ATI RN Comprehensive Predictor 2026 Practice Exam |
Proctored Nursing Assessment | Verified Q&A Pack with
Clinical Judgment Rationales
1. A nurse is assessing a client who is 24 hours postoperative following a total hip arthroplasty. Which
of the following findings should the nurse report to the provider immediately?
A. Serosanguineous drainage on the dressing
B. Temperature of 37.8°C (100.0°F)
C. Shortness of breath and chest pain
D. Pain at the surgical site rated 5/10
Correct Answer: C
Rationale: Shortness of breath and chest pain following hip arthroplasty are classic signs of a
pulmonary embolism, a life-threatening complication. The nurse should report these findings
immediately. Serosanguineous drainage, low-grade fever, and moderate pain are expected
postoperative findings.
2. A nurse is caring for a client who is receiving mechanical ventilation. Which of the following findings
indicates the client may be developing acute respiratory distress syndrome (ARDS)?
A. PaO2 of 95 mm Hg on 40% FiO2
B. Refractory hypoxemia despite increased oxygen
C. Respiratory rate of 16/min
D. Clear breath sounds bilaterally
Correct Answer: B
Rationale: ARDS is characterized by refractory hypoxemia that does not improve with increased
oxygen supplementation. The nurse should recognize this as a hallmark sign of ARDS and report
it to the provider.
3. A nurse is reviewing the laboratory results of a client who has disseminated intravascular
coagulation (DIC). Which of the following findings should the nurse expect?
A. Increased platelet count
B. Decreased D-dimer
C. Prolonged PT and aPTT
D. Increased fibrinogen level
Correct Answer: C
,Rationale: DIC is characterized by widespread clotting that consumes clotting factors and
platelets, leading to prolonged PT and aPTT, decreased platelet count, elevated D-dimer, and
decreased fibrinogen levels.
4. A nurse is caring for a client who has been prescribed lithium carbonate. Which of the following
findings indicates lithium toxicity?
A. Serum lithium level of 0.8 mEq/L
B. Fine hand tremors
C. Coarse hand tremors and confusion
D. Increased appetite
Correct Answer: C
Rationale: Coarse hand tremors, confusion, and ataxia are signs of moderate to severe lithium
toxicity. A therapeutic lithium level ranges from 0.6 to 1.2 mEq/L. Fine hand tremors may be a
side effect but not necessarily toxicity.
5. A nurse is assessing a client who has increased intracranial pressure (ICP). Which of the following
findings should the nurse expect?
A. Decreased blood pressure
B. Bradycardia
C. Tachycardia
D. Hyperthermia
Correct Answer: B
Rationale: Cushing's triad, associated with increased ICP, includes bradycardia, hypertension,
and irregular respirations. The nurse should recognize these as signs of impending herniation.
6. A nurse is caring for a client who is in the acute phase of a burn injury. Which of the following
findings indicates the client is developing hypovolemic shock?
A. Urine output of 50 mL/hr
B. Heart rate of 120/min
C. Blood pressure of 130/80 mm Hg
D. Warm, dry skin
Correct Answer: B
Rationale: Tachycardia is an early sign of hypovolemic shock as the body compensates for
decreased circulating volume. Other signs include hypotension, decreased urine output, and
cool, clammy skin.
,7. A nurse is reviewing the ECG of a client who has hyperkalemia. Which of the following findings
should the nurse expect?
A. Prolonged QT interval
B. Peaked T waves
C. U waves
D. Prominent Q waves
Correct Answer: B
Rationale: Peaked T waves are a classic ECG finding in hyperkalemia. Other findings include
widened QRS complexes and, in severe cases, a sine wave pattern. U waves are associated with
hypokalemia.
8. A nurse is caring for a client who has been prescribed warfarin. The client's INR is 6.5. Which of the
following actions should the nurse take first?
A. Administer vitamin K
B. Hold the warfarin dose
C. Prepare for a blood transfusion
D. Increase the client's intake of leafy greens
Correct Answer: B
Rationale: The first action is to hold the warfarin dose to prevent further elevation of INR. The
nurse should then notify the provider, who may prescribe vitamin K. The client should not
increase leafy green intake without provider guidance.
