Ultimate ATI RN 2026 Proctored Exam
Bundle | 150 Advanced Multiple-Choice
Questions with Detailed Answer Rationales
Covering Comprehensive Predictor, Medical-
Surgical, Pediatrics, Pharmacology,
Fundamentals, Maternal Newborn, Mental
Health, Leadership, Community Health, and
Nutrition for Nursing Exam Success
Table of Contents
1. Comprehensive Predictor (Questions 1-15)
2. Medical-Surgical Nursing (Questions 16-35)
3. Pediatrics (Questions 36-50)
4. Pharmacology (Questions 51-70)
5. Fundamentals of Nursing (Questions 71-85)
6. Maternal Newborn (Questions 86-100)
7. Mental Health (Questions 101-115)
8. Leadership and Management (Questions 116-130)
9. Community Health (Questions 131-140)
10. Nutrition (Questions 141-150)
1. Comprehensive Predictor
🟢 1. A nurse is caring for a client who is postoperative day one following an open cholecystectomy.
The client reports nausea and has an NG tube set to low intermittent suction. Which of the following
actions should the nurse take first?
A. Administer a prescribed antiemetic.
B. Assess the client's bowel sounds.
,C. Measure the client's abdominal girth.
D. Check the patency of the NG tube.
🔴🔴 Correct Answer: D. Check the patency of the NG tube.
Rationale: The first action the nurse should take is to assess the patency of the NG tube. Nausea in a
postoperative client with an NG tube can indicate that the tube is clogged or not functioning correctly,
leading to gastric distention. Ensuring patency is a priority to relieve the immediate symptom and
prevent complications like aspiration. Administering an antiemetic (A) might be necessary but is not the
first step; the underlying cause must be addressed. Assessing bowel sounds (B) and measuring
abdominal girth (C) are important assessments, but checking the tube's function is the most direct and
immediate intervention for the reported nausea.
🟢 2. A nurse is reviewing the laboratory results of a client who has a new prescription for furosemide.
Which of the following findings should the nurse report to the provider?
A. Potassium 3.1 mEq/L
B. Sodium 138 mEq/L
C. Chloride 101 mEq/L
D. Magnesium 2.0 mg/dL
🔴🔴 Correct Answer: A. Potassium 3.1 mEq/L
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss (hypokalemia). A
potassium level of 3.1 mEq/L is below the expected reference range (3.5-5.0 mEq/L) and places the
client at risk for cardiac dysrhythmias. This finding is critical and must be reported. The other values (B,
C, D) are within expected reference ranges.
🟢 3. A charge nurse is making client assignments for the upcoming shift. Which of the following clients
should the nurse assign to a float pool nurse who is not familiar with the unit?
A. A client who is 1 day postoperative following a craniotomy.
B. A client who requires a blood transfusion.
C. A client who is scheduled for a cardiac catheterization.
D. A client who is receiving chemotherapy.
🔴🔴 Correct Answer: B. A client who requires a blood transfusion.
Rationale: The nurse should assign the most stable client to the float pool nurse. A client requiring a
blood transfusion is a common procedure with a standard protocol, making it an appropriate
assignment for a nurse unfamiliar with the specific unit, though they would still require orientation to
the unit's policy. Clients who are postoperative craniotomy (A), pre-cardiac catheterization (C), or
receiving chemotherapy (D) are higher-acuity and require specialized knowledge of the unit and the
client's specific condition.
🟢 4. A nurse is caring for a client who has a new prescription for a continuous passive motion (CPM)
machine following a total knee arthroplasty. Which of the following actions should the nurse take?
A. Set the machine to a flexion setting of 90 degrees.
B. Apply the CPM machine over the client's clothing.
C. Assess the client's neurovascular status every 4 hours.
D. Ensure the client's knee is in a dependent position.
,🔴🔴 Correct Answer: C. Assess the client's neurovascular status every 4 hours.
Rationale: The nurse must assess the client's neurovascular status (pulse, sensation, movement, color,
temperature, and capillary refill) of the affected extremity frequently, at least every 4 hours or per
protocol, to detect complications such as nerve or vessel compression from the CPM machine. The initial
flexion setting is typically started low and increased gradually (A). The machine should be applied
directly to the skin, not over clothing (B), to prevent shearing. The leg should be in a neutral, supported
position, not dependent (D).
🟢 5. A nurse is assessing a client who is at 34 weeks of gestation and reports a sudden gush of fluid
from the vagina. Which of the following actions should the nurse take first?
