Virtual ATI + BoardVitals NCLEX-RN Comprehensive
Review 2026/2027 | ATI Virtual-ATI NCLEX-RN
Review & BoardVitals Study Guide | NCLEX-RN
Comprehensive Exam Prep, NGN-Style Practice
Questions, Clinical Judgment, Case Studies, Adaptive
CAT Quizzes, Prioritization, Delegation, Pharmacology,
Fundamentals, Adult Medical-Surgical Nursing,
Maternal-Newborn, Pediatrics, Mental Health,
Community Health, Leadership & Management,
Nursing Safety, Health Promotion, Physiological
Integrity, Psychosocial Integrity & Detailed Rationales
Question 1: A nurse is caring for a client who is receiving
continuous enteral feeding via a nasogastric tube. Which finding
requires immediate intervention?
A. Gastric residual volume of 100 mL
B. Soft, non-tender abdomen
C. Blood glucose of 250 mg/dL
D. Bowel sounds in all four quadrants
CORRECT ANSWER: C. Blood glucose of 250 mg/dL
Rationale: Elevated blood glucose can indicate intolerance to the formula or
hyperglycemia, which requires intervention to prevent complications. A
residual under 250 mL, a soft abdomen, and bowel sounds are expected
findings.
Question 2: A nurse is preparing to administer digoxin to a client
with heart failure. Which finding should prompt the nurse to
withhold the medication?
A. Apical pulse of 58/min
B. Serum potassium of 4.0 mEq/L
C. Blood pressure of 110/70 mm Hg
D. Respiratory rate of 18/min
CORRECT ANSWER: A. Apical pulse of 58/min
Rationale: Digoxin is withheld if the apical pulse is below 60/min in adults,
as bradycardia increases the risk of toxicity. The other values are within
normal limits.
,Question 3: A nurse is caring for four clients. Which client should
the nurse assess first?
A. Client with pneumonia who has crackles in the lung bases
B. Client who reports sudden onset of chest pain and shortness of breath
C. Client with diabetes who has a blood glucose of 220 mg/dL
D. Client with a wound infection who has a temperature of 101.2°F
CORRECT ANSWER: B. Client who reports sudden onset of chest
pain and shortness of breath
Rationale: The client with sudden onset of chest pain and shortness of
breath is experiencing a potential life-threatening emergency. Airway and
breathing are compromised, making this the priority per the ABC
framework.
Question 4: A nurse is preparing to administer a medication. Which
action should the nurse take to ensure the right patient?
A. Ask the client, "What is your name?"
B. Verify the client's name and date of birth against the MAR using two
identifiers
C. Check the client's room number
D. Ask the client's family member to identify the client
CORRECT ANSWER: B. Verify the client's name and date of birth
against the MAR using two identifiers
Rationale: The correct method for verifying patient identification is to use
two identifiers and compare them to the MAR. Asking only the client's
name or using room numbers is insufficient.
Question 5: A nurse is caring for a client who is confused and
attempting to remove their IV line. Which action should the nurse
take first?
A. Apply soft wrist restraints
B. Ask a family member to sit with the client
C. Administer a sedative
D. Notify the provider
CORRECT ANSWER: B. Ask a family member to sit with the client
,Rationale: The least restrictive intervention should be used first. Asking a
family member to sit with the client is the least restrictive option before
considering restraints or sedation.
Question 6: A client is admitted with diabetic ketoacidosis. The
nurse anticipates an order for which type of insulin?
A. NPH insulin
B. Insulin glargine
C. Regular insulin
D. Insulin detemir
CORRECT ANSWER: C. Regular insulin
Rationale: Regular insulin is the only insulin given intravenously and is used
for rapid correction of hyperglycemia in DKA. NPH, glargine, and detemir
are not appropriate for acute intravenous management.
Question 7: A nurse is performing a neurological assessment on a
client who sustained a head injury. Which finding suggests
increased intracranial pressure?
A. Glasgow Coma Scale score of 15
B. Pupils equal and reactive
C. Widening pulse pressure
D. Flexion to painful stimuli
CORRECT ANSWER: C. Widening pulse pressure
Rationale: Cushing's triad (hypertension, bradycardia, and widened pulse
pressure) is a late sign of increased ICP. A GCS of 15 and equal pupils are
normal findings.
