Virtual ATI Green Light Comprehensive Predictor 2026 Updated Questions and Answers |
Complete ATI Comprehensive Predictor Review and NCLEX Readiness Study Guide with Verified
Solutions, Detailed Rationales, Medical-Surgical Nursing, Pharmacology, Fundamentals,
Maternal-Newborn Nursing, Pediatric Nursing, Mental Health Nursing, Leadership and
Management, Community Health, Prioritization and Delegation, Patient Safety, Infection
Control, NGN Clinical Judgment Case Studies and Comprehensive NCLEX-RN Exam Preparation
Question 1: Which finding requires immediate intervention in a client receiving a
continuous heparin infusion? A. aPTT of 60 seconds B. Bleeding gums C. Heart rate of
72 bpm D. Blood pressure of 120/80 mm Hg CORRECT ANSWER: B. Bleeding gums
Rationale: Bleeding gums indicate active hemorrhage, a severe complication of
anticoagulant therapy.
Question 2: A client with heart failure is prescribed digoxin. Which symptom
indicates toxicity? A. Dry mouth B. Yellow visual halos C. Constipation D. Mild
dizziness CORRECT ANSWER: B. Yellow visual halos Rationale: Visual disturbances
like yellow halos, along with anorexia and nausea, are classic signs of digoxin toxicity.
Question 3: Which assessment finding indicates lithium toxicity? A. Fine hand
tremors B. Severe vomiting and confusion C. Polyuria D. Mild thirst CORRECT ANSWER:
B. Severe vomiting and confusion Rationale: Severe GI distress, confusion, and
coarse tremors indicate severe lithium toxicity requiring immediate medical
intervention.
Question 4: A client taking warfarin should be instructed to maintain a consistent
intake of which nutrient? A. Vitamin C B. Vitamin K C. Calcium D. Potassium
CORRECT ANSWER: B. Vitamin K Rationale: Vitamin K antagonizes the effects of
warfarin; sudden changes in intake can alter INR levels and affect coagulation.
Question 5: When does insulin lispro reach its peak effect? A. 30 to 90 minutes B. 2
to 4 hours C. 4 to 12 hours D. 14 to 24 hours CORRECT ANSWER: A. 30 to 90 minutes
Rationale: Insulin lispro is a rapid-acting insulin that peaks in 30 to 90 minutes,
requiring the client to eat immediately after injection.
Question 6: Which ECG change is characteristic of hyperkalemia? A. Prominent U
waves B. Peaked T waves C. ST segment depression D. Prolonged QT interval CORRECT
ANSWER: B. Peaked T waves Rationale: Hyperkalemia causes tall, peaked T waves,
widened QRS complexes, and eventually absent P waves.
Question 7: A client with hypocalcemia is assessed. Which clinical sign is
expected? A. Decreased deep tendon reflexes B. Positive Chvostek's sign C. Muscle
flaccidity D. Bradycardia CORRECT ANSWER: B. Positive Chvostek's sign Rationale:
Hypocalcemia increases neuromuscular excitability, causing positive Chvostek's and
Trousseau's signs.
Question 8: Which symptom is most common in a client with hyponatremia? A.
Extreme thirst B. Confusion and lethargy C. Dry, sticky mucous membranes D.
Hyperreflexia CORRECT ANSWER: B. Confusion and lethargy Rationale:
Hyponatremia causes cerebral edema, leading to neurological symptoms like
confusion, lethargy, and seizures.
,Question 9: A client receiving total parenteral nutrition (TPN) is at highest risk for
which complication? A. Hypoglycemia B. Hyperglycemia C. Hyperkalemia D.
Hypocalcemia CORRECT ANSWER: B. Hyperglycemia Rationale: TPN contains high
concentrations of dextrose, placing the client at significant risk for hyperglycemia.
Question 10: What is the priority nursing action before administering an enteral
tube feeding? A. Auscultate bowel sounds B. Elevate the head of the bed to 30 to 45
degrees C. Flush the tube with 30 mL of sterile water D. Check the expiration date of the
formula CORRECT ANSWER: B. Elevate the head of the bed to 30 to 45 degrees
Rationale: Elevating the head of the bed prevents aspiration, which is the most serious
complication of enteral feedings.
Question 11: During a blood transfusion, the client develops flank pain and chills.
What is the nurse's first action? A. Administer diphenhydramine B. Stop the
transfusion immediately C. Call the healthcare provider D. Obtain a urine specimen
CORRECT ANSWER: B. Stop the transfusion immediately Rationale: Flank pain and
chills indicate a hemolytic transfusion reaction; the transfusion must be stopped
instantly to prevent further harm.
