2026 UPDATED QUESTIONS DOWNLOAD
ATI RN Comprehensive Predictor 2026-2027 | 350-Question Practice Set: Med-Surg,
Pharmacology, Pediatrics, OB, Mental Health, & Lead Management with Detailed
Rationales
Achieve a 90% or higher predictability score on your nursing exit exam with this
meticulously updated 350-question practice set for the 2026-2027 cycle. Each
question is designed to test high-level clinical judgment, focusing on the most "must-
know" topics like electrolyte imbalances, acid-base disorders, and emergency
interventions. Every answer includes a detailed italicized rationale to bridge the gap
between knowing a fact and applying it to complex patient scenarios.
1. Leadership: Delegation
A nurse is caring for a client who is 1 day postoperative following a total hip arthroplasty.
Which of the following tasks should the nurse delegate to an Assistive Personnel (AP)?
A. Assessing the client’s surgical incision for signs of infection.
B. Assisting the client to sit in a chair for the first time.
C. Monitoring the client’s pain level using a scale of 0 to 10.
D. Recording the client’s intake and output for the shift.
Answer: D
Rationale: Recording intake and output is a routine task within the AP's scope of practice.
Assessment (A), initial mobilization (B), and pain monitoring (C) require the clinical judgment of
a licensed nurse.
2. Med-Surg: Post-Op Care
A nurse is assessing a client following a thyroidectomy. Which of the following findings is the
priority to report to the provider?
A. Sore throat when speaking.
B. Tingling in the fingers and toes.
C. Serosanguineous drainage on the dressing.
D. Pain at the incision site of 5 on a scale of 0 to 10.
Answer: B
Rationale: Tingling in the extremities (paresthesia) is a sign of hypocalcemia, which can occur
if the parathyroid glands are accidentally damaged or removed during surgery. This can lead to
life-threatening tetany and laryngospasm.
3. Pharmacology: Anticoagulants
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following
actions should the nurse take?
A. Massage the site after injection to increase absorption.
, 2026 UPDATED QUESTIONS DOWNLOAD
B. Use a 22-gauge needle to administer the medication.
C. Administer the injection into the abdomen, at least 2 inches from the umbilicus.
D. Aspirate for blood return before injecting the medication.
Answer: C
Rationale: Heparin should be injected into the abdominal fat at least 2 inches away from the
umbilicus. Massaging (A), using a large needle (B), or aspirating (D) can cause tissue trauma
and hematoma formation.
4. Pediatrics: Vital Signs
A nurse is assessing a 6-month-old infant. Which of the following findings should the nurse
report to the provider?
A. Heart rate of 140/min.
B. Respiratory rate of 25/min.
C. Temperature of 37.5°C (99.5°F).
D. Closed anterior fontanel.
Answer: D
Rationale: The anterior fontanel typically closes between 12 and 18 months of age. Early
closure (craniosynostosis) can interfere with brain growth and requires medical evaluation.
5. Mental Health: Therapeutic Communication
A client with schizophrenia says, "The government has planted a chip in my brain to monitor
my thoughts." Which of the following responses should the nurse make?
A. "That is impossible; the government doesn't have that technology."
B. "It must be very frightening to feel like you are being monitored."
C. "I believe you, but let’s talk about something else."
D. "Why do you think the government wants to monitor you?"
Answer: B
Rationale: This response uses the therapeutic technique of reflecting the client's feelings
without validating the delusion. Challenging the delusion (A) or asking "why" (D) can make the
client defensive.
6. Maternal-Newborn: Postpartum
A nurse is caring for a client who is 2 hours postpartum. Which of the following findings
indicates the client is experiencing postpartum hemorrhage?
A. Blood pressure 110/70 mm Hg.
B. Soft, boggy uterus.
C. Small amount of lochia rubra.
D. Pulse rate 80/min.
Answer: B
Rationale: A soft, boggy uterus indicates uterine atony, which is the leading cause of
postpartum hemorrhage. The nurse should immediately perform fundal massage to stimulate
contraction.
, 2026 UPDATED QUESTIONS DOWNLOAD
7. Fundamentals: Infection Control
A nurse is caring for a client who has a prescription for Vancomycin-resistant enterococcus
(VRE). Which of the following precautions should the nurse initiate?
A. Airborne.
B. Droplet.
C. Contact.
D. Protective Environment.
Answer: C
Rationale: VRE is transmitted via direct or indirect contact with the patient or their environment.
Contact precautions require gowns and gloves.
8. Med-Surg: Endocrine
A nurse is reviewing the laboratory results for a client who has Diabetes Insipidus. Which of
the following findings should the nurse expect?
A. Urine specific gravity 1.002.
B. Serum sodium 130 mEq/L.
C. Urine osmolality 1,200 mOsm/kg.
D. Serum potassium 5.5 mEq/L.
Answer: A
Rationale: Diabetes Insipidus is characterized by a deficiency in ADH, leading to the excretion
of large amounts of dilute urine. A specific gravity of 1.002 is very low, indicating dilute urine.
