ATI RN Comprehensive Predictor 2026 –
Version B | Practice Exam with Verified
Answers & Detailed Rationales
1. A nurse is caring for a client who has a chest tube. The
nurse notes continuous bubbling in the water seal chamber.
What is the priority action?
• A. Increase the suction pressure.
• B. Check the tubing for an air leak.
• C. Clamp the chest tube near the insertion site.
• D. Document the finding as expected.
• Rationale: Continuous bubbling in the water seal
chamber indicates an air leak between the patient and
the drainage system. This is not expected and requires
investigation.
2. A nurse is reviewing lab results for a client receiving
digoxin. Which result should the nurse report to the
provider?
• A. Potassium 3.0 mEq/L
• B. Digoxin level 1.2 ng/mL
• C. BUN 15 mg/dL
• D. Creatinine 0.9 mg/dL
, • Rationale: Hypokalemia (low potassium) significantly
increases the risk of digoxin toxicity. Digoxin levels are
therapeutic in the 0.5–2.0 ng/mL range.
3. A nurse is preparing to administer enoxaparin to a client.
Which action is correct?
• A. Aspirate before injecting.
• B. Massage the site after injection.
• C. Administer in the abdomen, 2 inches from the
umbilicus.
• D. Administer into a muscle.
• Rationale: Enoxaparin should be administered
subcutaneously in the abdomen, avoiding the area
around the umbilicus. Aspirating or massaging can cause
bruising.
4. A client with type 1 diabetes is found unconscious and
diaphoretic. Which action is the priority?
• A. Administer 50% dextrose IV push.
• B. Check the client’s blood glucose level.
• C. Offer the client a glass of orange juice.
• D. Administer subcutaneous insulin.
• Rationale: The client is exhibiting signs of severe
hypoglycemia. In an unconscious client, IV dextrose is the
immediate intervention to restore blood glucose levels.
5. Which client should the nurse see first during shift
assessment?
, • A. A client with a cast on the lower leg reporting itching.
• B. A client with a respiratory rate of 28/min and oxygen
saturation of 88%.
• C. A client requesting pain medication for 4/10 pain.
• D. A client with a Foley catheter who has not voided in 4
hours.
• Rationale: According to ABC (Airway, Breathing,
Circulation), the client with respiratory distress is the
highest priority.
6. A nurse is teaching a client about lithium carbonate.
Which statement by the client indicates understanding?
• A. "I will restrict my salt intake."
• B. "I will maintain a consistent fluid intake."
• C. "I will take my medication on an empty stomach."
• D. "I will stop the medication if I feel dizzy."
• Rationale: Lithium levels are affected by sodium and
water balance. Consistent fluid intake is required to
prevent lithium toxicity.
7. A nurse is caring for a client with neutropenia. Which
action should be included in the plan of care?
• A. Place the client in a room with a roommate.
• B. Encourage fresh flowers in the room.
• C. Perform meticulous hand hygiene.
• D. Limit the client's protein intake.
, • Rationale: Neutropenic clients are at high risk for
infection. Strict hand hygiene is the most effective way to
prevent the spread of microorganisms.
8. Which finding is the earliest sign of increased intracranial
pressure (ICP)?
• A. Alteration in level of consciousness.
• B. Widening pulse pressure.
• C. Decerebrate posturing.
• D. Bradycardia.
• Rationale: A change in the level of consciousness (LOC) is
the most sensitive and earliest indicator of increased ICP.
9. A client is prescribed phenytoin. Which assessment is the
priority?
• A. Monitor for gingival hyperplasia.
• B. Check serum creatinine.
• C. Monitor for urinary retention.
• D. Assess for visual disturbances.
• Rationale: Gingival hyperplasia is a common adverse
effect of long-term phenytoin use, requiring diligent oral
hygiene.
10. A nurse is caring for a client with a history of heart
failure who is receiving furosemide. Which finding is the
primary concern?