A. Perform a sterile vaginal exam.
B. Check the fetal heart rate.
C. Obtain a sample of the fluid for testing.
D. Place the client in a supine position.
🔴🔴 Correct Answer: B. Check the fetal heart rate.
Rationale: The priority nursing action is to assess the fetal status. A sudden gush of fluid can indicate
premature rupture of membranes (PROM), which can lead to cord prolapse, a life-threatening
emergency for the fetus. Checking the fetal heart rate provides immediate information about fetal well-
being. A sterile vaginal exam (A) should be avoided until the fetal status is confirmed and a prolapsed
cord is ruled out. Testing the fluid (C) and positioning the client (D) are subsequent actions.
🟢 6. A nurse is teaching a client who has a new diagnosis of type 1 diabetes mellitus about sick-day
management. Which of the following statements by the client indicates an understanding of the
teaching?
A. "I will stop taking my insulin if I am unable to eat."
B. "I will check my blood glucose every 4 to 6 hours."
C. "I will consume 50 grams of carbohydrates every 2 hours."
D. "I will drink a diet soda every hour to stay hydrated."
🔴🔴 Correct Answer: B. "I will check my blood glucose every 4 to 6 hours."
Rationale: During illness, stress hormones can cause blood glucose to rise, even if the client is not
eating. Therefore, the client should continue to take insulin and monitor blood glucose more frequently,
at least every 4 hours. Never stop taking insulin (A). The client should consume 30-50 grams of
carbohydrates every 3-4 hours if unable to eat a normal meal (C). While staying hydrated is important,
the client should drink fluids containing sugar and electrolytes, not diet soda (D).
🟢 7. A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following
findings is the highest priority for the nurse to report?
A. Heart rate 110/min
B. Blood pressure 150/90 mm Hg
C. Tremors in the hands
D. Seizure activity
🔴🔴 Correct Answer: D. Seizure activity.
Rationale: Seizures are a severe and life-threatening complication of alcohol withdrawal. They indicate
severe central nervous system hyperexcitability and require immediate medical intervention, typically
, with benzodiazepines. While tachycardia (A), hypertension (B), and tremors (C) are common
manifestations of withdrawal, a seizure is the highest priority as it poses an immediate threat to the
client's safety and life.
🟢 8. A nurse is planning care for a client who has dementia and is at risk for wandering. Which of the
following interventions should the nurse include in the plan of care?
A. Place a bed alarm on the client's bed.
B. Assign the client to a room at the end of the hall.
C. Restrain the client in a geriatric chair.
D. Administer a sedative at bedtime.
🔴🔴 Correct Answer: A. Place a bed alarm on the client's bed.
Rationale: A bed alarm is a non-restrictive safety device that alerts staff when a client attempts to get
out of bed, helping to prevent falls and wandering. This is a safe and appropriate intervention. Assigning
the client to a room at the end of the hall (B) increases the risk of unsupervised wandering. Restraints
(C) are a last resort and are not indicated for wandering. Sedatives (D) can increase confusion and the
risk of falls and are not a first-line intervention.
🟢 9. A nurse is preparing to administer a blood transfusion to a client. Which of the following actions is
the priority before initiating the transfusion?
A. Obtain the client's vital signs.
B. Verify the client's identification with a second nurse.
C. Prime the blood tubing with 0.9% sodium chloride.
D. Explain the procedure to the client.
🔴🔴 Correct Answer: B. Verify the client's identification with a second nurse.
Rationale: The highest priority action before a blood transfusion is to ensure client safety by preventing
a transfusion reaction. This is done through a two-nurse verification process of the client's identification
and the blood product label at the bedside. While obtaining vital signs (A), priming the tubing with saline
(C), and explaining the procedure (D) are all essential steps, the verification process is the most critical
safety check.
🟢 10. A nurse is evaluating a client's understanding of a low-purine diet. Which of the following food
choices by the client indicates a need for further teaching?
A. Grilled chicken breast
B. Salmon fillet
C. Scrambled eggs
D. Spinach salad
🔴🔴 Correct Answer: B. Salmon fillet
Rationale: A low-purine diet is prescribed for clients with gout to reduce uric acid production. Organ
meats, red meats, and certain seafoods, including salmon, sardines, and shellfish, are high in purines.
The client's choice of a salmon fillet indicates a need for further teaching. Chicken (A), eggs (C), and
spinach (D) are lower in purines and are appropriate choices.
🟢 11. A nurse manager is developing a plan to improve client satisfaction scores on the unit. Which of
the following actions should the manager take first?
