NUR 280 COMPREHENSIVE ATI EXAM – ADVANCED PRACTICE
QUESTIONS ENHANCED WITH ANSWERS & HELPFUL
RATIONALES |2026 NEWEST AND UPDATED VERSION|A PIECE
THAT HAS MADE MANY EXCEL WITH GRADE A+
Question 1: Priority Setting (Management of Care)
A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess
first?
A. A client with pneumonia who has a temperature of 38.3°C (101°F) and productive cough
B. A client 2 days postoperative with a hemoglobin of 8.5 g/dL reporting fatigue
C. A client with heart failure who has new onset confusion and restlessness
D. A client with diabetes mellitus whose blood glucose is 240 mg/dL before lunch
Correct Answer: C
Rationale:
• C (Correct): New-onset confusion and restlessness in a client with heart failure may
indicate hypoxia or decreased cardiac output, which is life-threatening and requires
immediate assessment. This reflects an acute change in mental status, a priority under
ABCs and neurological deterioration.
• A: Fever and productive cough are expected findings in pneumonia; not immediately life-
threatening unless severe respiratory distress is present.
• B: Hemoglobin of 8.5 g/dL is low but expected postoperatively; fatigue alone does not
indicate immediate instability.
• D: Blood glucose of 240 mg/dL is elevated but not an emergency unless accompanied by
ketoacidosis symptoms.
Question 2: Pharmacology (Adverse Effects & Monitoring)
A nurse is administering furosemide to a client with heart failure. Which finding indicates a
serious adverse effect that requires immediate action?
A. Potassium level of 3.1 mEq/L
B. Urine output of 1500 mL in 8 hours
C. Blood pressure of 100/60 mmHg
D. Mild dizziness upon standing
,Correct Answer: A
Rationale:
• A (Correct): A potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to
life-threatening dysrhythmias. Loop diuretics like furosemide increase potassium
excretion.
• B: Increased urine output is expected and therapeutic.
• C: Blood pressure is slightly low but not critically concerning unless symptomatic.
• D: Mild orthostatic dizziness is a common side effect but not immediately dangerous.
Question 3: Infection Control (Isolation Precautions)
A nurse is caring for a client diagnosed with Clostridium difficile infection. Which intervention
is appropriate?
A. Use alcohol-based hand sanitizer after client contact
B. Place the client in a negative-pressure room
C. Wear gloves and a gown when entering the room
D. Use surgical mask when within 3 feet of the client
Correct Answer: C
Rationale:
• C (Correct): C. difficile requires contact precautions, including gloves and gown to
prevent transmission via spores.
• A: Alcohol-based sanitizers are ineffective against spores; handwashing with soap and
water is required.
• B: Negative-pressure rooms are for airborne diseases (e.g., TB), not C. difficile.
• D: Masks are unnecessary unless there is risk of splash or another infection requiring it.
Question 4: Maternal-Newborn (Complications)
A nurse is assessing a postpartum client. Which finding indicates postpartum hemorrhage?
A. Saturating one perineal pad within 15 minutes
B. Moderate lochia rubra on day 2 postpartum
C. Fundus firm at the umbilicus
D. Mild uterine cramping during breastfeeding
Correct Answer: A
,Rationale:
• A (Correct): Saturating a pad within 15 minutes indicates excessive bleeding, a hallmark
of postpartum hemorrhage.
• B: Moderate lochia rubra is expected within the first few days postpartum.
• C: A firm fundus is a good sign, indicating proper uterine contraction.
• D: Cramping during breastfeeding is normal due to oxytocin release.
Question 5: Mental Health (Therapeutic Communication)
A client with major depressive disorder states, “I feel like my life is worthless.” What is the
nurse’s best response?
A. “You shouldn’t feel that way; things will get better.”
B. “Why do you think your life is worthless?”
C. “Tell me more about why you feel this way.”
D. “You have so much to be grateful for.”
Correct Answer: C
Rationale:
• C (Correct): Encourages open-ended expression and supports therapeutic
communication.
• A: Minimizes the client’s feelings and is non-therapeutic.
• B: “Why” questions can feel interrogative and defensive.
• D: Dismisses the client’s emotions and may increase feelings of guilt.
Question 6: Pediatrics (Safety & Development)
A nurse is teaching parents about safety for a toddler. Which statement by the parents indicates
understanding?
A. “We will keep the crib mattress at the highest level.”
B. “We will give our child whole grapes as snacks.”
C. “We will keep cleaning supplies locked away.”
D. “We will allow our child to play near the pool unsupervised.”
Correct Answer: C
Rationale:
, • C (Correct): Toddlers are at high risk for poisoning, so securing hazardous substances is
essential.
• A: Crib mattress should be lowered once the child can stand.
• B: Whole grapes are a choking hazard; they should be cut.
• D: Toddlers require constant supervision near water.
Question 7: Critical Care (ABG Interpretation)
A client’s arterial blood gas results are:
pH = 7.30, PaCO₂ = 50 mmHg, HCO₃⁻ = 24 mEq/L
What is the interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B
Rationale:
• B (Correct): Low pH (acidic) + elevated PaCO₂ = respiratory acidosis.
• A: Would show low HCO₃⁻.
• C: Would show high pH and low PaCO₂.
• D: Would show high pH and high HCO₃⁻.
Question 8: Leadership & Delegation
A charge nurse is assigning tasks. Which task is appropriate to delegate to an assistive personnel
(AP)?
A. Assessing a client’s pain level
B. Administering oral medications
C. Assisting a client with ambulation
D. Teaching a client about discharge instructions
Correct Answer: C
Rationale:
• C (Correct): AP can perform non-invasive, routine tasks like ambulation.
