Fall Semester 2026–2027 ATI Comprehensive
Predictor Updated 2026 | 190+ Questions and
Answers | ATI RN Comprehensive Predictor
Practice Exam, Comprehensive Study Guide, Exam
Prep Test Bank, Medical-Surgical Nursing,
Pharmacology, Fundamentals of Nursing, Maternal-
Newborn Nursing, Pediatric Nursing, Mental Health
Nursing, Leadership & Management, Clinical
Judgment, Prioritization, Delegation, NCLEX-RN
Comprehensive Review, 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. Obtain the client's vital signs.
B. Verify the client's identity using two identifiers.
C. Ensure informed consent is on the chart.
D. Prime the IV tubing with normal saline.
CORRECT ANSWER: B. Verify the client's identity using two identifiers.
Rationale: The first action the nurse should take is to verify the client's identity to
ensure the correct blood product is administered to the correct client. This is a critical
safety step prior to any other preparation or administration.
Question 2: A nurse is caring for a client with a chest tube following a
thoracotomy. Which of the following findings should indicate to the nurse that
the chest tube system is functioning correctly?
A. Continuous bubbling in the water seal chamber.
B. Intermittent bubbling in the suction control chamber.
C. Cessation of tidaling in the water seal chamber.
D. Constant bubbling in the water seal chamber.
CORRECT ANSWER: B. Intermittent bubbling in the suction control chamber.
Rationale: Intermittent bubbling in the suction control chamber is expected when
suction is applied. Continuous bubbling in the water seal chamber indicates an air leak.
Tidaling (fluctuation) in the water seal chamber is normal and should rise with
inspiration and fall with expiration.
Question 3: A nurse is assessing a client who has a hip fracture. Which of the
following findings should the nurse expect?
A. Abduction of the affected leg.
B. Shortening of the affected leg.
C. Internal rotation of the affected leg.
D. Full range of motion of the affected hip.
CORRECT ANSWER: B. Shortening of the affected leg.
Rationale: A hip fracture often presents with the affected leg shortened and externally
rotated due to muscle spasm and the pull of the muscles on the broken bone fragments.
,Question 4: A nurse is providing teaching to a client about dietary
management of hyperkalemia. Which of the following foods should the nurse
instruct the client to avoid?
A. Apples
B. Bananas
C. Green beans
D. White rice
CORRECT ANSWER: B. Bananas
Rationale: Bananas are a high-potassium food. Clients with hyperkalemia should avoid
high-potassium foods to prevent cardiac complications. Apples, green beans, and white
rice are low in potassium.
Question 5: A nurse is administering a medication that has a high first-pass
effect. The nurse should anticipate that the medication will be administered
via which of the following routes?
A. Intravenous
B. Topical
C. Oral
D. Sublingual
CORRECT ANSWER: C. Oral
Rationale: The first-pass effect refers to the extensive metabolism of a drug by the liver
before it reaches systemic circulation. This effect is most significant with orally
administered medications, as they are absorbed from the GI tract and transported
directly to the liver via the portal vein.
Question 6: A nurse is assessing a client who has a new diagnosis of
Parkinson's disease. Which of the following manifestations should the nurse
expect to find?
A. Hyperactive deep tendon reflexes.
B. Resting tremors.
C. Choreiform movements.
D. Muscle flaccidity.
CORRECT ANSWER: B. Resting tremors.
Rationale: Resting tremors are a cardinal sign of Parkinson's disease, often described as
a "pill-rolling" tremor. Hyperactive reflexes and choreiform movements are seen in other
neurological disorders, and muscle rigidity, not flaccidity, is common.
Question 7: A nurse is caring for a post-operative client who is receiving
morphine via a patient-controlled analgesia (PCA) pump. The nurse notes the
client has a respiratory rate of 8 breaths/min. Which of the following
medications should the nurse anticipate administering?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
CORRECT ANSWER: A. Naloxone
,Rationale: Naloxone is an opioid antagonist used to reverse the effects of opioid
toxicity, including respiratory depression. Flumazenil reverses benzodiazepines,
acetylcysteine is for acetaminophen overdose, and protamine sulfate reverses heparin.
Question 8: A nurse is performing a neurological assessment on a client. To
test cranial nerve III (oculomotor), which of the following actions should the
nurse take?