9. Pharmacology: Toxicity
A client is taking Digoxin for heart failure. Which of the following symptoms should the nurse
instruct the client to report as a sign of toxicity?
A. Tinnitus.
B. Yellow-tinged vision.
C. Dry, nonproductive cough.
D. Photosensitivity.
Answer: B
Rationale: Visual disturbances, such as yellow or green "halos" or tinged vision, are classic
signs of digoxin toxicity, along with nausea, vomiting, and bradycardia.
10. Leadership: Ethical Principles
A nurse provides a client with accurate information about their diagnosis and treatment options
to help them make an informed decision. Which of the following ethical principles is the nurse
demonstrating?
A. Veracity.
B. Nonmaleficence.
C. Fidelity.
D. Justice.
Answer: A
, 2026 UPDATED QUESTIONS DOWNLOAD
Rationale: Veracity is the duty to tell the truth. By providing accurate information, the nurse is
being truthful with the client.
11. Med-Surg: Respiratory
A nurse is assessing a client with a chest tube. Which of the following findings in the water seal
chamber indicates a potential air leak?
A. Constant bubbling.
B. Intermittent bubbling with coughing.
C. Tidaling with inspiration and expiration.
D. Fluid level at the 2 cm mark.
Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system.
Intermittent bubbling (B) is expected when the client coughs or exhales, and tidaling (C) is a
normal finding.
12. Pediatrics: Developmental Milestones
At what age should a nurse expect a child to be able to jump in place and stand on one foot for
a moment?
A. 18 months.
B. 2 years.
C. 3 years.
D. 4 years.
Answer: C
Rationale: Standing on one foot and jumping in place are typical gross motor skills for a 3-
year-old child.
13. Maternal-Newborn: Fetal Monitoring
A nurse is observing a fetal heart rate (FHR) tracing and notes early decelerations. Which of
the following actions should the nurse take?
A. Reposition the client on her left side.
B. Administer oxygen via nonrebreather mask.
C. Prepare for an emergency Cesarean section.
D. Continue to monitor the tracing.
Answer: D
Rationale: Early decelerations are caused by fetal head compression during contractions and
are a reassuring finding. No intervention is required other than continued monitoring.
14. Fundamentals: Electrolytes
A nurse is reviewing the ECG of a client with a potassium level of 2.8 mEq/L. Which of the
following findings should the nurse expect?
A. Tall, peaked T waves.
B. Widened QRS complex.
C. Presence of U waves.
ATI RN Comprehensive Predictor 2026-2027 | 350-Question Practice Set: Med-Surg,
Pharmacology, Pediatrics, OB, Mental Health, & Lead Management with Detailed
Rationales
Achieve a 90% or higher predictability score on your nursing exit exam with this
meticulously updated 350-question practice set for the 2026-2027 cycle. Each
question is designed to test high-level clinical judgment, focusing on the most "must-
know" topics like electrolyte imbalances, acid-base disorders, and emergency
interventions. Every answer includes a detailed italicized rationale to bridge the gap
between knowing a fact and applying it to complex patient scenarios.
1. Leadership: Delegation
A nurse is caring for a client who is 1 day postoperative following a total hip arthroplasty.
Which of the following tasks should the nurse delegate to an Assistive Personnel (AP)?
A. Assessing the client’s surgical incision for signs of infection.
B. Assisting the client to sit in a chair for the first time.
C. Monitoring the client’s pain level using a scale of 0 to 10.
D. Recording the client’s intake and output for the shift.
Answer: D
Rationale: Recording intake and output is a routine task within the AP's scope of practice.
Assessment (A), initial mobilization (B), and pain monitoring (C) require the clinical judgment of
a licensed nurse.
2. Med-Surg: Post-Op Care
A nurse is assessing a client following a thyroidectomy. Which of the following findings is the
priority to report to the provider?
A. Sore throat when speaking.
B. Tingling in the fingers and toes.
C. Serosanguineous drainage on the dressing.
D. Pain at the incision site of 5 on a scale of 0 to 10.
Answer: B
Rationale: Tingling in the extremities (paresthesia) is a sign of hypocalcemia, which can occur
if the parathyroid glands are accidentally damaged or removed during surgery. This can lead to
life-threatening tetany and laryngospasm.
3. Pharmacology: Anticoagulants
A nurse is preparing to administer heparin subcutaneously to a client. Which of the following
actions should the nurse take?
A. Massage the site after injection to increase absorption.
, 2026 UPDATED QUESTIONS DOWNLOAD
B. Use a 22-gauge needle to administer the medication.
C. Administer the injection into the abdomen, at least 2 inches from the umbilicus.
D. Aspirate for blood return before injecting the medication.
Answer: C
Rationale: Heparin should be injected into the abdominal fat at least 2 inches away from the
umbilicus. Massaging (A), using a large needle (B), or aspirating (D) can cause tissue trauma
and hematoma formation.
