Ultimate ATI RN 2026 Proctored Exam
Bundle: 150 Advanced Practice Questions
with Detailed Rationales for
Comprehensive Predictor, Med-Surg,
Pediatrics, Pharmacology, Fundamentals,
Maternal Newborn, Mental Health,
Leadership, and Community Health
Table of Contents
1. Comprehensive Predictor & Fundamentals of Nursing (Questions 1-25)
2. Medical-Surgical Nursing (Questions 26-55)
3. Pharmacology (Questions 56-85)
4. Maternal Newborn Nursing (Questions 86-105)
5. Pediatric Nursing (Questions 106-125)
6. Mental Health Nursing (Questions 126-135)
7. Leadership & Management (Questions 136-143)
8. Community Health & Nutrition (Questions 144-150)
1. Comprehensive Predictor & Fundamentals of Nursing
🟢 1. A nurse is caring for a client who is receiving continuous enteral tube feedings. Which of the
following actions should the nurse take to prevent aspiration?
A. Flush the tube with 30 mL of water every 4 hours.
B. Verify tube placement by auscultating the epigastric area for a whooshing sound.
C. Maintain the head of the bed at a 15-degree angle.
🔴🔴 D. Elevate the head of the bed to 30 to 45 degrees.
Rationale: Elevating the head of the bed to at least 30 degrees is the most effective intervention to
,prevent aspiration in a client receiving enteral feedings. Auscultation is not a reliable method for
verifying tube placement. A 15-degree angle is insufficient.
🟢 2. A nurse is assessing a client who has a new onset of confusion and agitation. The client's oxygen
saturation is 88% on room air. Which of the following actions should the nurse take first?
A. Administer a prescribed PRN antipsychotic medication.
B. Obtain a full set of vital signs.
C. Apply oxygen via nasal cannula.
🔴🔴 D. Apply oxygen via nasal cannula and raise the head of the bed.
Rationale: The client is exhibiting signs of hypoxia (confusion, agitation, low SpO2). The priority action is
to improve oxygenation. Applying oxygen and positioning the client to maximize lung expansion (raising
the head of the bed) are immediate, independent nursing interventions. Administering an antipsychotic
would be inappropriate and potentially dangerous.
🟢 3. A nurse is preparing to administer a blood transfusion. Which of the following client findings
indicates a hemolytic transfusion reaction?
A. Urticaria and itching.
B. Fever and chills.
🔴🔴 C. Low back pain and dark, reddish-brown urine.
D. Crackles in the lung bases and jugular venous distension.
Rationale: Low back pain and hemoglobinuria (dark, reddish-brown urine) are classic signs of an acute
hemolytic transfusion reaction, caused by the destruction of red blood cells. Urticaria indicates a mild
allergic reaction. Fever and chills can indicate a febrile non-hemolytic reaction. Crackles and JVD indicate
circulatory overload.
🟢 4. A nurse is evaluating a client's understanding of a low-sodium diet. Which of the following food
choices by the client indicates a need for further teaching?
A. Fresh fruit salad.
B. Grilled chicken breast.
C. Steamed broccoli.
🔴🔴 D. Canned tomato soup.
Rationale: Canned soups are notoriously high in sodium and are a poor choice for a low-sodium diet.
Fresh fruits, unprocessed meats, and fresh vegetables are all appropriate low-sodium choices.
🟢 5. A nurse is caring for a client who is at risk for developing a pressure injury. Which of the following
actions should the nurse take?
A. Massage reddened areas over bony prominences.
B. Position the client directly on the trochanter when side-lying.
C. Use a donut-shaped cushion for the client's sacrum.
🔴🔴 D. Reposition the client at least every 2 hours.
Rationale: Repositioning the client at least every 2 hours is a key intervention to relieve pressure and
prevent pressure injuries. Massaging reddened areas can cause further tissue damage. Positioning
directly on the trochanter increases pressure. Donut cushions can cause pressure and impair circulation.
🟢 6. A nurse is calculating the intake and output for a client. The client has consumed 8 oz of coffee, 4
oz of gelatin, and 12 oz of water. The client has a continuous IV infusion of 0.9% sodium chloride at 75
,mL/hr. What is the client's total fluid intake in mL for the 8-hour shift? (Fill in the blank).
🔴🔴 Answer: 1320 mL.
Rationale: 8 oz coffee + 4 oz gelatin + 12 oz water = 24 oz of oral intake. 24 oz * 30 mL/oz = 720 mL. IV
intake = 75 mL/hr * 8 hr = 600 mL. Total intake = 720 + 600 = 1320 mL.
