Fall Semester 2026–2027 ATI Comprehensive
Predictor Updated 2026 | 190+ Questions and
Answers | ATI RN Comprehensive Predictor Study
Guide, Practice Exam, Comprehensive Review,
Exam Prep Test Bank, Medical-Surgical Nursing,
Pharmacology, Fundamentals, Maternal-Newborn
Nursing, Pediatrics, Mental Health, Leadership and
Management, Nutrition, Clinical Judgment,
Prioritization, Delegation, NCLEX-RN Readiness,
Detailed Rationales and Complete Revision Material
Question 1: A nurse is preparing to administer a blood transfusion to a client
who has anemia. Which of the following actions should the nurse take first?
A. Verify the client's blood type and crossmatch with the unit of blood.
B. Obtain the client's baseline vital signs.
C. Prime the blood administration tubing with 0.9% sodium chloride.
D. Ask the client about any previous history of transfusion reactions.
CORRECT ANSWER: B. Obtain the client's baseline vital signs.
Rationale: The first action the nurse should take is to obtain baseline vital signs. This
provides a reference point for detecting early signs of a transfusion reaction, such as
fever, tachycardia, or hypotension. While verifying the blood type and crossmatch is
crucial, it is done before the blood is brought to the bedside.
Question 2: A client with chronic kidney disease has a potassium level of 6.8
mEq/L. Which of the following interventions should the nurse anticipate?
A. Administering oral potassium supplements.
B. Restricting dietary intake of potassium.
C. Preparing the client for hemodialysis.
D. Administering a loop diuretic.
CORRECT ANSWER: C. Preparing the client for hemodialysis.
Rationale: A potassium level of 6.8 mEq/L is critically high and poses a significant risk
for cardiac dysrhythmias. The most definitive and rapid treatment for severe
hyperkalemia, especially in a client with chronic kidney disease, is hemodialysis. Oral
potassium supplements would worsen the condition, and dietary restriction is a
preventive measure, not an acute treatment.
Question 3: A nurse is providing discharge teaching to a client prescribed
warfarin. Which of the following over-the-counter medications should the
nurse instruct the client to avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
CORRECT ANSWER: B. Ibuprofen
Rationale: Ibuprofen, an NSAID, should be avoided because it can increase the risk of
,gastrointestinal bleeding and interact with warfarin, potentially increasing the
international normalized ratio (INR) and the risk of hemorrhage. Acetaminophen is
generally considered safe for pain/fever in clients on warfarin, though it should be used
in moderation.
Question 4: A nurse is assessing a newborn who is 12 hours old. Which of the
following findings should the nurse report to the provider?
A. A heart rate of 140/min.
B. A respiratory rate of 60/min.
C. A single umbilical artery.
D. Apical pulse irregularity with respirations.
CORRECT ANSWER: C. A single umbilical artery.
Rationale: A normal umbilical cord contains two arteries and one vein. The presence of
a single umbilical artery is an abnormal finding that can be associated with congenital
anomalies of the renal and cardiovascular systems. A heart rate of 140/min and a
respiratory rate of 60/min are within normal limits for a newborn. Irregular heart rate
with respirations (sinus arrhythmia) is a normal finding in newborns.
Question 5: A client is admitted with a diagnosis of heart failure. The nurse
notes jugular venous distention (JVD), peripheral edema, and crackles in the
lungs. Which of the following medications is most likely to be prescribed to
address these symptoms?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Lisinopril
CORRECT ANSWER: B. Furosemide
Rationale: The client is exhibiting signs of fluid volume overload (JVD, edema,
crackles). Furosemide is a loop diuretic that is used to reduce fluid volume by promoting
diuresis, thereby decreasing preload and relieving these symptoms. Digoxin increases
contractility, metoprolol reduces heart rate, and lisinopril is an ACE inhibitor, but
furosemide directly addresses the fluid overload.
Question 6: A nurse is caring for a client with diabetic ketoacidosis (DKA).
Which of the following is the priority nursing intervention?
A. Administering regular insulin via IV infusion.
B. Monitoring blood glucose levels every hour.
C. Administering IV fluids.
D. Assessing for signs of infection.
CORRECT ANSWER: A. Administering regular insulin via IV infusion.
Rationale: While all options are important, the priority intervention in DKA is to reverse
the acidosis and hyperglycemia by administering regular insulin via IV infusion. The
insulin stops ketogenesis and allows glucose to enter cells, directly addressing the
underlying metabolic derangement. Fluid resuscitation is also a high priority but
typically follows or is concurrent with insulin therapy.
