Fall Semester 2026–2027 ATI Comprehensive Predictor Updated 2026 | 190+
Questions and Answers | ATI RN Comprehensive Predictor Exam Prep, Practice
Test, Comprehensive Study Guide, Nursing Test Bank, Medical-Surgical Nursing,
Pharmacology, Fundamentals of Nursing, Maternal-Newborn Nursing, Pediatric
Nursing, Mental Health Nursing, Leadership and Management, Clinical Judgment,
NCLEX Preparation, Detailed Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who has a new prescription for enalapril.
Which of the following adverse effects should the nurse instruct the client to report
immediately?
A. Dry cough
B. Dizziness
C. Angioedema
D. Hypotension
CORRECT ANSWER: C. Angioedema
Rationale: Angioedema (swelling of the face, lips, tongue, or throat) is a life-threatening
adverse effect of ACE inhibitors like enalapril and requires immediate medical
attention. While dry cough, dizziness, and hypotension are also adverse effects, they
are not immediately life-threatening.
Question 2: A nurse is preparing to administer a blood transfusion to a client.
Which of the following actions should the nurse take first?
A. Obtain the client's vital signs.
B. Verify the client's identity using two identifiers.
C. Prime the IV tubing with 0.9% sodium chloride.
D. Check the expiration date on the blood unit.
CORRECT ANSWER: B. Verify the client's identity using two identifiers
Rationale: The priority action is to verify the client's identity using two identifiers (e.g.,
name and date of birth) to ensure the correct blood is given to the correct client,
preventing a life-threatening hemolytic reaction. This is a safety priority.
Question 3: A client with a history of heart failure is prescribed metoprolol. Which
assessment finding would indicate the medication is achieving its intended
therapeutic effect?
A. Decreased blood pressure
B. Improved ejection fraction
C. Increased heart rate
D. Reduced peripheral edema
CORRECT ANSWER: B. Improved ejection fraction
Rationale: Metoprolol is a beta-blocker used in heart failure to reduce cardiac workload
and improve cardiac function over time, which is best measured by an improved
ejection fraction. Decreased blood pressure and reduced edema are beneficial effects
but are not the primary indicator of long-term therapeutic success.
Question 4: A nurse is assessing a client for signs of hypoglycemia. Which of the
following manifestations is an early indicator?
A. Polyuria
,B. Kussmaul respirations
C. Diaphoresis
D. Fruity breath odor
CORRECT ANSWER: C. Diaphoresis
Rationale: Diaphoresis (sweating) is an early autonomic manifestation of hypoglycemia
due to the release of epinephrine. Polyuria, Kussmaul respirations, and fruity breath are
signs of hyperglycemia or diabetic ketoacidosis.
Question 5: During a sterile dressing change, the nurse drops the sterile gauze onto
the client's bed. What is the appropriate action?
A. Pick up the gauze and use it immediately.
B. Discard the gauze and obtain a new sterile one.
C. Use sterile forceps to retrieve the gauze.
D. Turn the gauze over and use the unexposed side.
CORRECT ANSWER: B. Discard the gauze and obtain a new sterile one
Rationale: Any sterile item that touches a non-sterile surface is considered
contaminated and must be discarded. The bed is not a sterile field.
Question 6: A nurse is providing discharge teaching to a client with a new
colostomy. Which statement by the client indicates a need for further teaching?
A. "I should avoid foods like popcorn and nuts."
B. "I need to irrigate the colostomy daily to ensure regular bowel movements."
C. "I should change the ostomy pouch if it is leaking."
D. "My stoma should remain pink and moist."
CORRECT ANSWER: B. "I need to irrigate the colostomy daily to ensure regular
bowel movements."
Rationale: Not all colostomies require irrigation; this depends on the type of ostomy
and the client's bowel pattern. Routine irrigation is not standard for all colostomy
clients and is often only done for specific descending/sigmoid colostomies. The other
statements are correct.
Question 7: A nurse is calculating the intake and output for a client over an 8-hour
shift. The client received 1000 mL of IV fluid, drank 240 mL of water, and ate 120 mL
of ice chips. The client's urinary output was 900 mL. What is the total intake?
