GALEN COLLEGE OF NURSING
NSG 4800 - Transition to Professional Nursing Practice
ATI RN COMPREHENSIVE PREDICTOR PROCTORED ASSESSMENT REVIEW
Exam - Fall 2026
150 Multiple-Choice Questions with Correct Answers and Rationales
1. A client has atrial fibrillation with a ventricular rate of 150/min. Which assessment finding is consistent
with the review notes?
A. Severe bradycardia below 40/min as the defining feature
B. Only localized abdominal pain
C. A consistently strong regular pulse with no symptoms
D. Palpitations with possible hypotension and pulse deficit
✓ Correct Answer: D. Palpitations with possible hypotension and pulse deficit
Rationale: The review materials associate atrial fibrillation with palpitations, chest discomfort, hypotension, pulse
deficit, fatigue, and reduced exercise tolerance.
2. Which intervention is appropriate during active bleeding from peptic ulcer disease according to the
review?
A. Give aspirin for pain
B. Maintain NPO status and administer IV fluids as prescribed
C. Ignore hemoglobin and hematocrit
D. Encourage large solid meals immediately
✓ Correct Answer: B. Maintain NPO status and administer IV fluids as prescribed
Rationale: The PUD section recommends NPO status, IV fluid replacement, close vital-sign monitoring, and monitoring
hemoglobin/hematocrit during active bleeding.
3. A laboring client receiving oxytocin develops concerning fetal heart rate changes. Which action is
included in the source notes?
A. Stop the oxytocin infusion
B. Delay assessment until the next scheduled check
C. Place the client flat and continue the infusion
D. Increase the oxytocin rate
✓ Correct Answer: A. Stop the oxytocin infusion
Rationale: The fetal monitoring notes state that with significant decelerations, oxytocin should be discontinued if
infusing.
4. Which auscultatory finding is associated with pericarditis in the uploaded materials?
A. Pericardial friction rub
B. Carotid bruit only
C. Absent bowel sounds
D. Pleural silence
✓ Correct Answer: A. Pericardial friction rub
Rationale: A pericardial friction rub is highlighted as a characteristic pericarditis finding.
Page 1
,5. Which personal protective equipment is emphasized for airborne precautions in the review notes?
A. Only sterile gloves
B. N95 respirator
C. No mask is needed
D. Only a face shield without respiratory protection
✓ Correct Answer: B. N95 respirator
Rationale: The isolation section lists an N95 respirator for airborne precautions.
6. Which nursing approach is consistent with the dementia care described in the source?
A. Encourage unsupervised wandering to promote independence.
B. Frequently change the client's room and caregivers.
C. Use complex multi-step instructions.
D. Use a consistent routine, familiar objects, simple step-by-step directions, and a safe uncluttered environment.
✓ Correct Answer: D. Use a consistent routine, familiar objects, simple step-by-step
directions, and a safe uncluttered environment.
Rationale: The dementia review emphasizes orientation, familiar possessions, consistent routines, simple directions,
safety, and supervision.
7. A nurse is preparing to start a packed red blood cell transfusion. Which setup is supported by the
uploaded comprehensive review?
A. Begin the transfusion without a type-and-crossmatch if the client is stable.
B. Use lactated Ringer's as the only compatible solution.
C. Prime the blood tubing with dextrose solution.
D. Use Y-type blood tubing primed with normal saline and complete the required two-nurse verification.
✓ Correct Answer: D. Use Y-type blood tubing primed with normal saline and complete
the required two-nurse verification.
Rationale: The review lists type and crossmatch, consent, Y tubing, normal saline only, two-nurse verification, and
close monitoring at the start of the transfusion.
8. A client is hyperventilating during severe anxiety. Which acid-base imbalance is associated with this
pattern in the review?
A. Respiratory alkalosis.
B. Respiratory acidosis.
C. Metabolic acidosis.
D. Metabolic alkalosis from vomiting.
✓ Correct Answer: A. Respiratory alkalosis.
Rationale: The review links hyperventilation from anxiety or panic with respiratory alkalosis.
9. A client receiving a gastric tube feeding has a residual greater than 100 mL. What action is indicated in
the review?
A. Discard all gastric contents and give the feeding immediately.
B. Place the client flat and continue the feeding.
C. Hold the feeding.
D. Increase the feeding rate.
✓ Correct Answer: C. Hold the feeding.
Rationale: The tube-feeding review states to check residual volume and hold the feeding when the residual exceeds
the listed threshold of 100 mL.