Question 12: Continuous bubbling in the water seal chamber of a chest tube
indicates: A. Normal functioning B. An air leak in the system C. Lung re-expansion D.
Obstruction of the tube CORRECT ANSWER: B. An air leak in the system Rationale:
Continuous bubbling in the water seal chamber is abnormal and indicates a system
leak that must be identified and corrected.
Question 13: Which oxygen delivery device provides the most precise FiO2 for a
client with COPD? A. Nasal cannula B. Nonrebreather mask C. Venturi mask D. Simple
face mask CORRECT ANSWER: C. Venturi mask Rationale: The Venturi mask delivers
a precise, constant concentration of oxygen, which is essential for clients with COPD
who rely on hypoxic drive.
Question 14: A client with asthma is using a peak flow meter. A reading in the
yellow zone indicates: A. Good asthma control B. Airway narrowing requiring a rescue
inhaler C. A medical emergency D. The need to stop all medications CORRECT
ANSWER: B. Airway narrowing requiring a rescue inhaler Rationale: The yellow zone
(50-80% of personal best) indicates worsening asthma and the need for short-acting
bronchodilators.
Question 15: When should a tuberculin skin test (PPD) be read? A. 12 to 24 hours B.
24 to 48 hours C. 48 to 72 hours D. 72 to 96 hours CORRECT ANSWER: C. 48 to 72
hours Rationale: The PPD test must be evaluated for induration between 48 and 72
hours after administration.
Question 16: Following a thoracentesis, which complication should the nurse
monitor for? A. Pneumothorax B. Fluid volume overload C. Hypertension D.
Bradycardia CORRECT ANSWER: A. Pneumothorax Rationale: Thoracentesis involves
, inserting a needle into the pleural space, which carries a risk of puncturing the lung and
causing a pneumothorax.
Question 17: A client returns to the unit following a paracentesis. Which
assessment finding is most concerning? A. Clear drainage on the dressing B.
Hypotension and tachycardia C. Mild abdominal discomfort D. Decreased urine output
CORRECT ANSWER: B. Hypotension and tachycardia Rationale: Rapid fluid removal
can cause a massive fluid shift, leading to hypovolemic shock manifested by
hypotension and tachycardia.
Question 18: Which nursing intervention is appropriate after a lumbar puncture? A.
Keep the client flat for 4 to 8 hours B. Elevate the head of the bed to 45 degrees C.
Encourage vigorous coughing D. Restrict oral fluid intake CORRECT ANSWER: A. Keep
the client flat for 4 to 8 hours Rationale: Remaining flat helps prevent a spinal
headache caused by the leakage of cerebrospinal fluid from the puncture site.
Question 19: Before offering fluids to a client post-bronchoscopy, what must the
nurse assess? A. Bowel sounds B. Gag reflex C. Lung sounds D. Pupillary response
CORRECT ANSWER: B. Gag reflex Rationale: The gag reflex must return before oral
intake to prevent aspiration, as the throat is anesthetized during the procedure.
Question 20: Following an upper GI series (barium swallow), the nurse should
instruct the client to: A. Restrict fluids for 24 hours B. Expect white-colored stools C.
Avoid all dairy products D. Remain NPO for 12 hours CORRECT ANSWER: B. Expect
white-colored stools Rationale: Barium is excreted in the feces, causing stools to
appear chalky white for a few days after the procedure.
Question 21: A client has a temporary pacemaker. The ECG shows a pacing spike
but no QRS complex. This is termed: A. Failure to capture B. Failure to sense C.
Undersensing D. Oversensing CORRECT ANSWER: A. Failure to capture Rationale:
Failure to capture occurs when the pacemaker generates an impulse (spike) but the
heart muscle does not depolarize (no QRS).
Question 22: Which medication is administered first for a client experiencing an
acute myocardial infarction? A. Morphine B. Aspirin C. Nitroglycerin D. Oxygen
CORRECT ANSWER: B. Aspirin Rationale: Aspirin prevents further platelet aggregation
and clot formation, and should be chewed immediately during an MI.
Question 23: A client with deep vein thrombosis (DVT) is prescribed bed rest. Which
action should the nurse avoid? A. Elevating the affected leg B. Applying warm
compresses C. Massaging the affected leg D. Administering anticoagulants CORRECT
ANSWER: C. Massaging the affected leg Rationale: Massaging the leg can dislodge
the thrombus, leading to a life-threatening pulmonary embolism.
Question 24: For a client with peripheral arterial disease (PAD), which position is
most appropriate? A. Elevate the legs above the heart B. Dependent position (legs
dangling) C. Supine with legs flat D. Knee-chest position CORRECT ANSWER: B.
