VIRTUAL ATI GREEN LIGHT
COMPREHENSIVE PREDICTOR 2026–2027 |
180+ NCLEX-STYLE PRACTICE QUESTIONS
WITH DETAILED ANSWERS & RATIONALES |
COMPLETE V-ATI READINESS REVIEW
• This 200-question practice exam mirrors the Virtual ATI Green Light
Comprehensive Predictor format, featuring NCLEX-style questions with detailed
EXPERT RATIONALE to sharpen your clinical reasoning and boost exam readiness.
• Study each question carefully, review the EXPERT RATIONALE for the correct
answer even when you get it right, and revisit any topic area where you miss two or
more questions in a row.
VIRTUAL ATI GREEN LIGHT COMPREHENSIVE PREDICTOR 2026–2027 180+
NCLEX-STYLE PRACTICE QUESTIONS WITH DETAILED ANSWERS & EXPERT
RATIONALE COMPLETE V-ATI READINESS REVIEW
1. A nurse is caring for a client who has been diagnosed with heart failure and
is prescribed furosemide. Which assessment finding requires immediate
intervention?
A. Urine output of 200 mL over 4 hours
B. Blood pressure of 118/76 mmHg
C. Serum potassium of 2.8 mEq/L
D. Weight loss of 1 lb since yesterday
E. Mild ankle edema bilaterally
✔ C. Serum potassium of 2.8 mEq/L
EXPERT RATIONALE: Furosemide is a loop diuretic that causes potassium wasting.
A serum potassium of 2.8 mEq/L is critically low (normal 3.5–5.0 mEq/L), placing the
client at risk for life-threatening dysrhythmias. This requires immediate intervention
including potassium replacement and provider notification.
,2. A nurse is preparing to administer a blood transfusion. Which action is the
priority before initiating the transfusion?
A. Obtain vital signs 15 minutes after starting the transfusion
B. Warm the blood to room temperature for 45 minutes
C. Verify the blood product with another licensed nurse at the bedside
D. Insert a 22-gauge IV catheter for the transfusion
E. Premedicate the client with acetaminophen routinely
✔ C. Verify the blood product with another licensed nurse at the bedside
EXPERT RATIONALE: The priority safety action before any blood transfusion is two-
nurse verification of the blood product, client identification, blood type, and
expiration date. This prevents potentially fatal transfusion reactions from
mismatched blood.
3. A nurse is assessing a client with chronic obstructive pulmonary disease
(COPD). Which finding is expected?
A. Bradycardia and hypertension
B. Barrel chest and prolonged expiratory phase
C. Inspiratory crackles bilaterally
D. SpO₂ of 99% on room air
E. Decreased anteroposterior chest diameter
✔ B. Barrel chest and prolonged expiratory phase
EXPERT RATIONALE: Chronic air trapping in COPD causes hyperinflation, resulting
in a barrel-shaped chest with increased anteroposterior diameter. Expiration
becomes prolonged and labored as the client tries to exhale trapped air through
narrowed airways.
,4. A nurse is teaching a client with type 2 diabetes mellitus about foot care.
Which statement by the client indicates a need for further teaching?
A. "I will inspect my feet every day."
B. "I will wear well-fitting shoes at all times."
C. "I will soak my feet in hot water to improve circulation."
D. "I will cut my toenails straight across."
E. "I will notify my provider if I notice any sores."
✔ C. "I will soak my feet in hot water to improve circulation."
EXPERT RATIONALE: Soaking feet in hot water is contraindicated in diabetic clients
due to peripheral neuropathy, which impairs the ability to sense temperature. This
can lead to burns and serious wounds. Clients should wash feet in lukewarm water
and dry thoroughly.
5. A nurse is caring for a client receiving patient-controlled analgesia (PCA).
Which finding requires immediate intervention?
A. Respiratory rate of 10 breaths/min
B. Client reports pain of 4/10
C. Client pushing the PCA button every 30 minutes
D. SpO₂ of 96%
E. Client is drowsy but arouses to voice
✔ A. Respiratory rate of 10 breaths/min
EXPERT RATIONALE: A respiratory rate of 10 breaths/min indicates opioid-induced
respiratory depression, which is a life-threatening emergency. Normal adult
respiratory rate is 12–20 breaths/min. The nurse must intervene immediately,
which may include administering naloxone.
, 6. A nurse is caring for a postoperative client who reports chest pain and
shortness of breath. The nurse suspects pulmonary embolism. Which action
should the nurse take first?
A. Administer oxygen via face mask
B. Notify the provider immediately
C. Obtain a 12-lead ECG
D. Elevate the head of the bed to 90 degrees
E. Prepare for anticoagulant therapy
✔ A. Administer oxygen via face mask
EXPERT RATIONALE: Using the ABCs (Airway, Breathing, Circulation), the priority
action is to address oxygenation. Administering oxygen helps correct hypoxia
caused by the PE. Notifying the provider is important but comes after stabilizing the
client's airway and breathing.
7. A nurse is assessing a newborn at 1 minute after birth. The newborn has a
heart rate of 96, weak cry, some flexion of extremities, grimaces to
stimulation, and is pink with blue extremities. What is the Apgar score?
