Fall Semester 2026–2027 ATI Comprehensive Predictor Updated 2026 |
190+ Questions and Answers | ATI RN Comprehensive Predictor Study
Guide, Practice Exam, Comprehensive Review, Exam Prep Test Bank,
Medical-Surgical Nursing, Pharmacology, Fundamentals of Nursing,
Maternal-Newborn Nursing, Pediatric Nursing, Mental Health Nursing,
Leadership and Management, Clinical Judgment, Prioritization and
Delegation, NCLEX Readiness, Detailed Rationales and Complete Revision
Material
Question 1: A client who is 24 hours post-operative following an abdominal
hysterectomy reports severe pain in the right calf. Which of the following actions
should the nurse take first?
A. Administer the prescribed PRN analgesic.
B. Apply a warm compress to the affected area.
C. Measure the circumference of the affected calf.
D. Instruct the client to perform ankle pumps.
CORRECT ANSWER: C. Measure the circumference of the affected calf.
Rationale: The client's symptoms suggest a possible deep vein thrombosis (DVT). While
all options may be part of the assessment or management, the nurse's first action
should be to measure the calf circumference to obtain an objective baseline
measurement for comparison. This data is crucial for monitoring the progression of
edema. The nurse should then notify the provider; applying heat or massage is
contraindicated if a DVT is suspected.
Question 2: A nurse is providing teaching to a client who has a new prescription for
digoxin. Which of the following statements by the client indicates an understanding
of the teaching?
A. "I will take my pulse for 30 seconds and multiply it by 2 before taking my medication."
B. "I can stop taking this medication if my heart rate is below 60."
C. "I should expect my vision to be slightly blurred."
D. "I will take an antacid with my digoxin if I experience heartburn."
CORRECT ANSWER: A. "I will take my pulse for 30 seconds and multiply it by 2
before taking my medication."
Rationale: Digoxin has a narrow therapeutic range. Clients should be taught to take
their apical pulse for a full minute before administration due to the risk of bradycardia.
However, taking it for 30 seconds and multiplying by 2 is the standard method if a full
minute is not feasible. A heart rate below 60 is a contraindication for administration, not
a reason to stop the medication independently. Blurred vision is a sign of toxicity, not a
side effect to expect. Antacids can decrease digoxin absorption and should be taken at
least 2 hours apart.
Question 3: A nurse is caring for a client with a chest tube connected to a closed-
chest drainage system. Which of the following findings requires immediate
intervention?
A. Continuous bubbling in the suction control chamber.
,B. Constant, vigorous bubbling in the water seal chamber.
C. Fluctuation of fluid in the water seal chamber with respirations.
D. A drainage output of 50 mL over the past 4 hours.
CORRECT ANSWER: B. Constant, vigorous bubbling in the water seal chamber.
Rationale: Constant, vigorous bubbling in the water seal chamber indicates an air leak
in the system, which requires immediate intervention to prevent the collapse of the lung
re-expansion. Continuous bubbling in the suction control chamber is an expected
finding. Fluctuation (tidaling) in the water seal chamber is a normal sign that the chest
tube is patent. A drainage output of 50 mL over 4 hours is within an expected range.
Question 4: A nurse is preparing to administer a blood transfusion of packed red
blood cells to a client. Which of the following IV solutions should the nurse prime
the blood administration set with?
A. Lactated Ringer's solution
B. 0.9% Sodium Chloride
C. 5% Dextrose in Water (D5W)
D. 0.45% Sodium Chloride
CORRECT ANSWER: B. 0.9% Sodium Chloride
Rationale: Normal saline (0.9% Sodium Chloride) is the only compatible IV solution for
priming the tubing and for concurrent infusion with blood products. Lactated Ringer's
and D5W contain calcium and dextrose, respectively, which can cause hemolysis or
clotting of the red blood cells. Hypotonic solutions (0.45% Sodium Chloride) can cause
lysis of the red blood cells.
