ATI Comprehensive Predictor 2026/2027 Study Guide |
ACTUAL-Style ATI Comprehensive Predictor Practice
Questions & Answers, RN Comprehensive Predictor Exam
Prep, NCLEX Readiness Review, Verified Answers, Detailed
Rationales, NGN & Clinical Judgment, Fundamentals,
Pharmacology, Adult Medical-Surgical, Maternal-Newborn,
Mental Health, Pediatrics, Leadership, Community Health &
Comprehensive Nursing Practice Test
Question 1: A nurse is caring for a client who is 2 days postoperative
following a total hip arthroplasty. The nurse observes a 5 cm area of
bright red drainage on the surgical dressing. Which of the following
actions should the nurse take first?
A. Notify the surgeon immediately.
B. Reinforce the dressing with sterile gauze.
C. Mark the perimeter of the drainage on the dressing.
D. Change the dressing completely.
CORRECT ANSWER: C. Mark the perimeter of the drainage on the
dressing.
Rationale: Marking the perimeter of the drainage allows the nurse to
objectively monitor for any increase in bleeding over time without
disrupting the surgical site. This provides crucial data for the healthcare
team to determine if further intervention is needed. Notifying the surgeon
immediately or changing the dressing are actions reserved for excessive or
rapidly expanding drainage .
Question 2: A nurse is preparing to administer a blood transfusion to a
client. Which of the following actions is the highest priority before
initiating the transfusion?
A. Obtain baseline vital signs.
B. Prime the IV tubing with 0.9% sodium chloride.
C. Verify the client's identity and blood product with another nurse.
D. Assess the client's lung sounds.
CORRECT ANSWER: C. Verify the client's identity and blood product
with another nurse.
Rationale: Verification of client identity and blood compatibility with a
second nurse is the absolute priority to prevent a fatal hemolytic
,transfusion reaction. While obtaining vital signs, priming tubing, and
assessing lung sounds are necessary steps, they follow the critical safety
check of product verification .
Question 3: A nurse is caring for a client who has a nasogastric tube set
to low intermittent suction. Which of the following findings indicates
that the tube is functioning properly?
A. The client reports persistent nausea.
B. The pH of the aspirated gastric fluid is 7.5.
C. The client's abdomen is soft and non-distended.
D. There is continuous bubbling in the suction canister.
CORRECT ANSWER: C. The client's abdomen is soft and non-distended.
Rationale: A soft, non-distended abdomen indicates effective gastric
decompression. Persistent nausea suggests poor tube function, a pH of 7.5
is too alkaline for gastric contents, and continuous bubbling in the canister
is not an expected finding with low intermittent suction .
Question 4: A nurse is reviewing the laboratory results of a client who
has chronic kidney disease. Which of the following values requires the
most immediate intervention?
A. Serum potassium 5.8 mEq/L
B. Serum sodium 135 mEq/L
C. Hemoglobin 9.2 g/dL
D. Blood urea nitrogen 38 mg/dL
CORRECT ANSWER: A. Serum potassium 5.8 mEq/L
Rationale: Hyperkalemia (potassium >5.0 mEq/L) in a client with chronic
kidney disease poses a high risk for life-threatening cardiac dysrhythmias
and requires immediate intervention. The other values are abnormal but
not immediately life-threatening .
Question 5: A nurse is teaching a client who has type 2 diabetes
mellitus about foot care. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I will soak my feet in warm water for 20 minutes daily."
B. "I will trim my toenails straight across."
,C. "I will apply lotion between my toes to prevent dryness."
D. "I will walk barefoot only inside my home."
CORRECT ANSWER: B. "I will trim my toenails straight across."
Rationale: Trimming toenails straight across prevents ingrown nails and
reduces the risk of skin breakdown. Soaking feet, applying lotion between
toes, and walking barefoot all increase the risk of maceration, infection, or
injury in diabetic clients .
Question 6: A nurse is caring for a client who is receiving heparin via
continuous IV infusion. The client's aPTT is 110 seconds. Which of the
following actions should the nurse take?
A. Administer the next scheduled dose.
B. Decrease the infusion rate by 50%.
C. Stop the infusion and notify the provider.
D. Increase the infusion rate to achieve therapeutic levels.
CORRECT ANSWER: C. Stop the infusion and notify the provider.
Rationale: An aPTT greater than 100 seconds indicates a high risk for
hemorrhage. The infusion must be stopped immediately, and the provider
notified for further instructions .