A. 1240 mL
B. 1360 mL
C. 1120 mL
D. 1480 mL
CORRECT ANSWER: B. 1360 mL
Rationale: Total intake includes IV fluids (1000 mL), oral water (240 mL), and ice chips
(120 mL, measured as half the volume of ice chips, which is 120 mL). 1000 + 240 + 120 =
1360 mL.
Question 8: A client who is postoperative day 1 following a total hip arthroplasty
reports sudden chest pain and shortness of breath. Which of the following is the
priority nursing action?
,A. Administer oxygen at 2 L/min via nasal cannula.
B. Notify the healthcare provider.
C. Assess the client's surgical incision.
D. Elevate the head of the bed.
CORRECT ANSWER: A. Administer oxygen at 2 L/min via nasal cannula
Rationale: The client is at risk for a pulmonary embolism. While all actions are
necessary, the immediate priority is to administer oxygen to address hypoxemia,
followed by notifying the provider.
Question 9: A nurse is preparing to administer an enteral feeding via a nasogastric
tube. Which of the following actions should be taken prior to the feeding?
A. Flush the tube with 50 mL of air.
B. Verify tube placement by measuring the pH of gastric aspirate.
C. Place the client in a supine position.
D. Administer a full dose of the client's daily medications.
CORRECT ANSWER: B. Verify tube placement by measuring the pH of gastric
aspirate
Rationale: Verifying tube placement by checking the pH of gastric aspirate (should be
0-4) is essential before each intermittent feeding to prevent aspiration. The client should
be in semi-Fowler's position.
Question 10: A client is prescribed warfarin. Which laboratory value is most critical
for the nurse to monitor?
A. Platelet count
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Hemoglobin
CORRECT ANSWER: B. International Normalized Ratio (INR)
Rationale: The INR is the standard test used to monitor the therapeutic effect of
warfarin, which is an anticoagulant. The target INR varies but is typically 2.0 to 3.0 for
most indications.
Question 11: A nurse is caring for a client who has a prescription for furosemide.
Which of the following assessment findings indicates that the medication is having
the desired effect?
A. Decreased urinary output
B. Increased blood pressure
C. Decreased weight
D. Increased pedal edema
CORRECT ANSWER: C. Decreased weight
Rationale: Furosemide is a loop diuretic used to manage fluid overload. The desired
effect is diuresis and fluid loss, which is best indicated by a decrease in daily weight.
Edema should also decrease, not increase.
Question 12: A client is admitted with a diagnosis of major depressive disorder.
Which of the following findings would the nurse expect to see?
, A. Grandiose delusions
B. Pressured speech
C. Anhedonia
D. Psychomotor agitation
CORRECT ANSWER: C. Anhedonia
Rationale: Anhedonia, the loss of interest or pleasure in activities previously enjoyed, is
a hallmark symptom of major depressive disorder. Grandiose delusions and pressured
speech are more consistent with bipolar disorder.
Question 13: During a physical assessment, a nurse auscultates a client's lungs
and hears coarse, low-pitched sounds that are cleared with coughing. This is best
described as:
A. Wheezes
B. Fine crackles
C. Rhonchi
D. Stridor
CORRECT ANSWER: C. Rhonchi
Rationale: Rhonchi are coarse, low-pitched, sonorous sounds that often clear with
coughing and are associated with secretions in the large airways. They are distinct from
high-pitched wheezes and fine crackles.
Question 14: A nurse is performing a cardiovascular assessment. The S1 heart
sound is best heard at which location?
A. Second intercostal space, right sternal border
B. Fifth intercostal space, left midclavicular line
C. Second intercostal space, left sternal border
D. Fourth intercostal space, left sternal border
CORRECT ANSWER: B. Fifth intercostal space, left midclavicular line
Rationale: S1 ("lub") is produced by the closure of the mitral and tricuspid valves and is
best heard at the apex of the heart, which is at the fifth intercostal space at the
midclavicular line.
Question 15: A client with a nasogastric tube to suction has a serum potassium
level of 3.0 mEq/L. Which of the following acid-base imbalances is this client at risk
for?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
CORRECT ANSWER: B. Metabolic alkalosis
Rationale: Loss of gastric acid through nasogastric suctioning leads to a loss of
hydrogen and chloride ions, causing a metabolic alkalosis. This is often accompanied
by hypokalemia.
Question 16: A nurse is preparing a client for a paracentesis. Which of the following
actions should be taken to prepare the client?
