ATI Comprehensive Predictor Exam Versions 1–3 |2026
Complete Package | Verified Questions with Correct
Answers & Rationales, Graded A+
1. (Medical-Surgical / Priority)
A nurse is caring for four clients on a medical-surgical unit. After receiving shift
report, which client should the nurse assess FIRST?
a) A 72-year-old with chronic heart failure who has 2+ bilateral ankle edema and
reports mild fatigue
b) A 58-year-old postoperative client 6 hours after abdominal surgery with a BP of
100/64 mmHg and urine output of 35 mL/hr
c) A 64-year-old with pneumonia whose oxygen saturation dropped from 95% to
88% on 2 L nasal cannula
d) A 45-year-old with diabetes who reports a blood glucose reading of 210 mg/dL
before lunch
Answer: c) A 64-year-old with pneumonia whose oxygen saturation dropped
from 95% to 88% on 2 L nasal cannula
Rationale: Using ABC priority, airway and breathing take precedence. A
sudden drop in oxygen saturation indicates impaired gas exchange and potential
respiratory deterioration requiring immediate intervention. The other clients are
stable or expected findings.*
2. (Pharmacology / Adverse Effects)
A client newly prescribed lisinopril for hypertension returns to the clinic reporting
fatigue, dizziness when standing, and a persistent dry cough. Laboratory results
show potassium level of 5.8 mEq/L. Which findings should concern the nurse
MOST?
,a) Persistent dry cough
b) Dizziness when standing
c) Potassium level of 5.8 mEq/L
d) Mild fatigue
Answer: c) Potassium level of 5.8 mEq/L
Rationale: ACE inhibitors can cause hyperkalemia. A potassium level of 5.8
mEq/L is elevated and increases risk for life-threatening cardiac dysrhythmias.
Orthostatic hypotension and cough are common but less dangerous.*
3. (SATA – Infection Control)
A nurse is caring for a client diagnosed with Clostridioides difficile infection.
Which interventions should the nurse implement? (Select all that apply.)
a) Use alcohol-based hand sanitizer before leaving room
b) Wear gloves when entering room
c) Place client in private room
d) Use disposable stethoscope
e) Wear N95 respirator mask
Answers: b) Wear gloves when entering room
c) Place client in private room
d) Use disposable stethoscope
Rationale: C. difficile requires contact precautions. Handwashing must be
performed with soap and water (not alcohol-based sanitizer). Private room and
dedicated equipment reduce transmission risk. N95 is unnecessary unless
airborne pathogen.*
4. (Endocrine / Emergency Recognition)
, A nurse is monitoring a client with type 1 diabetes admitted for diabetic
ketoacidosis (DKA). Which assessment finding indicates the client’s condition is
improving?
a) Blood glucose 450 mg/dL
b) Respiratory rate 30/min with Kussmaul pattern
c) Serum potassium 6.0 mEq/L
d) Serum bicarbonate level rising toward normal
Answer: d) Serum bicarbonate level rising toward normal
Rationale: DKA causes metabolic acidosis. Improvement is indicated by
correction of acidosis and normalization of bicarbonate levels. The other findings
indicate ongoing acidosis or hyperglycemia.*
5. (Maternal-Newborn / Safety)
A postpartum client 2 hours after vaginal delivery reports sudden heavy vaginal
bleeding and feeling dizzy. The fundus is boggy and displaced to the right of the
umbilicus. What is the nurse’s FIRST action?
a) Call the provider immediately
b) Administer oxytocin IV
c) Massage the fundus until firm
d) Insert indwelling urinary catheter
Answer: c) Massage the fundus until firm
Rationale: A boggy, displaced fundus indicates uterine atony, the leading
cause of postpartum hemorrhage. Immediate fundal massage promotes uterine
contraction. A full bladder may contribute, but massage is first priority.*
6. (Cardiac / Prioritization)
A nurse in a telemetry unit is reviewing morning lab results for four clients. Which
client requires immediate intervention?
