2026 ATI Comprehensive Predictor Final Exam 180
Questions and Answers|2026 ATI Comprehensive
1. A nurse is preparing to assist a client with ambulation for the first time after surgery. Which
action should the nurse take first?
A. Apply a gait belt around the client's waist
B. Assess the client's orthostatic vital signs and dizziness
C. Ask the UAP to walk with the client
D. Instruct the client to look at the floor while walking
Correct: B
Rationale: Assessment precedes intervention. Orthostatic hypotension and dizziness are the
primary fall risks during first ambulation; the nurse must assess before mobilizing. A gait belt (A)
is appropriate but comes after assessment. Delegating first ambulation to a UAP (C) is
inappropriate for an unstable/post-op client. Looking at the floor (D) increases fall risk — the
client should look forward.
2. Which of the following are risk factors for falls in an older adult? (Select All That Apply)
A. Taking a benzodiazepine at bedtime
B. Use of a cane
C. Postural hypotension
D. Urinary urgency
E. Bilateral hearing aids
Correct: A, C, D
Rationale: Sedatives (A), orthostatic hypotension (C), and urgency/nocturia (D) are
established fall risks. A cane (B) is an assistive device that reduces risk when used correctly.
Hearing aids (E) improve sensory input and reduce fall risk.
3. A nurse is teaching a client about a low-sodium diet. Which statement indicates
understanding?
A. "I will use kosher salt instead of table salt."
B. "I can eat canned soup as long as I drain the liquid."
C. "I should read labels and choose foods with less than 140 mg per serving."
D. "Sea salt is a safe substitute because it is natural."
Correct: C
Rationale: The FDA "low sodium" threshold is ≤140 mg per serving; label reading is the key
skill. Kosher and sea salt (A, D) both contain sodium. Draining canned soup (B) removes only a
small fraction of sodium — the food remains high in sodium.
,4. A client is on fall precautions. Which nursing intervention is the priority?
A. Place the bed in the lowest position with the call light within reach
B. Apply a vest restraint
C. Raise all four side rails
D. Keep the room dark to promote rest
Correct: A
Rationale: Environmental safety (low bed, call light in reach) is the first-line, least-restrictive
intervention. Restraints (B) require a provider order and are a last resort. Raising all four side
rails (C) is considered a restraint and is dangerous. A dark room (D) increases fall risk.
5. A nurse is performing a skin assessment and notes a stage 2 pressure injury. Which finding is
expected?
A. Intact skin with nonblanchable redness
B. Partial-thickness loss of skin with a shallow open ulcer
C. Full-thickness tissue loss with visible subcutaneous fat
D. Full-thickness loss with exposed bone, tendon, or muscle
Correct: B
Rationale: Stage 2 = partial-thickness loss with a shallow open ulcer (or intact/ruptured
serum-filled blister). Stage 1 (A) is intact skin with nonblanchable redness. Stage 3 (C) exposes
fat. Stage 4 (D) exposes bone/tendon/muscle.
6. Which action by the nurse best prevents VAP (ventilator-associated pneumonia)?
A. Suctioning the client every 2 hours routinely
B. Keeping the head of the bed elevated 30–45 degrees
C. Changing the ventilator circuit daily
D. Instilling normal saline before suctioning
Correct: B
Rationale: HOB elevation 30–45° reduces aspiration of gastric contents — a core VAP
prevention bundle element. Routine suctioning (A) is not recommended (suction as needed).
Daily circuit changes (C) are unnecessary and increase infection risk. Saline instillation (D) is not
recommended.
7. A nurse is caring for a client with dysphagia. Which intervention should the nurse implement?
A. Provide thin liquids to ease swallowing
B. Have the client tuck the chin down when swallowing
C. Encourage talking during meals
D. Place food on the unaffected side of the mouth only
Correct: B
Rationale: The chin-tuck ( Mendelsohn/chin-tuck maneuver) protects the airway. Thin
,liquids (A) increase aspiration risk — thickened liquids are used. Talking (C) increases aspiration
risk. Food placement (D) applies to unilateral neglect (stroke), not dysphagia specifically.
