VATI PN Comprehensive Predictor 2026/2027
| Virtual-ATI Practical Nursing
Comprehensive Predictor Exam Study Guide,
Practice Questions & Answers, PN NCLEX
Readiness, Nursing Fundamentals,
Pharmacology, Medical-Surgical, Maternal-
Newborn, Pediatrics, Mental Health,
Leadership & Detailed Rationales
Question 1: A nurse is reinforcing teaching with a client who has a new
prescription for sublingual nitroglycerin. Which of the following client
statements indicates an understanding of the teaching?
A. "I should swallow the tablet with a full glass of water."
B. "I will call 911 if the pain is not relieved after taking one tablet."
C. "I should take this medication immediately before meals."
D. "I will store the tablets in the refrigerator to keep them fresh."
CORRECT ANSWER: B. "I will call 911 if the pain is not relieved after
taking one tablet."
Rationale: Sublingual nitroglycerin is used to relieve anginal pain. If chest
pain persists after taking one sublingual tablet, the client should call 911
immediately as this may indicate an acute myocardial infarction. Option A
is incorrect because sublingual tablets are placed under the tongue and
allowed to dissolve, not swallowed. Option C is incorrect as nitroglycerin is
taken at the onset of chest pain, not prophylactically before meals. Option
D is incorrect because nitroglycerin tablets should be stored in a dark,
glass container at room temperature, not refrigerated.
Question 2: A nurse is caring for a client who is receiving a blood
transfusion. Which of the following findings should the nurse identify
as the priority to report to the provider?
A. Temperature of 100.4° F (38° C)
B. Urticaria and itching
C. Blood pressure of 90/60 mm Hg
D. Client report of mild nausea
CORRECT ANSWER: C. Blood pressure of 90/60 mm Hg
,Rationale: A drop in blood pressure during a blood transfusion is a sign of a
hemolytic transfusion reaction, which is a life-threatening emergency
requiring immediate cessation of the transfusion and provider notification.
While fever and urticaria are also signs of transfusion reactions,
hypotension indicates possible hemolysis and cardiovascular
compromise. Mild nausea is a common, less urgent finding.
Question 3: A nurse is planning care for a client who has a new
colostomy. Which of the following actions should the nurse include to
promote stoma health?
A. Apply petroleum jelly around the stoma to protect the skin.
B. Cleanse the stoma with alcohol-based wipes daily.
C. Ensure the skin barrier fits snugly around the stoma.
D. Change the ostomy pouch every 12 hours regardless of leakage.
CORRECT ANSWER: C. Ensure the skin barrier fits snugly around the
stoma.
Rationale: A properly fitted skin barrier prevents leakage of stool onto
peristomal skin, which protects against irritation and breakdown,
promoting stoma health. Petroleum jelly can interfere with the adhesive
seal. Alcohol-based wipes are drying and irritating to the stoma. Changing
the pouch every 12 hours is too frequent and unnecessary unless leakage
occurs, as it can damage the skin.
Question 4: A nurse is assessing a client who is 24 hours postoperative
following an abdominal hysterectomy. Which of the following findings
should the nurse report to the provider?
A. Serosanguineous drainage on the abdominal dressing.
B. Urine output of 100 mL over the past 4 hours.
C. Pain rating of 4 on a scale of 0 to 10.
D. Temperature of 99.2° F (37.3° C).
CORRECT ANSWER: B. Urine output of 100 mL over the past 4 hours.
Rationale: Urine output of less than 30 mL per hour indicates inadequate
renal perfusion and possible hypovolemia or urinary retention, which
requires provider notification. Serosanguineous drainage is an expected
finding in the immediate postoperative period. A pain rating of 4 indicates
moderate pain that can be managed with prescribed analgesics. A low-
,grade temperature elevation is common after surgery due to the
inflammatory response.
Question 5: A nurse is reinforcing teaching with a client who has type 2
diabetes mellitus about foot care. Which of the following instructions
should the nurse include?
A. Soak the feet in warm water for 30 minutes daily.
B. Apply lotion between the toes after bathing.
C. Inspect the feet daily for cuts, blisters, and redness.
D. Cut toenails in a rounded shape to prevent ingrown nails.
CORRECT ANSWER: C. Inspect the feet daily for cuts, blisters, and
redness.
Rationale: Clients with diabetes have decreased sensation and circulation
in the feet, making daily inspection essential to detect injuries early and
prevent complications such as ulcers and infection. Soaking feet can lead
to maceration and infection. Lotion should not be applied between the toes
as moisture promotes fungal growth. Toenails should be cut straight
across, not rounded, to prevent ingrown nails.
Question 6: A nurse is caring for a client who has chronic obstructive
pulmonary disease (COPD) and is receiving oxygen at 2 L/min via nasal
cannula. Which of the following findings indicates the need for
immediate intervention?
