Fall Semester 2026–2027 ATI450 – ATI Comprehensive Predictor Updated 2026 |
190+ Questions and Answers | ATI450 Comprehensive Predictor Exam Prep,
Practice Exam, Comprehensive Study Guide, Test Bank, Medical-Surgical Nursing,
Pharmacology, Fundamentals of Nursing, Maternal-Newborn Nursing, Pediatric
Nursing, Mental Health Nursing, Leadership & Management, Community Health,
Clinical Judgment, Prioritization, Delegation, Next Generation NCLEX (NGN),
Detailed Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who is post-operative following a
total hip arthroplasty. Which of the following actions is most important for the
nurse to take to prevent dislocation of the new joint?
A. Maintain the client in a high-Fowler's position.
B. Instruct the client to cross their legs at the ankles when turning.
C. Place an abduction pillow between the client's legs.
D. Encourage the client to perform active range of motion exercises immediately.
CORRECT ANSWER: C. Place an abduction pillow between the client's legs.
Rationale: An abduction pillow is used to keep the hip abducted and prevent adduction
past the midline, which is a primary risk factor for dislocation following a total hip
arthroplasty. Crossing the legs (B) would cause adduction and is contraindicated. High-
Fowler's position (A) is not indicated immediately post-op for hip precautions. Active
ROM (D) is too aggressive initially and should be passive or assisted.
Question 2: A nurse is preparing to administer a blood transfusion to a client.
Which of the following intravenous (IV) solutions should the nurse use to
prime the blood administration tubing?
A. 0.9% sodium chloride
B. 5% dextrose in water
C. Lactated Ringer's solution
D. 0.45% sodium chloride
CORRECT ANSWER: A. 0.9% sodium chloride
Rationale: 0.9% sodium chloride (normal saline) is the only isotonic solution that is
compatible with blood products and does not cause hemolysis. Dextrose solutions (B)
can cause crenation and hemolysis of red blood cells. Lactated Ringer's (C) contains
calcium, which can cause clotting in the tubing.
Question 3: A charge nurse is observing a newly licensed nurse perform wound
care on a client with a pressure injury. Which of the following actions by the
newly licensed nurse indicates a need for intervention?
A. Cleans the wound from the center outward.
B. Uses a sterile cotton-tipped applicator to apply the wound dressing.
C. Irrigates the wound with a 30-mL syringe and an 18-gauge needle.
D. Applies a transparent dressing over a clean, dry wound.
,CORRECT ANSWER: C. Irrigates the wound with a 30-mL syringe and an 18-
gauge needle.
Rationale: Wound irrigation requires a 30- to 60-mL syringe with a 19-gauge needle or
an angiocatheter to provide enough pressure (8-15 psi) for effective debridement
without causing tissue damage. An 18-gauge needle provides too much pressure and
can damage tissue. Cleaning from center outward (A), sterile applicators (B), and
transparent dressings for clean wounds (D) are correct practices.
Question 4: A nurse is assessing a client who has a new diagnosis of
hyperthyroidism. Which of the following findings should the nurse anticipate?
A. Cold intolerance
B. Bradycardia
C. Weight gain
D. Exophthalmos
CORRECT ANSWER: D. Exophthalmos
Rationale: Exophthalmos (protrusion of the eyeballs) is a classic finding in Graves'
disease, an autoimmune form of hyperthyroidism. Cold intolerance (A), bradycardia (B),
and weight gain (C) are signs of hypothyroidism, not hyperthyroidism.
Question 5: A nurse is reinforcing teaching with a client about the use of a
patient-controlled analgesia (PCA) pump. Which of the following statements
indicates the client understands the teaching?
A. "I will push the button every 15 minutes regardless of pain level."
B. "My family can push the button for me if I am asleep."
C. "I will wait until my pain is severe before pushing the button."
D. "I should push the button before activities that cause pain."
CORRECT ANSWER: D. "I should push the button before activities that cause
pain."
Rationale: The client should use the PCA bolus before painful activities (e.g., turning,
deep breathing) to manage pain proactively. Pushing the button regardless of pain (A)
could lead to overdose. Only the client should push the button (B) to prevent accidental
overdose. Waiting until pain is severe (C) is less effective for pain management.