Question 7: A nurse is caring for a client who has a new prescription for
a metered-dose inhaler with a spacer. Which of the following actions by
the client indicates an understanding of the teaching?
A. Inhales rapidly upon actuation of the MDI
B. Holds the breath for 10 seconds after inhaling the medication
C. Places the spacer in the mouth before actuating the MDI
D. Activates the MDI before placing the spacer in the mouth
CORRECT ANSWER: B. Holds the breath for 10 seconds after inhaling
the medication
Rationale: Holding the breath for 5 to 10 seconds after inhaling allows for
maximum deposition of the aerosolized medication in the lungs. Inhaling
rapidly can cause the medication to impact the oropharynx. The spacer
should be placed in the mouth first, followed by actuation .
, Question 8: A charge nurse is observing a newly licensed nurse perform
a sterile dressing change. Which of the following actions should the
charge nurse identify as a breach of sterile technique?
A. Opens the sterile package away from the body
B. Holds sterile objects above the waist
C. Places the sterile field within 2.5 cm (1 in) of the edge of the table
D. Sets up the sterile field before applying sterile gloves
CORRECT ANSWER: C. Places the sterile field within 2.5 cm (1 in) of the
edge of the table
Rationale: A sterile field must be at least 2.5 cm (1 inch) from the edge of
the table, as the edges are considered unsterile. Opening the package
away from the body, holding objects above the waist, and setting up the
field before gloving are appropriate techniques .
Question 9: A nurse is monitoring a client who is receiving a blood
transfusion. Which of the following findings indicates a hemolytic
transfusion reaction?
A. Flank pain and chills
B. Hypertension and bradycardia
C. Urticaria and wheezing
D. Fever and hypotension
CORRECT ANSWER: A. Flank pain and chills
Rationale: Hemolytic transfusion reactions occur when the recipient's
antibodies attack the donor's red blood cells. Manifestations include low
back/flank pain, chills, fever, tachycardia, tachypnea, and hypotension.
Urticaria and wheezing are signs of an allergic reaction .
Question 10: A nurse is preparing to administer a continuous enteral
feeding via a nasogastric tube. Which of the following actions should
the nurse take first?
A. Elevate the head of the bed to 30 degrees
B. Verify tube placement by aspirating gastric contents
C. Flush the tube with 30 mL of water
D. Connect the feeding bag to the tubing
ACTUAL-Style ATI Comprehensive Predictor Practice
Questions & Answers, RN Comprehensive Predictor Exam
Prep, NCLEX Readiness Review, Verified Answers, Detailed
Rationales, NGN & Clinical Judgment, Fundamentals,
Pharmacology, Adult Medical-Surgical, Maternal-Newborn,
Mental Health, Pediatrics, Leadership, Community Health &
Comprehensive Nursing Practice Test
Question 1: A nurse is caring for a client who is 2 days postoperative
following a total hip arthroplasty. The nurse observes a 5 cm area of
bright red drainage on the surgical dressing. Which of the following
actions should the nurse take first?
A. Notify the surgeon immediately.
B. Reinforce the dressing with sterile gauze.
C. Mark the perimeter of the drainage on the dressing.
D. Change the dressing completely.
CORRECT ANSWER: C. Mark the perimeter of the drainage on the
dressing.
Rationale: Marking the perimeter of the drainage allows the nurse to
objectively monitor for any increase in bleeding over time without
disrupting the surgical site. This provides crucial data for the healthcare
team to determine if further intervention is needed. Notifying the surgeon
immediately or changing the dressing are actions reserved for excessive or
rapidly expanding drainage .
Question 2: A nurse is preparing to administer a blood transfusion to a
client. Which of the following actions is the highest priority before
initiating the transfusion?
A. Obtain baseline vital signs.
B. Prime the IV tubing with 0.9% sodium chloride.
C. Verify the client's identity and blood product with another nurse.
D. Assess the client's lung sounds.
CORRECT ANSWER: C. Verify the client's identity and blood product
with another nurse.
Rationale: Verification of client identity and blood compatibility with a
second nurse is the absolute priority to prevent a fatal hemolytic
,transfusion reaction. While obtaining vital signs, priming tubing, and
assessing lung sounds are necessary steps, they follow the critical safety
check of product verification .
Question 3: A nurse is caring for a client who has a nasogastric tube set
to low intermittent suction. Which of the following findings indicates
that the tube is functioning properly?
A. The client reports persistent nausea.
B. The pH of the aspirated gastric fluid is 7.5.
C. The client's abdomen is soft and non-distended.
D. There is continuous bubbling in the suction canister.
CORRECT ANSWER: C. The client's abdomen is soft and non-distended.
