse take?
A. Use alcohol-based hand sanitizer after removing gloves.
B. Place the client in a negative-pressure room.
C. Wash hands with soap and water after removing gloves.
D. Wear an N95 respirator when entering the room.
Answer: C
Rationale: C. difficile spores are not reliably removed by alcohol-based hand sanitizer. Soap
and water should be used after caring for a client with C. difficile. Negative-pressure rooms and
N95 respirators are associated with airborne precautions, not routine C. difficile care.
2. Fundamentals — Safety
A nurse enters a client's room and finds the client lying on the floor. What should the nurse do
first?
A. Notify the provider.
B. Assess the client for injury.
C. Complete an incident report.
D. Help the client back into bed.
Answer: B
Rationale: The nurse's priority is assessment of the client for injury, including airway, breathing,
circulation, neurologic status, and possible musculoskeletal injury. Moving the client before
assessment could worsen an injury.
3. Pharmacology — Digoxin
,A nurse is preparing to administer digoxin to an adult client. Which finding requires the nurse to
withhold the medication?
A. Apical pulse 56/min
B. Respiratory rate 18/min
C. Blood pressure 128/76 mm Hg
D. Potassium 4.2 mEq/L
Answer: A
Rationale: Digoxin can cause bradycardia. An adult client's apical pulse should generally be at
least 60/min before administration unless otherwise prescribed. A pulse of 56/min requires
withholding the medication and notifying the provider.
4. Adult Medical-Surgical — Heart Failure
A client with heart failure reports increasing shortness of breath and has bilateral crackles.
Which action should the nurse take first?
A. Encourage oral fluids.
B. Place the client in high-Fowler's position.
C. Obtain the client's daily weight.
D. Restrict dietary sodium.
Answer: B
Rationale: High-Fowler's positioning improves lung expansion and decreases venous return,
which can reduce pulmonary congestion and improve breathing. Airway and breathing take
priority over routine monitoring or dietary interventions.
5. Maternal-Newborn — Fetal Monitoring
A pregnant client receiving oxytocin has recurrent late fetal heart rate decelerations. Which
action should the nurse take first?
A. Increase the oxytocin infusion.
B. Place the client supine.
C. Stop the oxytocin infusion.
D. Encourage the client to push.
Answer: C
,Rationale: Oxytocin can increase uterine contractions and worsen uteroplacental insufficiency.
The nurse should stop the infusion and initiate appropriate intrauterine resuscitation measures.
6. Pediatrics — Respiratory
A child with suspected epiglottitis is sitting upright, drooling, and experiencing respiratory
distress. Which action should the nurse take?
A. Inspect the throat with a tongue blade.
B. Place the child supine.
C. Keep the child calm and prepare for airway management.
D. Obtain a throat culture immediately.
Answer: C
Rationale: Epiglottitis can cause sudden, life-threatening airway obstruction. The child should
be kept calm and airway equipment and experienced personnel should be prepared. Throat
inspection can trigger complete airway obstruction.
7. Mental Health — Therapeutic Communication
A client says, "Nobody cares about me anymore." Which response is most therapeutic?
A. "You shouldn't feel that way."
B. "Why do you think nobody cares?"
C. "Tell me more about what makes you feel that way."
D. "Your family probably cares about you."
Answer: C
Rationale: This response encourages the client to explore feelings without judgment. The other
responses minimize feelings, ask a potentially challenging "why" question, or provide
reassurance without addressing the client's concerns.
8. Pharmacology — Warfarin
Which laboratory value is most important for a nurse to monitor for a client receiving warfarin?
A. aPTT
B. INR
, C. Platelet count only
D. Serum sodium
Answer: B
Rationale: INR is used to monitor the therapeutic effect of warfarin and guide dosing. aPTT is
primarily used for unfractionated heparin therapy.
9. Leadership — Delegation
Which task is appropriate for the nurse to delegate to an assistive personnel (AP)?
A. Assessing a client with new chest pain
B. Teaching a client how to use an incentive spirometer
C. Obtaining vital signs for a stable client
D. Evaluating a client's response to medication
Answer: C
Rationale: Obtaining routine vital signs for a stable client is within the typical role of AP
personnel. Assessment, teaching, and evaluation require nursing judgment.
10. Adult Medical-Surgical — COPD
A client with COPD is receiving oxygen. Which oxygen prescription should the nurse question?
A. Oxygen at 1 L/min by nasal cannula
B. Oxygen at 2 L/min by nasal cannula
C. Oxygen titrated according to prescribed target saturation
D. Oxygen at 10 L/min by nonrebreather mask for a stable client without acute distress
Answer: D
Rationale: A high-flow nonrebreather mask is not a routine oxygen delivery method for a stable
client with COPD. Oxygen therapy should be carefully titrated according to the client's
condition and prescribed target.
11. Fundamentals — Pressure Injury Prevention
Which intervention is most appropriate for preventing pressure injuries in an immobile client?
