ATI RN Comprehensive Predictor
2026: Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct
Section 1: NGN Case Study – Septic Shock (Med-Surg)
Scenario: A 72-year-old female is brought to the ED with fever, confusion, and
weakness. History of UTI 3 days ago. Vitals: T 39.1°C (102.4°F), HR 124, RR 30,
BP 82/48, SpO₂ 91% on RA. Labs: WBC 19,000, Lactate 5.1 mmol/L, Creatinine
2.4 (baseline 1.1).
1. Recognizing Cues: Which findings indicate septic shock? (Select All That
Apply)
A. Hypotension
B. Elevated lactate
C. Tachycardia
D. Elevated creatinine
E. Fever
Correct Answer: A, B, C, D
Rationale: Septic shock is defined as sepsis with persistent hypotension requiring
vasopressors and having a serum lactate level >2 mmol/L despite adequate volume
resuscitation. This patient has hypotension (BP 82/48), elevated lactate (5.1),
tachycardia (HR 124), and organ dysfunction (elevated creatinine indicating acute
kidney injury). While fever (E) indicates infection, it is not a specific criterion
for shock (hypoperfusion).
2. Taking Action: What is the nurse’s priority action?
A. Administer acetaminophen for fever
B. Begin 30 mL/kg IV fluid resuscitation
C. Obtain a urine sample
D. Start insulin drip for hyperglycemia
,Correct Answer: B. Begin 30 mL/kg IV fluids
Rationale: The Surviving Sepsis Campaign recommends rapid administration of
30 mL/kg of crystalloid fluids for hypotension or lactate ≥4 mmol/L. Fluid
resuscitation is first-line to restore intravascular volume and improve tissue
perfusion before vasopactive agents are considered.
3. Evaluate Outcomes: Which finding indicates that treatment is effective?
A. Heart rate increases to 132
B. Lactate level rises to 6.2
C. Mean Arterial Pressure (MAP) is 70 mmHg
D. Urine output drops to 20 mL/hr
Correct Answer: C. Mean Arterial Pressure (MAP) is 70 mmHg
Rationale: Resuscitation goals typically include MAP ≥65 mmHg (70 indicates
stability), urine output >0.5 mL/kg/hr (not dropping), and decreasing lactate.
Tachycardia and rising lactate indicate worsening perfusion.
Section 2: NGN Case Study – Postpartum Hemorrhage (Maternal-Newborn)
Scenario: A 25-year-old G1P1 is 1 hour post vaginal delivery of a 7lb 2oz infant.
The nurse notes the perineal pad is saturated in 10 minutes. The fundus is boggy
and displaced above the umbilicus.
4. Generating Solutions: Which medication is contraindicated for this patient?
A. Oxytocin (Pitocin)
B. Methylergonovine (Methergine)
C. Misoprostol (Cytotec)
D. Carboprost (Hemabate)
Correct Answer: B. Methylergonovine (Methergine)
Rationale: Methylergonovine is contraindicated in patients
with hypertension because it causes smooth muscle constriction leading to
elevated blood pressure. Oxytocin is first-line for atony; misoprostol and
carboprost are second-line uterotonics.
5. Priority Action: What is the immediate nursing action?
A. Call the provider stat
B. Increase IV fluids
, C. Perform fundal massage
D. Prepare for blood transfusion
Correct Answer: C. Perform fundal massage
Rationale: A boggy uterus indicates uterine atony, the leading cause of postpartum
hemorrhage. The immediate priority is mechanical stimulation via fundal
massage to promote contraction and expel clots. The nurse should massage first,
then check for placental fragments while administering oxytocin.
Section 3: Comprehensive Content Review (Management of Care & Safety)
6. (SATA) Delegation: Which tasks can the RN delegate to an LPN/LVN?
(Select All That Apply)
A. Initial admission assessment of a new patient
B. Administration of a tube feeding to a stable patient
C. Suctioning a tracheostomy for a patient with a stable airway
D. Teaching a diabetic patient how to administer insulin
E. Monitoring for side effects of a blood transfusion
Correct Answer: B, C
Rationale: The LPN/LVN can perform stable and standardized procedures (e.g.,
tube feedings, trach care, med admin). The RN cannot
delegate assessment (A), teaching (D), or unstable patient monitoring (E).
7. Priority: A nurse receives report on 4 clients. Which should be seen first?
A. Client with chest pain radiating to the jaw
B. Client requesting discharge instructions
C. Client with a blood glucose of 140 mg/dL
D. Client with a new order for a diet
Correct Answer: A. Client with chest pain radiating to the jaw
Rationale: Using the ABCs (Airway, Breathing, Circulation) and acute vs.
chronic prioritization, chest pain radiating to the jaw suggests an acute myocardial
infarction or angina, requiring immediate assessment. The other options are stable
or non-urgent.
8. Disaster Triage: In a mass casualty event, which color tag is assigned to a
patient with a tension pneumothorax?
