ATI RN Comprehensive Predictor Exit Exam (2026 Latest Update)
– Actual Questions & Verified Answers with Detailed Rationales |
Comprehensive NGN Review | Full PDF Study Guide | Complete
Questions | NCLEX-RN Readiness Mastery Edition
1. A nurse notes a newborn with jitteriness and a blood glucose of 45 mg/dL. What action is
priority?
A. Recheck glucose in 4 hours
B. Administer early feeding
C. Place a warming blanket
D. Notify the neonatologist immediately
➢ Correct Answer: B. Administer early feeding – Jitteriness with glucose below 70 mg/dL
indicates newborn hypoglycemia; early oral or IV feeding rapidly stabilizes glucose and
prevents neurological sequelae.
2. After a total hip arthroplasty, the nurse positions the client’s hips in which position?
A. Adducted with a pillow between the knees
B. Abducted with an abduction pillow
C. Flexed to 90 degrees
D. Internally rotated
➢ Correct Answer: B. Abducted with an abduction pillow – Abduction keeps the prosthetic
head in the acetabulum; adduction or internal rotation causes dislocation.
3. A client post-subtotal thyroidectomy is at risk for hypocalcemia. Which medication should be
available at the bedside?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Sodium bicarbonate
➢ Correct Answer: B. Calcium gluconate – Thyroid surgery may damage or remove
parathyroid glands, causing hypocalcemia; IV calcium gluconate reverses tetany and
laryngospasm.
4. A nurse teaches a client that the time required for half of a drug to be eliminated from the body
is called:
A. Onset of action
B. Peak concentration
C. Half-life
D. Therapeutic index
➢ Correct Answer: C. Half-life – Half-life determines dosing interval and time to steady
state; it is essential for scheduling medications safely, especially for drugs with narrow
therapeutic windows.
,5. A client receiving digoxin has an apical pulse of 52 bpm and reports nausea. What is the
nurse’s priority action?
A. Administer the digoxin as ordered
B. Withhold the medication and notify the provider
C. Give atropine to increase the heart rate
D. Recheck the pulse in 30 minutes
➢ Correct Answer: B. Withhold the medication and notify the provider – Apical pulse
below 60 bpm with nausea suggests digoxin toxicity; withholding prevents further
bradycardia and dysrhythmias.
6. A client with sickle-cell anemia reports sudden chest pain, fever, and difficulty breathing. The
nurse suspects which complication?
A. Aplastic crisis
B. Acute chest syndrome
C. Pulmonary embolism
D. Hemolytic crisis
➢ Correct Answer: B. Acute chest syndrome – Acute chest syndrome is a life-threatening
complication of sickle-cell disease with pulmonary infarction, hypoxemia, and infiltrates
requiring immediate intervention.
7. A nurse observes substernal retractions in a 2-year-old child. This finding indicates:
A. Normal breathing pattern
B. Respiratory distress
C. Compensated shock
D. Metabolic acidosis
➢ Correct Answer: B. Respiratory distress – Substernal retractions indicate increased work
of breathing from lower airway obstruction or poor lung compliance; it signals impending
respiratory failure.
8. A client’s serum potassium level is 3.2 mEq/L. The nurse should assess for which finding?
A. Hyperactive bowel sounds
B. Constipation and muscle weakness
C. Tetany and paresthesias
D. Hypertension
➢ Correct Answer: B. Constipation and muscle weakness – Hypokalemia (normal 3.5-5.0)
slows GI motility causing constipation and impairs neuromuscular function leading to
weakness and hyporeflexia.
9. A nurse is caring for a client with a gastrostomy tube. How often should the feeding bag be
changed?
A. Every 8 hours
B. Daily
C. Every 3 days
D. Every week
, ➢ Correct Answer: C. Every 3 days – Changing the feeding bag every 3 days reduces
bacterial contamination and risk of foodborne illness while maintaining safe enteral
nutrition delivery.
10. A client with amyotrophic lateral sclerosis (ALS) has difficulty swallowing. To which
professional should the nurse refer the client?
A. Physical therapist
B. Occupational therapist
C. Speech-language pathologist
D. Respiratory therapist
➢ Correct Answer: C. Speech-language pathologist – Speech-language pathologists
evaluate and treat dysphagia in neurodegenerative diseases like ALS, recommending safe
swallowing strategies or alternative feeding.
11. A client with rheumatoid arthritis has an elevated erythrocyte sedimentation rate (ESR). This
indicates:
A. Active inflammation
B. Anemia of chronic disease
C. Liver dysfunction
D. Medication toxicity
➢ Correct Answer: A. Active inflammation – ESR rises nonspecifically with systemic
inflammation; in rheumatoid arthritis, elevated ESR correlates with disease flares and
joint destruction.
12. A nurse finds petechiae on a client’s arms and legs. Which lab value should be checked first?
A. Hemoglobin
B. White blood cell count
C. Platelet count
D. Prothrombin time
➢ Correct Answer: C. Platelet count – Petechiae result from thrombocytopenia (low
platelets) causing bleeding from capillaries; a low count increases risk for spontaneous
hemorrhage.
