ATI RN Comprehensive Predictor 2026 Practice Questions and
Answers with Rationales – Nursing Exam Prep
1. Heart Failure
A nurse is assessing a client with heart failure. Which finding requires immediate intervention?
A. 1+ bilateral ankle edema
B. Fatigue after ambulation
C. Pink, frothy sputum
D. Weight gain of 1 kg in a week
Answer: C. Pink, frothy sputum
Rationale: Pink, frothy sputum is a classic sign of acute pulmonary edema, indicating severe
fluid accumulation in the lungs and impaired oxygenation. This is an emergency.
2. Hypoglycemia
A conscious client with type 1 diabetes has a blood glucose level of 52 mg/dL (2.9 mmol/L).
What should the nurse do first?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Give glucagon IM
D. Have the client eat a high-protein meal
Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can swallow should receive approximately 15 g of rapid-
acting carbohydrate, followed by glucose reassessment.
3. Digoxin
Before administering digoxin, which finding should cause the nurse to withhold the medication?
A. Apical pulse 52/min
B. Respiratory rate 18/min
C. Blood pressure 130/78 mm Hg
D. Temperature 37°C (98.6°F)
Answer: A. Apical pulse 52/min
,Rationale: Digoxin can cause bradycardia. The nurse should generally withhold the medication
and notify the provider when the adult apical pulse is below the prescribed threshold, commonly
60/min.
4. Heparin
Which laboratory value is commonly used to monitor an IV infusion of unfractionated heparin?
A. INR
B. aPTT
C. HbA1c
D. Serum potassium
Answer: B. aPTT
Rationale: The activated partial thromboplastin time (aPTT) is commonly used to monitor and
adjust unfractionated heparin therapy.
5. Postoperative Atelectasis
Which intervention should the nurse prioritize to help prevent atelectasis after abdominal
surgery?
A. Encourage incentive spirometry
B. Maintain bed rest
C. Restrict fluids
D. Encourage shallow breathing
Answer: A. Encourage incentive spirometry
Rationale: Incentive spirometry promotes deep inspiration and alveolar expansion, reducing the
risk of postoperative atelectasis.
6. Chest Pain
A client reports crushing substernal chest pain radiating to the left arm. What is the nurse’s
priority action?
A. Obtain a stool specimen
B. Assess the client’s airway, breathing, and circulation
C. Encourage ambulation
D. Offer a high-protein meal
,Answer: B. Assess the client’s airway, breathing, and circulation
Rationale: Acute chest pain can indicate myocardial ischemia. The nurse first assesses ABCs and
overall stability, while activating appropriate emergency measures.
7. Warfarin
Which laboratory test is used to monitor warfarin therapy?
A. aPTT
B. INR
C. Troponin
D. Platelet count
Answer: B. INR
Rationale: INR is used to monitor the therapeutic effect of warfarin and guide dosage
adjustments.
8. COPD
Which position is most beneficial for a client experiencing dyspnea related to COPD?
A. Supine
B. Trendelenburg
C. High-Fowler’s position
D. Flat with legs elevated
Answer: C. High-Fowler’s position
Rationale: Upright positioning improves lung expansion and can decrease the work of breathing.
9. Stroke
A client suddenly develops facial drooping and weakness of the right arm. What should the nurse
do first?
A. Give the client food
B. Determine the time symptoms began
C. Encourage the client to walk
D. Administer oral medication
Answer: B. Determine the time symptoms began
, Rationale: The last-known-well time is critical when evaluating a possible acute ischemic stroke
because it affects eligibility for time-sensitive treatment.
10. Seizure
A client begins having a generalized tonic-clonic seizure. Which action should the nurse take?
A. Insert a tongue blade
B. Restrain the client’s extremities
C. Protect the client’s head and clear nearby objects
D. Place a spoon in the client’s mouth
Answer: C. Protect the client’s head and clear nearby objects
Rationale: During a seizure, protect the client from injury. Do not restrain the client or place
objects in the mouth.
11. Blood Transfusion
Fifteen minutes after a blood transfusion begins, the client develops chills and low back pain.
What should the nurse do first?
A. Slow the infusion
B. Stop the transfusion
C. Administer acetaminophen
D. Continue the transfusion and reassess
Answer: B. Stop the transfusion
Rationale: Chills and back pain can indicate an acute transfusion reaction. The nurse should stop
the transfusion immediately and follow the facility’s reaction protocol.
12. Potassium
Which ECG change is associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval
C. ST elevation only
D. U waves
Answer: A. Peaked T waves
Answers with Rationales – Nursing Exam Prep
1. Heart Failure
A nurse is assessing a client with heart failure. Which finding requires immediate intervention?
