ATI Comprehensive Predictor Final Exam Version 3 2026 |Questions
|Answers |Rationales
1. A nurse is caring for a client who is receiving lithium carbonate for bipolar
disorder. Which of the following findings should the nurse identify as an early
sign of lithium toxicity?
A. Coarse hand tremors
B. Nausea and vomiting
C. Confusion
D. Tinnitus
Answer: B
Rationale: Early signs of lithium toxicity include gastrointestinal upset such as nausea,
vomiting, and diarrhea, as well as fine hand tremors and muscle weakness.
2. A nurse is providing teaching to a client who has a new prescription for
warfarin. Which of the following instructions should the nurse include?
A. Increase intake of dark green leafy vegetables.
B. Use a soft-bristled toothbrush.
C. Take aspirin for minor headaches.
D. Double the dose if a day is missed.
Answer: B
Rationale: Warfarin increases the risk of bleeding; using a soft-bristled toothbrush
prevents trauma to the gums. Leafy greens contain Vitamin K, which antagonizes warfarin,
and aspirin increases bleeding risk.
,3. A nurse is assessing a client who is 2 hours postpartum. The nurse notes the
fundus is boggy and displaced to the right. Which of the following actions
should the nurse take first?
A. Administer oxytocin.
B. Massage the fundus.
C. Notify the provider.
D. Assist the client to the bathroom.
Answer: D
Rationale: A boggy fundus displaced to the right is a classic sign of bladder distention,
which prevents the uterus from contracting. The priority is to empty the bladder.
4. A nurse is caring for a client with a prescription for digoxin 0.25 mg PO daily.
Which of the following assessments should the nurse report to the provider
before administration?
A. Respiratory rate of 16/min
B. Blood pressure of 110/70 mmHg
C. Apical heart rate of 52/min
D. Potassium level of 4.2 mEq/L
Answer: C
Rationale: Digoxin should be withheld if the apical pulse is less than 60/min in an adult to
avoid worsening bradycardia.
5. A nurse is preparing to administer an intramuscular injection to a school-age
child. Which of the following actions should the nurse take to minimize pain?
A. Apply a lidocaine/prilocaine cream 60 minutes before.
B. Use a 20-gauge needle.
C. Inject the medication rapidly.
D. Pinch the skin tightly during the injection.
Answer: A
, Rationale: Emla cream (lidocaine/prilocaine) is a topical anesthetic that reduces
procedural pain when applied well in advance.
6. A client is diagnosed with right-sided heart failure. Which of the following
clinical manifestations should the nurse expect?
A. Crackles in the lungs
B. Dyspnea on exertion
C. Frothy pink sputum
D. Peripheral edema
Answer: D
Rationale: Right-sided heart failure causes systemic congestion, leading to jugular venous
distention and peripheral edema. Lung symptoms are typically left-sided.
7. A nurse is caring for a client who is experiencing a manic episode. Which of
the following snacks should the nurse provide?
A. Apple slices with peanut butter
B. A bowl of vegetable soup
C. A container of yogurt
D. Spaghetti with meatballs
Answer: A
Rationale: Clients in a manic state require high-calorie, portable ‘finger foods’ because
they often cannot sit down to eat a full meal.
|Answers |Rationales
1. A nurse is caring for a client who is receiving lithium carbonate for bipolar
disorder. Which of the following findings should the nurse identify as an early
sign of lithium toxicity?
A. Coarse hand tremors
B. Nausea and vomiting
C. Confusion
D. Tinnitus
Answer: B
Rationale: Early signs of lithium toxicity include gastrointestinal upset such as nausea,
vomiting, and diarrhea, as well as fine hand tremors and muscle weakness.
2. A nurse is providing teaching to a client who has a new prescription for
warfarin. Which of the following instructions should the nurse include?
A. Increase intake of dark green leafy vegetables.
B. Use a soft-bristled toothbrush.
C. Take aspirin for minor headaches.
D. Double the dose if a day is missed.
Answer: B
Rationale: Warfarin increases the risk of bleeding; using a soft-bristled toothbrush
prevents trauma to the gums. Leafy greens contain Vitamin K, which antagonizes warfarin,
and aspirin increases bleeding risk.
,3. A nurse is assessing a client who is 2 hours postpartum. The nurse notes the
fundus is boggy and displaced to the right. Which of the following actions
should the nurse take first?
A. Administer oxytocin.
B. Massage the fundus.
C. Notify the provider.
D. Assist the client to the bathroom.
Answer: D
Rationale: A boggy fundus displaced to the right is a classic sign of bladder distention,
which prevents the uterus from contracting. The priority is to empty the bladder.
4. A nurse is caring for a client with a prescription for digoxin 0.25 mg PO daily.
Which of the following assessments should the nurse report to the provider
before administration?
A. Respiratory rate of 16/min
B. Blood pressure of 110/70 mmHg
C. Apical heart rate of 52/min
D. Potassium level of 4.2 mEq/L
Answer: C
Rationale: Digoxin should be withheld if the apical pulse is less than 60/min in an adult to
avoid worsening bradycardia.
5. A nurse is preparing to administer an intramuscular injection to a school-age
child. Which of the following actions should the nurse take to minimize pain?
A. Apply a lidocaine/prilocaine cream 60 minutes before.
B. Use a 20-gauge needle.
C. Inject the medication rapidly.
D. Pinch the skin tightly during the injection.
Answer: A
, Rationale: Emla cream (lidocaine/prilocaine) is a topical anesthetic that reduces
procedural pain when applied well in advance.
6. A client is diagnosed with right-sided heart failure. Which of the following
clinical manifestations should the nurse expect?
A. Crackles in the lungs
B. Dyspnea on exertion
C. Frothy pink sputum
D. Peripheral edema
Answer: D
Rationale: Right-sided heart failure causes systemic congestion, leading to jugular venous
distention and peripheral edema. Lung symptoms are typically left-sided.
7. A nurse is caring for a client who is experiencing a manic episode. Which of
the following snacks should the nurse provide?
A. Apple slices with peanut butter
B. A bowl of vegetable soup
C. A container of yogurt
D. Spaghetti with meatballs
Answer: A
Rationale: Clients in a manic state require high-calorie, portable ‘finger foods’ because
they often cannot sit down to eat a full meal.
