Virtual ATI Green Light Comprehensive Predictor Practice Questions and
Answers Updated 2026 | Complete ATI NCLEX Readiness Study Guide with
Verified Questions, Detailed Rationales, Medical-Surgical Nursing,
Pharmacology, Maternal-Newborn, Pediatrics, Mental Health,
Fundamentals, Leadership & Management, Community Health & NGN
Clinical Judgment Exam Prep
Question 1: Which action is the priority for a client with suspected cervical spine
injury and airway obstruction? A. Administer oxygen via nasal cannula. B. Perform a
jaw-thrust maneuver. C. Insert an oropharyngeal airway. D. Prepare for endotracheal
intubation. CORRECT ANSWER: B. Perform a jaw-thrust maneuver. Rationale: The
jaw-thrust maneuver is the priority intervention to open the airway without extending
the neck in a client with a suspected cervical spine injury.
Question 2: A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD). Which oxygen delivery device is most appropriate for precise
oxygen concentration? A. Nasal cannula. B. Simple face mask. C. Venturi mask. D.
Non-rebreather mask. CORRECT ANSWER: C. Venturi mask. Rationale: A Venturi
mask delivers the most precise concentration of oxygen, which is crucial for clients with
COPD to prevent suppressing their hypoxic drive to breathe.
Question 3: A client’s telemetry monitor suddenly shows ventricular fibrillation.
What is the nurse’s first action? A. Call a code blue. B. Defibrillate the client
immediately. C. Assess the client and check the monitor leads. D. Begin
cardiopulmonary resuscitation (CPR). CORRECT ANSWER: C. Assess the client and
check the monitor leads. Rationale: The nurse must first assess the client to verify the
rhythm and rule out artifact or lead displacement before initiating emergency
interventions like defibrillation.
Question 4: A nurse is preparing to administer a unit of packed red blood cells
(PRBCs). Which IV solution should be used to prime the blood administration
tubing? A. 5% Dextrose in water (D5W). B. 0.9% Sodium chloride (Normal saline). C.
Lactated Ringer’s solution. D. 0.45% Sodium chloride. CORRECT ANSWER: B. 0.9%
Sodium chloride (Normal saline). Rationale: Normal saline is the only IV solution
compatible with blood products; dextrose and calcium-containing solutions can cause
hemolysis or clotting of the blood.
Question 5: A client with methicillin-resistant Staphylococcus aureus (MRSA) in a
wound requires contact precautions. Which personal protective equipment (PPE) is
mandatory upon entry? A. N95 respirator and eye protection. B. Surgical mask and
face shield. C. Gown and gloves. D. Gown, gloves, and N95 respirator. CORRECT
ANSWER: C. Gown and gloves. Rationale: Contact precautions require the use of a
gown and gloves to prevent the transmission of multidrug-resistant organisms like
MRSA via direct or indirect contact.
Question 6: A nurse is implementing fall precautions for a client. Which action is
the most effective environmental intervention? A. Keep all four side rails up at all
,times. B. Ensure the bed is in the lowest position. C. Turn off the lights to promote sleep.
D. Restrict the client’s fluid intake in the evening. CORRECT ANSWER: B. Ensure the
bed is in the lowest position. Rationale: Keeping the bed in the lowest position
minimizes the distance to the floor in the event of a fall, reducing the risk of injury.
Question 7: A nurse is administering oral medications. Which action best ensures
the "right patient" according to the rights of medication administration? A. Asking
the client, "Are you Mr. Smith?" B. Checking the client’s armband and asking them to
state their name and date of birth. C. Checking the room number against the
medication administration record (MAR). D. Asking the client’s spouse to confirm the
client's identity. CORRECT ANSWER: B. Checking the client’s armband and asking
them to state their name and date of birth. Rationale: Using two patient identifiers,
such as name and date of birth, and verifying them against the armband and MAR is the
standard practice to ensure the right patient.
Question 8: A client reports a pain level of 8 out of 10. What is the nurse’s priority
action before administering prescribed analgesia? A. Administer the medication
immediately. B. Assess the client's vital signs and pain characteristics. C. Call the
provider to request a higher dose. D. Document the pain level in the medical record.