Question 6: A nurse is caring for a client who has a central venous catheter.
Which of the following findings indicates an infection at the insertion site?
A. Clear, serous drainage
B. Absence of redness
C. Purulent drainage and warmth
D. Client reports mild tenderness
CORRECT ANSWER: C. Purulent drainage and warmth
,Rationale: Purulent drainage and warmth at the insertion site are hallmark signs of
infection. Clear drainage (A) and absence of redness (B) are normal findings. Mild
tenderness (D) is expected immediately after insertion but can be a sign of irritation;
purulent drainage is more definitive for infection.
Question 7: A nurse is performing a neurological assessment on a client.
Which of the following tests is used to assess the function of cranial nerve III
(Oculomotor)?
A. Pupillary reaction to light
B. Swallowing ability
C. Shoulder shrug strength
D. Tongue movement
CORRECT ANSWER: A. Pupillary reaction to light
Rationale: Cranial nerve III (Oculomotor) innervates the pupillary sphincter muscle,
controlling pupillary constriction in response to light and accommodation. Swallowing
(B) is CN IX and X. Shoulder shrug (C) is CN XI. Tongue movement (D) is CN XII.
Question 8: A nurse is monitoring a client receiving a continuous IV infusion of
normal saline at 125 mL/hr via an infusion pump. The pump alarm sounds,
indicating an occlusion. Which of the following is the priority nursing action?
A. Check the IV site for swelling or infiltration.
B. Flush the IV catheter with normal saline.
C. Discontinue the IV and restart in the opposite arm.
D. Increase the pump pressure to clear the occlusion.
CORRECT ANSWER: A. Check the IV site for swelling or infiltration.
Rationale: The priority action is to assess the client and the IV site for signs of
infiltration, phlebitis, or occlusion. Flushing (B) should only be done after assessing the
site. Restarting the IV (C) is not the first action. Increasing pressure (D) is unsafe and
could cause harm.
Question 9: A nurse is preparing to administer an intramuscular injection to an
adult client. Which of the following sites is most appropriate for a volume of 3
mL?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Vastus lateralis
CORRECT ANSWER: B. Ventrogluteal
Rationale: The ventrogluteal site is the preferred site for IM injections in adults because
it is free of major nerves and blood vessels and can accommodate up to 3 mL of fluid.
The deltoid (A) can only hold up to 1 mL. The dorsogluteal (C) is not recommended due
, to the proximity of the sciatic nerve. The vastus lateralis (D) is commonly used in infants
and children.
Question 10: A nurse is reinforcing dietary teaching with a client who has
chronic kidney disease and is on a low-potassium diet. Which of the following
foods should the nurse recommend?
A. Bananas
B. Potatoes
C. Apples
D. Oranges
CORRECT ANSWER: C. Apples
Rationale: Apples are low in potassium and are safe for a client on a low-potassium diet.
Bananas (A), potatoes (B), and oranges (D) are all high-potassium foods and should be
avoided or limited.
Question 11: A nurse is caring for a client with a new diagnosis of diabetes
mellitus type 1. The client asks why they need insulin injections instead of
oral medication. Which of the following is an appropriate response by the
nurse?
A. "Your body's immune system destroyed the cells that produce insulin in your
pancreas."
B. "Your body is resistant to the insulin your pancreas produces."
C. "Oral medications are used only for gestational diabetes."
D. "You will eventually be able to switch to oral medications."
CORRECT ANSWER: A. "Your body's immune system destroyed the cells that
produce insulin in your pancreas."
Rationale: Type 1 diabetes is characterized by autoimmune destruction of beta cells in
the pancreas, leading to an absolute insulin deficiency requiring exogenous insulin. B
describes type 2 diabetes. C is incorrect as oral medications are used in type 2. D is
incorrect because type 1 requires lifelong insulin therapy.
Question 12: A nurse is assessing a client's peripheral circulation. Which of the
following findings is a sign of arterial insufficiency?