A. 5
B. 6
C. 7
D. 8
E. 4
✔ B. 6
EXPERT RATIONALE: Apgar scoring: Heart rate <100 = 1 point; weak cry = 1 point;
some flexion = 1 point; grimace = 1 point; pink body with blue extremities
(acrocyanosis) = 1 point. Total = 5 points. Wait — heart rate 96 = 1, weak cry = 1,
COMPREHENSIVE PREDICTOR 2026–2027 |
180+ NCLEX-STYLE PRACTICE QUESTIONS
WITH DETAILED ANSWERS & RATIONALES |
COMPLETE V-ATI READINESS REVIEW
• This 200-question practice exam mirrors the Virtual ATI Green Light
Comprehensive Predictor format, featuring NCLEX-style questions with detailed
EXPERT RATIONALE to sharpen your clinical reasoning and boost exam readiness.
• Study each question carefully, review the EXPERT RATIONALE for the correct
answer even when you get it right, and revisit any topic area where you miss two or
more questions in a row.
VIRTUAL ATI GREEN LIGHT COMPREHENSIVE PREDICTOR 2026–2027 180+
NCLEX-STYLE PRACTICE QUESTIONS WITH DETAILED ANSWERS & EXPERT
RATIONALE COMPLETE V-ATI READINESS REVIEW
1. A nurse is caring for a client who has been diagnosed with heart failure and
is prescribed furosemide. Which assessment finding requires immediate
intervention?
A. Urine output of 200 mL over 4 hours
B. Blood pressure of 118/76 mmHg
C. Serum potassium of 2.8 mEq/L
D. Weight loss of 1 lb since yesterday
E. Mild ankle edema bilaterally
✔ C. Serum potassium of 2.8 mEq/L
EXPERT RATIONALE: Furosemide is a loop diuretic that causes potassium wasting.
A serum potassium of 2.8 mEq/L is critically low (normal 3.5–5.0 mEq/L), placing the
client at risk for life-threatening dysrhythmias. This requires immediate intervention
including potassium replacement and provider notification.
,2. A nurse is preparing to administer a blood transfusion. Which action is the
priority before initiating the transfusion?
A. Obtain vital signs 15 minutes after starting the transfusion
B. Warm the blood to room temperature for 45 minutes
C. Verify the blood product with another licensed nurse at the bedside
D. Insert a 22-gauge IV catheter for the transfusion
E. Premedicate the client with acetaminophen routinely
✔ C. Verify the blood product with another licensed nurse at the bedside
EXPERT RATIONALE: The priority safety action before any blood transfusion is two-
nurse verification of the blood product, client identification, blood type, and
expiration date. This prevents potentially fatal transfusion reactions from
mismatched blood.
3. A nurse is assessing a client with chronic obstructive pulmonary disease
(COPD). Which finding is expected?
A. Bradycardia and hypertension
B. Barrel chest and prolonged expiratory phase
C. Inspiratory crackles bilaterally
D. SpO₂ of 99% on room air
E. Decreased anteroposterior chest diameter
✔ B. Barrel chest and prolonged expiratory phase
EXPERT RATIONALE: Chronic air trapping in COPD causes hyperinflation, resulting
in a barrel-shaped chest with increased anteroposterior diameter. Expiration
becomes prolonged and labored as the client tries to exhale trapped air through
narrowed airways.
,4. A nurse is teaching a client with type 2 diabetes mellitus about foot care.
Which statement by the client indicates a need for further teaching?
A. "I will inspect my feet every day."
B. "I will wear well-fitting shoes at all times."
C. "I will soak my feet in hot water to improve circulation."
D. "I will cut my toenails straight across."
E. "I will notify my provider if I notice any sores."
✔ C. "I will soak my feet in hot water to improve circulation."
EXPERT RATIONALE: Soaking feet in hot water is contraindicated in diabetic clients
due to peripheral neuropathy, which impairs the ability to sense temperature. This
can lead to burns and serious wounds. Clients should wash feet in lukewarm water
and dry thoroughly.
5. A nurse is caring for a client receiving patient-controlled analgesia (PCA).
Which finding requires immediate intervention?
A. Respiratory rate of 10 breaths/min
B. Client reports pain of 4/10
C. Client pushing the PCA button every 30 minutes
D. SpO₂ of 96%
E. Client is drowsy but arouses to voice
✔ A. Respiratory rate of 10 breaths/min
EXPERT RATIONALE: A respiratory rate of 10 breaths/min indicates opioid-induced
respiratory depression, which is a life-threatening emergency. Normal adult
respiratory rate is 12–20 breaths/min. The nurse must intervene immediately,
which may include administering naloxone.
, 6. A nurse is caring for a postoperative client who reports chest pain and
shortness of breath. The nurse suspects pulmonary embolism. Which action
should the nurse take first?
A. Administer oxygen via face mask
B. Notify the provider immediately
C. Obtain a 12-lead ECG
D. Elevate the head of the bed to 90 degrees
E. Prepare for anticoagulant therapy
✔ A. Administer oxygen via face mask
EXPERT RATIONALE: Using the ABCs (Airway, Breathing, Circulation), the priority
action is to address oxygenation. Administering oxygen helps correct hypoxia
caused by the PE. Notifying the provider is important but comes after stabilizing the
client's airway and breathing.
7. A nurse is assessing a newborn at 1 minute after birth. The newborn has a
heart rate of 96, weak cry, some flexion of extremities, grimaces to
stimulation, and is pink with blue extremities. What is the Apgar score?
A. 5
B. 6
C. 7
D. 8
E. 4
✔ B. 6
EXPERT RATIONALE: Apgar scoring: Heart rate <100 = 1 point; weak cry = 1 point;
some flexion = 1 point; grimace = 1 point; pink body with blue extremities
(acrocyanosis) = 1 point. Total = 5 points. Wait — heart rate 96 = 1, weak cry = 1,
