ATI Comprehensive Live Review 2026–2027 Complete
Nursing Study Guide with Practice Questions,
Comprehensive Review, and Verified Rationales
Question 1
A nurse is caring for four clients. Which of the following clients should the nurse
assess FIRST?
A. Client with pneumonia who has crackles in the lung bases
B. Client who reports sudden onset of chest pain and shortness of breath
C. Client with diabetes who has a blood glucose of 220 mg/dL
D. Client with a wound infection who has a temperature of 101.2°F
Rationale: The client with sudden onset of chest pain and shortness of breath is
experiencing a potential life-threatening emergency (possibly pulmonary embolism or
myocardial infarction). Airway and breathing are compromised, making this the priority.
Crackles in pneumonia, hyperglycemia, and fever with wound infection are important but not
immediately life-threatening. Apply the ABC framework: Airway, Breathing, Circulation.
Question 2
A nurse is preparing to administer a medication. Which of the following actions should the
nurse take to ensure the right patient?
A. Ask the client, "What is your name?"
B. Verify the client's name and date of birth against the MAR using two identifiers
C. Check the client's room number
D. Ask the client's family member to identify the client
Rationale: The correct method for verifying patient identification is to use two
identifiers (e.g., name and date of birth) and compare them to the MAR. Asking only the
client's name or using room numbers is insufficient. Family members are not reliable
identifiers. The "Rights of Medication Administration" include Right Patient, Right
Medication, Right Dose, Right Route, Right Time, Right Documentation, Right Reason,
Right Response, and Right to Refuse.
,Question 3
A nurse is caring for a client who is NPO (nothing by mouth) and has an NG tube set to low
intermittent suction. Which of the following actions should the nurse take?
A. Provide oral care every 2 hours
B. Offer the client small sips of water
C. Keep the client in a supine position
D. Irrigate the NG tube with 100 mL of saline
Rationale: Clients who are NPO with an NG tube require frequent oral care to maintain
comfort and prevent dry mouth. Sips of water are contraindicated for NPO clients. Supine
positioning increases aspiration risk. Irrigation should be done with 30–50 mL of normal
saline, not 100 mL, and only with an order.
Question 4
A nurse is assessing a client's pain using the PQRST method. Which of the following
questions addresses the R in PQRST?
A. "Where is your pain located?"
B. "When did the pain start?"
C. "What makes the pain worse?"
D. "What is the quality of your pain?"
Rationale: PQRST stands
for P (Provocation/Palliation), Q (Quality), R (Region/Radiation), S (Severity), T (Timing).
The "R" addresses the location and radiation of pain. Asking about the start of pain
addresses Timing (T). Asking about what makes pain worse addresses Provocation (P).
Asking about quality addresses Quality (Q).
Question 5
NGN Case Study Question:
Scenario: A nurse is caring for a client who is 1 day post-operative following abdominal
surgery. The client reports incisional pain rated 7 on a 0–10 scale. The client's vital signs
,are: BP 142/90 mmHg, HR 100/min, RR 20/min, Temperature 99.6°F (37.6°C). The client
has an IV infusing at 125 mL/hr and a PCA pump with morphine.
Part 1: Recognize Cues
Which of the following findings should the nurse identify as significant?
Select all that apply.
A. Incisional pain rated 7/10
B. BP 142/90 mmHg
C. HR 100/min
D. RR 20/min
E. Temperature 99.6°F (37.6°C)
Rationale: The significant findings are pain rated 7/10 (indicates inadequate pain
control), BP 142/90 mmHg (elevated, possibly due to pain), and HR 100/min (tachycardia,
possibly due to pain). RR 20/min is within normal limits. Temperature 99.6°F is slightly
elevated but not immediately concerning post-operatively.
Part 2: Analyze Cues
The nurse analyzes the data. Which of the following is the priority hypothesis?
A. Wound infection
B. Inadequate pain management
C. Fluid volume deficit
D. Hypoxia
Rationale: The client's elevated vital signs and pain rating indicate inadequate pain
management. Pain can cause tachycardia and hypertension. While wound infection, fluid
volume deficit, and hypoxia are possible, the primary issue is pain control.
Part 3: Generate Solutions & Take Action
Which of the following interventions should the nurse implement?
Select all that apply.
A. Assess the PCA pump for proper functioning
B. Assess the client's pain level using a standardized pain scale
C. Administer a bolus dose of morphine as prescribed
D. Evaluate the effectiveness of pain interventions
, E. Ignore the client's report of pain
F. Tell the client to wait until the next scheduled dose
Rationale: The nurse should assess the PCA pump, assess the client's pain level,
administer a bolus dose if prescribed, and evaluate effectiveness. Ignoring pain or
telling the client to wait is not appropriate.
Part 4: Evaluate Outcomes
Which of the following findings indicates the interventions are effective?
A. Client reports pain decreased to 3/10
B. Client reports pain increased to 9/10
C. Vital signs remain elevated
D. Client requests more pain medication
Rationale: The client reporting pain decreased to 3/10 indicates the interventions are
effective. Increased pain, elevated vital signs, or continued requests for medication indicate
inadequate pain management.
Question 6
A nurse is providing discharge teaching to a client who has a new colostomy. Which of the
following instructions should the nurse include?
A. Change the pouch when it is one-third to one-half full
B. Change the pouch daily
C. Apply the pouch directly to the stoma
D. Use scissors to cut the opening smaller than the stoma
Rationale: The pouch should be changed when it is one-third to one-half full to prevent
leakage. It should be changed every 3–7 days, not daily. The pouch should be applied
around the stoma. The opening should be cut slightly larger (about 1/8 inch) than the stoma.
Question 7
A nurse is caring for a client who has a pressure injury. Which of the following
interventions should the nurse implement?