13. A client on contact precautions for Clostridioides difficile requires cardiac rehabilitation after
an MI. The nurse should:
A. Cancel cardiac rehab until precautions are discontinued
B. Coordinate with rehab to maintain contact precautions
C. Send the client to group rehab without changes
D. Ask the provider to discharge the client early
➢ Correct Answer: B. Coordinate with rehab to maintain contact precautions – Infection
control must continue during therapy; coordinating ensures staff use gowns, gloves, and
dedicated equipment to prevent C. diff spread.
14. A client taking combination oral contraceptives reports left calf pain and swelling. The nurse
suspects:
A. Muscle strain
, B. Deep vein thrombophlebitis
C. Electrolyte imbalance
D. Peripheral neuropathy
➢ Correct Answer: B. Deep vein thrombophlebitis – Estrogen in oral contraceptives
increases clotting risk; calf pain with swelling warrants immediate Doppler evaluation for
DVT to prevent pulmonary embolism.
15. A comatose client has a living will refusing life support. The family requests continued
mechanical ventilation. The nurse should first:
A. Continue ventilation per family request
B. Withdraw ventilation immediately
C. Review advance directives with the ethics committee
D. Ask the provider to override the living will
➢ Correct Answer: C. Review advance directives with the ethics committee – Living wills
are legally binding; the ethics committee helps resolve family-provider conflicts while
respecting client autonomy and legal documents.
16. A nurse approaches a visually impaired client from which direction to avoid startling them?
A. From directly behind
B. From the side while speaking
C. From the front without speaking
D. From any direction quietly
➢ Correct Answer: B. From the side while speaking – Approaching from the side within
the client’s hearing field allows them to detect presence without sudden startle, reducing
fall risk and anxiety.
17. A client with a new burn injury from a house fire receives 100% humidified oxygen first. The
purpose is to:
A. Prevent carbon monoxide poisoning complications
B. Reduce pain from burned airways
C. Promote wound healing
D. Decrease metabolic demand
➢ Correct Answer: A. Prevent carbon monoxide poisoning complications – Humidified
oxygen displaces carbon monoxide from hemoglobin, improving tissue oxygenation and
preventing neurological damage in smoke inhalation.
18. A client with left-sided hemiplegia from a stroke is eating lunch. Where should the nurse
place the food tray?
A. On the right side of the tray
B. On the left side of the tray
C. In the center of the tray
D. On a nearby table
➢ Correct Answer: B. On the left side of the tray – Placing food on the unaffected (left)
side allows the client to see, reach, and manage food independently, promoting self-
feeding and dignity.
– Actual Questions & Verified Answers with Detailed Rationales |
Comprehensive NGN Review | Full PDF Study Guide | Complete
Questions | NCLEX-RN Readiness Mastery Edition
1. A nurse notes a newborn with jitteriness and a blood glucose of 45 mg/dL. What action is
priority?
A. Recheck glucose in 4 hours
B. Administer early feeding
C. Place a warming blanket
D. Notify the neonatologist immediately
➢ Correct Answer: B. Administer early feeding – Jitteriness with glucose below 70 mg/dL
indicates newborn hypoglycemia; early oral or IV feeding rapidly stabilizes glucose and
prevents neurological sequelae.
2. After a total hip arthroplasty, the nurse positions the client’s hips in which position?
A. Adducted with a pillow between the knees
B. Abducted with an abduction pillow
C. Flexed to 90 degrees
D. Internally rotated
➢ Correct Answer: B. Abducted with an abduction pillow – Abduction keeps the prosthetic
head in the acetabulum; adduction or internal rotation causes dislocation.
3. A client post-subtotal thyroidectomy is at risk for hypocalcemia. Which medication should be
available at the bedside?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Sodium bicarbonate
➢ Correct Answer: B. Calcium gluconate – Thyroid surgery may damage or remove
parathyroid glands, causing hypocalcemia; IV calcium gluconate reverses tetany and
laryngospasm.
4. A nurse teaches a client that the time required for half of a drug to be eliminated from the body
is called:
A. Onset of action
B. Peak concentration
C. Half-life
D. Therapeutic index
➢ Correct Answer: C. Half-life – Half-life determines dosing interval and time to steady
state; it is essential for scheduling medications safely, especially for drugs with narrow
therapeutic windows.
,5. A client receiving digoxin has an apical pulse of 52 bpm and reports nausea. What is the
nurse’s priority action?
A. Administer the digoxin as ordered
B. Withhold the medication and notify the provider
C. Give atropine to increase the heart rate
D. Recheck the pulse in 30 minutes
➢ Correct Answer: B. Withhold the medication and notify the provider – Apical pulse
below 60 bpm with nausea suggests digoxin toxicity; withholding prevents further
bradycardia and dysrhythmias.
6. A client with sickle-cell anemia reports sudden chest pain, fever, and difficulty breathing. The
nurse suspects which complication?
A. Aplastic crisis
B. Acute chest syndrome
C. Pulmonary embolism
D. Hemolytic crisis
➢ Correct Answer: B. Acute chest syndrome – Acute chest syndrome is a life-threatening
complication of sickle-cell disease with pulmonary infarction, hypoxemia, and infiltrates
requiring immediate intervention.