A. Dependent rubor
B. Pedal edema
C. Stasis dermatitis
D. Thickened, hard nails
CORRECT ANSWER: A. Dependent rubor
Rationale: Dependent rubor (a reddish-blue discoloration when the leg is dependent) is
a sign of severe arterial insufficiency. Pedal edema (B) and stasis dermatitis (C) are signs
190+ Questions and Answers | ATI450 Comprehensive Predictor Exam Prep,
Practice Exam, Comprehensive Study Guide, Test Bank, Medical-Surgical Nursing,
Pharmacology, Fundamentals of Nursing, Maternal-Newborn Nursing, Pediatric
Nursing, Mental Health Nursing, Leadership & Management, Community Health,
Clinical Judgment, Prioritization, Delegation, Next Generation NCLEX (NGN),
Detailed Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who is post-operative following a
total hip arthroplasty. Which of the following actions is most important for the
nurse to take to prevent dislocation of the new joint?
A. Maintain the client in a high-Fowler's position.
B. Instruct the client to cross their legs at the ankles when turning.
C. Place an abduction pillow between the client's legs.
D. Encourage the client to perform active range of motion exercises immediately.
CORRECT ANSWER: C. Place an abduction pillow between the client's legs.
Rationale: An abduction pillow is used to keep the hip abducted and prevent adduction
past the midline, which is a primary risk factor for dislocation following a total hip
arthroplasty. Crossing the legs (B) would cause adduction and is contraindicated. High-
Fowler's position (A) is not indicated immediately post-op for hip precautions. Active
ROM (D) is too aggressive initially and should be passive or assisted.
Question 2: A nurse is preparing to administer a blood transfusion to a client.
Which of the following intravenous (IV) solutions should the nurse use to
prime the blood administration tubing?
A. 0.9% sodium chloride
B. 5% dextrose in water
C. Lactated Ringer's solution
D. 0.45% sodium chloride
CORRECT ANSWER: A. 0.9% sodium chloride
Rationale: 0.9% sodium chloride (normal saline) is the only isotonic solution that is
compatible with blood products and does not cause hemolysis. Dextrose solutions (B)
can cause crenation and hemolysis of red blood cells. Lactated Ringer's (C) contains
calcium, which can cause clotting in the tubing.
Question 3: A charge nurse is observing a newly licensed nurse perform wound
care on a client with a pressure injury. Which of the following actions by the
newly licensed nurse indicates a need for intervention?
A. Cleans the wound from the center outward.
B. Uses a sterile cotton-tipped applicator to apply the wound dressing.
C. Irrigates the wound with a 30-mL syringe and an 18-gauge needle.
D. Applies a transparent dressing over a clean, dry wound.
,CORRECT ANSWER: C. Irrigates the wound with a 30-mL syringe and an 18-
gauge needle.
Rationale: Wound irrigation requires a 30- to 60-mL syringe with a 19-gauge needle or
an angiocatheter to provide enough pressure (8-15 psi) for effective debridement
without causing tissue damage. An 18-gauge needle provides too much pressure and
can damage tissue. Cleaning from center outward (A), sterile applicators (B), and
transparent dressings for clean wounds (D) are correct practices.
Question 4: A nurse is assessing a client who has a new diagnosis of
hyperthyroidism. Which of the following findings should the nurse anticipate?
A. Cold intolerance
B. Bradycardia
C. Weight gain
D. Exophthalmos
CORRECT ANSWER: D. Exophthalmos
Rationale: Exophthalmos (protrusion of the eyeballs) is a classic finding in Graves'
disease, an autoimmune form of hyperthyroidism. Cold intolerance (A), bradycardia (B),
and weight gain (C) are signs of hypothyroidism, not hyperthyroidism.
Question 5: A nurse is reinforcing teaching with a client about the use of a
patient-controlled analgesia (PCA) pump. Which of the following statements
indicates the client understands the teaching?
A. "I will push the button every 15 minutes regardless of pain level."
B. "My family can push the button for me if I am asleep."
C. "I will wait until my pain is severe before pushing the button."
D. "I should push the button before activities that cause pain."
CORRECT ANSWER: D. "I should push the button before activities that cause
pain."
Rationale: The client should use the PCA bolus before painful activities (e.g., turning,
deep breathing) to manage pain proactively. Pushing the button regardless of pain (A)
could lead to overdose. Only the client should push the button (B) to prevent accidental
overdose. Waiting until pain is severe (C) is less effective for pain management.
Question 6: A nurse is caring for a client who has a central venous catheter.
Which of the following findings indicates an infection at the insertion site?