9. A nurse is assessing a client who has been diagnosed with a bowel obstruction. Which of the
following findings should the nurse expect?
A. Hyperactive bowel sounds
B. Passage of flatus
C. Abdominal distension
D. Diarrhea
Correct Answer: C
Rationale: Abdominal distension is a common finding in bowel obstruction due to the
accumulation of gas and fluid. Bowel sounds may be hyperactive initially, then become absent.
Passage of flatus and diarrhea are not expected.
, 10. A nurse is caring for a client who has a new prescription for vancomycin. Which of the following
findings should the nurse monitor for as an adverse effect?
A. Hypertension
B. Flushing of the face and neck
C. Bradycardia
D. Hyperglycemia
Correct Answer: B
Rationale: Vancomycin can cause "vancomycin infusion reaction" (formerly known as red man
syndrome), characterized by flushing of the face, neck, and upper body. The nurse should infuse
the medication over at least 60 minutes to prevent this reaction.
11. A nurse is assessing a client who has been admitted with diabetic ketoacidosis (DKA). Which of the
following findings should the nurse expect?
A. Blood glucose of 180 mg/dL
B. pH of 7.45
C. Kussmaul respirations
D. Bradycardia
Correct Answer: C
Rationale: Kussmaul respirations (deep, rapid breathing) are a compensatory mechanism to
blow off excess carbon dioxide in DKA. Other findings include blood glucose >250 mg/dL, pH
<7.35, and tachycardia.
12. A nurse is caring for a client who has been prescribed furosemide. Which of the following findings
indicates a therapeutic response?
A. Weight loss of 2 kg in 24 hours
B. Decreased urine output
C. Increased peripheral edema
D. Blood pressure of 160/90 mm Hg
Correct Answer: A
Rationale: A weight loss of 1–2 kg in 24 hours indicates effective diuresis. The nurse should
monitor for signs of dehydration and electrolyte imbalances.
13. A nurse is assessing a client who has a new onset of atrial fibrillation. Which of the following
findings should the nurse expect?
Proctored Nursing Assessment | Verified Q&A Pack with
Clinical Judgment Rationales
1. A nurse is assessing a client who is 24 hours postoperative following a total hip arthroplasty. Which
of the following findings should the nurse report to the provider immediately?
A. Serosanguineous drainage on the dressing
B. Temperature of 37.8°C (100.0°F)
C. Shortness of breath and chest pain
D. Pain at the surgical site rated 5/10
Correct Answer: C
Rationale: Shortness of breath and chest pain following hip arthroplasty are classic signs of a
pulmonary embolism, a life-threatening complication. The nurse should report these findings
immediately. Serosanguineous drainage, low-grade fever, and moderate pain are expected
postoperative findings.
2. A nurse is caring for a client who is receiving mechanical ventilation. Which of the following findings
indicates the client may be developing acute respiratory distress syndrome (ARDS)?
A. PaO2 of 95 mm Hg on 40% FiO2
B. Refractory hypoxemia despite increased oxygen
C. Respiratory rate of 16/min
D. Clear breath sounds bilaterally
Correct Answer: B
Rationale: ARDS is characterized by refractory hypoxemia that does not improve with increased
oxygen supplementation. The nurse should recognize this as a hallmark sign of ARDS and report
it to the provider.
3. A nurse is reviewing the laboratory results of a client who has disseminated intravascular
coagulation (DIC). Which of the following findings should the nurse expect?
A. Increased platelet count
B. Decreased D-dimer
C. Prolonged PT and aPTT
D. Increased fibrinogen level
Correct Answer: C
,Rationale: DIC is characterized by widespread clotting that consumes clotting factors and
platelets, leading to prolonged PT and aPTT, decreased platelet count, elevated D-dimer, and
decreased fibrinogen levels.
4. A nurse is caring for a client who has been prescribed lithium carbonate. Which of the following
findings indicates lithium toxicity?
