ATI RN Comprehensive Predictor 2026: Exam-Focused Review and SelfAssessment

A nurse is caring for a client with a history of chronic obstructive pulmonary disease (COPD) who is experiencing increased shortness of breath and wheezing. Which action should the nurse take first? A. Assess oxygen saturation and respiratory status B. Administer a bronchodilator C. Encourage pursed-lip breathing D. Notify the provider RATIONALE: Assessment comes first to determine the severity of respiratory compromise. Interventions like bronchodilators follow the initial assessment. A nurse is providing discharge teaching to a client who has a new colostomy. Which statement indicates understanding? A. "I should use the same pouch indefinitely" B. "I should empty the pouch when it is one-third to one-half full" C. "I should wash the stoma with harsh soap" D. "I should place the wafer loosely around the stoma" RATIONALE: Emptying the pouch at one-third to one-half full prevents leakage. Using harsh soap or loosely placing the wafer can cause skin breakdown and leakage. A nurse is preparing to administer a medication via a nasogastric tube. Which action is most important before giving the medication? A. Verify the medication label B. Elevate the head of the bed 15 degrees C. Confirm tube placement D. Flush the tube after medication RATIONALE: Confirming tube placement is critical to prevent aspiration or medication entering the lungs. Label verification and flushing are secondary safety steps. A nurse is caring for a client who has type 2 diabetes mellitus and reports a blood glucose of 250 mg/dL. Which action should the nurse take first? A. Assess the client for signs of hyperglycemia B. Administer insulin per sliding scale C. Provide the client with a snack D. Notify the provider RATIONALE: Assessment is the first step to determine severity and any acute complications such as dehydration or ketoacidosis before taking further action. A nurse is teaching a client how to prevent venous thromboembolism (VTE) after surgery. Which statement indicates correct understanding? A. "I should cross my legs while sitting" B. "I should avoid walking for 2 weeks" C. "I should perform leg exercises and ambulate as instructed" D. "I should take short naps frequently during the day" RATIONALE: Leg exercises and early ambulation improve circulation and reduce the risk of VTE. Crossing legs or prolonged immobility increases risk. A nurse is caring for a client receiving morphine via patient-controlled analgesia (PCA) and notes that the client’s respirations are 8/min. Which action should the nurse take first? A. Notify the provider B. Administer naloxone C. Stop the PCA infusion and assess the client D. Encourage deep breathing RATIONALE: Respiratory depression is life-threatening. Stopping the infusion and assessing the client comes before other interventions to prevent harm. A nurse is caring for a client who is receiving a blood transfusion and develops chills and fever within 15 minutes. Which action should the nurse take first? A. Administer antipyretics B. Stop the transfusion and maintain IV line with normal saline C. Notify the provider after the transfusion D. Slow the transfusion rate RATIONALE: Signs of a transfusion reaction require immediate cessation of the transfusion to prevent further complications. Antipyretics and notification follow the initial emergency response. A nurse is caring for a client with hypertension who has been prescribed hydrochlorothiazide. Which electrolyte imbalance should the nurse monitor for? A. Hyperkalemia B. Hypokalemia C. Hypermagnesemia D. Hypercalcemia RATIONALE: Hydrochlorothiazide is a thiazide diuretic that can cause potassium loss, leading to hypokalemia. Monitoring is essential to prevent cardiac complications. A nurse is teaching a client about the proper use of an inhaler. Which instruction is correct? A. "Shake the inhaler for 10 seconds after each puff" B. "Exhale completely, place the mouthpiece in your mouth, and inhale while pressing the canister" C. "Breathe in quickly and exhale slowly before inhaling the medication" D. "Use the inhaler only when symptoms occur, not as prescribed" RATIONALE: Correct inhaler technique ensures medication reaches the lungs. Shaking and coordinating inhalation with actuation is critical for effectiveness. A nurse is caring for a client who has Parkinson’s disease and experiences frequent drooling. Which intervention should the nurse implement? A. Encourage large meals B. Avoid oral hygiene to prevent gag reflex C. Provide frequent oral care and encourage swallowing exercises D. Position the client supine during meals RATIONALE: Frequent oral care and swallowing exercises reduce drooling and risk of aspiration. Positioning supine or neglecting oral hygiene can worsen symptoms. A nurse is assessing a client who has a new onset of confusion, restlessness, and a temperature of 102°F after surgery. Which action should the nurse take first? A. Assess vital signs and oxygen saturation B. Notify the provider immediately C. Administer prescribed antipyretics D. Encourage oral fluids RATIONALE: The nurse must first assess the client to determine the severity and underlying cause of confusion and fever before taking further interventions. A nurse is teaching a client who has chronic kidney disease