CORRECT ANSWER: B. Assess the client's vital signs and pain characteristics.
Rationale: A comprehensive pain assessment, including vital signs and pain
characteristics (PQRST), must be completed to establish a baseline and guide
appropriate intervention.
Question 9: A nurse is applying a continuous pulse oximetry monitor to a client.
Which factor can cause a falsely low reading? A. Warming the extremity. B. Applying
the probe to a finger with nail polish. C. Ensuring the probe is snug but not tight. D.
Placing the probe on the earlobe. CORRECT ANSWER: B. Applying the probe to a
finger with nail polish. Rationale: Nail polish, artificial nails, or dark skin pigmentation
can interfere with the light transmission of the pulse oximeter, leading to inaccurate,
often falsely low, readings.
Question 10: A nurse is suctioning a client’s tracheostomy. Which action is correct
to prevent hypoxia? A. Apply suction while inserting the catheter. B. Suction
continuously for 20 seconds. C. Hyperoxygenate the client before and after suctioning.
D. Limit suctioning to three passes per session. CORRECT ANSWER: C.
Hyperoxygenate the client before and after suctioning. Rationale: Hyperoxygenating
with 100% oxygen before and after suctioning prevents hypoxemia caused by the
removal of oxygen along with secretions during the procedure.
Question 11: A nurse is caring for a client with a newly placed indwelling urinary
catheter. Which action is essential to prevent catheter-associated urinary tract
infections (CAUTI)? A. Keep the collection bag above the level of the bladder. B.
Perform routine daily perineal care with antimicrobial soap. C. Maintain a closed
drainage system and keep the bag below the bladder. D. Irrigate the catheter daily with
normal saline. CORRECT ANSWER: C. Maintain a closed drainage system and keep
,the bag below the bladder. Rationale: Maintaining a closed system and keeping the
bag below the bladder prevents backflow of urine and bacterial entry, which are primary
causes of CAUTI.
Question 12: A client with a cast on the right arm reports severe pain unrelieved by
medication. What is the nurse’s priority assessment? A. Check the capillary refill and
sensation of the right hand. B. Elevate the arm above the level of the heart. C. Apply an
ice pack directly to the cast. D. Administer a prescribed breakthrough analgesic.
CORRECT ANSWER: A. Check the capillary refill and sensation of the right hand.
Rationale: Severe, unrelieved pain in a casted extremity is a hallmark sign of
compartment syndrome; the nurse must immediately assess neurovascular status
(pulse, pallor, paresthesia, pain, paralysis).
Question 13: A nurse is preparing to administer a subcutaneous injection of insulin.
Which site is most appropriate for consistent absorption? A. The deltoid muscle. B.
The abdomen, 2 inches away from the umbilicus. C. The vastus lateralis muscle. D. The
gluteal muscle. CORRECT ANSWER: B. The abdomen, 2 inches away from the
umbilicus. Rationale: The abdomen provides the most rapid and consistent absorption
for subcutaneous insulin injections compared to the arms, thighs, or buttocks.
Question 14: A client is prescribed a low-sodium diet. Which food choice indicates
an understanding of the diet? A. Canned tomato soup. B. Fresh bananas and apples.
C. Processed deli turkey. D. Instant oatmeal packets. CORRECT ANSWER: B. Fresh
bananas and apples. Rationale: Fresh fruits and vegetables are naturally low in
sodium, whereas canned soups, processed meats, and instant oatmeal are typically
high in sodium.
Question 15: A nurse is caring for a client with a stage 3 pressure injury. Which
wound characteristic is expected? A. Full-thickness tissue loss with exposed bone,
tendon, or muscle. B. Partial-thickness loss of dermis presenting as a shallow open
ulcer. C. Full-thickness tissue loss where subcutaneous fat may be visible, but bone is
not exposed. D. Intact skin with non-blanchable redness. CORRECT ANSWER: C. Full-
thickness tissue loss where subcutaneous fat may be visible, but bone is not
exposed. Rationale: A stage 3 pressure injury involves full-thickness tissue loss where
subcutaneous fat may be visible, but bone, tendon, or muscle are not exposed.