Page 2
,10. If the cause of a ventilator alarm cannot be determined quickly, what should the nurse do?
A. Manually ventilate the client until the problem is corrected
B. Disconnect oxygen permanently
C. Lower the head of the bed flat and leave
D. Turn off the alarm and wait
✓ Correct Answer: A. Manually ventilate the client until the problem is corrected
Rationale: The review states that if the alarm cause cannot be found, the client should be manually resuscitated until
the problem is corrected.
11. A client with traumatic brain injury is at risk for increased intracranial pressure. Which environmental
approach is emphasized in the review?
A. Decrease stimulation and limit visitors.
B. Encourage frequent loud conversation.
C. Keep the room brightly lit and busy.
D. Place the client flat with no neurologic monitoring.
✓ Correct Answer: A. Decrease stimulation and limit visitors.
Rationale: The TBI review recommends decreased stimulation, limited visitors, a quiet/dark environment, and
positioning to help manage increased intracranial pressure.
12. Which medication is identified in the review as contraindicated for a client with asthma?
A. Oxytocin
B. Carboprost
C. Desmopressin
D. Pyridostigmine
✓ Correct Answer: B. Carboprost
Rationale: The review explicitly notes carboprost as contraindicated in asthma.
13. A client is receiving external radiation therapy. Which skin-care instruction is supported by the review?
A. Use a rough washcloth to remove dry skin.
B. Scrub the treatment markings off each day.
C. Use mild soap gently, avoid rubbing the markings, and protect the area from sun exposure.
D. Apply any scented lotion desired.
✓ Correct Answer: C. Use mild soap gently, avoid rubbing the markings, and protect the
area from sun exposure.
Rationale: The radiation review instructs the client not to rub or remove treatment markings, to use mild soap gently,
and to avoid sun exposure.
14. What legal medication-safety step is required when wasting part of a controlled narcotic dose?
A. Place the unused narcotic in a sharps container without a witness.
B. Discard the remainder in private without documentation.
C. Have another nurse witness the waste.
D. Ask a visitor to witness the waste.
✓ Correct Answer: C. Have another nurse witness the waste.
Rationale: The review states that wasting controlled medications such as hydromorphone requires another nurse to
witness the discarded remainder.
Page 3
, 15. A client's clothing is contaminated by a hazardous chemical. Which removal method is specified in the
review?
A. Place the clothing in regular trash.
B. Use tongs or forceps to remove the contaminated clothing.
C. Shake the clothing before removal.
D. Use bare hands for faster removal.
✓ Correct Answer: B. Use tongs or forceps to remove the contaminated clothing.
Rationale: The hazardous-material review directs use of tongs or forceps and disposal in designated biohazard waste
rather than regular trash.
16. Which exercise teaching is given for a client with type 1 diabetes?
A. Take extra insulin immediately before every exercise session regardless of glucose.
B. Have a small snack before exercise to reduce the risk of hypoglycemia and avoid exercising at insulin peak.
C. Skip glucose checks on exercise days.
D. Exercise only when blood glucose is falling rapidly.
✓ Correct Answer: B. Have a small snack before exercise to reduce the risk of
hypoglycemia and avoid exercising at insulin peak.
Rationale: The diabetes review teaches frequent glucose checks, avoiding exercise at insulin peak, and using a snack
before exercise for type 1 diabetes to reduce hypoglycemia risk.
17. A child with spina bifida has undergone multiple surgeries and catheterizations. Which allergy risk is
emphasized in the review?
A. Iodine allergy in every case.
B. Shellfish allergy only.
C. Penicillin allergy in every case.
D. Latex allergy.
✓ Correct Answer: D. Latex allergy.
Rationale: The review notes that repeated exposure to latex products places clients with spina bifida at increased risk
for latex sensitivity.
18. A Mantoux tuberculin skin test is administered. When should the client return for the reading?
A. After 7 to 10 days
B. 48 to 72 hours later
C. Within 30 minutes
D. Exactly 24 hours later only
✓ Correct Answer: B. 48 to 72 hours later
Rationale: The source procedure states that the test area is read 48 to 72 hours after injection.
19. Which assessment pattern is consistent with DVT in the source review?
A. Bilateral cold hands with no leg symptoms
B. Unilateral calf pain or cramping with a warm, red, swollen leg
C. A painless pink stoma
D. Generalized itching without swelling
✓ Correct Answer: B. Unilateral calf pain or cramping with a warm, red, swollen leg
Rationale: The review uses COWS: calf pain/cramping, one-sided swelling, and a warm red leg; shortness of breath or
chest pain suggests PE.