A. Ask the client to smile and show teeth.
B. Assess the client's ability to shrug shoulders.
C. Assess the client's pupillary response to light.
D. Have the client stick out the tongue and move it side to side.
CORRECT ANSWER: C. Assess the client's pupillary response to light.
Rationale: Cranial nerve III (oculomotor) controls pupillary constriction, as well as most
extraocular movements. Testing pupillary response to light assesses the function of this
nerve. Smiling is CN VII, shoulder shrug is CN XI, and tongue movement is CN XII.
Question 9: A nurse is providing discharge teaching to a client who has a new
prescription for digoxin. Which of the following statements by the client
indicates a need for further teaching?
A. "I will check my heart rate before I take the medication."
B. "I can take the medication with food if I get an upset stomach."
C. "I will report any yellow or green vision to my doctor."
D. "I should avoid eating grapefruit while taking this medication."
CORRECT ANSWER: D. "I should avoid eating grapefruit while taking this
medication."
Rationale: Grapefruit juice interacts with many medications, but digoxin is not one of
them. The client should be taught to check their pulse, take with food if needed, and
report visual disturbances (yellow/green halos), which are signs of digoxin toxicity.
Question 10: A nurse is caring for a client who has a new prescription for a
low-sodium diet. Which of the following food choices by the client indicates an
understanding of the teaching?
A. Canned vegetable soup
B. Salted peanuts
C. A baked potato with margarine
D. A dill pickle
CORRECT ANSWER: C. A baked potato with margarine
Rationale: A baked potato with margarine is a low-sodium choice. Canned vegetable
soup, salted peanuts, and pickles are all high in sodium.
Question 11: A nurse is assessing a client with a suspected pulmonary
embolism. Which of the following findings should the nurse anticipate?
A. Bradypnea and bradycardia.
B. Hemoptysis and pleural friction rub.
C. Sudden onset of dyspnea and pleuritic chest pain.
D. Productive cough with green sputum.
, CORRECT ANSWER: C. Sudden onset of dyspnea and pleuritic chest pain.
Rationale: A pulmonary embolism typically presents with the sudden onset of dyspnea
and sharp, pleuritic chest pain. Hemoptysis can occur, but a friction rub is less common.
The classic presentation is sudden, severe respiratory distress.
Question 12: A nurse is preparing to administer an IM injection to a 15-month-
old toddler. Which of the following sites is most appropriate?
A. Deltoid muscle
B. Dorsogluteal muscle
C. Ventrogluteal muscle
D. Vastus lateralis muscle
CORRECT ANSWER: D. Vastus lateralis muscle.
Rationale: For toddlers and children, the vastus lateralis is the preferred site for IM
injections. The deltoid is not well-developed enough, the dorsogluteal is avoided due to
the risk of sciatic nerve injury, and the ventrogluteal can be used but is often more
appropriate for older children and adults.
Question 13: A nurse is reviewing the laboratory results for a client who has
chronic kidney disease. Which of the following findings should the nurse
expect?
A. Elevated serum calcium.
B. Decreased serum creatinine.
C. Elevated serum potassium.
D. Decreased serum phosphorus.
CORRECT ANSWER: C. Elevated serum potassium.
Rationale: In chronic kidney disease, the kidneys are unable to excrete potassium
effectively, leading to hyperkalemia. Serum calcium is often low, creatinine is elevated,
and phosphorus is elevated.
Question 14: A nurse is teaching a client about the proper use of a metered-
dose inhaler (MDI). Which of the following instructions should the nurse
include?
A. Inhale rapidly when activating the inhaler.
B. Activate the inhaler before starting to inhale.
C. Hold the breath for 10 seconds after inhalation.
D. Perform multiple inhalations without waiting between puffs.
CORRECT ANSWER: C. Hold the breath for 10 seconds after inhalation.
Rationale: The client should be instructed to hold their breath for 5 to 10 seconds after
inhalation to allow for maximal deposition of the medication in the lungs. The client
should activate the inhaler after starting a slow inhalation, not before.
Question 15: A nurse is caring for a client with a history of heart failure who
reports a weight gain of 2 lbs in 24 hours. Which of the following actions
should the nurse take first?