8. A nurse is teaching about the use of a metered-dose inhaler (MDI) with a spacer. Which
statement indicates correct technique?
A. "I will shake the inhaler and breathe out fully before activating it."
B. "I will inhale quickly and forcefully after activating the inhaler."
C. "I will hold my breath for 1 second after inhaling."
D. "I will use the inhaler without a spacer for a better effect."
Correct: A
Rationale: Shake the inhaler and exhale fully before activation. Inhalation should be slow
and deep (B is wrong). Breath-hold should be 10 seconds (C is wrong). A spacer improves
delivery and reduces oropharyngeal deposition (D is wrong).
9. A nurse is documenting a client's intake and output. Which item should the nurse include as
intake?
A. Ice chips
B. Urine output
C. Emesis
D. Wound drainage
Correct: A
Rationale: Ice chips count as intake (approximately half their volume). Urine (B), emesis (C),
and wound drainage (D) are all output.
10. A nurse is assessing for dehydration in an older adult. Which finding is most reliable?
A. Dry mucous membranes
B. Poor skin turgor
C. Tachycardia and orthostatic hypotension
D. Decreased urine output
Correct: C
Rationale: In older adults, skin turgor (B) and mucous membranes (A) are unreliable due to
normal aging changes. Vital sign changes (tachycardia, orthostatic hypotension) are more
reliable indicators of significant volume loss. Decreased urine output (D) supports the diagnosis
but is less specific.
11. A nurse is caring for a client on seizure precautions. Which action is appropriate?
A. Keep the bed in the high position
B. Pad the side rails and keep suction and oxygen at the bedside
C. Place a tongue blade at the bedside for use during a seizure
, D. Restrain the client during a seizure
Correct: B
Rationale: Padding rails and having suction/O2 ready are standard seizure precautions. High
bed (A) increases fall risk. Tongue blades (C) are never placed in the mouth. Restraints (D) are
contraindicated during seizures and can cause injury.
12. A nurse is teaching a client about the use of a walker. Which instruction is correct?
A. "Move the walker forward, then step into it with your weaker leg first."
B. "Lift the walker and place it far ahead of you."
C. "Step forward with your stronger leg first, then the weaker leg."
D. "Use the walker only when you feel unsteady."
Correct: A
Rationale: For a walker, move it forward, then step with the weaker leg, followed by the
stronger leg (weaker leg bears weight with the arms). Placing it far ahead (B) destabilizes
balance. Strong leg first (C) is incorrect. Intermittent use (D) is unsafe.
13. A nurse is preparing to insert an indwelling urinary catheter. Which action reduces the risk
of CAUTI?
A. Use sterile technique and maintain a closed drainage system
B. Irrigate the catheter routinely
C. Change the catheter every 48 hours
D. Disconnect the tubing to obtain a urine specimen
Correct: A
Rationale: Sterile technique and a closed system are cornerstones of CAUTI prevention.
Routine irrigation (B) is not recommended. Routine catheter changes (C) are unnecessary.
Disconnecting tubing (D) breaks the closed system and increases infection risk; specimens
should be obtained via the sampling port.
14. A nurse is teaching a client about crutch walking. Which statement indicates correct
understanding?
A. "I should bear weight on my axillae when using crutches."
B. "I should keep my elbows bent at about 30 degrees when standing."
C. "I should place the crutch tips 12 inches ahead of my feet."
D. "I should use a three-point gait if I can bear weight on both legs."
Correct: B
Rationale: Elbows flexed ~30° with the crutch pad 2–3 finger widths below the axilla.
Bearing weight on the axillae (A) can cause nerve damage. Crutch tips should be ~6 inches
ahead (C). Three-point gait (D) is used for non-weight-bearing on one leg, not bilateral weight
bearing.