Question 8: A nurse is teaching a client about the use of a metered-
dose inhaler. Which action indicates a need for further teaching?
A. Exhaling fully before placing the mouthpiece in the mouth
B. Inhaling slowly while depressing the canister
C. Holding breath for 10 seconds after inhalation
D. Activating the inhaler after beginning inhalation
CORRECT ANSWER: B. Inhaling slowly while depressing the
canister
, Rationale: The client should inhale slowly and deeply while activating the
inhaler, not depress the canister after inhalation begins. Proper technique
involves coordinating activation with the start of inhalation.
Question 9: A charge nurse is assigning tasks to staff members.
Which task should the nurse delegate to an LPN?
A. Administering a prescribed oral medication
B. Performing an initial admission assessment
C. Developing a plan of care
D. Educating a client about a new diagnosis
CORRECT ANSWER: A. Administering a prescribed oral medication
Rationale: LPNs can administer oral medications and perform stable client
care. Initial assessments, care planning, and client education are within the
RN scope of practice.
Question 10: A client with chronic kidney disease is prescribed
epoetin alfa. Which laboratory value should the nurse monitor to
evaluate the effectiveness of this medication?
A. Serum creatinine
B. Hemoglobin and hematocrit
C. Serum potassium
D. Blood urea nitrogen
CORRECT ANSWER: B. Hemoglobin and hematocrit
Rationale: Epoetin alfa stimulates red blood cell production, so hemoglobin
and hematocrit levels are monitored to assess therapeutic effectiveness.
Serum creatinine and potassium reflect kidney function, not the drug's
primary effect.
Question 11: A nurse is preparing to administer a blood
transfusion. Which action is most important before starting the
transfusion?
A. Checking the patient's temperature
B. Verifying the blood type with another nurse
C. Administering an antihistamine
D. Flushing the IV line with D5W
CORRECT ANSWER: B. Verifying the blood type with another nurse
Review 2026/2027 | ATI Virtual-ATI NCLEX-RN
Review & BoardVitals Study Guide | NCLEX-RN
Comprehensive Exam Prep, NGN-Style Practice
Questions, Clinical Judgment, Case Studies, Adaptive
CAT Quizzes, Prioritization, Delegation, Pharmacology,
Fundamentals, Adult Medical-Surgical Nursing,
Maternal-Newborn, Pediatrics, Mental Health,
Community Health, Leadership & Management,
Nursing Safety, Health Promotion, Physiological
Integrity, Psychosocial Integrity & Detailed Rationales
Question 1: A nurse is caring for a client who is receiving
continuous enteral feeding via a nasogastric tube. Which finding
requires immediate intervention?
A. Gastric residual volume of 100 mL
B. Soft, non-tender abdomen
C. Blood glucose of 250 mg/dL
D. Bowel sounds in all four quadrants
CORRECT ANSWER: C. Blood glucose of 250 mg/dL
Rationale: Elevated blood glucose can indicate intolerance to the formula or
hyperglycemia, which requires intervention to prevent complications. A
residual under 250 mL, a soft abdomen, and bowel sounds are expected
findings.
Question 2: A nurse is preparing to administer digoxin to a client
with heart failure. Which finding should prompt the nurse to
withhold the medication?
A. Apical pulse of 58/min
B. Serum potassium of 4.0 mEq/L
C. Blood pressure of 110/70 mm Hg
D. Respiratory rate of 18/min
CORRECT ANSWER: A. Apical pulse of 58/min
Rationale: Digoxin is withheld if the apical pulse is below 60/min in adults,
as bradycardia increases the risk of toxicity. The other values are within
normal limits.
,Question 3: A nurse is caring for four clients. Which client should
the nurse assess first?