Complete Package | Verified Questions with Correct
Answers & Rationales, Graded A+
1. (Medical-Surgical / Priority)
A nurse is caring for four clients on a medical-surgical unit. After receiving shift
report, which client should the nurse assess FIRST?
a) A 72-year-old with chronic heart failure who has 2+ bilateral ankle edema and
reports mild fatigue
b) A 58-year-old postoperative client 6 hours after abdominal surgery with a BP of
100/64 mmHg and urine output of 35 mL/hr
c) A 64-year-old with pneumonia whose oxygen saturation dropped from 95% to
88% on 2 L nasal cannula
d) A 45-year-old with diabetes who reports a blood glucose reading of 210 mg/dL
before lunch
Answer: c) A 64-year-old with pneumonia whose oxygen saturation dropped
from 95% to 88% on 2 L nasal cannula
Rationale: Using ABC priority, airway and breathing take precedence. A
sudden drop in oxygen saturation indicates impaired gas exchange and potential
respiratory deterioration requiring immediate intervention. The other clients are
stable or expected findings.*
2. (Pharmacology / Adverse Effects)
A client newly prescribed lisinopril for hypertension returns to the clinic reporting
fatigue, dizziness when standing, and a persistent dry cough. Laboratory results
show potassium level of 5.8 mEq/L. Which findings should concern the nurse
MOST?
,a) Persistent dry cough
b) Dizziness when standing
c) Potassium level of 5.8 mEq/L
d) Mild fatigue
Answer: c) Potassium level of 5.8 mEq/L
Rationale: ACE inhibitors can cause hyperkalemia. A potassium level of 5.8
mEq/L is elevated and increases risk for life-threatening cardiac dysrhythmias.
Orthostatic hypotension and cough are common but less dangerous.*
3. (SATA – Infection Control)
A nurse is caring for a client diagnosed with Clostridioides difficile infection.
Which interventions should the nurse implement? (Select all that apply.)
a) Use alcohol-based hand sanitizer before leaving room
b) Wear gloves when entering room
c) Place client in private room
d) Use disposable stethoscope
e) Wear N95 respirator mask
Answers: b) Wear gloves when entering room
c) Place client in private room
d) Use disposable stethoscope
Rationale: C. difficile requires contact precautions. Handwashing must be
performed with soap and water (not alcohol-based sanitizer). Private room and
dedicated equipment reduce transmission risk. N95 is unnecessary unless
airborne pathogen.*
4. (Endocrine / Emergency Recognition)
, A nurse is monitoring a client with type 1 diabetes admitted for diabetic
ketoacidosis (DKA). Which assessment finding indicates the client’s condition is
improving?
a) Blood glucose 450 mg/dL
b) Respiratory rate 30/min with Kussmaul pattern
c) Serum potassium 6.0 mEq/L
d) Serum bicarbonate level rising toward normal
Answer: d) Serum bicarbonate level rising toward normal
Rationale: DKA causes metabolic acidosis. Improvement is indicated by
correction of acidosis and normalization of bicarbonate levels. The other findings
indicate ongoing acidosis or hyperglycemia.*
5. (Maternal-Newborn / Safety)
A postpartum client 2 hours after vaginal delivery reports sudden heavy vaginal
bleeding and feeling dizzy. The fundus is boggy and displaced to the right of the
umbilicus. What is the nurse’s FIRST action?
a) Call the provider immediately
b) Administer oxytocin IV
c) Massage the fundus until firm
d) Insert indwelling urinary catheter
Answer: c) Massage the fundus until firm
Rationale: A boggy, displaced fundus indicates uterine atony, the leading
cause of postpartum hemorrhage. Immediate fundal massage promotes uterine
contraction. A full bladder may contribute, but massage is first priority.*
6. (Cardiac / Prioritization)
A nurse in a telemetry unit is reviewing morning lab results for four clients. Which
client requires immediate intervention?