Questions and Answers|2026 ATI Comprehensive
1. A nurse is preparing to assist a client with ambulation for the first time after surgery. Which
action should the nurse take first?
A. Apply a gait belt around the client's waist
B. Assess the client's orthostatic vital signs and dizziness
C. Ask the UAP to walk with the client
D. Instruct the client to look at the floor while walking
Correct: B
Rationale: Assessment precedes intervention. Orthostatic hypotension and dizziness are the
primary fall risks during first ambulation; the nurse must assess before mobilizing. A gait belt (A)
is appropriate but comes after assessment. Delegating first ambulation to a UAP (C) is
inappropriate for an unstable/post-op client. Looking at the floor (D) increases fall risk — the
client should look forward.
2. Which of the following are risk factors for falls in an older adult? (Select All That Apply)
A. Taking a benzodiazepine at bedtime
B. Use of a cane
C. Postural hypotension
D. Urinary urgency
E. Bilateral hearing aids
Correct: A, C, D
Rationale: Sedatives (A), orthostatic hypotension (C), and urgency/nocturia (D) are
established fall risks. A cane (B) is an assistive device that reduces risk when used correctly.
Hearing aids (E) improve sensory input and reduce fall risk.
3. A nurse is teaching a client about a low-sodium diet. Which statement indicates
understanding?
A. "I will use kosher salt instead of table salt."
B. "I can eat canned soup as long as I drain the liquid."
C. "I should read labels and choose foods with less than 140 mg per serving."
D. "Sea salt is a safe substitute because it is natural."
Correct: C
Rationale: The FDA "low sodium" threshold is ≤140 mg per serving; label reading is the key
skill. Kosher and sea salt (A, D) both contain sodium. Draining canned soup (B) removes only a
small fraction of sodium — the food remains high in sodium.
,4. A client is on fall precautions. Which nursing intervention is the priority?
A. Place the bed in the lowest position with the call light within reach
B. Apply a vest restraint
C. Raise all four side rails
D. Keep the room dark to promote rest
Correct: A
Rationale: Environmental safety (low bed, call light in reach) is the first-line, least-restrictive
intervention. Restraints (B) require a provider order and are a last resort. Raising all four side
rails (C) is considered a restraint and is dangerous. A dark room (D) increases fall risk.
5. A nurse is performing a skin assessment and notes a stage 2 pressure injury. Which finding is
expected?
A. Intact skin with nonblanchable redness
B. Partial-thickness loss of skin with a shallow open ulcer
C. Full-thickness tissue loss with visible subcutaneous fat
D. Full-thickness loss with exposed bone, tendon, or muscle
Correct: B
Rationale: Stage 2 = partial-thickness loss with a shallow open ulcer (or intact/ruptured
serum-filled blister). Stage 1 (A) is intact skin with nonblanchable redness. Stage 3 (C) exposes
fat. Stage 4 (D) exposes bone/tendon/muscle.
6. Which action by the nurse best prevents VAP (ventilator-associated pneumonia)?
A. Suctioning the client every 2 hours routinely
B. Keeping the head of the bed elevated 30–45 degrees
C. Changing the ventilator circuit daily
D. Instilling normal saline before suctioning
Correct: B
Rationale: HOB elevation 30–45° reduces aspiration of gastric contents — a core VAP
prevention bundle element. Routine suctioning (A) is not recommended (suction as needed).
Daily circuit changes (C) are unnecessary and increase infection risk. Saline instillation (D) is not
recommended.
7. A nurse is caring for a client with dysphagia. Which intervention should the nurse implement?
A. Provide thin liquids to ease swallowing
B. Have the client tuck the chin down when swallowing
C. Encourage talking during meals
D. Place food on the unaffected side of the mouth only
Correct: B
Rationale: The chin-tuck ( Mendelsohn/chin-tuck maneuver) protects the airway. Thin
,liquids (A) increase aspiration risk — thickened liquids are used. Talking (C) increases aspiration
risk. Food placement (D) applies to unilateral neglect (stroke), not dysphagia specifically.
