ATI RN Comprehensive Predictor Exit
Retake Exam Study Guide Questions And
Well Graded Solutions With Rationales
Updated 2026-2027
Pass your ATI RN Comprehensive Predictor Exit Retake Exam on the first try. This premium
study guide provides verified multiple-choice questions, accurate answers, and highly detailed
clinical rationales matching current test variants. Covers high-yield NCLEX-RN content:
advanced pharmacology, adult medical-surgical nursing, maternal-newborn emergencies,
pediatric milestones, prioritization, and management strategies. Perfect for mandatory school
remediation and boosting your passing probability score.
Question 1
A nurse is preparing to administer blood to a client. Which of the following actions
should the nurse take first?
A) Check the client's vital signs.
B) Verify the blood product with another registered nurse.
C) Primary tubing should be primed with 0.9% sodium chloride.
D) Establish intravenous access with a 20-gauge needle.
Rationale: The nurse must verify the client's identity and the blood product with
another licensed nurse prior to administration to prevent a potentially fatal hemolytic
transfusion reaction. While vital signs, proper tubing priming, and large-bore IV
access are necessary components of blood transfusion protocols, verifying the
product with a second nurse is the critical final safety check before initiation.
Question 2
A nurse is caring for a client who is 2 hours postoperative following a total
thyroidectomy. Which of the following assessment findings is the priority?
A) Incisional pain rated at 6 on a scale of 0 to 10
B) Sore throat when speaking
C) Laryngeal stridor or harsh, high-pitched respirations
D) Minimal serosanguineous drainage on the dressing
Rationale: Stridor indicates an acute airway obstruction, which can be caused by
edema, laryngeal nerve damage, or a hematoma compressing the trachea following
thyroid surgery. Airway takes priority over pain management, expected mild
,postoperative throat soreness, and minor dressing drainage. This finding requires
immediate notification of the provider and preparation for emergency airway
management.
Question 3
A nurse is reviewing laboratory results for a client who is receiving a heparin infusion
for a deep vein thrombosis. Which of the following values indicates the medication is
therapeutic?
A) Prothrombin time (PT) of 22 seconds
B) Activated partial thromboplastin time (aPTT) of 70 seconds
C) International normalized ratio (INR) of 3.0
D) Platelet count of 90,000/mm³
Rationale: Heparin therapy effectiveness is monitored using the aPTT, with a
therapeutic range typically being 1.5 to 2.5 times the normal baseline (around 60 to
80 seconds). PT and INR are used to monitor oral warfarin therapy. A platelet count
below 100,000/mm³ is abnormal and indicates a potential complication known as
heparin-induced thrombocytopenia (HIT), rather than a therapeutic target.
Question 4
A nurse is assessing a client who has a chest tube connected to a water-seal
drainage system. The nurse notes continuous bubbling in the water-seal chamber.
Which of the following interpretations should the nurse make?
A) There is an air leak in the system.
B) The lung has fully re-expanded.
C) The suction pressure is set too high.
D) This is a normal and expected finding.
Rationale: Continuous bubbling in the water-seal chamber signifies that air is leaking
into the drainage system, either from the client's chest or a loose connection in the
tubing. Intermittent bubbling is normal during exhalation or coughing when an air
leak is resolving. Continuous bubbling is never expected and requires systematic
checking of the system to locate the leak.
Question 5
A nurse is assigning tasks to an assistive personnel (AP). Which of the following
tasks is appropriate for the nurse to delegate to the AP?
A) Feeding a client who has dysphagia following a recent stroke
B) Administering a tap-water enema to a stable client
C) Teaching a client how to use an incentive spirometer
D) Assessing the pain level of a postoperative client
,Rationale: Administering a routine enema to a stable client is a standardized
procedural task that fits within the scope of practice for an AP. Feeding a client with
dysphagia, teaching a client, and assessing pain all require specialized nursing
judgment, clinical evaluation, or skill, making them inappropriate for delegation to an
AP.
Question 6
A nurse is caring for a client who is in the oliguric phase of acute kidney injury (AKI).
Which of the following electrolyte imbalances should the nurse expect?
A) Hypokalemia
B) Hyperkalemia
C) Hypercalcemia
D) Hyponatremia due to severe dehydration
Rationale: During the oliguric phase of AKI, the kidneys are unable to effectively
excrete potassium, leading to potassium retention and hyperkalemia. Hyperkalemia
is a critical complication because it can induce severe cardiac dysrhythmias.
Potassium restriction and monitoring are vital interventions during this phase.
Question 7
A nurse is preparing a sterile field for a dressing change. Which of the following
actions by the nurse violates sterile technique?