,Question 7: A nurse is teaching a client with a new colostomy about dietary
modifications. Which of the following foods should the nurse recommend to
help thicken the stool?
A. Applesauce
B. Prune juice
C. Bran cereal
D. Broccoli
CORRECT ANSWER: A. Applesauce
Rationale: Applesauce is a source of soluble fiber and is part of the BRAT diet
(Bananas, Rice, Applesauce, Toast), which is known to help thicken stool. Prune juice
and bran cereal would increase peristalsis and loosen stool, and broccoli is a gas-
forming food.
Question 8: A client is receiving IV heparin for a deep vein thrombosis. The
nurse monitors the client for which of the following adverse effects?
A. Hyperkalemia
B. Hemorrhage
C. Bradycardia
D. Hypotension
CORRECT ANSWER: B. Hemorrhage
Rationale: The primary adverse effect of heparin, an anticoagulant, is bleeding or
hemorrhage. The nurse should monitor for signs of bleeding such as hematuria,
hematemesis, and bleeding from the gums or IV sites. Hyperkalemia is more associated
with potassium-sparing diuretics.
Question 9: A nurse is preparing to administer an intramuscular (IM) injection
to a 6-month-old infant. Which of the following sites is the safest to use?
A. Deltoid
B. Vastus lateralis
C. Dorsogluteal
D. Ventrogluteal
CORRECT ANSWER: B. Vastus lateralis
Rationale: For infants and toddlers, the vastus lateralis muscle is the preferred and
safest site for IM injections. It is well-developed, has a large muscle mass, and is located
away from major nerves and blood vessels. The dorsogluteal site should never be used
in children under 3 years of age due to the risk of sciatic nerve damage.
Question 10: A client is experiencing a panic attack. Which of the following
actions should the nurse take first?
A. Encourage the client to use deep breathing techniques.
B. Place the client in a quiet, calm, and safe environment.
C. Administer an anxiolytic medication as prescribed.
D. Stay with the client and remain calm.
CORRECT ANSWER: D. Stay with the client and remain calm.
Rationale: The first action during a panic attack is to stay with the client, remain calm,
and provide a sense of safety. This helps reduce the client's fear and prevents the
, situation from escalating. The client's safety and therapeutic presence are the immediate
priorities before further interventions.
Question 11: A nurse is reviewing the lab values of a client who is at risk for
developing metabolic acidosis. Which of the following findings supports this
diagnosis?
A. pH 7.40, PaCO2 40, HCO3 24
B. pH 7.35, PaCO2 45, HCO3 22
C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.48, PaCO2 35, HCO3 28
CORRECT ANSWER: C. pH 7.32, PaCO2 38, HCO3 18
Rationale: Metabolic acidosis is characterized by a low pH (< 7.35) and a low
bicarbonate (HCO3) level (< 22 mEq/L). The PaCO2 may be normal or low if
compensation occurs. Option C shows a low pH and a low HCO3.
Question 12: A nurse is assessing a client who is postoperative following a hip
arthroplasty. The client reports sudden shortness of breath and chest pain.
Which of the following is the priority nursing action?
A. Apply oxygen at 2 L/min via nasal cannula.
B. Elevate the head of the bed.
C. Assess the client's oxygen saturation.
D. Notify the healthcare provider.
CORRECT ANSWER: B. Elevate the head of the bed.
Rationale: The client is exhibiting signs of a possible pulmonary embolism (PE). The
priority action is to elevate the head of the bed to facilitate breathing and maximize
chest expansion. While applying oxygen and notifying the provider are important,
positioning the client in a high-Fowler's position is the immediate priority to improve
oxygenation.
Question 13: A client with a history of peptic ulcer disease is prescribed
prednisone. The nurse should monitor the client for which of the following
side effects?
A. Weight loss
B. Hypoglycemia
C. Gastrointestinal bleeding
D. Bradycardia
CORRECT ANSWER: C. Gastrointestinal bleeding
Rationale: Prednisone is a corticosteroid that can increase the risk of gastric ulcer
formation and gastrointestinal bleeding. Clients with a history of peptic ulcer disease are
at a particularly high risk. The nurse should monitor for signs of GI bleeding (melena,
hematemesis, abdominal pain).
Question 14: A nurse is providing teaching to a client about the use of a
metered-dose inhaler (MDI) with a spacer. Which of the following instructions
is correct?