Nursing Study Guide with Practice Questions,
Comprehensive Review, and Verified Rationales
Question 1
A nurse is caring for four clients. Which of the following clients should the nurse
assess FIRST?
A. Client with pneumonia who has crackles in the lung bases
B. Client who reports sudden onset of chest pain and shortness of breath
C. Client with diabetes who has a blood glucose of 220 mg/dL
D. Client with a wound infection who has a temperature of 101.2°F
Rationale: The client with sudden onset of chest pain and shortness of breath is
experiencing a potential life-threatening emergency (possibly pulmonary embolism or
myocardial infarction). Airway and breathing are compromised, making this the priority.
Crackles in pneumonia, hyperglycemia, and fever with wound infection are important but not
immediately life-threatening. Apply the ABC framework: Airway, Breathing, Circulation.
Question 2
A nurse is preparing to administer a medication. Which of the following actions should the
nurse take to ensure the right patient?
A. Ask the client, "What is your name?"
B. Verify the client's name and date of birth against the MAR using two identifiers
C. Check the client's room number
D. Ask the client's family member to identify the client
Rationale: The correct method for verifying patient identification is to use two
identifiers (e.g., name and date of birth) and compare them to the MAR. Asking only the
client's name or using room numbers is insufficient. Family members are not reliable
identifiers. The "Rights of Medication Administration" include Right Patient, Right
Medication, Right Dose, Right Route, Right Time, Right Documentation, Right Reason,
Right Response, and Right to Refuse.
,Question 3
A nurse is caring for a client who is NPO (nothing by mouth) and has an NG tube set to low
intermittent suction. Which of the following actions should the nurse take?
A. Provide oral care every 2 hours
B. Offer the client small sips of water
C. Keep the client in a supine position
D. Irrigate the NG tube with 100 mL of saline
Rationale: Clients who are NPO with an NG tube require frequent oral care to maintain
comfort and prevent dry mouth. Sips of water are contraindicated for NPO clients. Supine
positioning increases aspiration risk. Irrigation should be done with 30–50 mL of normal
saline, not 100 mL, and only with an order.
Question 4
A nurse is assessing a client's pain using the PQRST method. Which of the following
questions addresses the R in PQRST?
A. "Where is your pain located?"
B. "When did the pain start?"
C. "What makes the pain worse?"
D. "What is the quality of your pain?"
Rationale: PQRST stands
for P (Provocation/Palliation), Q (Quality), R (Region/Radiation), S (Severity), T (Timing).
The "R" addresses the location and radiation of pain. Asking about the start of pain
addresses Timing (T). Asking about what makes pain worse addresses Provocation (P).
Asking about quality addresses Quality (Q).
Question 5
NGN Case Study Question:
Scenario: A nurse is caring for a client who is 1 day post-operative following abdominal
surgery. The client reports incisional pain rated 7 on a 0–10 scale. The client's vital signs
,are: BP 142/90 mmHg, HR 100/min, RR 20/min, Temperature 99.6°F (37.6°C). The client
has an IV infusing at 125 mL/hr and a PCA pump with morphine.
Part 1: Recognize Cues
Which of the following findings should the nurse identify as significant?
Select all that apply.
A. Incisional pain rated 7/10
B. BP 142/90 mmHg
C. HR 100/min
D. RR 20/min
E. Temperature 99.6°F (37.6°C)
Rationale: The significant findings are pain rated 7/10 (indicates inadequate pain
control), BP 142/90 mmHg (elevated, possibly due to pain), and HR 100/min (tachycardia,
possibly due to pain). RR 20/min is within normal limits. Temperature 99.6°F is slightly
elevated but not immediately concerning post-operatively.
Part 2: Analyze Cues
The nurse analyzes the data. Which of the following is the priority hypothesis?
A. Wound infection
B. Inadequate pain management
C. Fluid volume deficit
D. Hypoxia
Rationale: The client's elevated vital signs and pain rating indicate inadequate pain
management. Pain can cause tachycardia and hypertension. While wound infection, fluid
volume deficit, and hypoxia are possible, the primary issue is pain control.
Part 3: Generate Solutions & Take Action
Which of the following interventions should the nurse implement?
Select all that apply.
A. Assess the PCA pump for proper functioning
B. Assess the client's pain level using a standardized pain scale
C. Administer a bolus dose of morphine as prescribed
D. Evaluate the effectiveness of pain interventions
, E. Ignore the client's report of pain
F. Tell the client to wait until the next scheduled dose
Rationale: The nurse should assess the PCA pump, assess the client's pain level,
administer a bolus dose if prescribed, and evaluate effectiveness. Ignoring pain or
telling the client to wait is not appropriate.
Part 4: Evaluate Outcomes
Which of the following findings indicates the interventions are effective?
A. Client reports pain decreased to 3/10
B. Client reports pain increased to 9/10
C. Vital signs remain elevated
D. Client requests more pain medication
Rationale: The client reporting pain decreased to 3/10 indicates the interventions are
effective. Increased pain, elevated vital signs, or continued requests for medication indicate
inadequate pain management.
Question 6
A nurse is providing discharge teaching to a client who has a new colostomy. Which of the
following instructions should the nurse include?
A. Change the pouch when it is one-third to one-half full
B. Change the pouch daily
C. Apply the pouch directly to the stoma
D. Use scissors to cut the opening smaller than the stoma
Rationale: The pouch should be changed when it is one-third to one-half full to prevent
leakage. It should be changed every 3–7 days, not daily. The pouch should be applied
around the stoma. The opening should be cut slightly larger (about 1/8 inch) than the stoma.
Question 7
A nurse is caring for a client who has a pressure injury. Which of the following
interventions should the nurse implement?