🟢 7. A nurse is teaching a client about the use of a metered-dose inhaler (MDI) with a spacer. Which of
the following instructions should the nurse include?
A. "Inhale rapidly and deeply after activating the inhaler."
B. "Hold your breath for 2 seconds after inhaling the medication."
C. "Wait 5 minutes between puffs of the same medication."
🔴🔴 D. "Rinse your mouth with water after using the inhaler."
Rationale: Rinsing the mouth after using an MDI, especially with corticosteroids, helps prevent oral
candidiasis. The client should inhale slowly and deeply. The breath should be held for 10 seconds. The
client should wait 1-2 minutes between puffs of the same medication.
🟢 8. A nurse is performing a sterile dressing change. Which of the following actions violates sterile
technique?
A. Opening the sterile dressing package away from the body.
B. Placing the sterile drape on the client's bed.
🔴🔴 C. Reaching over the sterile field to obtain a supply.
D. Using sterile gloves to apply the new dressing.
Rationale: Reaching over a sterile field contaminates it. The nurse must not reach over the field but
should move around it or have an assistant provide supplies. All other actions are appropriate.
🟢 9. A nurse is assessing a client for dehydration. Which of the following findings should the nurse
expect?
A. Bounding pulse.
B. Hypertension.
C. Crackles in the lungs.
🔴🔴 D. Poor skin turgor.
Rationale: Poor skin turgor is a classic sign of dehydration. A bounding pulse, hypertension, and crackles
are signs of fluid volume excess.
🟢 10. A nurse is preparing to administer a medication via a nasogastric (NG) tube. Which of the
following actions should the nurse take?
A. Administer the medication with the client in a supine position.
B. Mix all medications together to administer at once.
C. Verify tube placement by injecting air and listening with a stethoscope.
🔴🔴 D. Check for residual volume before administering the medication.
Rationale: Checking for residual volume helps determine if the tube is in the stomach and if the client is
tolerating feedings. The client should be in a high-Fowler's position. Medications should be administered
separately to prevent interactions. Auscultation is not a reliable method for verifying placement.
🟢 11. A nurse is caring for a client who has a new prescription for a clear liquid diet. Which of the
following items should the nurse offer the client?
A. Cream of chicken soup.
, B. Vanilla ice cream.
C. Orange juice.
🔴🔴 D. Apple juice.
Rationale: Apple juice is a clear liquid. Cream of chicken soup and vanilla ice cream are full liquids.
Orange juice is considered a full liquid because it contains pulp.
🟢 12. A nurse is assessing a client's pain using a 0-10 numeric scale. The client reports a pain level of 8.
Which of the following actions should the nurse take first?
A. Document the pain score.
B. Administer the prescribed analgesic.
C. Reassess the pain in 1 hour.
🔴🔴 D. Assess the characteristics of the pain.
Rationale: The nurse should perform a comprehensive pain assessment (location, quality, duration, etc.)
before intervening. This assessment guides the choice of intervention. Documentation should occur
after the assessment and intervention.
🟢 13. A nurse is teaching a client about fall prevention. Which of the following statements by the client
indicates a need for further teaching?
A. "I will use the call light to ask for help getting out of bed."
B. "I will wear non-skid socks when I am walking."
C. "I will keep my personal items within easy reach."
🔴🔴 D. "I will use the side rails to help me get out of bed."
Rationale: Using side rails to get out of bed can be dangerous and is a common cause of falls. The client
should always call for assistance. The other statements are correct.
🟢 14. A nurse is caring for a client who has an order for NPO (nothing by mouth). Which of the
following actions should the nurse take?
A. Provide oral care every 4 hours.
B. Offer small sips of water.
🔴🔴 C. Post a "NPO" sign above the client's bed.
D. Remove the water pitcher from the bedside table.
Rationale: Posting an NPO sign is a critical communication tool for all staff. Oral care should be provided
more frequently, at least every 2 hours, for comfort. Offering water violates the order. While removing
the water pitcher is appropriate, posting the sign is a more comprehensive safety action.
🟢 15. A nurse is preparing to insert a urinary catheter. Which of the following actions should the nurse
take to prevent a catheter-associated urinary tract infection (CAUTI)?
A. Use sterile technique for insertion.
B. Maintain a closed drainage system.
C. Ensure the drainage bag is below the level of the bladder.
🔴🔴 D. All of the above.
Rationale: All of these actions are essential for preventing CAUTIs. Sterile technique during insertion,
maintaining a closed system, and keeping the bag below the bladder to prevent backflow of urine are all
standard precautions.
