Virtual ATI / Green Light 2026/2027 | Virtual-
ATI NCLEX Review Study Guide | Green Light
NCLEX Exam Prep, Practice Questions &
Answers
VIRTUAL ATI / GREEN LIGHT 2026/2027 - NCLEX REVIEW PRACTICE EXAM
DOCUMENT OVERVIEW
• This comprehensive 200-question practice exam mirrors the structure and
content distribution of the actual NCLEX-RN examination, providing authentic test
conditions and building confidence through repeated exposure to high-yield
nursing concepts and clinical scenarios.
• Study this material by working through questions in timed blocks (50 questions
per session), reviewing each rationale thoroughly regardless of whether you
answered correctly, and tracking your performance across content areas to identify
knowledge gaps requiring additional study.
PRACTICE EXAM - 200 QUESTIONS
1. A nurse is assessing a client with acute myocardial infarction who is
experiencing chest pain. Which assessment finding would be the PRIORITY for
the nurse to monitor?
A) Blood pressure of 120/80 mmHg
B) Heart rate of 88 beats per minute
C) Cardiac rhythm and ST segment changes on ECG
D) Respiratory rate of 16 breaths per minute
E) Oxygen saturation of 96% on room air
CORRECT ANSWER: C) Cardiac rhythm and ST segment changes on ECG
Rationale: In acute myocardial infarction, monitoring cardiac rhythm and ST
segment changes on the ECG is the priority assessment. ST segment elevation or
depression indicates myocardial injury and helps determine the extent and location
,of the infarction. This information guides immediate treatment decisions including
thrombolytic therapy or percutaneous coronary intervention. While the other vital
signs are important, identifying the specific cardiac changes determines the
urgency and type of intervention needed.
2. A client newly diagnosed with type 2 diabetes is receiving education about
dietary management. Which statement by the client indicates understanding
of appropriate carbohydrate intake?
A) "I should completely eliminate all carbohydrates from my diet"
B) "I should choose complex carbohydrates and monitor portion sizes"
C) "Carbohydrates are not important for blood glucose management"
D) "I can eat unlimited amounts of fruit because it is natural"
E) "White bread and pasta are the best choices for my diet"
CORRECT ANSWER: B) "I should choose complex carbohydrates and monitor
portion sizes"
Rationale: Complex carbohydrates with fiber (whole grains, vegetables, legumes)
are metabolized more slowly, resulting in a gradual increase in blood glucose.
Portion control is essential for preventing blood glucose spikes. Eliminating
carbohydrates entirely is unnecessary and unhealthy. While fruit has nutritional
value, portion control remains important as natural sugars affect blood glucose.
Refined carbohydrates like white bread and pasta cause rapid blood glucose
elevation and should be limited.
3. A nurse is preparing a client for surgery. The client states, "I am very
nervous about this surgery." Which response by the nurse would be MOST
therapeutic?
A) "Don't worry; this is a very common procedure"
B) "Your surgeon is very experienced, so everything will be fine"
,C) "Tell me more about your specific concerns regarding the surgery"
D) "Everyone feels nervous before surgery; it will pass"
E) "You should have asked questions before signing the consent form"
CORRECT ANSWER: C) "Tell me more about your specific concerns regarding
the surgery"
Rationale: Using open-ended questions and active listening allows the client to
express feelings and concerns. This therapeutic communication technique
demonstrates empathy and helps the nurse identify specific fears that can be
addressed with education or support. Minimizing feelings ("don't worry"), giving
false reassurance, or using clichés does not address the client's actual concerns and
diminishes the therapeutic relationship. Blaming the client is inappropriate and
non-therapeutic.
4. A client with chronic kidney disease is prescribed a potassium-restricted
diet. Which food choice indicates the client understands the dietary
restriction?
A) A baked potato with skin
B) Orange juice and a banana
C) Boiled chicken breast with white rice
D) Spinach salad with tomatoes
E) Dried apricots and almonds
CORRECT ANSWER: C) Boiled chicken breast with white rice
Rationale: Boiled chicken breast and white rice are both low in potassium and
appropriate for a potassium-restricted diet. Potassium-rich foods to avoid include
potatoes with skin, citrus juices, bananas, dark leafy greens (spinach), tomatoes,
and dried fruits. Clients with chronic kidney disease have impaired ability to excrete
potassium, placing them at risk for hyperkalemia, which can cause cardiac
dysrhythmias.
, 5. A nurse is administering intravenous medication to a client. After injecting
the medication through an intravenous line, the client reports pain at the IV
site and swelling is noted. Which action should the nurse take FIRST?
A) Continue monitoring the IV site and notify the provider at the end of the shift
B) Immediately discontinue the IV and restart in another location
C) Apply a warm compress to reduce the swelling
D) Slow the infusion rate to minimize discomfort
E) Administer pain medication intravenously
CORRECT ANSWER: B) Immediately discontinue the IV and restart in another
location
Rationale: Pain and swelling at an IV site during medication infusion suggest
infiltration, extravasation, or phlebitis. The nurse must immediately stop the
infusion to prevent further tissue damage, particularly with certain medications
that can cause severe tissue necrosis if extravasated (chemotherapy agents,
vasopressors, hypertonic solutions). The IV should be discontinued, the site
documented, and a new line started in an unaffected area. Warm compresses
should not be applied without first assessing the type of infiltrate, as this could
worsen the situation with certain medications.
6. A client with a history of hypertension is taking lisinopril, an ACE inhibitor.
Which side effect requires the client to notify the provider immediately?
