ATI PREDICTOR COMPREHENSIVE ASSESSMENT
— 2026–2027 UPDATED EXAM TEST BANK —
Welcome to the ATI Predictor Comprehensive Assessment — 2026–2027 Updated Exam Test Bank. This
high-yield educational resource has been engineered to provide rigorous preparation for students preparing for
professional nursing licensure examinations. The test bank consists of exactly 100 comprehensive practice
questions mapped across five distinct chapters of clinical nursing practice. Each question follows an identical,
high-fidelity structure featuring a clinical or scenario-based multiple-choice question, a correct answer indicator,
and an in-depth clinical explanation detailing the regulatory, physiological, or pharmacological rationale. All
contents are fully grounded in official nursing curriculum blueprints. Please note: This resource is designed to
help students master critical thinking, procedural pathways, and commonly confused clinical concepts. Good
luck with your studies!
TEST BANK CHAPTER ORGANIZATION
Chapter 1: Medical-Surgical & Adult Health Nursing
Questions 1–20
Focuses on adult health, emergency triage, and surgical procedures.
Chapter 2: Maternal-Newborn & Obstetric Nursing
Questions 21–40
Covers antepartum, intrapartum, and postpartum clinical care.
Chapter 3: Pediatric & Adolescent Health Nursing
Questions 41–60
Addresses developmental milestones, pediatric diseases, and safety.
Chapter 4: Mental Health & Psychiatric Nursing
Questions 61–80
Explores therapeutic communication, psychiatric disorders, and ethics.
Chapter 5: Nursing Leadership, Management & Pharmacology
Questions 81–100
Covers delegation, scope of practice, and medication safety.
Grounded in Official Course Material Page 1
, CHAPTER 1: MEDICAL-SURGICAL & ADULT HEALTH NURSING (QUESTIONS
1–20)
Question 1: A nurse is caring for a client who is taking antihypertensive medication and is moving from
a supine to a seated position. Which of the following findings should indicate to the nurse that the
client is experiencing orthostatic hypotension?
A. The client's systolic blood pressure decreases by 25 mm Hg
B. The client's diastolic blood pressure increases by 10 mm Hg
C. The client's heart rate decreases by 15 beats per minute
D. The client's oxygen saturation levels drop to 91% on room air
ANSWER : A — The client's systolic blood pressure decreases by 25 mm Hg
Explanation: Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or more, or a
decrease in diastolic blood pressure of 10 mm Hg or more within 3 minutes of standing or moving from a supine to a
seated position. The client's decrease of 25 mm Hg in systolic blood pressure is a positive indicator. The other options
are incorrect, as a pulse increase (compensatory tachycardia) occurs rather than a decrease, and oxygen saturation
changes are not primary diagnostic parameters for orthostatic hypotension.
Question 2: A nurse is caring for a client who is receiving mechanical ventilation via an endotracheal
tube when the high-pressure alarm of the ventilator sounds. Which of the following actions should the
nurse plan to take?
A. Look for a leak in the tube's cuff
B. Disconnect the ventilator and manual bag the client
C. Suction the client's airway for secretions
D. Lower the high-pressure alarm limit setting
ANSWER : C — Suction the client's airway for secretions
Explanation: A high-pressure ventilator alarm is triggered by an increase in airway resistance or a decrease in lung
compliance. Common clinical causes include secretions obstructing the tube, the client biting the endotracheal tube,
coughing, or tube kinking. Suctioning the client's airway removes secretions and is a priority intervention to clear the
obstruction. Looking for a leak in the cuff is an action for a low-pressure alarm. Manual bagging is reserved for
mechanical failure. Adjusting alarm limits without correcting the pathology is dangerous and incorrect.
Grounded in Official Course Material Page 2
, Question 3: A nurse is preparing to insert an indwelling urinary catheter for a female client. Which of
the following actions should the nurse take first?
A. Position the sterile drape leaving the perineum exposed
B. Lubricate the tip of the catheter with sterile jelly
C. Cleanse the perineal area with antiseptic solution
D. Inflate the catheter balloon to test for patency
ANSWER : A — Position the sterile drape leaving the perineum exposed
Explanation: During indwelling catheter insertion, placing the sterile drape under the client's buttocks and over the
perineum establishes and expands the sterile field early in the procedure. This basic baseline sterile setup must occur
first before sterile items such as lubricating the tip or cleansing the meatus with antiseptic are executed. Testing the
balloon is no longer recommended prior to insertion due to potential micro-tears in the catheter material.