Page 4
NSG 4800 - Transition to Professional Nursing Practice
ATI RN COMPREHENSIVE PREDICTOR PROCTORED ASSESSMENT REVIEW
Exam - Fall 2026
150 Multiple-Choice Questions with Correct Answers and Rationales
1. A client has atrial fibrillation with a ventricular rate of 150/min. Which assessment finding is consistent
with the review notes?
A. Severe bradycardia below 40/min as the defining feature
B. Only localized abdominal pain
C. A consistently strong regular pulse with no symptoms
D. Palpitations with possible hypotension and pulse deficit
✓ Correct Answer: D. Palpitations with possible hypotension and pulse deficit
Rationale: The review materials associate atrial fibrillation with palpitations, chest discomfort, hypotension, pulse
deficit, fatigue, and reduced exercise tolerance.
2. Which intervention is appropriate during active bleeding from peptic ulcer disease according to the
review?
A. Give aspirin for pain
B. Maintain NPO status and administer IV fluids as prescribed
C. Ignore hemoglobin and hematocrit
D. Encourage large solid meals immediately
✓ Correct Answer: B. Maintain NPO status and administer IV fluids as prescribed
Rationale: The PUD section recommends NPO status, IV fluid replacement, close vital-sign monitoring, and monitoring
hemoglobin/hematocrit during active bleeding.
3. A laboring client receiving oxytocin develops concerning fetal heart rate changes. Which action is
included in the source notes?
A. Stop the oxytocin infusion
B. Delay assessment until the next scheduled check
C. Place the client flat and continue the infusion
D. Increase the oxytocin rate
✓ Correct Answer: A. Stop the oxytocin infusion
Rationale: The fetal monitoring notes state that with significant decelerations, oxytocin should be discontinued if
infusing.
4. Which auscultatory finding is associated with pericarditis in the uploaded materials?
A. Pericardial friction rub
B. Carotid bruit only
C. Absent bowel sounds
D. Pleural silence
✓ Correct Answer: A. Pericardial friction rub
Rationale: A pericardial friction rub is highlighted as a characteristic pericarditis finding.
Page 1
,5. Which personal protective equipment is emphasized for airborne precautions in the review notes?
A. Only sterile gloves
B. N95 respirator
C. No mask is needed
D. Only a face shield without respiratory protection
✓ Correct Answer: B. N95 respirator
Rationale: The isolation section lists an N95 respirator for airborne precautions.
6. Which nursing approach is consistent with the dementia care described in the source?
A. Encourage unsupervised wandering to promote independence.
B. Frequently change the client's room and caregivers.
C. Use complex multi-step instructions.
D. Use a consistent routine, familiar objects, simple step-by-step directions, and a safe uncluttered environment.
✓ Correct Answer: D. Use a consistent routine, familiar objects, simple step-by-step
directions, and a safe uncluttered environment.
Rationale: The dementia review emphasizes orientation, familiar possessions, consistent routines, simple directions,
safety, and supervision.
7. A nurse is preparing to start a packed red blood cell transfusion. Which setup is supported by the
uploaded comprehensive review?
A. Begin the transfusion without a type-and-crossmatch if the client is stable.
B. Use lactated Ringer's as the only compatible solution.
C. Prime the blood tubing with dextrose solution.
D. Use Y-type blood tubing primed with normal saline and complete the required two-nurse verification.
✓ Correct Answer: D. Use Y-type blood tubing primed with normal saline and complete
the required two-nurse verification.
Rationale: The review lists type and crossmatch, consent, Y tubing, normal saline only, two-nurse verification, and
close monitoring at the start of the transfusion.
8. A client is hyperventilating during severe anxiety. Which acid-base imbalance is associated with this
pattern in the review?
A. Respiratory alkalosis.
B. Respiratory acidosis.
C. Metabolic acidosis.
D. Metabolic alkalosis from vomiting.
✓ Correct Answer: A. Respiratory alkalosis.
Rationale: The review links hyperventilation from anxiety or panic with respiratory alkalosis.
9. A client receiving a gastric tube feeding has a residual greater than 100 mL. What action is indicated in
the review?
A. Discard all gastric contents and give the feeding immediately.
B. Place the client flat and continue the feeding.
C. Hold the feeding.
D. Increase the feeding rate.
✓ Correct Answer: C. Hold the feeding.
Rationale: The tube-feeding review states to check residual volume and hold the feeding when the residual exceeds
the listed threshold of 100 mL.
Page 2
,10. If the cause of a ventilator alarm cannot be determined quickly, what should the nurse do?