Question 16: A client with diabetes mellitus is scheduled for surgery. Which
preoperative instruction is most appropriate regarding their morning insulin dose?
A. Take the full usual dose of insulin. B. Skip the insulin dose entirely until after surgery.
C. Take half of the usual intermediate-acting insulin dose. D. Take the full dose of short-
acting insulin only. CORRECT ANSWER: C. Take half of the usual intermediate-acting
insulin dose. Rationale: Clients with diabetes typically receive 50% of their usual
intermediate-acting insulin on the morning of surgery to prevent hypoglycemia while
managing stress-induced hyperglycemia, per provider orders.
Question 17: A nurse is teaching a client about using a metered-dose inhaler (MDI)
with a spacer. Which statement by the client indicates correct understanding? A. "I
, will exhale completely, place the mouthpiece in my mouth, and press the canister as I
breathe in slowly." B. "I will shake the inhaler, press the canister three times before
inhaling, and then breathe in quickly." C. "I will hold my breath for 30 seconds after
inhaling the medication." D. "I will use the spacer only when I feel short of breath."
CORRECT ANSWER: A. "I will exhale completely, place the mouthpiece in my
mouth, and press the canister as I breathe in slowly." Rationale: Proper MDI
technique involves exhaling fully, placing the mouthpiece in the mouth, actuating the
inhaler while inhaling slowly and deeply, and holding the breath for 10 seconds.
Question 18: A nurse is caring for a client who is 1 day postoperative following a
total hip arthroplasty. Which positioning is contraindicated? A. Keeping the
operative leg in slight abduction. B. Placing a pillow between the legs when turning. C.
Flexing the hip of the operative leg greater than 90 degrees. D. Using an elevated toilet
seat. CORRECT ANSWER: C. Flexing the hip of the operative leg greater than 90
degrees. Rationale: Flexing the hip greater than 90 degrees, adducting the leg past the
midline, or internally rotating the leg can cause dislocation of the new hip prosthesis.
Question 19: A client with a history of peptic ulcer disease is taking omeprazole.
Which statement by the client indicates a need for further teaching? A. "I should
take this medication in the morning before breakfast." B. "I can crush the pill and mix it
with applesauce if I have trouble swallowing." C. "I will avoid taking NSAIDs for pain
relief." D. "I will report any black, tarry stools to my provider." CORRECT ANSWER: B. "I
can crush the pill and mix it with applesauce if I have trouble swallowing."
Rationale: Omeprazole is a delayed-release capsule or tablet that must be swallowed
whole; crushing or chewing it destroys the enteric coating, leading to premature
destruction of the drug by stomach acid.
Question 20: A nurse is assessing a client with suspected hypovolemic shock.
Which finding is an early indicator? A. Hypotension. B. Tachycardia. C. Oliguria. D.
Confusion. CORRECT ANSWER: B. Tachycardia. Rationale: Tachycardia is an early
compensatory mechanism in hypovolemic shock as the heart attempts to maintain
cardiac output in the presence of decreased blood volume; hypotension is a late sign.
Question 21: A nurse is preparing to administer a tuberculin skin test (PPD). Which
route and angle of insertion is correct? A. Subcutaneous, 45-degree angle. B.
Intramuscular, 90-degree angle. C. Intradermal, 5 to 15-degree angle. D. Subcutaneous,
90-degree angle. CORRECT ANSWER: C. Intradermal, 5 to 15-degree angle.
Rationale: The PPD test is administered intradermally, typically on the inner forearm,
with the bevel facing up at a 5 to 15-degree angle to create a wheal.
Question 22: A client is receiving total parenteral nutrition (TPN) via a central
venous catheter. The TPN bag is empty, and the new bag has not arrived from the
pharmacy. What is the nurse’s best action? A. Infuse 0.9% sodium chloride at the
same rate. B. Infuse 10% dextrose in water (D10W) at the same rate. C. Discontinue the
IV line until the new bag arrives. D. Infuse 0.45% sodium chloride at half the rate.
CORRECT ANSWER: B. Infuse 10% dextrose in water (D10W) at the same rate.