A. "Inhale the medication quickly and deeply."
Predictor Updated 2026 | 190+ Questions and
Answers | ATI RN Comprehensive Predictor Study
Guide, Practice Exam, Comprehensive Review,
Exam Prep Test Bank, Medical-Surgical Nursing,
Pharmacology, Fundamentals, Maternal-Newborn
Nursing, Pediatrics, Mental Health, Leadership and
Management, Nutrition, Clinical Judgment,
Prioritization, Delegation, NCLEX-RN Readiness,
Detailed Rationales and Complete Revision Material
Question 1: A nurse is preparing to administer a blood transfusion to a client
who has anemia. Which of the following actions should the nurse take first?
A. Verify the client's blood type and crossmatch with the unit of blood.
B. Obtain the client's baseline vital signs.
C. Prime the blood administration tubing with 0.9% sodium chloride.
D. Ask the client about any previous history of transfusion reactions.
CORRECT ANSWER: B. Obtain the client's baseline vital signs.
Rationale: The first action the nurse should take is to obtain baseline vital signs. This
provides a reference point for detecting early signs of a transfusion reaction, such as
fever, tachycardia, or hypotension. While verifying the blood type and crossmatch is
crucial, it is done before the blood is brought to the bedside.
Question 2: A client with chronic kidney disease has a potassium level of 6.8
mEq/L. Which of the following interventions should the nurse anticipate?
A. Administering oral potassium supplements.
B. Restricting dietary intake of potassium.
C. Preparing the client for hemodialysis.
D. Administering a loop diuretic.
CORRECT ANSWER: C. Preparing the client for hemodialysis.
Rationale: A potassium level of 6.8 mEq/L is critically high and poses a significant risk
for cardiac dysrhythmias. The most definitive and rapid treatment for severe
hyperkalemia, especially in a client with chronic kidney disease, is hemodialysis. Oral
potassium supplements would worsen the condition, and dietary restriction is a
preventive measure, not an acute treatment.
Question 3: A nurse is providing discharge teaching to a client prescribed
warfarin. Which of the following over-the-counter medications should the
nurse instruct the client to avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Loratadine
CORRECT ANSWER: B. Ibuprofen
Rationale: Ibuprofen, an NSAID, should be avoided because it can increase the risk of
,gastrointestinal bleeding and interact with warfarin, potentially increasing the
international normalized ratio (INR) and the risk of hemorrhage. Acetaminophen is
generally considered safe for pain/fever in clients on warfarin, though it should be used
in moderation.
Question 4: A nurse is assessing a newborn who is 12 hours old. Which of the
following findings should the nurse report to the provider?
A. A heart rate of 140/min.
B. A respiratory rate of 60/min.
C. A single umbilical artery.
D. Apical pulse irregularity with respirations.
CORRECT ANSWER: C. A single umbilical artery.
Rationale: A normal umbilical cord contains two arteries and one vein. The presence of
a single umbilical artery is an abnormal finding that can be associated with congenital
anomalies of the renal and cardiovascular systems. A heart rate of 140/min and a
respiratory rate of 60/min are within normal limits for a newborn. Irregular heart rate
with respirations (sinus arrhythmia) is a normal finding in newborns.
Question 5: A client is admitted with a diagnosis of heart failure. The nurse
notes jugular venous distention (JVD), peripheral edema, and crackles in the
lungs. Which of the following medications is most likely to be prescribed to
address these symptoms?
A. Digoxin
B. Furosemide
C. Metoprolol
D. Lisinopril
CORRECT ANSWER: B. Furosemide
Rationale: The client is exhibiting signs of fluid volume overload (JVD, edema,
crackles). Furosemide is a loop diuretic that is used to reduce fluid volume by promoting
diuresis, thereby decreasing preload and relieving these symptoms. Digoxin increases
contractility, metoprolol reduces heart rate, and lisinopril is an ACE inhibitor, but
furosemide directly addresses the fluid overload.
Question 6: A nurse is caring for a client with diabetic ketoacidosis (DKA).
Which of the following is the priority nursing intervention?
A. Administering regular insulin via IV infusion.
B. Monitoring blood glucose levels every hour.
C. Administering IV fluids.
D. Assessing for signs of infection.
CORRECT ANSWER: A. Administering regular insulin via IV infusion.
Rationale: While all options are important, the priority intervention in DKA is to reverse
the acidosis and hyperglycemia by administering regular insulin via IV infusion. The
insulin stops ketogenesis and allows glucose to enter cells, directly addressing the
underlying metabolic derangement. Fluid resuscitation is also a high priority but
typically follows or is concurrent with insulin therapy.