Questions and Answers | ATI RN Comprehensive Predictor Exam Prep, Practice
Test, Comprehensive Study Guide, Nursing Test Bank, Medical-Surgical Nursing,
Pharmacology, Fundamentals of Nursing, Maternal-Newborn Nursing, Pediatric
Nursing, Mental Health Nursing, Leadership and Management, Clinical Judgment,
NCLEX Preparation, Detailed Rationales and Complete Revision Material
Question 1: A nurse is caring for a client who has a new prescription for enalapril.
Which of the following adverse effects should the nurse instruct the client to report
immediately?
A. Dry cough
B. Dizziness
C. Angioedema
D. Hypotension
CORRECT ANSWER: C. Angioedema
Rationale: Angioedema (swelling of the face, lips, tongue, or throat) is a life-threatening
adverse effect of ACE inhibitors like enalapril and requires immediate medical
attention. While dry cough, dizziness, and hypotension are also adverse effects, they
are not immediately life-threatening.
Question 2: A nurse is preparing to administer a blood transfusion to a client.
Which of the following actions should the nurse take first?
A. Obtain the client's vital signs.
B. Verify the client's identity using two identifiers.
C. Prime the IV tubing with 0.9% sodium chloride.
D. Check the expiration date on the blood unit.
CORRECT ANSWER: B. Verify the client's identity using two identifiers
Rationale: The priority action is to verify the client's identity using two identifiers (e.g.,
name and date of birth) to ensure the correct blood is given to the correct client,
preventing a life-threatening hemolytic reaction. This is a safety priority.
Question 3: A client with a history of heart failure is prescribed metoprolol. Which
assessment finding would indicate the medication is achieving its intended
therapeutic effect?
A. Decreased blood pressure
B. Improved ejection fraction
C. Increased heart rate
D. Reduced peripheral edema
CORRECT ANSWER: B. Improved ejection fraction
Rationale: Metoprolol is a beta-blocker used in heart failure to reduce cardiac workload
and improve cardiac function over time, which is best measured by an improved
ejection fraction. Decreased blood pressure and reduced edema are beneficial effects
but are not the primary indicator of long-term therapeutic success.
Question 4: A nurse is assessing a client for signs of hypoglycemia. Which of the
following manifestations is an early indicator?
A. Polyuria
,B. Kussmaul respirations
C. Diaphoresis
D. Fruity breath odor
CORRECT ANSWER: C. Diaphoresis
Rationale: Diaphoresis (sweating) is an early autonomic manifestation of hypoglycemia
due to the release of epinephrine. Polyuria, Kussmaul respirations, and fruity breath are
signs of hyperglycemia or diabetic ketoacidosis.
Question 5: During a sterile dressing change, the nurse drops the sterile gauze onto
the client's bed. What is the appropriate action?
A. Pick up the gauze and use it immediately.
B. Discard the gauze and obtain a new sterile one.
C. Use sterile forceps to retrieve the gauze.
D. Turn the gauze over and use the unexposed side.
CORRECT ANSWER: B. Discard the gauze and obtain a new sterile one
Rationale: Any sterile item that touches a non-sterile surface is considered
contaminated and must be discarded. The bed is not a sterile field.
Question 6: A nurse is providing discharge teaching to a client with a new
colostomy. Which statement by the client indicates a need for further teaching?
A. "I should avoid foods like popcorn and nuts."
B. "I need to irrigate the colostomy daily to ensure regular bowel movements."
C. "I should change the ostomy pouch if it is leaking."
D. "My stoma should remain pink and moist."
CORRECT ANSWER: B. "I need to irrigate the colostomy daily to ensure regular
bowel movements."
Rationale: Not all colostomies require irrigation; this depends on the type of ostomy
and the client's bowel pattern. Routine irrigation is not standard for all colostomy
clients and is often only done for specific descending/sigmoid colostomies. The other
statements are correct.
Question 7: A nurse is calculating the intake and output for a client over an 8-hour
shift. The client received 1000 mL of IV fluid, drank 240 mL of water, and ate 120 mL
of ice chips. The client's urinary output was 900 mL. What is the total intake?