A. Serum lithium level of 0.8 mEq/L
B. Fine hand tremors
C. Coarse hand tremors and confusion
D. Increased appetite
Correct Answer: C
Rationale: Coarse hand tremors, confusion, and ataxia are signs of moderate to severe lithium
toxicity. A therapeutic lithium level ranges from 0.6 to 1.2 mEq/L. Fine hand tremors may be a
side effect but not necessarily toxicity.
5. A nurse is assessing a client who has increased intracranial pressure (ICP). Which of the following
findings should the nurse expect?
A. Decreased blood pressure
B. Bradycardia
C. Tachycardia
D. Hyperthermia
Correct Answer: B
Rationale: Cushing's triad, associated with increased ICP, includes bradycardia, hypertension,
and irregular respirations. The nurse should recognize these as signs of impending herniation.
6. A nurse is caring for a client who is in the acute phase of a burn injury. Which of the following
findings indicates the client is developing hypovolemic shock?
A. Urine output of 50 mL/hr
B. Heart rate of 120/min
C. Blood pressure of 130/80 mm Hg
D. Warm, dry skin
Correct Answer: B
Rationale: Tachycardia is an early sign of hypovolemic shock as the body compensates for
decreased circulating volume. Other signs include hypotension, decreased urine output, and
cool, clammy skin.
,7. A nurse is reviewing the ECG of a client who has hyperkalemia. Which of the following findings
should the nurse expect?
A. Prolonged QT interval
B. Peaked T waves
C. U waves
D. Prominent Q waves
Correct Answer: B
Rationale: Peaked T waves are a classic ECG finding in hyperkalemia. Other findings include
widened QRS complexes and, in severe cases, a sine wave pattern. U waves are associated with
hypokalemia.
8. A nurse is caring for a client who has been prescribed warfarin. The client's INR is 6.5. Which of the
following actions should the nurse take first?
A. Administer vitamin K
B. Hold the warfarin dose
C. Prepare for a blood transfusion
D. Increase the client's intake of leafy greens
Correct Answer: B
Rationale: The first action is to hold the warfarin dose to prevent further elevation of INR. The
nurse should then notify the provider, who may prescribe vitamin K. The client should not
increase leafy green intake without provider guidance.
9. A nurse is assessing a client who has been diagnosed with a bowel obstruction. Which of the
following findings should the nurse expect?
A. Hyperactive bowel sounds
B. Passage of flatus
C. Abdominal distension
D. Diarrhea
Correct Answer: C
Rationale: Abdominal distension is a common finding in bowel obstruction due to the
accumulation of gas and fluid. Bowel sounds may be hyperactive initially, then become absent.
Passage of flatus and diarrhea are not expected.
, 10. A nurse is caring for a client who has a new prescription for vancomycin. Which of the following
findings should the nurse monitor for as an adverse effect?
A. Hypertension
B. Flushing of the face and neck
C. Bradycardia
D. Hyperglycemia
Correct Answer: B
Rationale: Vancomycin can cause "vancomycin infusion reaction" (formerly known as red man
syndrome), characterized by flushing of the face, neck, and upper body. The nurse should infuse
the medication over at least 60 minutes to prevent this reaction.
11. A nurse is assessing a client who has been admitted with diabetic ketoacidosis (DKA). Which of the
following findings should the nurse expect?
A. Blood glucose of 180 mg/dL
B. pH of 7.45
C. Kussmaul respirations
D. Bradycardia
Correct Answer: C
Rationale: Kussmaul respirations (deep, rapid breathing) are a compensatory mechanism to
blow off excess carbon dioxide in DKA. Other findings include blood glucose >250 mg/dL, pH
<7.35, and tachycardia.
12. A nurse is caring for a client who has been prescribed furosemide. Which of the following findings
indicates a therapeutic response?
A. Weight loss of 2 kg in 24 hours
B. Decreased urine output
C. Increased peripheral edema
D. Blood pressure of 160/90 mm Hg
Correct Answer: A
Rationale: A weight loss of 1–2 kg in 24 hours indicates effective diuresis. The nurse should
monitor for signs of dehydration and electrolyte imbalances.
13. A nurse is assessing a client who has a new onset of atrial fibrillation. Which of the following
findings should the nurse expect?