Complete ATI Comprehensive Predictor Review and NCLEX Readiness Study Guide with Verified
Solutions, Detailed Rationales, Medical-Surgical Nursing, Pharmacology, Fundamentals,
Maternal-Newborn Nursing, Pediatric Nursing, Mental Health Nursing, Leadership and
Management, Community Health, Prioritization and Delegation, Patient Safety, Infection
Control, NGN Clinical Judgment Case Studies and Comprehensive NCLEX-RN Exam Preparation
Question 1: Which finding requires immediate intervention in a client receiving a
continuous heparin infusion? A. aPTT of 60 seconds B. Bleeding gums C. Heart rate of
72 bpm D. Blood pressure of 120/80 mm Hg CORRECT ANSWER: B. Bleeding gums
Rationale: Bleeding gums indicate active hemorrhage, a severe complication of
anticoagulant therapy.
Question 2: A client with heart failure is prescribed digoxin. Which symptom
indicates toxicity? A. Dry mouth B. Yellow visual halos C. Constipation D. Mild
dizziness CORRECT ANSWER: B. Yellow visual halos Rationale: Visual disturbances
like yellow halos, along with anorexia and nausea, are classic signs of digoxin toxicity.
Question 3: Which assessment finding indicates lithium toxicity? A. Fine hand
tremors B. Severe vomiting and confusion C. Polyuria D. Mild thirst CORRECT ANSWER:
B. Severe vomiting and confusion Rationale: Severe GI distress, confusion, and
coarse tremors indicate severe lithium toxicity requiring immediate medical
intervention.
Question 4: A client taking warfarin should be instructed to maintain a consistent
intake of which nutrient? A. Vitamin C B. Vitamin K C. Calcium D. Potassium
CORRECT ANSWER: B. Vitamin K Rationale: Vitamin K antagonizes the effects of
warfarin; sudden changes in intake can alter INR levels and affect coagulation.
Question 5: When does insulin lispro reach its peak effect? A. 30 to 90 minutes B. 2
to 4 hours C. 4 to 12 hours D. 14 to 24 hours CORRECT ANSWER: A. 30 to 90 minutes
Rationale: Insulin lispro is a rapid-acting insulin that peaks in 30 to 90 minutes,
requiring the client to eat immediately after injection.
Question 6: Which ECG change is characteristic of hyperkalemia? A. Prominent U
waves B. Peaked T waves C. ST segment depression D. Prolonged QT interval CORRECT
ANSWER: B. Peaked T waves Rationale: Hyperkalemia causes tall, peaked T waves,
widened QRS complexes, and eventually absent P waves.
Question 7: A client with hypocalcemia is assessed. Which clinical sign is
expected? A. Decreased deep tendon reflexes B. Positive Chvostek's sign C. Muscle
flaccidity D. Bradycardia CORRECT ANSWER: B. Positive Chvostek's sign Rationale:
Hypocalcemia increases neuromuscular excitability, causing positive Chvostek's and
Trousseau's signs.
Question 8: Which symptom is most common in a client with hyponatremia? A.
Extreme thirst B. Confusion and lethargy C. Dry, sticky mucous membranes D.
Hyperreflexia CORRECT ANSWER: B. Confusion and lethargy Rationale:
Hyponatremia causes cerebral edema, leading to neurological symptoms like
confusion, lethargy, and seizures.
,Question 9: A client receiving total parenteral nutrition (TPN) is at highest risk for
which complication? A. Hypoglycemia B. Hyperglycemia C. Hyperkalemia D.
Hypocalcemia CORRECT ANSWER: B. Hyperglycemia Rationale: TPN contains high
concentrations of dextrose, placing the client at significant risk for hyperglycemia.
Question 10: What is the priority nursing action before administering an enteral
tube feeding? A. Auscultate bowel sounds B. Elevate the head of the bed to 30 to 45
degrees C. Flush the tube with 30 mL of sterile water D. Check the expiration date of the
formula CORRECT ANSWER: B. Elevate the head of the bed to 30 to 45 degrees
Rationale: Elevating the head of the bed prevents aspiration, which is the most serious
complication of enteral feedings.
Question 11: During a blood transfusion, the client develops flank pain and chills.
What is the nurse's first action? A. Administer diphenhydramine B. Stop the
transfusion immediately C. Call the healthcare provider D. Obtain a urine specimen
CORRECT ANSWER: B. Stop the transfusion immediately Rationale: Flank pain and
chills indicate a hemolytic transfusion reaction; the transfusion must be stopped
instantly to prevent further harm.