4. Pediatrics: Vital Signs
A nurse is assessing a 6-month-old infant. Which of the following findings should the nurse
report to the provider?
A. Heart rate of 140/min.
B. Respiratory rate of 25/min.
C. Temperature of 37.5°C (99.5°F).
D. Closed anterior fontanel.
Answer: D
Rationale: The anterior fontanel typically closes between 12 and 18 months of age. Early
closure (craniosynostosis) can interfere with brain growth and requires medical evaluation.
5. Mental Health: Therapeutic Communication
A client with schizophrenia says, "The government has planted a chip in my brain to monitor
my thoughts." Which of the following responses should the nurse make?
A. "That is impossible; the government doesn't have that technology."
B. "It must be very frightening to feel like you are being monitored."
C. "I believe you, but let’s talk about something else."
D. "Why do you think the government wants to monitor you?"
Answer: B
Rationale: This response uses the therapeutic technique of reflecting the client's feelings
without validating the delusion. Challenging the delusion (A) or asking "why" (D) can make the
client defensive.
6. Maternal-Newborn: Postpartum
A nurse is caring for a client who is 2 hours postpartum. Which of the following findings
indicates the client is experiencing postpartum hemorrhage?
A. Blood pressure 110/70 mm Hg.
B. Soft, boggy uterus.
C. Small amount of lochia rubra.
D. Pulse rate 80/min.
Answer: B
Rationale: A soft, boggy uterus indicates uterine atony, which is the leading cause of
postpartum hemorrhage. The nurse should immediately perform fundal massage to stimulate
contraction.
, 2026 UPDATED QUESTIONS DOWNLOAD
7. Fundamentals: Infection Control
A nurse is caring for a client who has a prescription for Vancomycin-resistant enterococcus
(VRE). Which of the following precautions should the nurse initiate?
A. Airborne.
B. Droplet.
C. Contact.
D. Protective Environment.
Answer: C
Rationale: VRE is transmitted via direct or indirect contact with the patient or their environment.
Contact precautions require gowns and gloves.
8. Med-Surg: Endocrine
A nurse is reviewing the laboratory results for a client who has Diabetes Insipidus. Which of
the following findings should the nurse expect?
A. Urine specific gravity 1.002.
B. Serum sodium 130 mEq/L.
C. Urine osmolality 1,200 mOsm/kg.
D. Serum potassium 5.5 mEq/L.
Answer: A
Rationale: Diabetes Insipidus is characterized by a deficiency in ADH, leading to the excretion
of large amounts of dilute urine. A specific gravity of 1.002 is very low, indicating dilute urine.
9. Pharmacology: Toxicity
A client is taking Digoxin for heart failure. Which of the following symptoms should the nurse
instruct the client to report as a sign of toxicity?
A. Tinnitus.
B. Yellow-tinged vision.
C. Dry, nonproductive cough.
D. Photosensitivity.
Answer: B
Rationale: Visual disturbances, such as yellow or green "halos" or tinged vision, are classic
signs of digoxin toxicity, along with nausea, vomiting, and bradycardia.
10. Leadership: Ethical Principles
A nurse provides a client with accurate information about their diagnosis and treatment options
to help them make an informed decision. Which of the following ethical principles is the nurse
demonstrating?
A. Veracity.
B. Nonmaleficence.
C. Fidelity.
D. Justice.
Answer: A
, 2026 UPDATED QUESTIONS DOWNLOAD
Rationale: Veracity is the duty to tell the truth. By providing accurate information, the nurse is
being truthful with the client.
11. Med-Surg: Respiratory
A nurse is assessing a client with a chest tube. Which of the following findings in the water seal
chamber indicates a potential air leak?
A. Constant bubbling.
B. Intermittent bubbling with coughing.
C. Tidaling with inspiration and expiration.
D. Fluid level at the 2 cm mark.
Answer: A
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system.
Intermittent bubbling (B) is expected when the client coughs or exhales, and tidaling (C) is a
normal finding.
12. Pediatrics: Developmental Milestones
At what age should a nurse expect a child to be able to jump in place and stand on one foot for
a moment?
A. 18 months.
B. 2 years.
C. 3 years.
D. 4 years.
Answer: C
Rationale: Standing on one foot and jumping in place are typical gross motor skills for a 3-
year-old child.
13. Maternal-Newborn: Fetal Monitoring
A nurse is observing a fetal heart rate (FHR) tracing and notes early decelerations. Which of
the following actions should the nurse take?
A. Reposition the client on her left side.
B. Administer oxygen via nonrebreather mask.
C. Prepare for an emergency Cesarean section.
D. Continue to monitor the tracing.
Answer: D
Rationale: Early decelerations are caused by fetal head compression during contractions and
are a reassuring finding. No intervention is required other than continued monitoring.
14. Fundamentals: Electrolytes
A nurse is reviewing the ECG of a client with a potassium level of 2.8 mEq/L. Which of the
following findings should the nurse expect?
A. Tall, peaked T waves.
B. Widened QRS complex.
C. Presence of U waves.