7. A nurse observes substernal retractions in a 2-year-old child. This finding indicates:
A. Normal breathing pattern
B. Respiratory distress
C. Compensated shock
D. Metabolic acidosis
➢ Correct Answer: B. Respiratory distress – Substernal retractions indicate increased work
of breathing from lower airway obstruction or poor lung compliance; it signals impending
respiratory failure.
8. A client’s serum potassium level is 3.2 mEq/L. The nurse should assess for which finding?
A. Hyperactive bowel sounds
B. Constipation and muscle weakness
C. Tetany and paresthesias
D. Hypertension
➢ Correct Answer: B. Constipation and muscle weakness – Hypokalemia (normal 3.5-5.0)
slows GI motility causing constipation and impairs neuromuscular function leading to
weakness and hyporeflexia.
9. A nurse is caring for a client with a gastrostomy tube. How often should the feeding bag be
changed?
A. Every 8 hours
B. Daily
C. Every 3 days
D. Every week
, ➢ Correct Answer: C. Every 3 days – Changing the feeding bag every 3 days reduces
bacterial contamination and risk of foodborne illness while maintaining safe enteral
nutrition delivery.
10. A client with amyotrophic lateral sclerosis (ALS) has difficulty swallowing. To which
professional should the nurse refer the client?
A. Physical therapist
B. Occupational therapist
C. Speech-language pathologist
D. Respiratory therapist
➢ Correct Answer: C. Speech-language pathologist – Speech-language pathologists
evaluate and treat dysphagia in neurodegenerative diseases like ALS, recommending safe
swallowing strategies or alternative feeding.
11. A client with rheumatoid arthritis has an elevated erythrocyte sedimentation rate (ESR). This
indicates:
A. Active inflammation
B. Anemia of chronic disease
C. Liver dysfunction
D. Medication toxicity
➢ Correct Answer: A. Active inflammation – ESR rises nonspecifically with systemic
inflammation; in rheumatoid arthritis, elevated ESR correlates with disease flares and
joint destruction.
12. A nurse finds petechiae on a client’s arms and legs. Which lab value should be checked first?
A. Hemoglobin
B. White blood cell count
C. Platelet count
D. Prothrombin time
➢ Correct Answer: C. Platelet count – Petechiae result from thrombocytopenia (low
platelets) causing bleeding from capillaries; a low count increases risk for spontaneous
hemorrhage.
13. A client on contact precautions for Clostridioides difficile requires cardiac rehabilitation after
an MI. The nurse should:
A. Cancel cardiac rehab until precautions are discontinued
B. Coordinate with rehab to maintain contact precautions
C. Send the client to group rehab without changes
D. Ask the provider to discharge the client early
➢ Correct Answer: B. Coordinate with rehab to maintain contact precautions – Infection
control must continue during therapy; coordinating ensures staff use gowns, gloves, and
dedicated equipment to prevent C. diff spread.
14. A client taking combination oral contraceptives reports left calf pain and swelling. The nurse
suspects:
A. Muscle strain
, B. Deep vein thrombophlebitis
C. Electrolyte imbalance
D. Peripheral neuropathy
➢ Correct Answer: B. Deep vein thrombophlebitis – Estrogen in oral contraceptives
increases clotting risk; calf pain with swelling warrants immediate Doppler evaluation for
DVT to prevent pulmonary embolism.
15. A comatose client has a living will refusing life support. The family requests continued
mechanical ventilation. The nurse should first:
A. Continue ventilation per family request
B. Withdraw ventilation immediately
C. Review advance directives with the ethics committee
D. Ask the provider to override the living will
➢ Correct Answer: C. Review advance directives with the ethics committee – Living wills
are legally binding; the ethics committee helps resolve family-provider conflicts while
respecting client autonomy and legal documents.
16. A nurse approaches a visually impaired client from which direction to avoid startling them?
A. From directly behind
B. From the side while speaking
C. From the front without speaking
D. From any direction quietly
➢ Correct Answer: B. From the side while speaking – Approaching from the side within
the client’s hearing field allows them to detect presence without sudden startle, reducing
fall risk and anxiety.
17. A client with a new burn injury from a house fire receives 100% humidified oxygen first. The
purpose is to:
A. Prevent carbon monoxide poisoning complications
B. Reduce pain from burned airways
C. Promote wound healing
D. Decrease metabolic demand
➢ Correct Answer: A. Prevent carbon monoxide poisoning complications – Humidified
oxygen displaces carbon monoxide from hemoglobin, improving tissue oxygenation and
preventing neurological damage in smoke inhalation.
18. A client with left-sided hemiplegia from a stroke is eating lunch. Where should the nurse
place the food tray?
A. On the right side of the tray
B. On the left side of the tray
C. In the center of the tray
D. On a nearby table
➢ Correct Answer: B. On the left side of the tray – Placing food on the unaffected (left)
side allows the client to see, reach, and manage food independently, promoting self-
feeding and dignity.