A. Encourage the client to ambulate.
B. Restrict the client's fluid intake.
Predictor Updated 2026 | 190+ Questions and
Answers | ATI RN Comprehensive Predictor
Practice Exam, Comprehensive Study Guide, Exam
Prep Test Bank, Medical-Surgical Nursing,
Pharmacology, Fundamentals of Nursing, Maternal-
Newborn Nursing, Pediatric Nursing, Mental Health
Nursing, Leadership & Management, Clinical
Judgment, Prioritization, Delegation, NCLEX-RN
Comprehensive Review, 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. Obtain the client's vital signs.
B. Verify the client's identity using two identifiers.
C. Ensure informed consent is on the chart.
D. Prime the IV tubing with normal saline.
CORRECT ANSWER: B. Verify the client's identity using two identifiers.
Rationale: The first action the nurse should take is to verify the client's identity to
ensure the correct blood product is administered to the correct client. This is a critical
safety step prior to any other preparation or administration.
Question 2: A nurse is caring for a client with a chest tube following a
thoracotomy. Which of the following findings should indicate to the nurse that
the chest tube system is functioning correctly?
A. Continuous bubbling in the water seal chamber.
B. Intermittent bubbling in the suction control chamber.
C. Cessation of tidaling in the water seal chamber.
D. Constant bubbling in the water seal chamber.
CORRECT ANSWER: B. Intermittent bubbling in the suction control chamber.
Rationale: Intermittent bubbling in the suction control chamber is expected when
suction is applied. Continuous bubbling in the water seal chamber indicates an air leak.
Tidaling (fluctuation) in the water seal chamber is normal and should rise with
inspiration and fall with expiration.
Question 3: A nurse is assessing a client who has a hip fracture. Which of the
following findings should the nurse expect?
A. Abduction of the affected leg.
B. Shortening of the affected leg.
C. Internal rotation of the affected leg.
D. Full range of motion of the affected hip.
CORRECT ANSWER: B. Shortening of the affected leg.
Rationale: A hip fracture often presents with the affected leg shortened and externally
rotated due to muscle spasm and the pull of the muscles on the broken bone fragments.
,Question 4: A nurse is providing teaching to a client about dietary
management of hyperkalemia. Which of the following foods should the nurse
instruct the client to avoid?
A. Apples
B. Bananas
C. Green beans
D. White rice
CORRECT ANSWER: B. Bananas
Rationale: Bananas are a high-potassium food. Clients with hyperkalemia should avoid
high-potassium foods to prevent cardiac complications. Apples, green beans, and white
rice are low in potassium.
Question 5: A nurse is administering a medication that has a high first-pass
effect. The nurse should anticipate that the medication will be administered
via which of the following routes?
A. Intravenous
B. Topical
C. Oral
D. Sublingual
CORRECT ANSWER: C. Oral
Rationale: The first-pass effect refers to the extensive metabolism of a drug by the liver
before it reaches systemic circulation. This effect is most significant with orally
administered medications, as they are absorbed from the GI tract and transported
directly to the liver via the portal vein.
Question 6: A nurse is assessing a client who has a new diagnosis of
Parkinson's disease. Which of the following manifestations should the nurse
expect to find?
A. Hyperactive deep tendon reflexes.
B. Resting tremors.
C. Choreiform movements.
D. Muscle flaccidity.
CORRECT ANSWER: B. Resting tremors.
Rationale: Resting tremors are a cardinal sign of Parkinson's disease, often described as
a "pill-rolling" tremor. Hyperactive reflexes and choreiform movements are seen in other
neurological disorders, and muscle rigidity, not flaccidity, is common.
Question 7: A nurse is caring for a post-operative client who is receiving
morphine via a patient-controlled analgesia (PCA) pump. The nurse notes the
client has a respiratory rate of 8 breaths/min. Which of the following
medications should the nurse anticipate administering?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
CORRECT ANSWER: A. Naloxone
,Rationale: Naloxone is an opioid antagonist used to reverse the effects of opioid
toxicity, including respiratory depression. Flumazenil reverses benzodiazepines,
acetylcysteine is for acetaminophen overdose, and protamine sulfate reverses heparin.
Question 8: A nurse is performing a neurological assessment on a client. To
test cranial nerve III (oculomotor), which of the following actions should the
nurse take?