,Question 7: A nurse is teaching a client with a new colostomy about dietary
modifications. Which of the following foods should the nurse recommend to
help thicken the stool?
A. Applesauce
B. Prune juice
C. Bran cereal
D. Broccoli
CORRECT ANSWER: A. Applesauce
Rationale: Applesauce is a source of soluble fiber and is part of the BRAT diet
(Bananas, Rice, Applesauce, Toast), which is known to help thicken stool. Prune juice
and bran cereal would increase peristalsis and loosen stool, and broccoli is a gas-
forming food.
Question 8: A client is receiving IV heparin for a deep vein thrombosis. The
nurse monitors the client for which of the following adverse effects?
A. Hyperkalemia
B. Hemorrhage
C. Bradycardia
D. Hypotension
CORRECT ANSWER: B. Hemorrhage
Rationale: The primary adverse effect of heparin, an anticoagulant, is bleeding or
hemorrhage. The nurse should monitor for signs of bleeding such as hematuria,
hematemesis, and bleeding from the gums or IV sites. Hyperkalemia is more associated
with potassium-sparing diuretics.
Question 9: A nurse is preparing to administer an intramuscular (IM) injection
to a 6-month-old infant. Which of the following sites is the safest to use?
A. Deltoid
B. Vastus lateralis
C. Dorsogluteal
D. Ventrogluteal
CORRECT ANSWER: B. Vastus lateralis
Rationale: For infants and toddlers, the vastus lateralis muscle is the preferred and
safest site for IM injections. It is well-developed, has a large muscle mass, and is located
away from major nerves and blood vessels. The dorsogluteal site should never be used
in children under 3 years of age due to the risk of sciatic nerve damage.
Question 10: A client is experiencing a panic attack. Which of the following
actions should the nurse take first?
A. Encourage the client to use deep breathing techniques.
B. Place the client in a quiet, calm, and safe environment.
C. Administer an anxiolytic medication as prescribed.
D. Stay with the client and remain calm.
CORRECT ANSWER: D. Stay with the client and remain calm.
Rationale: The first action during a panic attack is to stay with the client, remain calm,
and provide a sense of safety. This helps reduce the client's fear and prevents the
, situation from escalating. The client's safety and therapeutic presence are the immediate
priorities before further interventions.
Question 11: A nurse is reviewing the lab values of a client who is at risk for
developing metabolic acidosis. Which of the following findings supports this
diagnosis?
A. pH 7.40, PaCO2 40, HCO3 24
B. pH 7.35, PaCO2 45, HCO3 22
C. pH 7.32, PaCO2 38, HCO3 18
D. pH 7.48, PaCO2 35, HCO3 28
CORRECT ANSWER: C. pH 7.32, PaCO2 38, HCO3 18
Rationale: Metabolic acidosis is characterized by a low pH (< 7.35) and a low
bicarbonate (HCO3) level (< 22 mEq/L). The PaCO2 may be normal or low if
compensation occurs. Option C shows a low pH and a low HCO3.
Question 12: A nurse is assessing a client who is postoperative following a hip
arthroplasty. The client reports sudden shortness of breath and chest pain.
Which of the following is the priority nursing action?
A. Apply oxygen at 2 L/min via nasal cannula.
B. Elevate the head of the bed.
C. Assess the client's oxygen saturation.
D. Notify the healthcare provider.
CORRECT ANSWER: B. Elevate the head of the bed.
Rationale: The client is exhibiting signs of a possible pulmonary embolism (PE). The
priority action is to elevate the head of the bed to facilitate breathing and maximize
chest expansion. While applying oxygen and notifying the provider are important,
positioning the client in a high-Fowler's position is the immediate priority to improve
oxygenation.
Question 13: A client with a history of peptic ulcer disease is prescribed
prednisone. The nurse should monitor the client for which of the following
side effects?
A. Weight loss
B. Hypoglycemia
C. Gastrointestinal bleeding
D. Bradycardia
CORRECT ANSWER: C. Gastrointestinal bleeding
Rationale: Prednisone is a corticosteroid that can increase the risk of gastric ulcer
formation and gastrointestinal bleeding. Clients with a history of peptic ulcer disease are
at a particularly high risk. The nurse should monitor for signs of GI bleeding (melena,
hematemesis, abdominal pain).
Question 14: A nurse is providing teaching to a client about the use of a
metered-dose inhaler (MDI) with a spacer. Which of the following instructions
is correct?
A. "Inhale the medication quickly and deeply."