Answers Updated 2026 | Complete ATI NCLEX Readiness Study Guide with
Verified Questions, Detailed Rationales, Medical-Surgical Nursing,
Pharmacology, Maternal-Newborn, Pediatrics, Mental Health,
Fundamentals, Leadership & Management, Community Health & NGN
Clinical Judgment Exam Prep
Question 1: Which action is the priority for a client with suspected cervical spine
injury and airway obstruction? A. Administer oxygen via nasal cannula. B. Perform a
jaw-thrust maneuver. C. Insert an oropharyngeal airway. D. Prepare for endotracheal
intubation. CORRECT ANSWER: B. Perform a jaw-thrust maneuver. Rationale: The
jaw-thrust maneuver is the priority intervention to open the airway without extending
the neck in a client with a suspected cervical spine injury.
Question 2: A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD). Which oxygen delivery device is most appropriate for precise
oxygen concentration? A. Nasal cannula. B. Simple face mask. C. Venturi mask. D.
Non-rebreather mask. CORRECT ANSWER: C. Venturi mask. Rationale: A Venturi
mask delivers the most precise concentration of oxygen, which is crucial for clients with
COPD to prevent suppressing their hypoxic drive to breathe.
Question 3: A client’s telemetry monitor suddenly shows ventricular fibrillation.
What is the nurse’s first action? A. Call a code blue. B. Defibrillate the client
immediately. C. Assess the client and check the monitor leads. D. Begin
cardiopulmonary resuscitation (CPR). CORRECT ANSWER: C. Assess the client and
check the monitor leads. Rationale: The nurse must first assess the client to verify the
rhythm and rule out artifact or lead displacement before initiating emergency
interventions like defibrillation.
Question 4: A nurse is preparing to administer a unit of packed red blood cells
(PRBCs). Which IV solution should be used to prime the blood administration
tubing? A. 5% Dextrose in water (D5W). B. 0.9% Sodium chloride (Normal saline). C.
Lactated Ringer’s solution. D. 0.45% Sodium chloride. CORRECT ANSWER: B. 0.9%
Sodium chloride (Normal saline). Rationale: Normal saline is the only IV solution
compatible with blood products; dextrose and calcium-containing solutions can cause
hemolysis or clotting of the blood.
Question 5: A client with methicillin-resistant Staphylococcus aureus (MRSA) in a
wound requires contact precautions. Which personal protective equipment (PPE) is
mandatory upon entry? A. N95 respirator and eye protection. B. Surgical mask and
face shield. C. Gown and gloves. D. Gown, gloves, and N95 respirator. CORRECT
ANSWER: C. Gown and gloves. Rationale: Contact precautions require the use of a
gown and gloves to prevent the transmission of multidrug-resistant organisms like
MRSA via direct or indirect contact.
Question 6: A nurse is implementing fall precautions for a client. Which action is
the most effective environmental intervention? A. Keep all four side rails up at all
,times. B. Ensure the bed is in the lowest position. C. Turn off the lights to promote sleep.
D. Restrict the client’s fluid intake in the evening. CORRECT ANSWER: B. Ensure the
bed is in the lowest position. Rationale: Keeping the bed in the lowest position
minimizes the distance to the floor in the event of a fall, reducing the risk of injury.
Question 7: A nurse is administering oral medications. Which action best ensures
the "right patient" according to the rights of medication administration? A. Asking
the client, "Are you Mr. Smith?" B. Checking the client’s armband and asking them to
state their name and date of birth. C. Checking the room number against the
medication administration record (MAR). D. Asking the client’s spouse to confirm the
client's identity. CORRECT ANSWER: B. Checking the client’s armband and asking
them to state their name and date of birth. Rationale: Using two patient identifiers,
such as name and date of birth, and verifying them against the armband and MAR is the
standard practice to ensure the right patient.
Question 8: A client reports a pain level of 8 out of 10. What is the nurse’s priority
action before administering prescribed analgesia? A. Administer the medication
immediately. B. Assess the client's vital signs and pain characteristics. C. Call the
provider to request a higher dose. D. Document the pain level in the medical record.