Bundle: 150 Advanced Practice Questions
with Detailed Rationales for
Comprehensive Predictor, Med-Surg,
Pediatrics, Pharmacology, Fundamentals,
Maternal Newborn, Mental Health,
Leadership, and Community Health
Table of Contents
1. Comprehensive Predictor & Fundamentals of Nursing (Questions 1-25)
2. Medical-Surgical Nursing (Questions 26-55)
3. Pharmacology (Questions 56-85)
4. Maternal Newborn Nursing (Questions 86-105)
5. Pediatric Nursing (Questions 106-125)
6. Mental Health Nursing (Questions 126-135)
7. Leadership & Management (Questions 136-143)
8. Community Health & Nutrition (Questions 144-150)
1. Comprehensive Predictor & Fundamentals of Nursing
🟢 1. A nurse is caring for a client who is receiving continuous enteral tube feedings. Which of the
following actions should the nurse take to prevent aspiration?
A. Flush the tube with 30 mL of water every 4 hours.
B. Verify tube placement by auscultating the epigastric area for a whooshing sound.
C. Maintain the head of the bed at a 15-degree angle.
🔴🔴 D. Elevate the head of the bed to 30 to 45 degrees.
Rationale: Elevating the head of the bed to at least 30 degrees is the most effective intervention to
,prevent aspiration in a client receiving enteral feedings. Auscultation is not a reliable method for
verifying tube placement. A 15-degree angle is insufficient.
🟢 2. A nurse is assessing a client who has a new onset of confusion and agitation. The client's oxygen
saturation is 88% on room air. Which of the following actions should the nurse take first?
A. Administer a prescribed PRN antipsychotic medication.
B. Obtain a full set of vital signs.
C. Apply oxygen via nasal cannula.
🔴🔴 D. Apply oxygen via nasal cannula and raise the head of the bed.
Rationale: The client is exhibiting signs of hypoxia (confusion, agitation, low SpO2). The priority action is
to improve oxygenation. Applying oxygen and positioning the client to maximize lung expansion (raising
the head of the bed) are immediate, independent nursing interventions. Administering an antipsychotic
would be inappropriate and potentially dangerous.
🟢 3. A nurse is preparing to administer a blood transfusion. Which of the following client findings
indicates a hemolytic transfusion reaction?
A. Urticaria and itching.
B. Fever and chills.
🔴🔴 C. Low back pain and dark, reddish-brown urine.
D. Crackles in the lung bases and jugular venous distension.
Rationale: Low back pain and hemoglobinuria (dark, reddish-brown urine) are classic signs of an acute
hemolytic transfusion reaction, caused by the destruction of red blood cells. Urticaria indicates a mild
allergic reaction. Fever and chills can indicate a febrile non-hemolytic reaction. Crackles and JVD indicate
circulatory overload.
🟢 4. A nurse is evaluating a client's understanding of a low-sodium diet. Which of the following food
choices by the client indicates a need for further teaching?
A. Fresh fruit salad.
B. Grilled chicken breast.
C. Steamed broccoli.
🔴🔴 D. Canned tomato soup.
Rationale: Canned soups are notoriously high in sodium and are a poor choice for a low-sodium diet.
Fresh fruits, unprocessed meats, and fresh vegetables are all appropriate low-sodium choices.
🟢 5. A nurse is caring for a client who is at risk for developing a pressure injury. Which of the following
actions should the nurse take?
A. Massage reddened areas over bony prominences.
B. Position the client directly on the trochanter when side-lying.
C. Use a donut-shaped cushion for the client's sacrum.
🔴🔴 D. Reposition the client at least every 2 hours.
Rationale: Repositioning the client at least every 2 hours is a key intervention to relieve pressure and
prevent pressure injuries. Massaging reddened areas can cause further tissue damage. Positioning
directly on the trochanter increases pressure. Donut cushions can cause pressure and impair circulation.
🟢 6. A nurse is calculating the intake and output for a client. The client has consumed 8 oz of coffee, 4
oz of gelatin, and 12 oz of water. The client has a continuous IV infusion of 0.9% sodium chloride at 75
,mL/hr. What is the client's total fluid intake in mL for the 8-hour shift? (Fill in the blank).
🔴🔴 Answer: 1320 mL.
Rationale: 8 oz coffee + 4 oz gelatin + 12 oz water = 24 oz of oral intake. 24 oz * 30 mL/oz = 720 mL. IV
intake = 75 mL/hr * 8 hr = 600 mL. Total intake = 720 + 600 = 1320 mL.
