ATI Comprehensive Predictor & NCLEX Decision-Making Practice Pack
2026 |Questions |Answers |Rationales
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client who had an abdominal surgery 6 hours ago and has a heart rate of 120/min.
B. A client with a hip fracture who reports pain as 7 on a scale of 0 to 10.
C. A client with chronic obstructive pulmonary disease (COPD) and an oxygen saturation of 90%.
D. A client receiving physical therapy who reports feeling tired.
Answer: A
Rationale: The client with a heart rate of 120/min post-surgery is showing signs of
tachycardia, which could indicate hemorrhage or shock, making them the priority
according to ABCs (Circulation).
2. A nurse is delegating tasks to an assistive personnel (AP). Which task is
appropriate for the nurse to delegate?
A. Assisting a stable client with post-operative ambulation.
B. Evaluating the effectiveness of a client’s pain medication.
C. Performing a sterile dressing change on a central line.
D. Providing discharge teaching to a client with a new diagnosis of diabetes.
Answer: A
Rationale: Assisting a stable client with ambulation is a standard task within the scope of
practice for an AP. Tasks involving sterile technique, evaluation, and teaching require the
judgment of an RN.
,3. A nurse receives a change-of-shift report. Which client should the nurse see
first?
A. A client with a history of heart failure who has 2+ pitting edema.
B. A client with pneumonia who has a new onset of confusion.
C. A client with diabetes whose morning blood glucose was 150 mg/dL.
D. A client who is scheduled for an ultrasound in two hours.
Answer: B
Rationale: New onset confusion in a patient with pneumonia is a sign of potential hypoxia
or sepsis, requiring immediate assessment (Airway/Breathing/Safety).
4. A nurse is caring for a client who is in the immediate post-operative period
following a subtotal thyroidectomy. Which of the following is the priority
assessment?
A. Pain level at the incision site.
B. Client’s ability to speak clearly.
C. Presence of stridor or hoarseness.
D. Urine output over the last 4 hours.
Answer: C
Rationale: Stridor indicates laryngeal edema or nerve damage, which can lead to airway
obstruction. Airway is the highest priority.
5. A nurse is planning care for a group of clients. Which task should be assigned
to an LPN?
A. Developing a plan of care for a client with a complex pressure ulcer.
B. Monitoring a client’s response to a blood transfusion during the first 15 minutes.
C. Initial assessment of a client admitted for chest pain.
D. Administering a scheduled dose of subcutaneous heparin.
Answer: D
, Rationale: Administering medications via standard routes (SQ, IM, PO) is within the LPN
scope of practice. Initial assessments and blood transfusions are RN responsibilities.
6. Which client should the nurse triage as ‘Red Tag’ (Emergent) during a mass
casualty incident?
A. A client with a large scalp laceration and stable vitals.
B. A client with a sucking chest wound and respiratory distress.
C. A client with an open fracture of the tibia and palpable pulses.
D. A client who is pulseless and non-breathing with a head injury.
Answer: B
Rationale: The Red Tag is for life-threatening injuries that are treatable. A sucking chest
wound requires immediate intervention for survival. The pulseless client would be tagged
Black.
7. A nurse is preparing to administer digoxin to a client. Which of the following
should the nurse check first?
A. Serum potassium level.
B. The client’s blood pressure.
C. Apical pulse for one full minute.
D. The last dose administration time.
Answer: C
Rationale: The priority action before giving digoxin is to check the apical pulse; the
medication is withheld if the heart rate is below 60/min.
2026 |Questions |Answers |Rationales
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client who had an abdominal surgery 6 hours ago and has a heart rate of 120/min.
B. A client with a hip fracture who reports pain as 7 on a scale of 0 to 10.
C. A client with chronic obstructive pulmonary disease (COPD) and an oxygen saturation of 90%.
D. A client receiving physical therapy who reports feeling tired.
Answer: A
Rationale: The client with a heart rate of 120/min post-surgery is showing signs of
tachycardia, which could indicate hemorrhage or shock, making them the priority
according to ABCs (Circulation).
2. A nurse is delegating tasks to an assistive personnel (AP). Which task is
appropriate for the nurse to delegate?
A. Assisting a stable client with post-operative ambulation.
B. Evaluating the effectiveness of a client’s pain medication.
C. Performing a sterile dressing change on a central line.
D. Providing discharge teaching to a client with a new diagnosis of diabetes.
Answer: A
Rationale: Assisting a stable client with ambulation is a standard task within the scope of
practice for an AP. Tasks involving sterile technique, evaluation, and teaching require the
judgment of an RN.
,3. A nurse receives a change-of-shift report. Which client should the nurse see
first?
A. A client with a history of heart failure who has 2+ pitting edema.
B. A client with pneumonia who has a new onset of confusion.
C. A client with diabetes whose morning blood glucose was 150 mg/dL.
D. A client who is scheduled for an ultrasound in two hours.
Answer: B
Rationale: New onset confusion in a patient with pneumonia is a sign of potential hypoxia
or sepsis, requiring immediate assessment (Airway/Breathing/Safety).
4. A nurse is caring for a client who is in the immediate post-operative period
following a subtotal thyroidectomy. Which of the following is the priority
assessment?
A. Pain level at the incision site.
B. Client’s ability to speak clearly.
C. Presence of stridor or hoarseness.
D. Urine output over the last 4 hours.
Answer: C
Rationale: Stridor indicates laryngeal edema or nerve damage, which can lead to airway
obstruction. Airway is the highest priority.
5. A nurse is planning care for a group of clients. Which task should be assigned
to an LPN?
A. Developing a plan of care for a client with a complex pressure ulcer.
B. Monitoring a client’s response to a blood transfusion during the first 15 minutes.
C. Initial assessment of a client admitted for chest pain.
D. Administering a scheduled dose of subcutaneous heparin.
Answer: D
, Rationale: Administering medications via standard routes (SQ, IM, PO) is within the LPN
scope of practice. Initial assessments and blood transfusions are RN responsibilities.
6. Which client should the nurse triage as ‘Red Tag’ (Emergent) during a mass
casualty incident?
A. A client with a large scalp laceration and stable vitals.
B. A client with a sucking chest wound and respiratory distress.
C. A client with an open fracture of the tibia and palpable pulses.
D. A client who is pulseless and non-breathing with a head injury.
Answer: B
Rationale: The Red Tag is for life-threatening injuries that are treatable. A sucking chest
wound requires immediate intervention for survival. The pulseless client would be tagged
Black.
7. A nurse is preparing to administer digoxin to a client. Which of the following
should the nurse check first?
A. Serum potassium level.
B. The client’s blood pressure.
C. Apical pulse for one full minute.
D. The last dose administration time.
Answer: C
Rationale: The priority action before giving digoxin is to check the apical pulse; the
medication is withheld if the heart rate is below 60/min.