Question 4: A nurse is planning to administer packed red blood cells (RBCs) to an older adult client
who has a low hemoglobin level. Which of the following actions should the nurse plan to take?
A. Monitor vital signs every hour throughout the transfusion
B. Infuse the blood product over a period of 5 to 6 hours
C. Verify the client's identity using the room number
D. Administer the transfusion using a standard microbore tubing set
ANSWER : A — Monitor vital signs every hour throughout the transfusion
Explanation: Monitoring vital signs hourly during blood administration is necessary to detect potential transfusion
reactions or fluid overload, particularly in vulnerable populations like older adults. Room number is never an acceptable
identifier. Blood products must be infused within a maximum of 4 hours to prevent bacterial contamination. Transfusions
require a dedicated Y-tubing set with an in-line filter rather than microbore tubing.
Question 5: A nurse in an acute care facility is caring for a client who has anorexia nervosa. During the
first week of inpatient care, which of the following actions should the nurse take?
A. Observe the client for 1 hour after meals
B. Weigh the client daily in the evening after their fluid intake
C. Allow the client to eat in private to reduce anxiety
D. Establish a daily calorie goal of 4,500 calories
ANSWER : A — Observe the client for 1 hour after meals
Explanation: Clients with anorexia nervosa must be observed for at least 1 hour after meals to prevent them from
purging or discarding hidden food. Allowing private dining is contraindicated because it facilitates food restriction or
purging. Weighing should occur in the morning before fluid/food intake and after voiding. Establishing excessively high
initial calorie goals can lead to refeeding syndrome, which is characterized by severe electrolyte imbalances.
Grounded in Official Course Material Page 3
, Question 6: A nurse is teaching a client who has sciatica and a prescription for a transcutaneous
electrical nerve stimulation (TENS) unit. Which of the following referrals should the nurse anticipate for
the client?
A. Occupational therapist
B. Physical therapist
C. Social worker
D. Chiropraiser
ANSWER : B — Physical therapist
Explanation: A transcutaneous electrical nerve stimulation (TENS) unit is a non-pharmacological pain management
modality commonly utilized in physical therapy to treat musculoskeletal and neuropathic pain, such as sciatica. Referrals
to a physical therapist help optimize unit settings, electrode placement, and general mobility. Occupational therapists
focus on ADLs, social workers focus on psychosocial resources, and chiropraisers are not standard hospital referrals for
sciatica TENS training.
Question 7: A nurse is teaching a client who has a new prescription for metformin extended-release
tablets. Which of the following statements by the client indicates an understanding of the teaching?
A. 'I will avoid crushing this medication'
B. 'I should take this medication on an empty stomach'
C. 'I can expect to lose a significant amount of weight quickly'
D. 'I will take my dose with a large glass of grapefruit juice'
ANSWER : A — 'I will avoid crushing this medication'
Explanation: Extended-release (ER) formulations are designed to release medication slowly over time. Crushing,
chewing, or breaking the tablet destroys this mechanism, leading to rapid drug release and toxic blood levels. Metformin
should be taken with meals to minimize gastrointestinal side effects. Metformin is not a primary weight-loss drug, and
grapefruit juice does not have a major clinical interaction with metformin compared to other cardiac medications.
Question 8: A nurse is assessing a client who is receiving enteral feeding via an nasogastric (NG) tube.
The client has developed hyperosmolar dehydration. Which of the following actions should the nurse
plan to take?
A. Switch to a lactose-free formula
B. Discontinue the enteral feeding immediately
C. Administer a high-sodium IV solution
D. Slow the rate of the tube feeding
ANSWER : A — Switch to a lactose-free formula
Explanation: Hyperosmolar dehydration can occur when enteral formulas have a high solute concentration, drawing
water into the intestinal lumen and causing diarrhea and fluid loss. Switching to a lactose-free formula can reduce
osmotic diarrheal losses and restore fluid balance. Discontinuing the feed is unnecessary and deprives the client of
nutrition. IV solutions for dehydration should be hypotonic or isotonic (such as 0.45% NaCl), not high-sodium. Slowing
the rate alone does not resolve formula-related osmotic diarrhea.