• A. Blood pressure 110/70 mmHg.
Version B | Practice Exam with Verified
Answers & Detailed Rationales
1. A nurse is caring for a client who has a chest tube. The
nurse notes continuous bubbling in the water seal chamber.
What is the priority action?
• A. Increase the suction pressure.
• B. Check the tubing for an air leak.
• C. Clamp the chest tube near the insertion site.
• D. Document the finding as expected.
• Rationale: Continuous bubbling in the water seal
chamber indicates an air leak between the patient and
the drainage system. This is not expected and requires
investigation.
2. A nurse is reviewing lab results for a client receiving
digoxin. Which result should the nurse report to the
provider?
• A. Potassium 3.0 mEq/L
• B. Digoxin level 1.2 ng/mL
• C. BUN 15 mg/dL
• D. Creatinine 0.9 mg/dL
, • Rationale: Hypokalemia (low potassium) significantly
increases the risk of digoxin toxicity. Digoxin levels are
therapeutic in the 0.5–2.0 ng/mL range.
3. A nurse is preparing to administer enoxaparin to a client.
Which action is correct?
• A. Aspirate before injecting.
• B. Massage the site after injection.
• C. Administer in the abdomen, 2 inches from the
umbilicus.
• D. Administer into a muscle.
• Rationale: Enoxaparin should be administered
subcutaneously in the abdomen, avoiding the area
around the umbilicus. Aspirating or massaging can cause
bruising.
4. A client with type 1 diabetes is found unconscious and
diaphoretic. Which action is the priority?
• A. Administer 50% dextrose IV push.
• B. Check the client’s blood glucose level.
• C. Offer the client a glass of orange juice.
• D. Administer subcutaneous insulin.
• Rationale: The client is exhibiting signs of severe
hypoglycemia. In an unconscious client, IV dextrose is the
immediate intervention to restore blood glucose levels.
5. Which client should the nurse see first during shift
assessment?
, • A. A client with a cast on the lower leg reporting itching.
• B. A client with a respiratory rate of 28/min and oxygen
saturation of 88%.
• C. A client requesting pain medication for 4/10 pain.
• D. A client with a Foley catheter who has not voided in 4
hours.
• Rationale: According to ABC (Airway, Breathing,
Circulation), the client with respiratory distress is the
highest priority.
6. A nurse is teaching a client about lithium carbonate.
Which statement by the client indicates understanding?
• A. "I will restrict my salt intake."
• B. "I will maintain a consistent fluid intake."
• C. "I will take my medication on an empty stomach."
• D. "I will stop the medication if I feel dizzy."
• Rationale: Lithium levels are affected by sodium and
water balance. Consistent fluid intake is required to
prevent lithium toxicity.
7. A nurse is caring for a client with neutropenia. Which
action should be included in the plan of care?
• A. Place the client in a room with a roommate.
• B. Encourage fresh flowers in the room.
• C. Perform meticulous hand hygiene.
• D. Limit the client's protein intake.
, • Rationale: Neutropenic clients are at high risk for
infection. Strict hand hygiene is the most effective way to
prevent the spread of microorganisms.
8. Which finding is the earliest sign of increased intracranial
pressure (ICP)?
• A. Alteration in level of consciousness.
• B. Widening pulse pressure.
• C. Decerebrate posturing.
• D. Bradycardia.
• Rationale: A change in the level of consciousness (LOC) is
the most sensitive and earliest indicator of increased ICP.
9. A client is prescribed phenytoin. Which assessment is the
priority?
• A. Monitor for gingival hyperplasia.
• B. Check serum creatinine.
• C. Monitor for urinary retention.
• D. Assess for visual disturbances.
• Rationale: Gingival hyperplasia is a common adverse
effect of long-term phenytoin use, requiring diligent oral
hygiene.
10. A nurse is caring for a client with a history of heart
failure who is receiving furosemide. Which finding is the
primary concern?
• A. Blood pressure 110/70 mmHg.