A) Opening the first flap of the sterile kit away from the body
B) Keeping sterile gloved hands above the level of the waist
C) Reaching over the sterile field to pick up a dressing component
D) Maintaining a 1-inch border around the edge of the sterile field
Rationale: Reaching over a sterile field introduces microorganisms from the nurse's
arms or clothing onto the sterile surfaces, contaminating the field. All sterile
movements must avoid crossing over the field. Opening flaps away from the body,
keeping hands above the waist, and acknowledging the 1-inch unsterile border are
all proper aseptic actions.
Question 8
A nurse is evaluating a client who is taking digoxin 0.25 mg daily. Which of the
following clinical manifestations should alert the nurse to potential digoxin toxicity?
A) Anorexia, nausea, and blurred yellow vision
B) Intermittent claudication and muscle cramping
C) Tachycardia and a blood pressure of 150/90 mm Hg
D) Increased urinary output and dependent edema
, Rationale: Gastrointestinal disturbances such as anorexia, nausea, and vomiting,
alongside visual disturbances like blurred or yellow-green vision (halos), are classic
early signs of digoxin toxicity. Digoxin toxicity typically causes bradycardia rather
than tachycardia, and it does not directly cause claudication or severe hypertension.
Question 9
A nurse is caring for an infant who has a prescription for digoxin. The nurse should
withhold the medication and notify the provider if the infant's apical pulse is below
which of the following thresholds?
A) 60 beats per minute
B) 70 beats per minute
C) 90 beats per minute
D) 110 beats per minute
Rationale: For an infant, digoxin should be held if the apical pulse is below 90 beats
per minute because bradycardia is a primary sign of digoxin toxicity in young
children. For older children, the cutoff is typically 70 beats per minute, and for adults,
it is 60 beats per minute.
Question 10
A nurse is admitting a client who has active pulmonary tuberculosis. Which of the
following transmission-based precautions should the nurse implement?
A) Protective environment
B) Droplet precautions
C) Contact precautions
D) Airborne precautions
Rationale: Mycobacterium tuberculosis is transmitted via small airborne particles that
can remain suspended in the air. Therefore, airborne precautions are required. This
includes placing the client in a negative-pressure airflow room and requiring health
care workers to wear an N95 respirator mask when entering.
Question 11
A nurse is assessing a client who has a major burn injury covering 40% of their body
surface area. Which of the following findings during the first 24 hours (emergent
phase) should the nurse expect?
A) Decreased hematocrit levels
B) Hyperkalemia and hyponatremia
C) Increased urinary output
D) Metabolic alkalosis
Retake Exam Study Guide Questions And
Well Graded Solutions With Rationales
Updated 2026-2027
Pass your ATI RN Comprehensive Predictor Exit Retake Exam on the first try. This premium
study guide provides verified multiple-choice questions, accurate answers, and highly detailed
clinical rationales matching current test variants. Covers high-yield NCLEX-RN content:
advanced pharmacology, adult medical-surgical nursing, maternal-newborn emergencies,
pediatric milestones, prioritization, and management strategies. Perfect for mandatory school
remediation and boosting your passing probability score.
Question 1
A nurse is preparing to administer blood to a client. Which of the following actions
should the nurse take first?
A) Check the client's vital signs.
B) Verify the blood product with another registered nurse.
C) Primary tubing should be primed with 0.9% sodium chloride.
D) Establish intravenous access with a 20-gauge needle.
Rationale: The nurse must verify the client's identity and the blood product with
another licensed nurse prior to administration to prevent a potentially fatal hemolytic
transfusion reaction. While vital signs, proper tubing priming, and large-bore IV
access are necessary components of blood transfusion protocols, verifying the
product with a second nurse is the critical final safety check before initiation.
Question 2
A nurse is caring for a client who is 2 hours postoperative following a total
thyroidectomy. Which of the following assessment findings is the priority?
A) Incisional pain rated at 6 on a scale of 0 to 10
B) Sore throat when speaking
C) Laryngeal stridor or harsh, high-pitched respirations
D) Minimal serosanguineous drainage on the dressing
Rationale: Stridor indicates an acute airway obstruction, which can be caused by
edema, laryngeal nerve damage, or a hematoma compressing the trachea following
thyroid surgery. Airway takes priority over pain management, expected mild
,postoperative throat soreness, and minor dressing drainage. This finding requires
immediate notification of the provider and preparation for emergency airway
management.
Question 3
A nurse is reviewing laboratory results for a client who is receiving a heparin infusion
for a deep vein thrombosis. Which of the following values indicates the medication is
therapeutic?
A) Prothrombin time (PT) of 22 seconds
B) Activated partial thromboplastin time (aPTT) of 70 seconds
C) International normalized ratio (INR) of 3.0
D) Platelet count of 90,000/mm³
Rationale: Heparin therapy effectiveness is monitored using the aPTT, with a
therapeutic range typically being 1.5 to 2.5 times the normal baseline (around 60 to
80 seconds). PT and INR are used to monitor oral warfarin therapy. A platelet count
below 100,000/mm³ is abnormal and indicates a potential complication known as
heparin-induced thrombocytopenia (HIT), rather than a therapeutic target.