A. Ask the client to smile and show teeth.
B. Assess the client's ability to shrug shoulders.
C. Assess the client's pupillary response to light.
D. Have the client stick out the tongue and move it side to side.
CORRECT ANSWER: C. Assess the client's pupillary response to light.
Rationale: Cranial nerve III (oculomotor) controls pupillary constriction, as well as most
extraocular movements. Testing pupillary response to light assesses the function of this
nerve. Smiling is CN VII, shoulder shrug is CN XI, and tongue movement is CN XII.
Question 9: A nurse is providing discharge teaching to a client who has a new
prescription for digoxin. Which of the following statements by the client
indicates a need for further teaching?
A. "I will check my heart rate before I take the medication."
B. "I can take the medication with food if I get an upset stomach."
C. "I will report any yellow or green vision to my doctor."
D. "I should avoid eating grapefruit while taking this medication."
CORRECT ANSWER: D. "I should avoid eating grapefruit while taking this
medication."
Rationale: Grapefruit juice interacts with many medications, but digoxin is not one of
them. The client should be taught to check their pulse, take with food if needed, and
report visual disturbances (yellow/green halos), which are signs of digoxin toxicity.
Question 10: A nurse is caring for a client who has a new prescription for a
low-sodium diet. Which of the following food choices by the client indicates an
understanding of the teaching?
A. Canned vegetable soup
B. Salted peanuts
C. A baked potato with margarine
D. A dill pickle
CORRECT ANSWER: C. A baked potato with margarine
Rationale: A baked potato with margarine is a low-sodium choice. Canned vegetable
soup, salted peanuts, and pickles are all high in sodium.
Question 11: A nurse is assessing a client with a suspected pulmonary
embolism. Which of the following findings should the nurse anticipate?
A. Bradypnea and bradycardia.
B. Hemoptysis and pleural friction rub.
C. Sudden onset of dyspnea and pleuritic chest pain.
D. Productive cough with green sputum.
, CORRECT ANSWER: C. Sudden onset of dyspnea and pleuritic chest pain.
Rationale: A pulmonary embolism typically presents with the sudden onset of dyspnea
and sharp, pleuritic chest pain. Hemoptysis can occur, but a friction rub is less common.
The classic presentation is sudden, severe respiratory distress.
Question 12: A nurse is preparing to administer an IM injection to a 15-month-
old toddler. Which of the following sites is most appropriate?
A. Deltoid muscle
B. Dorsogluteal muscle
C. Ventrogluteal muscle
D. Vastus lateralis muscle
CORRECT ANSWER: D. Vastus lateralis muscle.
Rationale: For toddlers and children, the vastus lateralis is the preferred site for IM
injections. The deltoid is not well-developed enough, the dorsogluteal is avoided due to
the risk of sciatic nerve injury, and the ventrogluteal can be used but is often more
appropriate for older children and adults.
Question 13: A nurse is reviewing the laboratory results for a client who has
chronic kidney disease. Which of the following findings should the nurse
expect?
A. Elevated serum calcium.
B. Decreased serum creatinine.
C. Elevated serum potassium.
D. Decreased serum phosphorus.
CORRECT ANSWER: C. Elevated serum potassium.
Rationale: In chronic kidney disease, the kidneys are unable to excrete potassium
effectively, leading to hyperkalemia. Serum calcium is often low, creatinine is elevated,
and phosphorus is elevated.
Question 14: A nurse is teaching a client about the proper use of a metered-
dose inhaler (MDI). Which of the following instructions should the nurse
include?
A. Inhale rapidly when activating the inhaler.
B. Activate the inhaler before starting to inhale.
C. Hold the breath for 10 seconds after inhalation.
D. Perform multiple inhalations without waiting between puffs.
CORRECT ANSWER: C. Hold the breath for 10 seconds after inhalation.
Rationale: The client should be instructed to hold their breath for 5 to 10 seconds after
inhalation to allow for maximal deposition of the medication in the lungs. The client
should activate the inhaler after starting a slow inhalation, not before.
Question 15: A nurse is caring for a client with a history of heart failure who
reports a weight gain of 2 lbs in 24 hours. Which of the following actions
should the nurse take first?
A. Encourage the client to ambulate.
B. Restrict the client's fluid intake.