Bundle | 150 Advanced Multiple-Choice
Questions with Detailed Answer Rationales
Covering Comprehensive Predictor, Medical-
Surgical, Pediatrics, Pharmacology,
Fundamentals, Maternal Newborn, Mental
Health, Leadership, Community Health, and
Nutrition for Nursing Exam Success
Table of Contents
1. Comprehensive Predictor (Questions 1-15)
2. Medical-Surgical Nursing (Questions 16-35)
3. Pediatrics (Questions 36-50)
4. Pharmacology (Questions 51-70)
5. Fundamentals of Nursing (Questions 71-85)
6. Maternal Newborn (Questions 86-100)
7. Mental Health (Questions 101-115)
8. Leadership and Management (Questions 116-130)
9. Community Health (Questions 131-140)
10. Nutrition (Questions 141-150)
1. Comprehensive Predictor
🟢 1. A nurse is caring for a client who is postoperative day one following an open cholecystectomy.
The client reports nausea and has an NG tube set to low intermittent suction. Which of the following
actions should the nurse take first?
A. Administer a prescribed antiemetic.
B. Assess the client's bowel sounds.
,C. Measure the client's abdominal girth.
D. Check the patency of the NG tube.
🔴🔴 Correct Answer: D. Check the patency of the NG tube.
Rationale: The first action the nurse should take is to assess the patency of the NG tube. Nausea in a
postoperative client with an NG tube can indicate that the tube is clogged or not functioning correctly,
leading to gastric distention. Ensuring patency is a priority to relieve the immediate symptom and
prevent complications like aspiration. Administering an antiemetic (A) might be necessary but is not the
first step; the underlying cause must be addressed. Assessing bowel sounds (B) and measuring
abdominal girth (C) are important assessments, but checking the tube's function is the most direct and
immediate intervention for the reported nausea.
🟢 2. A nurse is reviewing the laboratory results of a client who has a new prescription for furosemide.
Which of the following findings should the nurse report to the provider?
A. Potassium 3.1 mEq/L
B. Sodium 138 mEq/L
C. Chloride 101 mEq/L
D. Magnesium 2.0 mg/dL
🔴🔴 Correct Answer: A. Potassium 3.1 mEq/L
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss (hypokalemia). A
potassium level of 3.1 mEq/L is below the expected reference range (3.5-5.0 mEq/L) and places the
client at risk for cardiac dysrhythmias. This finding is critical and must be reported. The other values (B,
C, D) are within expected reference ranges.
🟢 3. A charge nurse is making client assignments for the upcoming shift. Which of the following clients
should the nurse assign to a float pool nurse who is not familiar with the unit?
A. A client who is 1 day postoperative following a craniotomy.
B. A client who requires a blood transfusion.
C. A client who is scheduled for a cardiac catheterization.
D. A client who is receiving chemotherapy.
🔴🔴 Correct Answer: B. A client who requires a blood transfusion.
Rationale: The nurse should assign the most stable client to the float pool nurse. A client requiring a
blood transfusion is a common procedure with a standard protocol, making it an appropriate
assignment for a nurse unfamiliar with the specific unit, though they would still require orientation to
the unit's policy. Clients who are postoperative craniotomy (A), pre-cardiac catheterization (C), or
receiving chemotherapy (D) are higher-acuity and require specialized knowledge of the unit and the
client's specific condition.
🟢 4. A nurse is caring for a client who has a new prescription for a continuous passive motion (CPM)
machine following a total knee arthroplasty. Which of the following actions should the nurse take?
A. Set the machine to a flexion setting of 90 degrees.
B. Apply the CPM machine over the client's clothing.
C. Assess the client's neurovascular status every 4 hours.
D. Ensure the client's knee is in a dependent position.
,🔴🔴 Correct Answer: C. Assess the client's neurovascular status every 4 hours.
Rationale: The nurse must assess the client's neurovascular status (pulse, sensation, movement, color,
temperature, and capillary refill) of the affected extremity frequently, at least every 4 hours or per
protocol, to detect complications such as nerve or vessel compression from the CPM machine. The initial
flexion setting is typically started low and increased gradually (A). The machine should be applied
directly to the skin, not over clothing (B), to prevent shearing. The leg should be in a neutral, supported
position, not dependent (D).
🟢 5. A nurse is assessing a client who is at 34 weeks of gestation and reports a sudden gush of fluid
from the vagina. Which of the following actions should the nurse take first?