🟢 7. A nurse is teaching a client about the use of a metered-dose inhaler (MDI) with a spacer. Which of
the following instructions should the nurse include?
A. "Inhale rapidly and deeply after activating the inhaler."
B. "Hold your breath for 2 seconds after inhaling the medication."
C. "Wait 5 minutes between puffs of the same medication."
🔴🔴 D. "Rinse your mouth with water after using the inhaler."
Rationale: Rinsing the mouth after using an MDI, especially with corticosteroids, helps prevent oral
candidiasis. The client should inhale slowly and deeply. The breath should be held for 10 seconds. The
client should wait 1-2 minutes between puffs of the same medication.
🟢 8. A nurse is performing a sterile dressing change. Which of the following actions violates sterile
technique?
A. Opening the sterile dressing package away from the body.
B. Placing the sterile drape on the client's bed.
🔴🔴 C. Reaching over the sterile field to obtain a supply.
D. Using sterile gloves to apply the new dressing.
Rationale: Reaching over a sterile field contaminates it. The nurse must not reach over the field but
should move around it or have an assistant provide supplies. All other actions are appropriate.
🟢 9. A nurse is assessing a client for dehydration. Which of the following findings should the nurse
expect?
A. Bounding pulse.
B. Hypertension.
C. Crackles in the lungs.
🔴🔴 D. Poor skin turgor.
Rationale: Poor skin turgor is a classic sign of dehydration. A bounding pulse, hypertension, and crackles
are signs of fluid volume excess.
🟢 10. A nurse is preparing to administer a medication via a nasogastric (NG) tube. Which of the
following actions should the nurse take?
A. Administer the medication with the client in a supine position.
B. Mix all medications together to administer at once.
C. Verify tube placement by injecting air and listening with a stethoscope.
🔴🔴 D. Check for residual volume before administering the medication.
Rationale: Checking for residual volume helps determine if the tube is in the stomach and if the client is
tolerating feedings. The client should be in a high-Fowler's position. Medications should be administered
separately to prevent interactions. Auscultation is not a reliable method for verifying placement.
🟢 11. A nurse is caring for a client who has a new prescription for a clear liquid diet. Which of the
following items should the nurse offer the client?
A. Cream of chicken soup.
, B. Vanilla ice cream.
C. Orange juice.
🔴🔴 D. Apple juice.
Rationale: Apple juice is a clear liquid. Cream of chicken soup and vanilla ice cream are full liquids.
Orange juice is considered a full liquid because it contains pulp.
🟢 12. A nurse is assessing a client's pain using a 0-10 numeric scale. The client reports a pain level of 8.
Which of the following actions should the nurse take first?
A. Document the pain score.
B. Administer the prescribed analgesic.
C. Reassess the pain in 1 hour.
🔴🔴 D. Assess the characteristics of the pain.
Rationale: The nurse should perform a comprehensive pain assessment (location, quality, duration, etc.)
before intervening. This assessment guides the choice of intervention. Documentation should occur
after the assessment and intervention.
🟢 13. A nurse is teaching a client about fall prevention. Which of the following statements by the client
indicates a need for further teaching?
A. "I will use the call light to ask for help getting out of bed."
B. "I will wear non-skid socks when I am walking."
C. "I will keep my personal items within easy reach."
🔴🔴 D. "I will use the side rails to help me get out of bed."
Rationale: Using side rails to get out of bed can be dangerous and is a common cause of falls. The client
should always call for assistance. The other statements are correct.
🟢 14. A nurse is caring for a client who has an order for NPO (nothing by mouth). Which of the
following actions should the nurse take?
A. Provide oral care every 4 hours.
B. Offer small sips of water.
🔴🔴 C. Post a "NPO" sign above the client's bed.
D. Remove the water pitcher from the bedside table.
Rationale: Posting an NPO sign is a critical communication tool for all staff. Oral care should be provided
more frequently, at least every 2 hours, for comfort. Offering water violates the order. While removing
the water pitcher is appropriate, posting the sign is a more comprehensive safety action.
🟢 15. A nurse is preparing to insert a urinary catheter. Which of the following actions should the nurse
take to prevent a catheter-associated urinary tract infection (CAUTI)?
A. Use sterile technique for insertion.
B. Maintain a closed drainage system.
C. Ensure the drainage bag is below the level of the bladder.
🔴🔴 D. All of the above.
Rationale: All of these actions are essential for preventing CAUTIs. Sterile technique during insertion,
maintaining a closed system, and keeping the bag below the bladder to prevent backflow of urine are all
standard precautions.
