ATI Comprehensive Predictor NCLEX-RN Readiness Exam
2 2026 UPDATED ACTUAL Questions and CORRECT
Answers
1. A nurse is delegating tasks to an Assistive Personnel (AP). Which of the
following tasks should the nurse assign to the AP?
A. Evaluating a client’s response to pain medication
B. Performing a sterile dressing change on a post-operative wound
C. Teaching a client how to use an incentive spirometer
D. Transferring a client from a bed to a chair using a mechanical lift
Answer: D
Rationale: Transferring a client using a mechanical lift is within the scope of practice for
an AP, provided they have been trained. Assessment, teaching, and sterile procedures are
responsibilities of the RN or LPN.
2. A nurse is caring for a client who is in the manic phase of bipolar disorder.
Which of the following snacks should the nurse offer?
A. A bowl of hot chicken noodle soup
B. A slice of pepperoni pizza
C. A bowl of fruit salad with a spoon
D. A turkey and cheese wrap
Answer: D
Rationale: Clients in a manic phase often have difficulty sitting still to eat. High-protein,
high-calorie ‘finger foods’ like a wrap allow them to eat while moving.
,3. A nurse is monitoring a client who is receiving a blood transfusion. Which of
the following findings indicates a hemolytic reaction?
A. A fever and chills occurring 2 hours after start
B. Distended neck veins and cough
C. Generalized pruritus and hives
D. Low back pain and apprehension
Answer: D
Rationale: Low back pain, tachycardia, and apprehension are classic signs of an acute
hemolytic transfusion reaction, often caused by ABO incompatibility.
4. A nurse is caring for a client with a prescription for lithium carbonate. Which
of the following laboratory results should the nurse report to the provider?
A. Sodium 140 mEq/L
B. Potassium 4.2 mEq/L
C. Creatinine 2.1 mg/dL
D. Lithium level 0.8 mEq/L
Answer: C
Rationale: Lithium is excreted by the kidneys. An elevated creatinine level (normal 0.6-1.2
mg/dL) indicates renal impairment, which increases the risk of lithium toxicity.
5. A nurse is providing discharge teaching to a client who has a new prescription
for warfarin. Which of the following instructions should the nurse include?
A. Increase your intake of dark green leafy vegetables
B. Report any black, tarry stools to your provider
C. Take aspirin for minor headaches
D. Use a firm-bristled toothbrush for oral care
Answer: B
, Rationale: Warfarin is an anticoagulant; black, tarry stools indicate GI bleeding and must
be reported immediately. Clients should maintain a consistent (not increased) intake of
Vitamin K.
6. A nurse is assessing a client who has a chest tube. Which of the following
findings should the nurse report to the provider?
A. Continuous bubbling in the suction control chamber
B. Persistent bubbling in the water seal chamber
C. Fluctuation of the water level in the water seal chamber with respiration
D. 50 mL of serosanguineous drainage in the first hour
Answer: B
Rationale: Continuous or persistent bubbling in the water seal chamber indicates an air
leak in the system, which is an abnormal finding that needs to be addressed.
7. A nurse is preparing to administer digoxin to a client. Which of the following
findings should lead the nurse to withhold the medication?
A. Blood pressure 145/90 mmHg
B. Potassium level 4.8 mEq/L
C. Apical pulse 52/min
D. Digoxin level 1.1 ng/mL
Answer: C
Rationale: Digoxin should be withheld if the apical pulse is less than 60/min in an adult, as
it can cause further bradycardia.
2 2026 UPDATED ACTUAL Questions and CORRECT
Answers
1. A nurse is delegating tasks to an Assistive Personnel (AP). Which of the
following tasks should the nurse assign to the AP?
A. Evaluating a client’s response to pain medication
B. Performing a sterile dressing change on a post-operative wound
C. Teaching a client how to use an incentive spirometer
D. Transferring a client from a bed to a chair using a mechanical lift
Answer: D
Rationale: Transferring a client using a mechanical lift is within the scope of practice for
an AP, provided they have been trained. Assessment, teaching, and sterile procedures are
responsibilities of the RN or LPN.
2. A nurse is caring for a client who is in the manic phase of bipolar disorder.
Which of the following snacks should the nurse offer?
A. A bowl of hot chicken noodle soup
B. A slice of pepperoni pizza
C. A bowl of fruit salad with a spoon
D. A turkey and cheese wrap
Answer: D
Rationale: Clients in a manic phase often have difficulty sitting still to eat. High-protein,
high-calorie ‘finger foods’ like a wrap allow them to eat while moving.
,3. A nurse is monitoring a client who is receiving a blood transfusion. Which of
the following findings indicates a hemolytic reaction?
A. A fever and chills occurring 2 hours after start
B. Distended neck veins and cough
C. Generalized pruritus and hives
D. Low back pain and apprehension
Answer: D
Rationale: Low back pain, tachycardia, and apprehension are classic signs of an acute
hemolytic transfusion reaction, often caused by ABO incompatibility.
4. A nurse is caring for a client with a prescription for lithium carbonate. Which
of the following laboratory results should the nurse report to the provider?
A. Sodium 140 mEq/L
B. Potassium 4.2 mEq/L
C. Creatinine 2.1 mg/dL
D. Lithium level 0.8 mEq/L
Answer: C
Rationale: Lithium is excreted by the kidneys. An elevated creatinine level (normal 0.6-1.2
mg/dL) indicates renal impairment, which increases the risk of lithium toxicity.
5. A nurse is providing discharge teaching to a client who has a new prescription
for warfarin. Which of the following instructions should the nurse include?
A. Increase your intake of dark green leafy vegetables
B. Report any black, tarry stools to your provider
C. Take aspirin for minor headaches
D. Use a firm-bristled toothbrush for oral care
Answer: B
, Rationale: Warfarin is an anticoagulant; black, tarry stools indicate GI bleeding and must
be reported immediately. Clients should maintain a consistent (not increased) intake of
Vitamin K.
6. A nurse is assessing a client who has a chest tube. Which of the following
findings should the nurse report to the provider?
A. Continuous bubbling in the suction control chamber
B. Persistent bubbling in the water seal chamber
C. Fluctuation of the water level in the water seal chamber with respiration
D. 50 mL of serosanguineous drainage in the first hour
Answer: B
Rationale: Continuous or persistent bubbling in the water seal chamber indicates an air
leak in the system, which is an abnormal finding that needs to be addressed.
7. A nurse is preparing to administer digoxin to a client. Which of the following
findings should lead the nurse to withhold the medication?
A. Blood pressure 145/90 mmHg
B. Potassium level 4.8 mEq/L
C. Apical pulse 52/min
D. Digoxin level 1.1 ng/mL
Answer: C
Rationale: Digoxin should be withheld if the apical pulse is less than 60/min in an adult, as
it can cause further bradycardia.