QUESTIONS ENHANCED WITH ANSWERS & HELPFUL
RATIONALES |2026 NEWEST AND UPDATED VERSION|A PIECE
THAT HAS MADE MANY EXCEL WITH GRADE A+
Question 1: Priority Setting (Management of Care)
A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess
first?
A. A client with pneumonia who has a temperature of 38.3°C (101°F) and productive cough
B. A client 2 days postoperative with a hemoglobin of 8.5 g/dL reporting fatigue
C. A client with heart failure who has new onset confusion and restlessness
D. A client with diabetes mellitus whose blood glucose is 240 mg/dL before lunch
Correct Answer: C
Rationale:
• C (Correct): New-onset confusion and restlessness in a client with heart failure may
indicate hypoxia or decreased cardiac output, which is life-threatening and requires
immediate assessment. This reflects an acute change in mental status, a priority under
ABCs and neurological deterioration.
• A: Fever and productive cough are expected findings in pneumonia; not immediately life-
threatening unless severe respiratory distress is present.
• B: Hemoglobin of 8.5 g/dL is low but expected postoperatively; fatigue alone does not
indicate immediate instability.
• D: Blood glucose of 240 mg/dL is elevated but not an emergency unless accompanied by
ketoacidosis symptoms.
Question 2: Pharmacology (Adverse Effects & Monitoring)
A nurse is administering furosemide to a client with heart failure. Which finding indicates a
serious adverse effect that requires immediate action?
A. Potassium level of 3.1 mEq/L
B. Urine output of 1500 mL in 8 hours
C. Blood pressure of 100/60 mmHg
D. Mild dizziness upon standing
,Correct Answer: A
Rationale:
• A (Correct): A potassium level of 3.1 mEq/L indicates hypokalemia, which can lead to
life-threatening dysrhythmias. Loop diuretics like furosemide increase potassium
excretion.
• B: Increased urine output is expected and therapeutic.
• C: Blood pressure is slightly low but not critically concerning unless symptomatic.
• D: Mild orthostatic dizziness is a common side effect but not immediately dangerous.
Question 3: Infection Control (Isolation Precautions)
A nurse is caring for a client diagnosed with Clostridium difficile infection. Which intervention
is appropriate?
A. Use alcohol-based hand sanitizer after client contact
B. Place the client in a negative-pressure room
C. Wear gloves and a gown when entering the room
D. Use surgical mask when within 3 feet of the client
Correct Answer: C
Rationale:
• C (Correct): C. difficile requires contact precautions, including gloves and gown to
prevent transmission via spores.
• A: Alcohol-based sanitizers are ineffective against spores; handwashing with soap and
water is required.
• B: Negative-pressure rooms are for airborne diseases (e.g., TB), not C. difficile.
• D: Masks are unnecessary unless there is risk of splash or another infection requiring it.
Question 4: Maternal-Newborn (Complications)
A nurse is assessing a postpartum client. Which finding indicates postpartum hemorrhage?
A. Saturating one perineal pad within 15 minutes
B. Moderate lochia rubra on day 2 postpartum
C. Fundus firm at the umbilicus
D. Mild uterine cramping during breastfeeding
Correct Answer: A
,Rationale:
• A (Correct): Saturating a pad within 15 minutes indicates excessive bleeding, a hallmark
of postpartum hemorrhage.
• B: Moderate lochia rubra is expected within the first few days postpartum.
• C: A firm fundus is a good sign, indicating proper uterine contraction.
• D: Cramping during breastfeeding is normal due to oxytocin release.
Question 5: Mental Health (Therapeutic Communication)
A client with major depressive disorder states, “I feel like my life is worthless.” What is the
nurse’s best response?
A. “You shouldn’t feel that way; things will get better.”
B. “Why do you think your life is worthless?”
C. “Tell me more about why you feel this way.”
D. “You have so much to be grateful for.”
Correct Answer: C
Rationale:
• C (Correct): Encourages open-ended expression and supports therapeutic
communication.
• A: Minimizes the client’s feelings and is non-therapeutic.
• B: “Why” questions can feel interrogative and defensive.
• D: Dismisses the client’s emotions and may increase feelings of guilt.
Question 6: Pediatrics (Safety & Development)
A nurse is teaching parents about safety for a toddler. Which statement by the parents indicates
understanding?
A. “We will keep the crib mattress at the highest level.”
B. “We will give our child whole grapes as snacks.”
C. “We will keep cleaning supplies locked away.”
D. “We will allow our child to play near the pool unsupervised.”
Correct Answer: C
Rationale:
, • C (Correct): Toddlers are at high risk for poisoning, so securing hazardous substances is
essential.
• A: Crib mattress should be lowered once the child can stand.
• B: Whole grapes are a choking hazard; they should be cut.
• D: Toddlers require constant supervision near water.
Question 7: Critical Care (ABG Interpretation)
A client’s arterial blood gas results are:
pH = 7.30, PaCO₂ = 50 mmHg, HCO₃⁻ = 24 mEq/L
What is the interpretation?
A. Metabolic acidosis
B. Respiratory acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
Correct Answer: B
Rationale:
• B (Correct): Low pH (acidic) + elevated PaCO₂ = respiratory acidosis.
• A: Would show low HCO₃⁻.
• C: Would show high pH and low PaCO₂.
• D: Would show high pH and high HCO₃⁻.
Question 8: Leadership & Delegation
A charge nurse is assigning tasks. Which task is appropriate to delegate to an assistive personnel
(AP)?
A. Assessing a client’s pain level
B. Administering oral medications
C. Assisting a client with ambulation
D. Teaching a client about discharge instructions
Correct Answer: C
Rationale:
• C (Correct): AP can perform non-invasive, routine tasks like ambulation.