A. 1240 mL
B. 1360 mL
C. 1120 mL
D. 1480 mL
CORRECT ANSWER: B. 1360 mL
Rationale: Total intake includes IV fluids (1000 mL), oral water (240 mL), and ice chips
(120 mL, measured as half the volume of ice chips, which is 120 mL). 1000 + 240 + 120 =
1360 mL.
Question 8: A client who is postoperative day 1 following a total hip arthroplasty
reports sudden chest pain and shortness of breath. Which of the following is the
priority nursing action?
,A. Administer oxygen at 2 L/min via nasal cannula.
B. Notify the healthcare provider.
C. Assess the client's surgical incision.
D. Elevate the head of the bed.
CORRECT ANSWER: A. Administer oxygen at 2 L/min via nasal cannula
Rationale: The client is at risk for a pulmonary embolism. While all actions are
necessary, the immediate priority is to administer oxygen to address hypoxemia,
followed by notifying the provider.
Question 9: A nurse is preparing to administer an enteral feeding via a nasogastric
tube. Which of the following actions should be taken prior to the feeding?
A. Flush the tube with 50 mL of air.
B. Verify tube placement by measuring the pH of gastric aspirate.
C. Place the client in a supine position.
D. Administer a full dose of the client's daily medications.
CORRECT ANSWER: B. Verify tube placement by measuring the pH of gastric
aspirate
Rationale: Verifying tube placement by checking the pH of gastric aspirate (should be
0-4) is essential before each intermittent feeding to prevent aspiration. The client should
be in semi-Fowler's position.
Question 10: A client is prescribed warfarin. Which laboratory value is most critical
for the nurse to monitor?
A. Platelet count
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Hemoglobin
CORRECT ANSWER: B. International Normalized Ratio (INR)
Rationale: The INR is the standard test used to monitor the therapeutic effect of
warfarin, which is an anticoagulant. The target INR varies but is typically 2.0 to 3.0 for
most indications.
Question 11: A nurse is caring for a client who has a prescription for furosemide.
Which of the following assessment findings indicates that the medication is having
the desired effect?
A. Decreased urinary output
B. Increased blood pressure
C. Decreased weight
D. Increased pedal edema
CORRECT ANSWER: C. Decreased weight
Rationale: Furosemide is a loop diuretic used to manage fluid overload. The desired
effect is diuresis and fluid loss, which is best indicated by a decrease in daily weight.
Edema should also decrease, not increase.
Question 12: A client is admitted with a diagnosis of major depressive disorder.
Which of the following findings would the nurse expect to see?
, A. Grandiose delusions
B. Pressured speech
C. Anhedonia
D. Psychomotor agitation
CORRECT ANSWER: C. Anhedonia
Rationale: Anhedonia, the loss of interest or pleasure in activities previously enjoyed, is
a hallmark symptom of major depressive disorder. Grandiose delusions and pressured
speech are more consistent with bipolar disorder.
Question 13: During a physical assessment, a nurse auscultates a client's lungs
and hears coarse, low-pitched sounds that are cleared with coughing. This is best
described as:
A. Wheezes
B. Fine crackles
C. Rhonchi
D. Stridor
CORRECT ANSWER: C. Rhonchi
Rationale: Rhonchi are coarse, low-pitched, sonorous sounds that often clear with
coughing and are associated with secretions in the large airways. They are distinct from
high-pitched wheezes and fine crackles.
Question 14: A nurse is performing a cardiovascular assessment. The S1 heart
sound is best heard at which location?
A. Second intercostal space, right sternal border
B. Fifth intercostal space, left midclavicular line
C. Second intercostal space, left sternal border
D. Fourth intercostal space, left sternal border
CORRECT ANSWER: B. Fifth intercostal space, left midclavicular line
Rationale: S1 ("lub") is produced by the closure of the mitral and tricuspid valves and is
best heard at the apex of the heart, which is at the fifth intercostal space at the
midclavicular line.
Question 15: A client with a nasogastric tube to suction has a serum potassium
level of 3.0 mEq/L. Which of the following acid-base imbalances is this client at risk
for?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
CORRECT ANSWER: B. Metabolic alkalosis
Rationale: Loss of gastric acid through nasogastric suctioning leads to a loss of
hydrogen and chloride ions, causing a metabolic alkalosis. This is often accompanied
by hypokalemia.
Question 16: A nurse is preparing a client for a paracentesis. Which of the following
actions should be taken to prepare the client?