Question 5: A nurse is assessing a client who is receiving a continuous morphine
infusion via a patient-controlled analgesia (PCA) pump. Which of the following
findings indicates a potential adverse effect of the medication?
A. A respiratory rate of 22 breaths per minute.
B. The client reports pain as a 3 on a 0-10 scale.
C. The client's oxygen saturation is 88%.
D. The client's heart rate is 80 beats per minute.
CORRECT ANSWER: C. The client's oxygen saturation is 88%.
Rationale: Morphine is a potent opioid analgesic that can cause respiratory depression.
An oxygen saturation of 88% indicates hypoxemia and is a sign of inadequate
oxygenation, which can be a direct result of opioid-induced respiratory depression. The
nurse should intervene immediately. A respiratory rate of 22 is within the normal range.
A pain level of 3 indicates effective analgesia. A heart rate of 80 is within normal limits.
Question 6: A nurse is providing discharge teaching to a client who has a new
colostomy. Which of the following dietary instructions should the nurse include?
A. "Increase your intake of carbonated beverages to help with odor control."
B. "Avoid foods like bananas and rice to prevent blockage."
C. "Chew your food thoroughly and eat slowly."
D. "Eat large meals to ensure adequate nutrition."
CORRECT ANSWER: C. "Chew your food thoroughly and eat slowly."
,Rationale: Chewing food thoroughly and eating slowly helps to break down food
particles, reducing the risk of a blockage in the colostomy. Carbonated beverages
increase gas. Bananas and rice are often recommended to help thicken stool. Eating
smaller, more frequent meals is generally preferred over large meals to manage output
and gas.
Question 7: A nurse is caring for a client in the immediate post-operative period
following a thyroidectomy. The nurse should place the client in which of the
following positions?
A. High-Fowler's position with the head in a neutral position.
B. Supine position with the head of the bed flat.
C. Semi-Fowler's position with the head and neck supported and slightly flexed.
D. Prone position to facilitate drainage.
CORRECT ANSWER: A. High-Fowler's position with the head in a neutral position.
Rationale: High-Fowler's position (head of bed elevated 45-90 degrees) promotes
venous drainage from the head and neck, reducing edema and the risk of hemorrhage.
The client's head should be in a neutral position to avoid hyperextension or excessive
flexion of the neck, which could put tension on the suture line. A semi-Fowler's position
with a flexed neck could place tension on the incision site.
Question 8: A nurse is performing a neurological assessment on a client who is
post-stroke. Which of the following findings is most indicative of damage to the
right hemisphere of the brain?
A. Aphasia
B. Inability to recognize familiar objects (agnosia)
C. Neglect of the left side of the body
D. Slow, cautious behavior
CORRECT ANSWER: C. Neglect of the left side of the body
Rationale: The right hemisphere of the brain is responsible for visuospatial awareness.
Damage to this area often results in left-sided neglect, where the client is unaware of or
ignores stimuli on the left side of their body and environment. Aphasia is associated
with left-hemisphere damage. Agnosia can occur with damage to the parietal lobe,
often on the right, but left-sided neglect is a more classic and specific hallmark of right
hemisphere stroke. Impulsive (rather than slow) behavior is more common with right
hemisphere damage.
Question 9: A nurse is educating a client with a new diagnosis of diabetes mellitus
type 2 about foot care. Which of the following instructions is a priority?
A. Apply lotion between the toes to prevent dryness.
B. Soak feet in warm water daily for 20 minutes.
C. Use a heating pad on the feet if they feel cold.
D. Wear well-fitting, closed-toe shoes at all times.
CORRECT ANSWER: D. Wear well-fitting, closed-toe shoes at all times.
Rationale: Wearing well-fitting, closed-toe shoes is the highest priority foot care
instruction to prevent injury and ulceration. Diabetic clients often have peripheral
, neuropathy and decreased sensation, making them at high risk for foot trauma. Lotion
should not be applied between the toes as it can lead to maceration and fungal
infections. Feet should be washed daily but not soaked. Heating pads should be
avoided due to the risk of burns from decreased sensation.