CORRECT ANSWER: B. Assess the client's vital signs and pain characteristics.
Rationale: A comprehensive pain assessment, including vital signs and pain
characteristics (PQRST), must be completed to establish a baseline and guide
appropriate intervention.
Question 9: A nurse is applying a continuous pulse oximetry monitor to a client.
Which factor can cause a falsely low reading? A. Warming the extremity. B. Applying
the probe to a finger with nail polish. C. Ensuring the probe is snug but not tight. D.
Placing the probe on the earlobe. CORRECT ANSWER: B. Applying the probe to a
finger with nail polish. Rationale: Nail polish, artificial nails, or dark skin pigmentation
can interfere with the light transmission of the pulse oximeter, leading to inaccurate,
often falsely low, readings.
Question 10: A nurse is suctioning a client’s tracheostomy. Which action is correct
to prevent hypoxia? A. Apply suction while inserting the catheter. B. Suction
continuously for 20 seconds. C. Hyperoxygenate the client before and after suctioning.
D. Limit suctioning to three passes per session. CORRECT ANSWER: C.
Hyperoxygenate the client before and after suctioning. Rationale: Hyperoxygenating
with 100% oxygen before and after suctioning prevents hypoxemia caused by the
removal of oxygen along with secretions during the procedure.
Question 11: A nurse is caring for a client with a newly placed indwelling urinary
catheter. Which action is essential to prevent catheter-associated urinary tract
infections (CAUTI)? A. Keep the collection bag above the level of the bladder. B.
Perform routine daily perineal care with antimicrobial soap. C. Maintain a closed
drainage system and keep the bag below the bladder. D. Irrigate the catheter daily with
normal saline. CORRECT ANSWER: C. Maintain a closed drainage system and keep
,the bag below the bladder. Rationale: Maintaining a closed system and keeping the
bag below the bladder prevents backflow of urine and bacterial entry, which are primary
causes of CAUTI.
Question 12: A client with a cast on the right arm reports severe pain unrelieved by
medication. What is the nurse’s priority assessment? A. Check the capillary refill and
sensation of the right hand. B. Elevate the arm above the level of the heart. C. Apply an
ice pack directly to the cast. D. Administer a prescribed breakthrough analgesic.
CORRECT ANSWER: A. Check the capillary refill and sensation of the right hand.
Rationale: Severe, unrelieved pain in a casted extremity is a hallmark sign of
compartment syndrome; the nurse must immediately assess neurovascular status
(pulse, pallor, paresthesia, pain, paralysis).
Question 13: A nurse is preparing to administer a subcutaneous injection of insulin.
Which site is most appropriate for consistent absorption? A. The deltoid muscle. B.
The abdomen, 2 inches away from the umbilicus. C. The vastus lateralis muscle. D. The
gluteal muscle. CORRECT ANSWER: B. The abdomen, 2 inches away from the
umbilicus. Rationale: The abdomen provides the most rapid and consistent absorption
for subcutaneous insulin injections compared to the arms, thighs, or buttocks.
Question 14: A client is prescribed a low-sodium diet. Which food choice indicates
an understanding of the diet? A. Canned tomato soup. B. Fresh bananas and apples.
C. Processed deli turkey. D. Instant oatmeal packets. CORRECT ANSWER: B. Fresh
bananas and apples. Rationale: Fresh fruits and vegetables are naturally low in
sodium, whereas canned soups, processed meats, and instant oatmeal are typically
high in sodium.
Question 15: A nurse is caring for a client with a stage 3 pressure injury. Which
wound characteristic is expected? A. Full-thickness tissue loss with exposed bone,
tendon, or muscle. B. Partial-thickness loss of dermis presenting as a shallow open
ulcer. C. Full-thickness tissue loss where subcutaneous fat may be visible, but bone is
not exposed. D. Intact skin with non-blanchable redness. CORRECT ANSWER: C. Full-
thickness tissue loss where subcutaneous fat may be visible, but bone is not
exposed. Rationale: A stage 3 pressure injury involves full-thickness tissue loss where
subcutaneous fat may be visible, but bone, tendon, or muscle are not exposed.