A. Client with pneumonia who has crackles in the lung bases
B. Client who reports sudden onset of chest pain and shortness of breath
C. Client with diabetes who has a blood glucose of 220 mg/dL
D. Client with a wound infection who has a temperature of 101.2°F
CORRECT ANSWER: B. Client who reports sudden onset of chest
pain and shortness of breath
Rationale: The client with sudden onset of chest pain and shortness of
breath is experiencing a potential life-threatening emergency. Airway and
breathing are compromised, making this the priority per the ABC
framework.
Question 4: A nurse is preparing to administer a medication. Which
action should the nurse take to ensure the right patient?
A. Ask the client, "What is your name?"
B. Verify the client's name and date of birth against the MAR using two
identifiers
C. Check the client's room number
D. Ask the client's family member to identify the client
CORRECT ANSWER: B. Verify the client's name and date of birth
against the MAR using two identifiers
Rationale: The correct method for verifying patient identification is to use
two identifiers and compare them to the MAR. Asking only the client's
name or using room numbers is insufficient.
Question 5: A nurse is caring for a client who is confused and
attempting to remove their IV line. Which action should the nurse
take first?
A. Apply soft wrist restraints
B. Ask a family member to sit with the client
C. Administer a sedative
D. Notify the provider
CORRECT ANSWER: B. Ask a family member to sit with the client
,Rationale: The least restrictive intervention should be used first. Asking a
family member to sit with the client is the least restrictive option before
considering restraints or sedation.
Question 6: A client is admitted with diabetic ketoacidosis. The
nurse anticipates an order for which type of insulin?
A. NPH insulin
B. Insulin glargine
C. Regular insulin
D. Insulin detemir
CORRECT ANSWER: C. Regular insulin
Rationale: Regular insulin is the only insulin given intravenously and is used
for rapid correction of hyperglycemia in DKA. NPH, glargine, and detemir
are not appropriate for acute intravenous management.
Question 7: A nurse is performing a neurological assessment on a
client who sustained a head injury. Which finding suggests
increased intracranial pressure?
A. Glasgow Coma Scale score of 15
B. Pupils equal and reactive
C. Widening pulse pressure
D. Flexion to painful stimuli
CORRECT ANSWER: C. Widening pulse pressure
Rationale: Cushing's triad (hypertension, bradycardia, and widened pulse
pressure) is a late sign of increased ICP. A GCS of 15 and equal pupils are
normal findings.
Question 8: A nurse is teaching a client about the use of a metered-
dose inhaler. Which action indicates a need for further teaching?
A. Exhaling fully before placing the mouthpiece in the mouth
B. Inhaling slowly while depressing the canister
C. Holding breath for 10 seconds after inhalation
D. Activating the inhaler after beginning inhalation
CORRECT ANSWER: B. Inhaling slowly while depressing the
canister
, Rationale: The client should inhale slowly and deeply while activating the
inhaler, not depress the canister after inhalation begins. Proper technique
involves coordinating activation with the start of inhalation.
Question 9: A charge nurse is assigning tasks to staff members.
Which task should the nurse delegate to an LPN?
A. Administering a prescribed oral medication
B. Performing an initial admission assessment
C. Developing a plan of care
D. Educating a client about a new diagnosis
CORRECT ANSWER: A. Administering a prescribed oral medication
Rationale: LPNs can administer oral medications and perform stable client
care. Initial assessments, care planning, and client education are within the
RN scope of practice.
Question 10: A client with chronic kidney disease is prescribed
epoetin alfa. Which laboratory value should the nurse monitor to
evaluate the effectiveness of this medication?
A. Serum creatinine
B. Hemoglobin and hematocrit
C. Serum potassium
D. Blood urea nitrogen
CORRECT ANSWER: B. Hemoglobin and hematocrit
Rationale: Epoetin alfa stimulates red blood cell production, so hemoglobin
and hematocrit levels are monitored to assess therapeutic effectiveness.
Serum creatinine and potassium reflect kidney function, not the drug's
primary effect.
Question 11: A nurse is preparing to administer a blood
transfusion. Which action is most important before starting the
transfusion?
A. Checking the patient's temperature
B. Verifying the blood type with another nurse
C. Administering an antihistamine
D. Flushing the IV line with D5W
CORRECT ANSWER: B. Verifying the blood type with another nurse