Grounded in Official Course Material Page 4
— 2026–2027 UPDATED EXAM TEST BANK —
Welcome to the ATI Predictor Comprehensive Assessment — 2026–2027 Updated Exam Test Bank. This
high-yield educational resource has been engineered to provide rigorous preparation for students preparing for
professional nursing licensure examinations. The test bank consists of exactly 100 comprehensive practice
questions mapped across five distinct chapters of clinical nursing practice. Each question follows an identical,
high-fidelity structure featuring a clinical or scenario-based multiple-choice question, a correct answer indicator,
and an in-depth clinical explanation detailing the regulatory, physiological, or pharmacological rationale. All
contents are fully grounded in official nursing curriculum blueprints. Please note: This resource is designed to
help students master critical thinking, procedural pathways, and commonly confused clinical concepts. Good
luck with your studies!
TEST BANK CHAPTER ORGANIZATION
Chapter 1: Medical-Surgical & Adult Health Nursing
Questions 1–20
Focuses on adult health, emergency triage, and surgical procedures.
Chapter 2: Maternal-Newborn & Obstetric Nursing
Questions 21–40
Covers antepartum, intrapartum, and postpartum clinical care.
Chapter 3: Pediatric & Adolescent Health Nursing
Questions 41–60
Addresses developmental milestones, pediatric diseases, and safety.
Chapter 4: Mental Health & Psychiatric Nursing
Questions 61–80
Explores therapeutic communication, psychiatric disorders, and ethics.
Chapter 5: Nursing Leadership, Management & Pharmacology
Questions 81–100
Covers delegation, scope of practice, and medication safety.
Grounded in Official Course Material Page 1
, CHAPTER 1: MEDICAL-SURGICAL & ADULT HEALTH NURSING (QUESTIONS
1–20)
Question 1: A nurse is caring for a client who is taking antihypertensive medication and is moving from
a supine to a seated position. Which of the following findings should indicate to the nurse that the
client is experiencing orthostatic hypotension?
A. The client's systolic blood pressure decreases by 25 mm Hg
B. The client's diastolic blood pressure increases by 10 mm Hg
C. The client's heart rate decreases by 15 beats per minute
D. The client's oxygen saturation levels drop to 91% on room air
ANSWER : A — The client's systolic blood pressure decreases by 25 mm Hg
Explanation: Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or more, or a
decrease in diastolic blood pressure of 10 mm Hg or more within 3 minutes of standing or moving from a supine to a
seated position. The client's decrease of 25 mm Hg in systolic blood pressure is a positive indicator. The other options
are incorrect, as a pulse increase (compensatory tachycardia) occurs rather than a decrease, and oxygen saturation
changes are not primary diagnostic parameters for orthostatic hypotension.
Question 2: A nurse is caring for a client who is receiving mechanical ventilation via an endotracheal
tube when the high-pressure alarm of the ventilator sounds. Which of the following actions should the
nurse plan to take?
A. Look for a leak in the tube's cuff
B. Disconnect the ventilator and manual bag the client
C. Suction the client's airway for secretions
D. Lower the high-pressure alarm limit setting
ANSWER : C — Suction the client's airway for secretions
Explanation: A high-pressure ventilator alarm is triggered by an increase in airway resistance or a decrease in lung
compliance. Common clinical causes include secretions obstructing the tube, the client biting the endotracheal tube,
coughing, or tube kinking. Suctioning the client's airway removes secretions and is a priority intervention to clear the
obstruction. Looking for a leak in the cuff is an action for a low-pressure alarm. Manual bagging is reserved for
mechanical failure. Adjusting alarm limits without correcting the pathology is dangerous and incorrect.
Grounded in Official Course Material Page 2
, Question 3: A nurse is preparing to insert an indwelling urinary catheter for a female client. Which of
the following actions should the nurse take first?
A. Position the sterile drape leaving the perineum exposed
B. Lubricate the tip of the catheter with sterile jelly
C. Cleanse the perineal area with antiseptic solution
D. Inflate the catheter balloon to test for patency
ANSWER : A — Position the sterile drape leaving the perineum exposed
Explanation: During indwelling catheter insertion, placing the sterile drape under the client's buttocks and over the
perineum establishes and expands the sterile field early in the procedure. This basic baseline sterile setup must occur
first before sterile items such as lubricating the tip or cleansing the meatus with antiseptic are executed. Testing the
balloon is no longer recommended prior to insertion due to potential micro-tears in the catheter material.