about dietary restrictions. Which statement indicates correct understanding? A. "I can eat unlimited bananas" B. "I should limit foods high in potassium, such as bananas and oranges" C. "I should drink at least 3 liters of fluid daily" D. "I should avoid protein entirely" RATIONALE: Clients with chronic kidney disease are at risk for hyperkalemia. Limiting highpotassium foods is essential for safety. A nurse is caring for a client with heart failure who is receiving furosemide. Which assessment finding requires immediate action? A. Blood pressure 120/80 mmHg B. Weight loss of 1 kg in 2 days C. Potassium level 2.9 mEq/L D. Clear lung sounds RATIONALE: Hypokalemia (K+ <3.5 mEq/L) is dangerous and can lead to cardiac dysrhythmias. Immediate intervention is required. A nurse is caring for a client who has a new tracheostomy. Which action promotes airway patency? A. Leave the tracheostomy uncovered B. Suction the tracheostomy as needed using sterile technique C. Encourage the client to speak continuously D. Keep the client in a supine position RATIONALE: Suctioning maintains airway patency and prevents obstruction. Improper positioning or neglecting suctioning can lead to hypoxia. A nurse is preparing to administer insulin glargine to a client with type 1 diabetes. Which statement is correct? A. "It is used to treat hypoglycemia" B. "It provides a long-acting baseline insulin and is not mixed with other insulins" C. "It should be administered only before meals" D. "It has a rapid onset and short duration" RATIONALE: Insulin glargine is long-acting and provides a baseline insulin level. It cannot be mixed with other insulins due to risk of altering absorption. A nurse is caring for a client receiving a blood transfusion who reports itching and hives. Which action should the nurse take first? A. Stop the transfusion and maintain the IV with normal saline B. Administer diphenhydramine immediately C. Notify the provider after documenting D. Slow the transfusion rate RATIONALE: The client is showing signs of an allergic transfusion reaction. The priority is stopping the transfusion to prevent further complications. A nurse is teaching a client with asthma how to use a peak flow meter. Which instruction is correct? A. "Breathe in slowly and then blow gently into the meter" B. "Take a deep breath and blow out as hard and fast as possible" C. "Use the meter only when experiencing shortness of breath" D. "Reset the meter only once a week" RATIONALE: Peak flow meters measure the maximal expiratory effort. Blowing hard and fast ensures accurate assessment of lung function. A nurse is planning care for a client with neutropenia. Which intervention is most important? A. Provide high-fiber foods B. Implement strict infection control measures C. Encourage daily exercise D. Limit fluid intake RATIONALE: Neutropenic clients are at high risk for infection. Strict infection control, including hand hygiene and isolation precautions, is critical. A nurse is assessing a client with deep vein thrombosis (DVT). Which finding requires immediate intervention? A. Mild leg edema B. Sudden shortness of breath and chest pain C. Warmth at the site of clot D. Positive Homan’s sign RATIONALE: Sudden shortness of breath and chest pain indicate a possible pulmonary embolism, a life-threatening complication of DVT requiring immediate action. A nurse is caring for a client receiving vancomycin. Which assessment finding requires immediate intervention? A. Mild nausea B. Blood pressure 120/80 mmHg C. Red rash on the face and neck during infusion D. Urine output 50 mL/hour RATIONALE: Red man syndrome is a reaction to vancomycin and requires slowing or stopping the infusion to prevent severe hypotension and complications. A nurse is caring for a client with newly diagnosed type 2 diabetes. Which statement by the client indicates understanding of lifestyle modifications? A. "I can skip exercise if I eat less sugar" B. "I should include regular physical activity and a balanced diet" C. "I only need to monitor my blood sugar once a week" D. "I must avoid all carbohydrates completely" RATIONALE: Effective diabetes management requires consistent exercise and a balanced diet to control blood glucose, not just sugar restriction. A nurse is planning care for a client with a pressure injury. Which intervention is priority? A. Administer analgesics routinely B. Reposition the client every 2 hours C. Encourage high-protein foods D. Clean the wound once daily RATIONALE: Repositioning relieves pressure, prevents further tissue damage, and is the most immediate preventive intervention. A nurse is assessing a client who reports palpitations and dizziness. Which vital sign finding is most concerning? A. BP 118/72 mmHg B. HR 88 bpm C. HR 160 bpm, irregular D. Temp 98.4°F RATIONALE: A rapid, irregular heart rate may indicate a serious arrhythmia requiring immediate intervention. A nurse is teaching a client about warfarin therapy. Which statement indicates correct understanding? A. "I will stop taking vitamin K-rich foods completely" B. "I should maintain a consistent intake of vitamin K" C. "I can double the dose if I miss one" D. "I do not need regular blood tests" RATIONALE: Maintaining a consistent intake of vitamin K prevents fluctuations in anticoagulation. Regular INR monitoring is essential.