Rationale: A soft, non-distended abdomen indicates effective gastric
decompression. Persistent nausea suggests poor tube function, a pH of 7.5
is too alkaline for gastric contents, and continuous bubbling in the canister
is not an expected finding with low intermittent suction .
Question 4: A nurse is reviewing the laboratory results of a client who
has chronic kidney disease. Which of the following values requires the
most immediate intervention?
A. Serum potassium 5.8 mEq/L
B. Serum sodium 135 mEq/L
C. Hemoglobin 9.2 g/dL
D. Blood urea nitrogen 38 mg/dL
CORRECT ANSWER: A. Serum potassium 5.8 mEq/L
Rationale: Hyperkalemia (potassium >5.0 mEq/L) in a client with chronic
kidney disease poses a high risk for life-threatening cardiac dysrhythmias
and requires immediate intervention. The other values are abnormal but
not immediately life-threatening .
Question 5: A nurse is teaching a client who has type 2 diabetes
mellitus about foot care. Which of the following statements by the
client indicates an understanding of the teaching?
A. "I will soak my feet in warm water for 20 minutes daily."
B. "I will trim my toenails straight across."
,C. "I will apply lotion between my toes to prevent dryness."
D. "I will walk barefoot only inside my home."
CORRECT ANSWER: B. "I will trim my toenails straight across."
Rationale: Trimming toenails straight across prevents ingrown nails and
reduces the risk of skin breakdown. Soaking feet, applying lotion between
toes, and walking barefoot all increase the risk of maceration, infection, or
injury in diabetic clients .
Question 6: A nurse is caring for a client who is receiving heparin via
continuous IV infusion. The client's aPTT is 110 seconds. Which of the
following actions should the nurse take?
A. Administer the next scheduled dose.
B. Decrease the infusion rate by 50%.
C. Stop the infusion and notify the provider.
D. Increase the infusion rate to achieve therapeutic levels.
CORRECT ANSWER: C. Stop the infusion and notify the provider.
Rationale: An aPTT greater than 100 seconds indicates a high risk for
hemorrhage. The infusion must be stopped immediately, and the provider
notified for further instructions .
Question 7: A nurse is caring for a client who has a new prescription for
a metered-dose inhaler with a spacer. Which of the following actions by
the client indicates an understanding of the teaching?
A. Inhales rapidly upon actuation of the MDI
B. Holds the breath for 10 seconds after inhaling the medication
C. Places the spacer in the mouth before actuating the MDI
D. Activates the MDI before placing the spacer in the mouth
CORRECT ANSWER: B. Holds the breath for 10 seconds after inhaling
the medication
Rationale: Holding the breath for 5 to 10 seconds after inhaling allows for
maximum deposition of the aerosolized medication in the lungs. Inhaling
rapidly can cause the medication to impact the oropharynx. The spacer
should be placed in the mouth first, followed by actuation .
, Question 8: A charge nurse is observing a newly licensed nurse perform
a sterile dressing change. Which of the following actions should the
charge nurse identify as a breach of sterile technique?
A. Opens the sterile package away from the body
B. Holds sterile objects above the waist
C. Places the sterile field within 2.5 cm (1 in) of the edge of the table
D. Sets up the sterile field before applying sterile gloves
CORRECT ANSWER: C. Places the sterile field within 2.5 cm (1 in) of the
edge of the table
Rationale: A sterile field must be at least 2.5 cm (1 inch) from the edge of
the table, as the edges are considered unsterile. Opening the package
away from the body, holding objects above the waist, and setting up the
field before gloving are appropriate techniques .
Question 9: A nurse is monitoring a client who is receiving a blood
transfusion. Which of the following findings indicates a hemolytic
transfusion reaction?
A. Flank pain and chills
B. Hypertension and bradycardia
C. Urticaria and wheezing
D. Fever and hypotension
CORRECT ANSWER: A. Flank pain and chills
Rationale: Hemolytic transfusion reactions occur when the recipient's
antibodies attack the donor's red blood cells. Manifestations include low
back/flank pain, chills, fever, tachycardia, tachypnea, and hypotension.
Urticaria and wheezing are signs of an allergic reaction .
Question 10: A nurse is preparing to administer a continuous enteral
feeding via a nasogastric tube. Which of the following actions should
the nurse take first?
A. Elevate the head of the bed to 30 degrees
B. Verify tube placement by aspirating gastric contents
C. Flush the tube with 30 mL of water
D. Connect the feeding bag to the tubing
