Bank 2026/2027
NCLEX-RN Comprehensive Readiness Assessment | Key Domains: Management of Care,
Safety & Infection Control, Health Promotion & Maintenance, Psychosocial Integrity, Basic
Care & Comfort, Pharmacological & Parenteral Therapies, Reduction of Risk Potential,
Physiological Adaptation, and the NCSBN Clinical Judgment Measurement Model |
Expert-Aligned Structure | Comprehensive Test Bank Format
Introduction
This structured ATI RN Comprehensive Predictor Test Bank for 2026/2027 provides an
extensive, updated collection of high-quality, exam-style questions with correct answers
and rationales. It is designed to simulate the comprehensive predictor exam and predict
NCLEX-RN success by assessing knowledge integration, clinical judgment, and the ability to
apply nursing concepts across all client needs categories.
Test Bank Structure:
• Comprehensive Test Bank: (180+ PREDICTOR-STYLE QUESTIONS)
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the clinical judgment process (e.g., recognizing cues of deterioration), the
priority-setting framework (ABCs, Maslow, acute vs. chronic), the correct application of a
nursing principle or procedure, and why alternative options are incorrect or represent
unsafe or ineffective nursing practice.
,1.
A nurse is caring for a client who is 2 hours postoperative following a total hip arthroplasty.
The client’s vital signs are: BP 90/50 mm Hg, HR 118/min, RR 24/min, SpO₂ 94% on room
air. The client reports dizziness and nausea. Which action should the nurse take first?
A) Administer antiemetic medication
B) Elevate the head of the bed
C) Assess for signs of hemorrhage
D) Notify the provider
C) Assess for signs of hemorrhage
Using the ABC (Airway, Breathing, Circulation) and acute vs. chronic priority frameworks,
hypotension (BP 90/50), tachycardia (HR 118), dizziness, and nausea in the immediate
postoperative period suggest possible hemorrhage—a life-threatening complication. The
nurse must first assess for bleeding (e.g., surgical site drainage, abdominal distention,
decreased hemoglobin) before notifying the provider or administering medications.
Administering antiemetics (A) or elevating the bed (B) does not address the underlying cause.
2.
A client with type 1 diabetes mellitus reports feeling shaky, sweaty, and anxious. The nurse
checks the client’s blood glucose and obtains a reading of 52 mg/dL. Which action should
the nurse take first?
A) Administer glucagon IM
B) Give 4 oz of orange juice
C) Recheck blood glucose in 15 minutes
D) Provide a protein snack
,B) Give 4 oz of orange juice
The client is conscious and exhibiting signs of hypoglycemia (glucose <70 mg/dL). The priority
is to administer 15–20 g of fast-acting carbohydrate (e.g., 4 oz juice). Glucagon (A) is reserved
for unconscious clients. Rechecking (C) delays treatment. Protein (D) slows glucose absorption
and is used after initial correction to prevent recurrence.
3.
A nurse is preparing to administer digoxin 0.25 mg IV bolus to a client. The available dose is
digoxin 0.25 mg/mL. How many mL should the nurse administer? (Round to the nearest
whole number.)
A) 0.5 mL
B) 1 mL
C) 2 mL
D) 0.25 mL
B) 1 mL
Desired dose = 0.25 mg; concentration = 0.25 mg/mL. Volume = 0.25 mg ÷ 0.25 mg/mL = 1 mL.
Options A, C, and D reflect calculation errors. Always verify compatibility and apical pulse
(>60 bpm) before administration.
4.
A client with heart failure is prescribed furosemide 40 mg IV daily. Which laboratory value
should the nurse monitor most closely?
A) Sodium
B) Potassium
C) Calcium
, D) Magnesium
B) Potassium
Furosemide is a loop diuretic that causes potassium loss, leading to hypokalemia (risk of
dysrhythmias). While sodium, calcium, and magnesium may also be affected, potassium is the
priority due to cardiac implications. Normal K⁺: 3.5–5.0 mEq/L.
5.
A nurse is caring for a client who has Clostridioides difficile infection. Which precaution
should the nurse implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
A) Contact precautions
C. diff is transmitted via spores on surfaces and hands, requiring contact precautions (gown,
gloves, dedicated equipment). Droplet (B) is for influenza; airborne (C) for TB; standard (D) is
insufficient due to high environmental contamination risk.
6.
A postpartum client reports severe perineal pain 24 hours after vaginal delivery with a
second-degree laceration. Vital signs: T 38.1°C (100.6°F), HR 92/min. The perineal area is
red, swollen, and warm to touch. What is the nurse’s priority action?
A) Administer prescribed analgesic
B) Apply ice pack to perineum