8. A nurse is teaching about the use of a metered-dose inhaler (MDI) with a spacer. Which
statement indicates correct technique?
A. "I will shake the inhaler and breathe out fully before activating it."
B. "I will inhale quickly and forcefully after activating the inhaler."
C. "I will hold my breath for 1 second after inhaling."
D. "I will use the inhaler without a spacer for a better effect."
Correct: A
Rationale: Shake the inhaler and exhale fully before activation. Inhalation should be slow
and deep (B is wrong). Breath-hold should be 10 seconds (C is wrong). A spacer improves
delivery and reduces oropharyngeal deposition (D is wrong).
9. A nurse is documenting a client's intake and output. Which item should the nurse include as
intake?
A. Ice chips
B. Urine output
C. Emesis
D. Wound drainage
Correct: A
Rationale: Ice chips count as intake (approximately half their volume). Urine (B), emesis (C),
and wound drainage (D) are all output.
10. A nurse is assessing for dehydration in an older adult. Which finding is most reliable?
A. Dry mucous membranes
B. Poor skin turgor
C. Tachycardia and orthostatic hypotension
D. Decreased urine output
Correct: C
Rationale: In older adults, skin turgor (B) and mucous membranes (A) are unreliable due to
normal aging changes. Vital sign changes (tachycardia, orthostatic hypotension) are more
reliable indicators of significant volume loss. Decreased urine output (D) supports the diagnosis
but is less specific.
11. A nurse is caring for a client on seizure precautions. Which action is appropriate?
A. Keep the bed in the high position
B. Pad the side rails and keep suction and oxygen at the bedside
C. Place a tongue blade at the bedside for use during a seizure
, D. Restrain the client during a seizure
Correct: B
Rationale: Padding rails and having suction/O2 ready are standard seizure precautions. High
bed (A) increases fall risk. Tongue blades (C) are never placed in the mouth. Restraints (D) are
contraindicated during seizures and can cause injury.
12. A nurse is teaching a client about the use of a walker. Which instruction is correct?
A. "Move the walker forward, then step into it with your weaker leg first."
B. "Lift the walker and place it far ahead of you."
C. "Step forward with your stronger leg first, then the weaker leg."
D. "Use the walker only when you feel unsteady."
Correct: A
Rationale: For a walker, move it forward, then step with the weaker leg, followed by the
stronger leg (weaker leg bears weight with the arms). Placing it far ahead (B) destabilizes
balance. Strong leg first (C) is incorrect. Intermittent use (D) is unsafe.
13. A nurse is preparing to insert an indwelling urinary catheter. Which action reduces the risk
of CAUTI?
A. Use sterile technique and maintain a closed drainage system
B. Irrigate the catheter routinely
C. Change the catheter every 48 hours
D. Disconnect the tubing to obtain a urine specimen
Correct: A
Rationale: Sterile technique and a closed system are cornerstones of CAUTI prevention.
Routine irrigation (B) is not recommended. Routine catheter changes (C) are unnecessary.
Disconnecting tubing (D) breaks the closed system and increases infection risk; specimens
should be obtained via the sampling port.
14. A nurse is teaching a client about crutch walking. Which statement indicates correct
understanding?
A. "I should bear weight on my axillae when using crutches."
B. "I should keep my elbows bent at about 30 degrees when standing."
C. "I should place the crutch tips 12 inches ahead of my feet."
D. "I should use a three-point gait if I can bear weight on both legs."
Correct: B
Rationale: Elbows flexed ~30° with the crutch pad 2–3 finger widths below the axilla.
Bearing weight on the axillae (A) can cause nerve damage. Crutch tips should be ~6 inches
ahead (C). Three-point gait (D) is used for non-weight-bearing on one leg, not bilateral weight
bearing.
