ATI RN Comprehensive Predictor 2026
Questions and Verified Answers Plus
Rationales Exam | 2026/27 Academic Year
SECTION 1: PHARMACOLOGY & MEDICATION SAFETY (Questions 1-
15)
QUESTION 1
A nurse is reviewing the medical record of a client who has schizophrenia
and is taking clozapine. Which of the following findings is a
contraindication to the administration of clozapine?
A) Heart rate 58/min
B) Fasting blood glucose 100 mg/dL
C) Hemoglobin 14 g/dL
D) WBC 2,900/mm³
Answer: D) WBC 2,900/mm³
Rationale: Clozapine can cause agranulocytosis, a life-threatening drop in
white blood cells. A WBC of 2,900/mm³ is below the normal range (4,500–
11,000) and is a contraindication. The provider should be notified
immediately. Heart rate 58 is slightly bradycardic but not a
contraindication; blood glucose 100 and hemoglobin 14 are normal
findings .
,QUESTION 2
A nurse is providing teaching to a client who has a depressive disorder
and a new prescription for amitriptyline. Which statement by the client
indicates an understanding of the teaching?
A) "I can continue to take St. John's wort while taking this medication."
B) "I know it will be a couple of weeks before the medication helps me
feel better."
C) "I expect this medication to raise my blood pressure."
D) "I should take this medication on an empty stomach."
Answer: B) "I know it will be a couple of weeks before the
medication helps me feel better."
Rationale: Tricyclic antidepressants like amitriptyline require 2–4 weeks to
achieve therapeutic effects. St. John's wort interacts dangerously with
antidepressants, increasing the risk of serotonin syndrome. Amitriptyline
may cause orthostatic hypotension (not hypertension) and should be taken
with food to reduce GI upset .
QUESTION 3
A nurse is preparing to administer digoxin to a client with heart failure.
Which finding should prompt the nurse to withhold the medication?
A) Heart rate 58 bpm
B) Blood pressure 118/76 mm Hg
C) Potassium 4.0 mEq/L
D) Respiratory rate 18/min
Answer: A) Heart rate 58 bpm
Rationale: Digoxin is held for a heart rate below 60 bpm in adults due to
the risk of bradycardia and heart block. Potassium 4.0 is normal, and both
BP and RR are within expected ranges .
,QUESTION 4
A nurse is providing teaching about digoxin administration to the
parents of a toddler who has heart failure. Which statement should the
nurse include?
A) "Limit your child's potassium intake while she is taking this
medication."
B) "You can add the medication to half a cup of your child's favorite
juice."
C) "Repeat the dose if your child vomits within 1 hour after taking the
medication."
D) "Have your child drink a small glass of water after swallowing the
medication."
Answer: D) "Have your child drink a small glass of water after
swallowing the medication."
Rationale: Liquid digoxin should be followed by water to ensure the full
dose is swallowed. Potassium should not be restricted (hypokalemia
increases digoxin toxicity risk). Medication should not be mixed with food
or juice; if vomiting occurs, do not repeat the dose without consulting the
provider .
QUESTION 5
A nurse is preparing to administer vancomycin IV to a client. Which
finding requires withholding the dose and notifying the provider?
A) Temperature 99.2°F (37.3°C)
B) BUN 18 mg/dL
C) Creatinine 2.5 mg/dL
D) WBC count 11,000/mm³
Answer: C) Creatinine 2.5 mg/dL
Rationale: Vancomycin is nephrotoxic. Creatinine of 2.5 mg/dL (normal
0.6–1.2) indicates significant renal impairment. The dose should be held
, and the provider notified. BUN 18, WBC 11,000, and temperature 99.2°F
are not immediate concerns .
QUESTION 6
A nurse is obtaining a client's medical history before initiating 1000 mL
of 0.9% NaCl with 20 mEq/L KCl IV to correct hypokalemia. Which finding
is a contraindication to receiving this IV solution?
A) Severe renal impairment (Stage IV kidney disease)
B) Chronic alcohol use disorder
C) Multiple sclerosis
D) Advanced cardiac disease
Answer: A) Severe renal impairment (Stage IV kidney disease)
Rationale: Potassium chloride is contraindicated in severe renal
impairment because the kidneys cannot excrete potassium effectively,
leading to life-threatening hyperkalemia. Cardiac disease is not a
contraindication, though monitoring is needed .
QUESTION 7
A nurse is conducting health promotion education regarding
contraindications to combination oral contraceptive use. Which
condition should the nurse include in the teaching?