A. Perform a sterile vaginal exam.
B. Check the fetal heart rate.
C. Obtain a sample of the fluid for testing.
D. Place the client in a supine position.
🔴🔴 Correct Answer: B. Check the fetal heart rate.
Rationale: The priority nursing action is to assess the fetal status. A sudden gush of fluid can indicate
premature rupture of membranes (PROM), which can lead to cord prolapse, a life-threatening
emergency for the fetus. Checking the fetal heart rate provides immediate information about fetal well-
being. A sterile vaginal exam (A) should be avoided until the fetal status is confirmed and a prolapsed
cord is ruled out. Testing the fluid (C) and positioning the client (D) are subsequent actions.
🟢 6. A nurse is teaching a client who has a new diagnosis of type 1 diabetes mellitus about sick-day
management. Which of the following statements by the client indicates an understanding of the
teaching?
A. "I will stop taking my insulin if I am unable to eat."
B. "I will check my blood glucose every 4 to 6 hours."
C. "I will consume 50 grams of carbohydrates every 2 hours."
D. "I will drink a diet soda every hour to stay hydrated."
🔴🔴 Correct Answer: B. "I will check my blood glucose every 4 to 6 hours."
Rationale: During illness, stress hormones can cause blood glucose to rise, even if the client is not
eating. Therefore, the client should continue to take insulin and monitor blood glucose more frequently,
at least every 4 hours. Never stop taking insulin (A). The client should consume 30-50 grams of
carbohydrates every 3-4 hours if unable to eat a normal meal (C). While staying hydrated is important,
the client should drink fluids containing sugar and electrolytes, not diet soda (D).
🟢 7. A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following
findings is the highest priority for the nurse to report?
A. Heart rate 110/min
B. Blood pressure 150/90 mm Hg
C. Tremors in the hands
D. Seizure activity
🔴🔴 Correct Answer: D. Seizure activity.
Rationale: Seizures are a severe and life-threatening complication of alcohol withdrawal. They indicate
severe central nervous system hyperexcitability and require immediate medical intervention, typically
, with benzodiazepines. While tachycardia (A), hypertension (B), and tremors (C) are common
manifestations of withdrawal, a seizure is the highest priority as it poses an immediate threat to the
client's safety and life.
🟢 8. A nurse is planning care for a client who has dementia and is at risk for wandering. Which of the
following interventions should the nurse include in the plan of care?
A. Place a bed alarm on the client's bed.
B. Assign the client to a room at the end of the hall.
C. Restrain the client in a geriatric chair.
D. Administer a sedative at bedtime.
🔴🔴 Correct Answer: A. Place a bed alarm on the client's bed.
Rationale: A bed alarm is a non-restrictive safety device that alerts staff when a client attempts to get
out of bed, helping to prevent falls and wandering. This is a safe and appropriate intervention. Assigning
the client to a room at the end of the hall (B) increases the risk of unsupervised wandering. Restraints
(C) are a last resort and are not indicated for wandering. Sedatives (D) can increase confusion and the
risk of falls and are not a first-line intervention.
🟢 9. A nurse is preparing to administer a blood transfusion to a client. Which of the following actions is
the priority before initiating the transfusion?
A. Obtain the client's vital signs.
B. Verify the client's identification with a second nurse.
C. Prime the blood tubing with 0.9% sodium chloride.
D. Explain the procedure to the client.
🔴🔴 Correct Answer: B. Verify the client's identification with a second nurse.
Rationale: The highest priority action before a blood transfusion is to ensure client safety by preventing
a transfusion reaction. This is done through a two-nurse verification process of the client's identification
and the blood product label at the bedside. While obtaining vital signs (A), priming the tubing with saline
(C), and explaining the procedure (D) are all essential steps, the verification process is the most critical
safety check.
🟢 10. A nurse is evaluating a client's understanding of a low-purine diet. Which of the following food
choices by the client indicates a need for further teaching?
A. Grilled chicken breast
B. Salmon fillet
C. Scrambled eggs
D. Spinach salad
🔴🔴 Correct Answer: B. Salmon fillet
Rationale: A low-purine diet is prescribed for clients with gout to reduce uric acid production. Organ
meats, red meats, and certain seafoods, including salmon, sardines, and shellfish, are high in purines.
The client's choice of a salmon fillet indicates a need for further teaching. Chicken (A), eggs (C), and
spinach (D) are lower in purines and are appropriate choices.
🟢 11. A nurse manager is developing a plan to improve client satisfaction scores on the unit. Which of
the following actions should the manager take first?