Question 4: A nurse is planning to administer packed red blood cells (RBCs) to an older adult client
who has a low hemoglobin level. Which of the following actions should the nurse plan to take?
A. Monitor vital signs every hour throughout the transfusion
B. Infuse the blood product over a period of 5 to 6 hours
C. Verify the client's identity using the room number
D. Administer the transfusion using a standard microbore tubing set
ANSWER : A — Monitor vital signs every hour throughout the transfusion
Explanation: Monitoring vital signs hourly during blood administration is necessary to detect potential transfusion
reactions or fluid overload, particularly in vulnerable populations like older adults. Room number is never an acceptable
identifier. Blood products must be infused within a maximum of 4 hours to prevent bacterial contamination. Transfusions
require a dedicated Y-tubing set with an in-line filter rather than microbore tubing.
Question 5: A nurse in an acute care facility is caring for a client who has anorexia nervosa. During the
first week of inpatient care, which of the following actions should the nurse take?
A. Observe the client for 1 hour after meals
B. Weigh the client daily in the evening after their fluid intake
C. Allow the client to eat in private to reduce anxiety
D. Establish a daily calorie goal of 4,500 calories
ANSWER : A — Observe the client for 1 hour after meals
Explanation: Clients with anorexia nervosa must be observed for at least 1 hour after meals to prevent them from
purging or discarding hidden food. Allowing private dining is contraindicated because it facilitates food restriction or
purging. Weighing should occur in the morning before fluid/food intake and after voiding. Establishing excessively high
initial calorie goals can lead to refeeding syndrome, which is characterized by severe electrolyte imbalances.
Grounded in Official Course Material Page 3
, Question 6: A nurse is teaching a client who has sciatica and a prescription for a transcutaneous
electrical nerve stimulation (TENS) unit. Which of the following referrals should the nurse anticipate for
the client?
A. Occupational therapist
B. Physical therapist
C. Social worker
D. Chiropraiser
ANSWER : B — Physical therapist
Explanation: A transcutaneous electrical nerve stimulation (TENS) unit is a non-pharmacological pain management
modality commonly utilized in physical therapy to treat musculoskeletal and neuropathic pain, such as sciatica. Referrals
to a physical therapist help optimize unit settings, electrode placement, and general mobility. Occupational therapists
focus on ADLs, social workers focus on psychosocial resources, and chiropraisers are not standard hospital referrals for
sciatica TENS training.
Question 7: A nurse is teaching a client who has a new prescription for metformin extended-release
tablets. Which of the following statements by the client indicates an understanding of the teaching?
A. 'I will avoid crushing this medication'
B. 'I should take this medication on an empty stomach'
C. 'I can expect to lose a significant amount of weight quickly'
D. 'I will take my dose with a large glass of grapefruit juice'
ANSWER : A — 'I will avoid crushing this medication'
Explanation: Extended-release (ER) formulations are designed to release medication slowly over time. Crushing,
chewing, or breaking the tablet destroys this mechanism, leading to rapid drug release and toxic blood levels. Metformin
should be taken with meals to minimize gastrointestinal side effects. Metformin is not a primary weight-loss drug, and
grapefruit juice does not have a major clinical interaction with metformin compared to other cardiac medications.
Question 8: A nurse is assessing a client who is receiving enteral feeding via an nasogastric (NG) tube.
The client has developed hyperosmolar dehydration. Which of the following actions should the nurse
plan to take?
A. Switch to a lactose-free formula
B. Discontinue the enteral feeding immediately
C. Administer a high-sodium IV solution
D. Slow the rate of the tube feeding
ANSWER : A — Switch to a lactose-free formula
Explanation: Hyperosmolar dehydration can occur when enteral formulas have a high solute concentration, drawing
water into the intestinal lumen and causing diarrhea and fluid loss. Switching to a lactose-free formula can reduce
osmotic diarrheal losses and restore fluid balance. Discontinuing the feed is unnecessary and deprives the client of
nutrition. IV solutions for dehydration should be hypotonic or isotonic (such as 0.45% NaCl), not high-sodium. Slowing
the rate alone does not resolve formula-related osmotic diarrhea.
Grounded in Official Course Material Page 4