A. Manually ventilate the client until the problem is corrected
B. Disconnect oxygen permanently
C. Lower the head of the bed flat and leave
D. Turn off the alarm and wait
✓ Correct Answer: A. Manually ventilate the client until the problem is corrected
Rationale: The review states that if the alarm cause cannot be found, the client should be manually resuscitated until
the problem is corrected.
11. A client with traumatic brain injury is at risk for increased intracranial pressure. Which environmental
approach is emphasized in the review?
A. Decrease stimulation and limit visitors.
B. Encourage frequent loud conversation.
C. Keep the room brightly lit and busy.
D. Place the client flat with no neurologic monitoring.
✓ Correct Answer: A. Decrease stimulation and limit visitors.
Rationale: The TBI review recommends decreased stimulation, limited visitors, a quiet/dark environment, and
positioning to help manage increased intracranial pressure.
12. Which medication is identified in the review as contraindicated for a client with asthma?
A. Oxytocin
B. Carboprost
C. Desmopressin
D. Pyridostigmine
✓ Correct Answer: B. Carboprost
Rationale: The review explicitly notes carboprost as contraindicated in asthma.
13. A client is receiving external radiation therapy. Which skin-care instruction is supported by the review?
A. Use a rough washcloth to remove dry skin.
B. Scrub the treatment markings off each day.
C. Use mild soap gently, avoid rubbing the markings, and protect the area from sun exposure.
D. Apply any scented lotion desired.
✓ Correct Answer: C. Use mild soap gently, avoid rubbing the markings, and protect the
area from sun exposure.
Rationale: The radiation review instructs the client not to rub or remove treatment markings, to use mild soap gently,
and to avoid sun exposure.
14. What legal medication-safety step is required when wasting part of a controlled narcotic dose?
A. Place the unused narcotic in a sharps container without a witness.
B. Discard the remainder in private without documentation.
C. Have another nurse witness the waste.
D. Ask a visitor to witness the waste.
✓ Correct Answer: C. Have another nurse witness the waste.
Rationale: The review states that wasting controlled medications such as hydromorphone requires another nurse to
witness the discarded remainder.
Page 3
, 15. A client's clothing is contaminated by a hazardous chemical. Which removal method is specified in the
review?
A. Place the clothing in regular trash.
B. Use tongs or forceps to remove the contaminated clothing.
C. Shake the clothing before removal.
D. Use bare hands for faster removal.
✓ Correct Answer: B. Use tongs or forceps to remove the contaminated clothing.
Rationale: The hazardous-material review directs use of tongs or forceps and disposal in designated biohazard waste
rather than regular trash.
16. Which exercise teaching is given for a client with type 1 diabetes?
A. Take extra insulin immediately before every exercise session regardless of glucose.
B. Have a small snack before exercise to reduce the risk of hypoglycemia and avoid exercising at insulin peak.
C. Skip glucose checks on exercise days.
D. Exercise only when blood glucose is falling rapidly.
✓ Correct Answer: B. Have a small snack before exercise to reduce the risk of
hypoglycemia and avoid exercising at insulin peak.
Rationale: The diabetes review teaches frequent glucose checks, avoiding exercise at insulin peak, and using a snack
before exercise for type 1 diabetes to reduce hypoglycemia risk.
17. A child with spina bifida has undergone multiple surgeries and catheterizations. Which allergy risk is
emphasized in the review?
A. Iodine allergy in every case.
B. Shellfish allergy only.
C. Penicillin allergy in every case.
D. Latex allergy.
✓ Correct Answer: D. Latex allergy.
Rationale: The review notes that repeated exposure to latex products places clients with spina bifida at increased risk
for latex sensitivity.
18. A Mantoux tuberculin skin test is administered. When should the client return for the reading?
A. After 7 to 10 days
B. 48 to 72 hours later
C. Within 30 minutes
D. Exactly 24 hours later only
✓ Correct Answer: B. 48 to 72 hours later
Rationale: The source procedure states that the test area is read 48 to 72 hours after injection.
19. Which assessment pattern is consistent with DVT in the source review?
A. Bilateral cold hands with no leg symptoms
B. Unilateral calf pain or cramping with a warm, red, swollen leg
C. A painless pink stoma
D. Generalized itching without swelling
✓ Correct Answer: B. Unilateral calf pain or cramping with a warm, red, swollen leg
Rationale: The review uses COWS: calf pain/cramping, one-sided swelling, and a warm red leg; shortness of breath or
chest pain suggests PE.
Page 4