A. 1+ bilateral ankle edema
B. Fatigue after ambulation
C. Pink, frothy sputum
D. Weight gain of 1 kg in a week
Answer: C. Pink, frothy sputum
Rationale: Pink, frothy sputum is a classic sign of acute pulmonary edema, indicating severe
fluid accumulation in the lungs and impaired oxygenation. This is an emergency.
2. Hypoglycemia
A conscious client with type 1 diabetes has a blood glucose level of 52 mg/dL (2.9 mmol/L).
What should the nurse do first?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Give glucagon IM
D. Have the client eat a high-protein meal
Answer: B. Give 15 g of rapid-acting carbohydrate
Rationale: A conscious client who can swallow should receive approximately 15 g of rapid-
acting carbohydrate, followed by glucose reassessment.
3. Digoxin
Before administering digoxin, which finding should cause the nurse to withhold the medication?
A. Apical pulse 52/min
B. Respiratory rate 18/min
C. Blood pressure 130/78 mm Hg
D. Temperature 37°C (98.6°F)
Answer: A. Apical pulse 52/min
,Rationale: Digoxin can cause bradycardia. The nurse should generally withhold the medication
and notify the provider when the adult apical pulse is below the prescribed threshold, commonly
60/min.
4. Heparin
Which laboratory value is commonly used to monitor an IV infusion of unfractionated heparin?
A. INR
B. aPTT
C. HbA1c
D. Serum potassium
Answer: B. aPTT
Rationale: The activated partial thromboplastin time (aPTT) is commonly used to monitor and
adjust unfractionated heparin therapy.
5. Postoperative Atelectasis
Which intervention should the nurse prioritize to help prevent atelectasis after abdominal
surgery?
A. Encourage incentive spirometry
B. Maintain bed rest
C. Restrict fluids
D. Encourage shallow breathing
Answer: A. Encourage incentive spirometry
Rationale: Incentive spirometry promotes deep inspiration and alveolar expansion, reducing the
risk of postoperative atelectasis.
6. Chest Pain
A client reports crushing substernal chest pain radiating to the left arm. What is the nurse’s
priority action?
A. Obtain a stool specimen
B. Assess the client’s airway, breathing, and circulation
C. Encourage ambulation
D. Offer a high-protein meal
,Answer: B. Assess the client’s airway, breathing, and circulation
Rationale: Acute chest pain can indicate myocardial ischemia. The nurse first assesses ABCs and
overall stability, while activating appropriate emergency measures.
7. Warfarin
Which laboratory test is used to monitor warfarin therapy?
A. aPTT
B. INR
C. Troponin
D. Platelet count
Answer: B. INR
Rationale: INR is used to monitor the therapeutic effect of warfarin and guide dosage
adjustments.
8. COPD
Which position is most beneficial for a client experiencing dyspnea related to COPD?
A. Supine
B. Trendelenburg
C. High-Fowler’s position
D. Flat with legs elevated
Answer: C. High-Fowler’s position
Rationale: Upright positioning improves lung expansion and can decrease the work of breathing.
9. Stroke
A client suddenly develops facial drooping and weakness of the right arm. What should the nurse
do first?
A. Give the client food
B. Determine the time symptoms began
C. Encourage the client to walk
D. Administer oral medication
Answer: B. Determine the time symptoms began
, Rationale: The last-known-well time is critical when evaluating a possible acute ischemic stroke
because it affects eligibility for time-sensitive treatment.
10. Seizure
A client begins having a generalized tonic-clonic seizure. Which action should the nurse take?
A. Insert a tongue blade
B. Restrain the client’s extremities
C. Protect the client’s head and clear nearby objects
D. Place a spoon in the client’s mouth
Answer: C. Protect the client’s head and clear nearby objects
Rationale: During a seizure, protect the client from injury. Do not restrain the client or place
objects in the mouth.
11. Blood Transfusion
Fifteen minutes after a blood transfusion begins, the client develops chills and low back pain.
What should the nurse do first?
A. Slow the infusion
B. Stop the transfusion
C. Administer acetaminophen
D. Continue the transfusion and reassess
Answer: B. Stop the transfusion
Rationale: Chills and back pain can indicate an acute transfusion reaction. The nurse should stop
the transfusion immediately and follow the facility’s reaction protocol.
12. Potassium
Which ECG change is associated with hyperkalemia?
A. Peaked T waves
B. Prolonged QT interval
C. ST elevation only
D. U waves
Answer: A. Peaked T waves