Question 16: A client with diabetes mellitus is scheduled for surgery. Which
preoperative instruction is most appropriate regarding their morning insulin dose?
A. Take the full usual dose of insulin. B. Skip the insulin dose entirely until after surgery.
C. Take half of the usual intermediate-acting insulin dose. D. Take the full dose of short-
acting insulin only. CORRECT ANSWER: C. Take half of the usual intermediate-acting
insulin dose. Rationale: Clients with diabetes typically receive 50% of their usual
intermediate-acting insulin on the morning of surgery to prevent hypoglycemia while
managing stress-induced hyperglycemia, per provider orders.
Question 17: A nurse is teaching a client about using a metered-dose inhaler (MDI)
with a spacer. Which statement by the client indicates correct understanding? A. "I
, will exhale completely, place the mouthpiece in my mouth, and press the canister as I
breathe in slowly." B. "I will shake the inhaler, press the canister three times before
inhaling, and then breathe in quickly." C. "I will hold my breath for 30 seconds after
inhaling the medication." D. "I will use the spacer only when I feel short of breath."
CORRECT ANSWER: A. "I will exhale completely, place the mouthpiece in my
mouth, and press the canister as I breathe in slowly." Rationale: Proper MDI
technique involves exhaling fully, placing the mouthpiece in the mouth, actuating the
inhaler while inhaling slowly and deeply, and holding the breath for 10 seconds.
Question 18: A nurse is caring for a client who is 1 day postoperative following a
total hip arthroplasty. Which positioning is contraindicated? A. Keeping the
operative leg in slight abduction. B. Placing a pillow between the legs when turning. C.
Flexing the hip of the operative leg greater than 90 degrees. D. Using an elevated toilet
seat. CORRECT ANSWER: C. Flexing the hip of the operative leg greater than 90
degrees. Rationale: Flexing the hip greater than 90 degrees, adducting the leg past the
midline, or internally rotating the leg can cause dislocation of the new hip prosthesis.
Question 19: A client with a history of peptic ulcer disease is taking omeprazole.
Which statement by the client indicates a need for further teaching? A. "I should
take this medication in the morning before breakfast." B. "I can crush the pill and mix it
with applesauce if I have trouble swallowing." C. "I will avoid taking NSAIDs for pain
relief." D. "I will report any black, tarry stools to my provider." CORRECT ANSWER: B. "I
can crush the pill and mix it with applesauce if I have trouble swallowing."
Rationale: Omeprazole is a delayed-release capsule or tablet that must be swallowed
whole; crushing or chewing it destroys the enteric coating, leading to premature
destruction of the drug by stomach acid.
Question 20: A nurse is assessing a client with suspected hypovolemic shock.
Which finding is an early indicator? A. Hypotension. B. Tachycardia. C. Oliguria. D.
Confusion. CORRECT ANSWER: B. Tachycardia. Rationale: Tachycardia is an early
compensatory mechanism in hypovolemic shock as the heart attempts to maintain
cardiac output in the presence of decreased blood volume; hypotension is a late sign.
Question 21: A nurse is preparing to administer a tuberculin skin test (PPD). Which
route and angle of insertion is correct? A. Subcutaneous, 45-degree angle. B.
Intramuscular, 90-degree angle. C. Intradermal, 5 to 15-degree angle. D. Subcutaneous,
90-degree angle. CORRECT ANSWER: C. Intradermal, 5 to 15-degree angle.
Rationale: The PPD test is administered intradermally, typically on the inner forearm,
with the bevel facing up at a 5 to 15-degree angle to create a wheal.
Question 22: A client is receiving total parenteral nutrition (TPN) via a central
venous catheter. The TPN bag is empty, and the new bag has not arrived from the
pharmacy. What is the nurse’s best action? A. Infuse 0.9% sodium chloride at the
same rate. B. Infuse 10% dextrose in water (D10W) at the same rate. C. Discontinue the
IV line until the new bag arrives. D. Infuse 0.45% sodium chloride at half the rate.
CORRECT ANSWER: B. Infuse 10% dextrose in water (D10W) at the same rate.