Question 12: Continuous bubbling in the water seal chamber of a chest tube
indicates: A. Normal functioning B. An air leak in the system C. Lung re-expansion D.
Obstruction of the tube CORRECT ANSWER: B. An air leak in the system Rationale:
Continuous bubbling in the water seal chamber is abnormal and indicates a system
leak that must be identified and corrected.
Question 13: Which oxygen delivery device provides the most precise FiO2 for a
client with COPD? A. Nasal cannula B. Nonrebreather mask C. Venturi mask D. Simple
face mask CORRECT ANSWER: C. Venturi mask Rationale: The Venturi mask delivers
a precise, constant concentration of oxygen, which is essential for clients with COPD
who rely on hypoxic drive.
Question 14: A client with asthma is using a peak flow meter. A reading in the
yellow zone indicates: A. Good asthma control B. Airway narrowing requiring a rescue
inhaler C. A medical emergency D. The need to stop all medications CORRECT
ANSWER: B. Airway narrowing requiring a rescue inhaler Rationale: The yellow zone
(50-80% of personal best) indicates worsening asthma and the need for short-acting
bronchodilators.
Question 15: When should a tuberculin skin test (PPD) be read? A. 12 to 24 hours B.
24 to 48 hours C. 48 to 72 hours D. 72 to 96 hours CORRECT ANSWER: C. 48 to 72
hours Rationale: The PPD test must be evaluated for induration between 48 and 72
hours after administration.
Question 16: Following a thoracentesis, which complication should the nurse
monitor for? A. Pneumothorax B. Fluid volume overload C. Hypertension D.
Bradycardia CORRECT ANSWER: A. Pneumothorax Rationale: Thoracentesis involves
, inserting a needle into the pleural space, which carries a risk of puncturing the lung and
causing a pneumothorax.
Question 17: A client returns to the unit following a paracentesis. Which
assessment finding is most concerning? A. Clear drainage on the dressing B.
Hypotension and tachycardia C. Mild abdominal discomfort D. Decreased urine output
CORRECT ANSWER: B. Hypotension and tachycardia Rationale: Rapid fluid removal
can cause a massive fluid shift, leading to hypovolemic shock manifested by
hypotension and tachycardia.
Question 18: Which nursing intervention is appropriate after a lumbar puncture? A.
Keep the client flat for 4 to 8 hours B. Elevate the head of the bed to 45 degrees C.
Encourage vigorous coughing D. Restrict oral fluid intake CORRECT ANSWER: A. Keep
the client flat for 4 to 8 hours Rationale: Remaining flat helps prevent a spinal
headache caused by the leakage of cerebrospinal fluid from the puncture site.
Question 19: Before offering fluids to a client post-bronchoscopy, what must the
nurse assess? A. Bowel sounds B. Gag reflex C. Lung sounds D. Pupillary response
CORRECT ANSWER: B. Gag reflex Rationale: The gag reflex must return before oral
intake to prevent aspiration, as the throat is anesthetized during the procedure.
Question 20: Following an upper GI series (barium swallow), the nurse should
instruct the client to: A. Restrict fluids for 24 hours B. Expect white-colored stools C.
Avoid all dairy products D. Remain NPO for 12 hours CORRECT ANSWER: B. Expect
white-colored stools Rationale: Barium is excreted in the feces, causing stools to
appear chalky white for a few days after the procedure.
Question 21: A client has a temporary pacemaker. The ECG shows a pacing spike
but no QRS complex. This is termed: A. Failure to capture B. Failure to sense C.
Undersensing D. Oversensing CORRECT ANSWER: A. Failure to capture Rationale:
Failure to capture occurs when the pacemaker generates an impulse (spike) but the
heart muscle does not depolarize (no QRS).
Question 22: Which medication is administered first for a client experiencing an
acute myocardial infarction? A. Morphine B. Aspirin C. Nitroglycerin D. Oxygen
CORRECT ANSWER: B. Aspirin Rationale: Aspirin prevents further platelet aggregation
and clot formation, and should be chewed immediately during an MI.
Question 23: A client with deep vein thrombosis (DVT) is prescribed bed rest. Which
action should the nurse avoid? A. Elevating the affected leg B. Applying warm
compresses C. Massaging the affected leg D. Administering anticoagulants CORRECT
ANSWER: C. Massaging the affected leg Rationale: Massaging the leg can dislodge
the thrombus, leading to a life-threatening pulmonary embolism.
Question 24: For a client with peripheral arterial disease (PAD), which position is
most appropriate? A. Elevate the legs above the heart B. Dependent position (legs
dangling) C. Supine with legs flat D. Knee-chest position CORRECT ANSWER: B.