A. Green (Minor)
2026: Questions And Answers With
Rationales/Graded A+/2026
Update/100% Correct
Section 1: NGN Case Study – Septic Shock (Med-Surg)
Scenario: A 72-year-old female is brought to the ED with fever, confusion, and
weakness. History of UTI 3 days ago. Vitals: T 39.1°C (102.4°F), HR 124, RR 30,
BP 82/48, SpO₂ 91% on RA. Labs: WBC 19,000, Lactate 5.1 mmol/L, Creatinine
2.4 (baseline 1.1).
1. Recognizing Cues: Which findings indicate septic shock? (Select All That
Apply)
A. Hypotension
B. Elevated lactate
C. Tachycardia
D. Elevated creatinine
E. Fever
Correct Answer: A, B, C, D
Rationale: Septic shock is defined as sepsis with persistent hypotension requiring
vasopressors and having a serum lactate level >2 mmol/L despite adequate volume
resuscitation. This patient has hypotension (BP 82/48), elevated lactate (5.1),
tachycardia (HR 124), and organ dysfunction (elevated creatinine indicating acute
kidney injury). While fever (E) indicates infection, it is not a specific criterion
for shock (hypoperfusion).
2. Taking Action: What is the nurse’s priority action?
A. Administer acetaminophen for fever
B. Begin 30 mL/kg IV fluid resuscitation
C. Obtain a urine sample
D. Start insulin drip for hyperglycemia
,Correct Answer: B. Begin 30 mL/kg IV fluids
Rationale: The Surviving Sepsis Campaign recommends rapid administration of
30 mL/kg of crystalloid fluids for hypotension or lactate ≥4 mmol/L. Fluid
resuscitation is first-line to restore intravascular volume and improve tissue
perfusion before vasopactive agents are considered.
3. Evaluate Outcomes: Which finding indicates that treatment is effective?
A. Heart rate increases to 132
B. Lactate level rises to 6.2
C. Mean Arterial Pressure (MAP) is 70 mmHg
D. Urine output drops to 20 mL/hr
Correct Answer: C. Mean Arterial Pressure (MAP) is 70 mmHg
Rationale: Resuscitation goals typically include MAP ≥65 mmHg (70 indicates
stability), urine output >0.5 mL/kg/hr (not dropping), and decreasing lactate.
Tachycardia and rising lactate indicate worsening perfusion.
Section 2: NGN Case Study – Postpartum Hemorrhage (Maternal-Newborn)
Scenario: A 25-year-old G1P1 is 1 hour post vaginal delivery of a 7lb 2oz infant.
The nurse notes the perineal pad is saturated in 10 minutes. The fundus is boggy
and displaced above the umbilicus.
4. Generating Solutions: Which medication is contraindicated for this patient?
A. Oxytocin (Pitocin)
B. Methylergonovine (Methergine)
C. Misoprostol (Cytotec)
D. Carboprost (Hemabate)
Correct Answer: B. Methylergonovine (Methergine)
Rationale: Methylergonovine is contraindicated in patients
with hypertension because it causes smooth muscle constriction leading to
elevated blood pressure. Oxytocin is first-line for atony; misoprostol and
carboprost are second-line uterotonics.
5. Priority Action: What is the immediate nursing action?
A. Call the provider stat
B. Increase IV fluids
, C. Perform fundal massage
D. Prepare for blood transfusion
Correct Answer: C. Perform fundal massage
Rationale: A boggy uterus indicates uterine atony, the leading cause of postpartum
hemorrhage. The immediate priority is mechanical stimulation via fundal
massage to promote contraction and expel clots. The nurse should massage first,
then check for placental fragments while administering oxytocin.
Section 3: Comprehensive Content Review (Management of Care & Safety)
6. (SATA) Delegation: Which tasks can the RN delegate to an LPN/LVN?
(Select All That Apply)
A. Initial admission assessment of a new patient
B. Administration of a tube feeding to a stable patient
C. Suctioning a tracheostomy for a patient with a stable airway
D. Teaching a diabetic patient how to administer insulin
E. Monitoring for side effects of a blood transfusion
Correct Answer: B, C
Rationale: The LPN/LVN can perform stable and standardized procedures (e.g.,
tube feedings, trach care, med admin). The RN cannot
delegate assessment (A), teaching (D), or unstable patient monitoring (E).
7. Priority: A nurse receives report on 4 clients. Which should be seen first?
A. Client with chest pain radiating to the jaw
B. Client requesting discharge instructions
C. Client with a blood glucose of 140 mg/dL
D. Client with a new order for a diet
Correct Answer: A. Client with chest pain radiating to the jaw
Rationale: Using the ABCs (Airway, Breathing, Circulation) and acute vs.
chronic prioritization, chest pain radiating to the jaw suggests an acute myocardial
infarction or angina, requiring immediate assessment. The other options are stable
or non-urgent.
8. Disaster Triage: In a mass casualty event, which color tag is assigned to a
patient with a tension pneumothorax?
A. Green (Minor)