A) Dry cough lasting several weeks
B) Dizziness when changing positions
C) Swelling of the lips, face, and tongue
D) Slight decrease in appetite
E) Mild fatigue in the morning
ATI NCLEX Review Study Guide | Green Light
NCLEX Exam Prep, Practice Questions &
Answers
VIRTUAL ATI / GREEN LIGHT 2026/2027 - NCLEX REVIEW PRACTICE EXAM
DOCUMENT OVERVIEW
• This comprehensive 200-question practice exam mirrors the structure and
content distribution of the actual NCLEX-RN examination, providing authentic test
conditions and building confidence through repeated exposure to high-yield
nursing concepts and clinical scenarios.
• Study this material by working through questions in timed blocks (50 questions
per session), reviewing each rationale thoroughly regardless of whether you
answered correctly, and tracking your performance across content areas to identify
knowledge gaps requiring additional study.
PRACTICE EXAM - 200 QUESTIONS
1. A nurse is assessing a client with acute myocardial infarction who is
experiencing chest pain. Which assessment finding would be the PRIORITY for
the nurse to monitor?
A) Blood pressure of 120/80 mmHg
B) Heart rate of 88 beats per minute
C) Cardiac rhythm and ST segment changes on ECG
D) Respiratory rate of 16 breaths per minute
E) Oxygen saturation of 96% on room air
CORRECT ANSWER: C) Cardiac rhythm and ST segment changes on ECG
Rationale: In acute myocardial infarction, monitoring cardiac rhythm and ST
segment changes on the ECG is the priority assessment. ST segment elevation or
depression indicates myocardial injury and helps determine the extent and location
,of the infarction. This information guides immediate treatment decisions including
thrombolytic therapy or percutaneous coronary intervention. While the other vital
signs are important, identifying the specific cardiac changes determines the
urgency and type of intervention needed.
2. A client newly diagnosed with type 2 diabetes is receiving education about
dietary management. Which statement by the client indicates understanding
of appropriate carbohydrate intake?
A) "I should completely eliminate all carbohydrates from my diet"
B) "I should choose complex carbohydrates and monitor portion sizes"
C) "Carbohydrates are not important for blood glucose management"
D) "I can eat unlimited amounts of fruit because it is natural"
E) "White bread and pasta are the best choices for my diet"
CORRECT ANSWER: B) "I should choose complex carbohydrates and monitor
portion sizes"
Rationale: Complex carbohydrates with fiber (whole grains, vegetables, legumes)
are metabolized more slowly, resulting in a gradual increase in blood glucose.
Portion control is essential for preventing blood glucose spikes. Eliminating
carbohydrates entirely is unnecessary and unhealthy. While fruit has nutritional
value, portion control remains important as natural sugars affect blood glucose.
Refined carbohydrates like white bread and pasta cause rapid blood glucose
elevation and should be limited.
3. A nurse is preparing a client for surgery. The client states, "I am very
nervous about this surgery." Which response by the nurse would be MOST
therapeutic?
A) "Don't worry; this is a very common procedure"
B) "Your surgeon is very experienced, so everything will be fine"
,C) "Tell me more about your specific concerns regarding the surgery"
D) "Everyone feels nervous before surgery; it will pass"
E) "You should have asked questions before signing the consent form"
CORRECT ANSWER: C) "Tell me more about your specific concerns regarding
the surgery"
Rationale: Using open-ended questions and active listening allows the client to
express feelings and concerns. This therapeutic communication technique
demonstrates empathy and helps the nurse identify specific fears that can be
addressed with education or support. Minimizing feelings ("don't worry"), giving
false reassurance, or using clichés does not address the client's actual concerns and
diminishes the therapeutic relationship. Blaming the client is inappropriate and
non-therapeutic.
4. A client with chronic kidney disease is prescribed a potassium-restricted
diet. Which food choice indicates the client understands the dietary
restriction?
A) A baked potato with skin
B) Orange juice and a banana
C) Boiled chicken breast with white rice
D) Spinach salad with tomatoes
E) Dried apricots and almonds
CORRECT ANSWER: C) Boiled chicken breast with white rice
Rationale: Boiled chicken breast and white rice are both low in potassium and
appropriate for a potassium-restricted diet. Potassium-rich foods to avoid include
potatoes with skin, citrus juices, bananas, dark leafy greens (spinach), tomatoes,
and dried fruits. Clients with chronic kidney disease have impaired ability to excrete
potassium, placing them at risk for hyperkalemia, which can cause cardiac
dysrhythmias.
, 5. A nurse is administering intravenous medication to a client. After injecting
the medication through an intravenous line, the client reports pain at the IV
site and swelling is noted. Which action should the nurse take FIRST?
A) Continue monitoring the IV site and notify the provider at the end of the shift
B) Immediately discontinue the IV and restart in another location
C) Apply a warm compress to reduce the swelling
D) Slow the infusion rate to minimize discomfort
E) Administer pain medication intravenously
CORRECT ANSWER: B) Immediately discontinue the IV and restart in another
location
Rationale: Pain and swelling at an IV site during medication infusion suggest
infiltration, extravasation, or phlebitis. The nurse must immediately stop the
infusion to prevent further tissue damage, particularly with certain medications
that can cause severe tissue necrosis if extravasated (chemotherapy agents,
vasopressors, hypertonic solutions). The IV should be discontinued, the site
documented, and a new line started in an unaffected area. Warm compresses
should not be applied without first assessing the type of infiltrate, as this could
worsen the situation with certain medications.
6. A client with a history of hypertension is taking lisinopril, an ACE inhibitor.
Which side effect requires the client to notify the provider immediately?
A) Dry cough lasting several weeks
B) Dizziness when changing positions
C) Swelling of the lips, face, and tongue
D) Slight decrease in appetite
E) Mild fatigue in the morning