A. Oxygen saturation of 90%.
B. Respiratory rate of 22 breaths/min.
C. Client report of headache and confusion.
D. Use of accessory muscles for breathing.
CORRECT ANSWER: C. Client report of headache and confusion.
Rationale: In clients with COPD, the drive to breathe is often stimulated by
low oxygen levels rather than high carbon dioxide. Excessive oxygen can
suppress this drive, leading to hypoventilation and carbon dioxide retention
(hypercapnia). Headache and confusion are early signs of hypercapnia and
require immediate intervention. An oxygen saturation of 90% is acceptable
for a client with COPD. A respiratory rate of 22 and accessory muscle use
indicate respiratory effort but are not immediately life-threatening.
, Question 7: A nurse is preparing to administer insulin lispro to a client.
The nurse should identify that the onset of action for this medication is
which of the following?
A. 15 to 30 minutes.
B. 1 to 2 hours.
C. 2 to 4 hours.
D. 4 to 6 hours.
CORRECT ANSWER: A. 15 to 30 minutes.
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action of
15 to 30 minutes. It peaks in 30 minutes to 2.5 hours and has a duration of 3
to 6 hours. This is important for timing meals, as the client should eat
within 15 minutes of administration to prevent hypoglycemia.
Question 8: A nurse is caring for a client who has a new prescription for
furosemide. Which of the following laboratory values should the nurse
monitor most closely?
A. Sodium level of 140 mEq/L.
B. Potassium level of 3.2 mEq/L.
C. Calcium level of 9.5 mg/dL.
D. Magnesium level of 2.0 mg/dL.
CORRECT ANSWER: B. Potassium level of 3.2 mEq/L.
Rationale: Furosemide is a loop diuretic that causes potassium loss,
leading to hypokalemia. A potassium level of 3.2 mEq/L is below the
normal range of 3.5 to 5.0 mEq/L and places the client at risk for cardiac
arrhythmias. The nurse should monitor potassium levels closely and
anticipate interventions such as potassium supplementation or dietary
modifications. Sodium, calcium, and magnesium levels are not as directly
affected by furosemide.
Question 9: A nurse is reinforcing teaching with a client who has a new
prescription for warfarin. Which of the following statements by the
client indicates a need for further teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I can take ibuprofen for my headaches."
C. "I will report any unusual bruising or bleeding to my doctor."
D. "I will use a soft-bristled toothbrush."
| Virtual-ATI Practical Nursing
Comprehensive Predictor Exam Study Guide,
Practice Questions & Answers, PN NCLEX
Readiness, Nursing Fundamentals,
Pharmacology, Medical-Surgical, Maternal-
Newborn, Pediatrics, Mental Health,
Leadership & Detailed Rationales
Question 1: A nurse is reinforcing teaching with a client who has a new
prescription for sublingual nitroglycerin. Which of the following client
statements indicates an understanding of the teaching?
A. "I should swallow the tablet with a full glass of water."
B. "I will call 911 if the pain is not relieved after taking one tablet."
C. "I should take this medication immediately before meals."
D. "I will store the tablets in the refrigerator to keep them fresh."
CORRECT ANSWER: B. "I will call 911 if the pain is not relieved after
taking one tablet."
Rationale: Sublingual nitroglycerin is used to relieve anginal pain. If chest
pain persists after taking one sublingual tablet, the client should call 911
immediately as this may indicate an acute myocardial infarction. Option A
is incorrect because sublingual tablets are placed under the tongue and
allowed to dissolve, not swallowed. Option C is incorrect as nitroglycerin is
taken at the onset of chest pain, not prophylactically before meals. Option
D is incorrect because nitroglycerin tablets should be stored in a dark,
glass container at room temperature, not refrigerated.
Question 2: A nurse is caring for a client who is receiving a blood
transfusion. Which of the following findings should the nurse identify
as the priority to report to the provider?
A. Temperature of 100.4° F (38° C)
B. Urticaria and itching
C. Blood pressure of 90/60 mm Hg
D. Client report of mild nausea
CORRECT ANSWER: C. Blood pressure of 90/60 mm Hg
,Rationale: A drop in blood pressure during a blood transfusion is a sign of a
hemolytic transfusion reaction, which is a life-threatening emergency
requiring immediate cessation of the transfusion and provider notification.
While fever and urticaria are also signs of transfusion reactions,
hypotension indicates possible hemolysis and cardiovascular
compromise. Mild nausea is a common, less urgent finding.
Question 3: A nurse is planning care for a client who has a new
colostomy. Which of the following actions should the nurse include to
promote stoma health?
A. Apply petroleum jelly around the stoma to protect the skin.
B. Cleanse the stoma with alcohol-based wipes daily.
C. Ensure the skin barrier fits snugly around the stoma.
D. Change the ostomy pouch every 12 hours regardless of leakage.
CORRECT ANSWER: C. Ensure the skin barrier fits snugly around the
stoma.