A) Hypertension
B) Fibromyalgia
C) Renal calculi
D) Fibrocystic breast disease
Answer: A) Hypertension
Questions and Verified Answers Plus
Rationales Exam | 2026/27 Academic Year
SECTION 1: PHARMACOLOGY & MEDICATION SAFETY (Questions 1-
15)
QUESTION 1
A nurse is reviewing the medical record of a client who has schizophrenia
and is taking clozapine. Which of the following findings is a
contraindication to the administration of clozapine?
A) Heart rate 58/min
B) Fasting blood glucose 100 mg/dL
C) Hemoglobin 14 g/dL
D) WBC 2,900/mm³
Answer: D) WBC 2,900/mm³
Rationale: Clozapine can cause agranulocytosis, a life-threatening drop in
white blood cells. A WBC of 2,900/mm³ is below the normal range (4,500–
11,000) and is a contraindication. The provider should be notified
immediately. Heart rate 58 is slightly bradycardic but not a
contraindication; blood glucose 100 and hemoglobin 14 are normal
findings .
,QUESTION 2
A nurse is providing teaching to a client who has a depressive disorder
and a new prescription for amitriptyline. Which statement by the client
indicates an understanding of the teaching?
A) "I can continue to take St. John's wort while taking this medication."
B) "I know it will be a couple of weeks before the medication helps me
feel better."
C) "I expect this medication to raise my blood pressure."
D) "I should take this medication on an empty stomach."
Answer: B) "I know it will be a couple of weeks before the
medication helps me feel better."
Rationale: Tricyclic antidepressants like amitriptyline require 2–4 weeks to
achieve therapeutic effects. St. John's wort interacts dangerously with
antidepressants, increasing the risk of serotonin syndrome. Amitriptyline
may cause orthostatic hypotension (not hypertension) and should be taken
with food to reduce GI upset .
QUESTION 3
A nurse is preparing to administer digoxin to a client with heart failure.
Which finding should prompt the nurse to withhold the medication?
A) Heart rate 58 bpm
B) Blood pressure 118/76 mm Hg
C) Potassium 4.0 mEq/L
D) Respiratory rate 18/min
Answer: A) Heart rate 58 bpm
Rationale: Digoxin is held for a heart rate below 60 bpm in adults due to
the risk of bradycardia and heart block. Potassium 4.0 is normal, and both
BP and RR are within expected ranges .
,QUESTION 4
A nurse is providing teaching about digoxin administration to the
parents of a toddler who has heart failure. Which statement should the
nurse include?
A) "Limit your child's potassium intake while she is taking this
medication."
B) "You can add the medication to half a cup of your child's favorite
juice."
C) "Repeat the dose if your child vomits within 1 hour after taking the
medication."
D) "Have your child drink a small glass of water after swallowing the
medication."
Answer: D) "Have your child drink a small glass of water after
swallowing the medication."
Rationale: Liquid digoxin should be followed by water to ensure the full
dose is swallowed. Potassium should not be restricted (hypokalemia
increases digoxin toxicity risk). Medication should not be mixed with food
or juice; if vomiting occurs, do not repeat the dose without consulting the
provider .
QUESTION 5
A nurse is preparing to administer vancomycin IV to a client. Which
finding requires withholding the dose and notifying the provider?
A) Temperature 99.2°F (37.3°C)
B) BUN 18 mg/dL
C) Creatinine 2.5 mg/dL
D) WBC count 11,000/mm³
Answer: C) Creatinine 2.5 mg/dL
Rationale: Vancomycin is nephrotoxic. Creatinine of 2.5 mg/dL (normal
0.6–1.2) indicates significant renal impairment. The dose should be held
, and the provider notified. BUN 18, WBC 11,000, and temperature 99.2°F
are not immediate concerns .
QUESTION 6
A nurse is obtaining a client's medical history before initiating 1000 mL
of 0.9% NaCl with 20 mEq/L KCl IV to correct hypokalemia. Which finding
is a contraindication to receiving this IV solution?
A) Severe renal impairment (Stage IV kidney disease)
B) Chronic alcohol use disorder
C) Multiple sclerosis
D) Advanced cardiac disease
Answer: A) Severe renal impairment (Stage IV kidney disease)
Rationale: Potassium chloride is contraindicated in severe renal
impairment because the kidneys cannot excrete potassium effectively,
leading to life-threatening hyperkalemia. Cardiac disease is not a
contraindication, though monitoring is needed .
QUESTION 7
A nurse is conducting health promotion education regarding
contraindications to combination oral contraceptive use. Which
condition should the nurse include in the teaching?
A) Hypertension
B) Fibromyalgia
C) Renal calculi
D) Fibrocystic breast disease
Answer: A) Hypertension