A. Clear, serous drainage
B. Absence of redness
C. Purulent drainage and warmth
D. Client reports mild tenderness
CORRECT ANSWER: C. Purulent drainage and warmth
,Rationale: Purulent drainage and warmth at the insertion site are hallmark signs of
infection. Clear drainage (A) and absence of redness (B) are normal findings. Mild
tenderness (D) is expected immediately after insertion but can be a sign of irritation;
purulent drainage is more definitive for infection.
Question 7: A nurse is performing a neurological assessment on a client.
Which of the following tests is used to assess the function of cranial nerve III
(Oculomotor)?
A. Pupillary reaction to light
B. Swallowing ability
C. Shoulder shrug strength
D. Tongue movement
CORRECT ANSWER: A. Pupillary reaction to light
Rationale: Cranial nerve III (Oculomotor) innervates the pupillary sphincter muscle,
controlling pupillary constriction in response to light and accommodation. Swallowing
(B) is CN IX and X. Shoulder shrug (C) is CN XI. Tongue movement (D) is CN XII.
Question 8: A nurse is monitoring a client receiving a continuous IV infusion of
normal saline at 125 mL/hr via an infusion pump. The pump alarm sounds,
indicating an occlusion. Which of the following is the priority nursing action?
A. Check the IV site for swelling or infiltration.
B. Flush the IV catheter with normal saline.
C. Discontinue the IV and restart in the opposite arm.
D. Increase the pump pressure to clear the occlusion.
CORRECT ANSWER: A. Check the IV site for swelling or infiltration.
Rationale: The priority action is to assess the client and the IV site for signs of
infiltration, phlebitis, or occlusion. Flushing (B) should only be done after assessing the
site. Restarting the IV (C) is not the first action. Increasing pressure (D) is unsafe and
could cause harm.
Question 9: A nurse is preparing to administer an intramuscular injection to an
adult client. Which of the following sites is most appropriate for a volume of 3
mL?
A. Deltoid
B. Ventrogluteal
C. Dorsogluteal
D. Vastus lateralis
CORRECT ANSWER: B. Ventrogluteal
Rationale: The ventrogluteal site is the preferred site for IM injections in adults because
it is free of major nerves and blood vessels and can accommodate up to 3 mL of fluid.
The deltoid (A) can only hold up to 1 mL. The dorsogluteal (C) is not recommended due
, to the proximity of the sciatic nerve. The vastus lateralis (D) is commonly used in infants
and children.
Question 10: A nurse is reinforcing dietary teaching with a client who has
chronic kidney disease and is on a low-potassium diet. Which of the following
foods should the nurse recommend?
A. Bananas
B. Potatoes
C. Apples
D. Oranges
CORRECT ANSWER: C. Apples
Rationale: Apples are low in potassium and are safe for a client on a low-potassium diet.
Bananas (A), potatoes (B), and oranges (D) are all high-potassium foods and should be
avoided or limited.
Question 11: A nurse is caring for a client with a new diagnosis of diabetes
mellitus type 1. The client asks why they need insulin injections instead of
oral medication. Which of the following is an appropriate response by the
nurse?
A. "Your body's immune system destroyed the cells that produce insulin in your
pancreas."
B. "Your body is resistant to the insulin your pancreas produces."
C. "Oral medications are used only for gestational diabetes."
D. "You will eventually be able to switch to oral medications."
CORRECT ANSWER: A. "Your body's immune system destroyed the cells that
produce insulin in your pancreas."
Rationale: Type 1 diabetes is characterized by autoimmune destruction of beta cells in
the pancreas, leading to an absolute insulin deficiency requiring exogenous insulin. B
describes type 2 diabetes. C is incorrect as oral medications are used in type 2. D is
incorrect because type 1 requires lifelong insulin therapy.
Question 12: A nurse is assessing a client's peripheral circulation. Which of the
following findings is a sign of arterial insufficiency?
A. Dependent rubor
B. Pedal edema
C. Stasis dermatitis
D. Thickened, hard nails
CORRECT ANSWER: A. Dependent rubor
Rationale: Dependent rubor (a reddish-blue discoloration when the leg is dependent) is
a sign of severe arterial insufficiency. Pedal edema (B) and stasis dermatitis (C) are signs