Rationale: A properly fitted skin barrier prevents leakage of stool onto
peristomal skin, which protects against irritation and breakdown,
promoting stoma health. Petroleum jelly can interfere with the adhesive
seal. Alcohol-based wipes are drying and irritating to the stoma. Changing
the pouch every 12 hours is too frequent and unnecessary unless leakage
occurs, as it can damage the skin.
Question 4: A nurse is assessing a client who is 24 hours postoperative
following an abdominal hysterectomy. Which of the following findings
should the nurse report to the provider?
A. Serosanguineous drainage on the abdominal dressing.
B. Urine output of 100 mL over the past 4 hours.
C. Pain rating of 4 on a scale of 0 to 10.
D. Temperature of 99.2° F (37.3° C).
CORRECT ANSWER: B. Urine output of 100 mL over the past 4 hours.
Rationale: Urine output of less than 30 mL per hour indicates inadequate
renal perfusion and possible hypovolemia or urinary retention, which
requires provider notification. Serosanguineous drainage is an expected
finding in the immediate postoperative period. A pain rating of 4 indicates
moderate pain that can be managed with prescribed analgesics. A low-
,grade temperature elevation is common after surgery due to the
inflammatory response.
Question 5: A nurse is reinforcing teaching with a client who has type 2
diabetes mellitus about foot care. Which of the following instructions
should the nurse include?
A. Soak the feet in warm water for 30 minutes daily.
B. Apply lotion between the toes after bathing.
C. Inspect the feet daily for cuts, blisters, and redness.
D. Cut toenails in a rounded shape to prevent ingrown nails.
CORRECT ANSWER: C. Inspect the feet daily for cuts, blisters, and
redness.
Rationale: Clients with diabetes have decreased sensation and circulation
in the feet, making daily inspection essential to detect injuries early and
prevent complications such as ulcers and infection. Soaking feet can lead
to maceration and infection. Lotion should not be applied between the toes
as moisture promotes fungal growth. Toenails should be cut straight
across, not rounded, to prevent ingrown nails.
Question 6: A nurse is caring for a client who has chronic obstructive
pulmonary disease (COPD) and is receiving oxygen at 2 L/min via nasal
cannula. Which of the following findings indicates the need for
immediate intervention?
A. Oxygen saturation of 90%.
B. Respiratory rate of 22 breaths/min.
C. Client report of headache and confusion.
D. Use of accessory muscles for breathing.
CORRECT ANSWER: C. Client report of headache and confusion.
Rationale: In clients with COPD, the drive to breathe is often stimulated by
low oxygen levels rather than high carbon dioxide. Excessive oxygen can
suppress this drive, leading to hypoventilation and carbon dioxide retention
(hypercapnia). Headache and confusion are early signs of hypercapnia and
require immediate intervention. An oxygen saturation of 90% is acceptable
for a client with COPD. A respiratory rate of 22 and accessory muscle use
indicate respiratory effort but are not immediately life-threatening.
, Question 7: A nurse is preparing to administer insulin lispro to a client.
The nurse should identify that the onset of action for this medication is
which of the following?
A. 15 to 30 minutes.
B. 1 to 2 hours.
C. 2 to 4 hours.
D. 4 to 6 hours.
CORRECT ANSWER: A. 15 to 30 minutes.
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action of
15 to 30 minutes. It peaks in 30 minutes to 2.5 hours and has a duration of 3
to 6 hours. This is important for timing meals, as the client should eat
within 15 minutes of administration to prevent hypoglycemia.
Question 8: A nurse is caring for a client who has a new prescription for
furosemide. Which of the following laboratory values should the nurse
monitor most closely?
A. Sodium level of 140 mEq/L.
B. Potassium level of 3.2 mEq/L.
C. Calcium level of 9.5 mg/dL.
D. Magnesium level of 2.0 mg/dL.
CORRECT ANSWER: B. Potassium level of 3.2 mEq/L.
Rationale: Furosemide is a loop diuretic that causes potassium loss,
leading to hypokalemia. A potassium level of 3.2 mEq/L is below the
normal range of 3.5 to 5.0 mEq/L and places the client at risk for cardiac
arrhythmias. The nurse should monitor potassium levels closely and
anticipate interventions such as potassium supplementation or dietary
modifications. Sodium, calcium, and magnesium levels are not as directly
affected by furosemide.
Question 9: A nurse is reinforcing teaching with a client who has a new
prescription for warfarin. Which of the following statements by the
client indicates a need for further teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I can take ibuprofen for my headaches."
C. "I will report any unusual bruising or bleeding to my doctor."
D. "I will use a soft-bristled toothbrush."