Question 4
A nurse is assessing a client who has a chest tube connected to a water-seal
drainage system. The nurse notes continuous bubbling in the water-seal chamber.
Which of the following interpretations should the nurse make?
A) There is an air leak in the system.
B) The lung has fully re-expanded.
C) The suction pressure is set too high.
D) This is a normal and expected finding.
Rationale: Continuous bubbling in the water-seal chamber signifies that air is leaking
into the drainage system, either from the client's chest or a loose connection in the
tubing. Intermittent bubbling is normal during exhalation or coughing when an air
leak is resolving. Continuous bubbling is never expected and requires systematic
checking of the system to locate the leak.
Question 5
A nurse is assigning tasks to an assistive personnel (AP). Which of the following
tasks is appropriate for the nurse to delegate to the AP?
A) Feeding a client who has dysphagia following a recent stroke
B) Administering a tap-water enema to a stable client
C) Teaching a client how to use an incentive spirometer
D) Assessing the pain level of a postoperative client
,Rationale: Administering a routine enema to a stable client is a standardized
procedural task that fits within the scope of practice for an AP. Feeding a client with
dysphagia, teaching a client, and assessing pain all require specialized nursing
judgment, clinical evaluation, or skill, making them inappropriate for delegation to an
AP.
Question 6
A nurse is caring for a client who is in the oliguric phase of acute kidney injury (AKI).
Which of the following electrolyte imbalances should the nurse expect?
A) Hypokalemia
B) Hyperkalemia
C) Hypercalcemia
D) Hyponatremia due to severe dehydration
Rationale: During the oliguric phase of AKI, the kidneys are unable to effectively
excrete potassium, leading to potassium retention and hyperkalemia. Hyperkalemia
is a critical complication because it can induce severe cardiac dysrhythmias.
Potassium restriction and monitoring are vital interventions during this phase.
Question 7
A nurse is preparing a sterile field for a dressing change. Which of the following
actions by the nurse violates sterile technique?
A) Opening the first flap of the sterile kit away from the body
B) Keeping sterile gloved hands above the level of the waist
C) Reaching over the sterile field to pick up a dressing component
D) Maintaining a 1-inch border around the edge of the sterile field
Rationale: Reaching over a sterile field introduces microorganisms from the nurse's
arms or clothing onto the sterile surfaces, contaminating the field. All sterile
movements must avoid crossing over the field. Opening flaps away from the body,
keeping hands above the waist, and acknowledging the 1-inch unsterile border are
all proper aseptic actions.
Question 8
A nurse is evaluating a client who is taking digoxin 0.25 mg daily. Which of the
following clinical manifestations should alert the nurse to potential digoxin toxicity?
A) Anorexia, nausea, and blurred yellow vision
B) Intermittent claudication and muscle cramping
C) Tachycardia and a blood pressure of 150/90 mm Hg
D) Increased urinary output and dependent edema
, Rationale: Gastrointestinal disturbances such as anorexia, nausea, and vomiting,
alongside visual disturbances like blurred or yellow-green vision (halos), are classic
early signs of digoxin toxicity. Digoxin toxicity typically causes bradycardia rather
than tachycardia, and it does not directly cause claudication or severe hypertension.
Question 9
A nurse is caring for an infant who has a prescription for digoxin. The nurse should
withhold the medication and notify the provider if the infant's apical pulse is below
which of the following thresholds?
A) 60 beats per minute
B) 70 beats per minute
C) 90 beats per minute
D) 110 beats per minute
Rationale: For an infant, digoxin should be held if the apical pulse is below 90 beats
per minute because bradycardia is a primary sign of digoxin toxicity in young
children. For older children, the cutoff is typically 70 beats per minute, and for adults,
it is 60 beats per minute.
Question 10
A nurse is admitting a client who has active pulmonary tuberculosis. Which of the
following transmission-based precautions should the nurse implement?
A) Protective environment
B) Droplet precautions
C) Contact precautions
D) Airborne precautions
Rationale: Mycobacterium tuberculosis is transmitted via small airborne particles that
can remain suspended in the air. Therefore, airborne precautions are required. This
includes placing the client in a negative-pressure airflow room and requiring health
care workers to wear an N95 respirator mask when entering.
Question 11
A nurse is assessing a client who has a major burn injury covering 40% of their body
surface area. Which of the following findings during the first 24 hours (emergent
phase) should the nurse expect?
A) Decreased hematocrit levels
B) Hyperkalemia and hyponatremia
C) Increased urinary output
D) Metabolic alkalosis