Question 10: A client has a prescription for a 24-hour urine collection. Which of the
following actions should the nurse take to ensure accurate results?
A. Discard the first voiding of the collection period and note the time.
B. Save all urine, including the first voiding of the collection period.
C. Instruct the client to increase fluid intake to 3L during the collection.
D. Keep the urine specimen at room temperature for the duration.
CORRECT ANSWER: A. Discard the first voiding of the collection period and note
the time.
Rationale: For a 24-hour urine collection, the collection begins after the client voids
and discards the first specimen. This marks the start time. All subsequent urine for the
next 24 hours is collected, including the final voiding at the end of the 24-hour period.
The specimen should be kept refrigerated or on ice unless otherwise specified. Fluid
intake is not altered to maintain test accuracy, unless specifically instructed by the
provider.
Question 11: A nurse is administering an enteral feeding via a nasogastric tube.
Which of the following actions should the nurse take prior to initiating the feeding?
A. Flush the tube with 50 mL of cold water.
B. Verify tube placement by auscultating for air insufflated over the stomach.
C. Place the client in a supine position.
D. Check for residual gastric volume and flush with 30 mL of warm water.
CORRECT ANSWER: D. Check for residual gastric volume and flush with 30 mL of
warm water.
Rationale: Prior to feeding, the nurse should check the residual volume to assess
gastric emptying and reduce the risk of aspiration. The tube should also be flushed with
30 mL of warm (not cold) water to clear the tube and verify patency. The most reliable
method to verify placement is an x-ray, but auscultation is a less reliable method and is
not recommended as the sole confirmation method. The client should be placed in a
semi-Fowler's (not supine) position to prevent aspiration.
Question 12: A nurse is reviewing the arterial blood gas (ABG) results for a client.
The results are: pH 7.31, PaCO2 50 mm Hg, and HCO3- 24 mEq/L. The nurse should
interpret these findings as indicating which of the following acid-base imbalances?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
CORRECT ANSWER: C. Respiratory acidosis
Rationale: A pH of 7.31 indicates acidemia. The PaCO2 is elevated at 50 mm Hg,
indicating respiratory involvement (carbon dioxide retention). The HCO3- is normal at 24
190+ Questions and Answers | ATI RN Comprehensive Predictor Study
Guide, Practice Exam, Comprehensive Review, Exam Prep Test Bank,
Medical-Surgical Nursing, Pharmacology, Fundamentals of Nursing,
Maternal-Newborn Nursing, Pediatric Nursing, Mental Health Nursing,
Leadership and Management, Clinical Judgment, Prioritization and
Delegation, NCLEX Readiness, Detailed Rationales and Complete Revision
Material
Question 1: A client who is 24 hours post-operative following an abdominal
hysterectomy reports severe pain in the right calf. Which of the following actions
should the nurse take first?
A. Administer the prescribed PRN analgesic.
B. Apply a warm compress to the affected area.
C. Measure the circumference of the affected calf.
D. Instruct the client to perform ankle pumps.
CORRECT ANSWER: C. Measure the circumference of the affected calf.
Rationale: The client's symptoms suggest a possible deep vein thrombosis (DVT). While
all options may be part of the assessment or management, the nurse's first action
should be to measure the calf circumference to obtain an objective baseline
measurement for comparison. This data is crucial for monitoring the progression of
edema. The nurse should then notify the provider; applying heat or massage is
contraindicated if a DVT is suspected.
Question 2: A nurse is providing teaching to a client who has a new prescription for
digoxin. Which of the following statements by the client indicates an understanding
of the teaching?
A. "I will take my pulse for 30 seconds and multiply it by 2 before taking my medication."
B. "I can stop taking this medication if my heart rate is below 60."
C. "I should expect my vision to be slightly blurred."
D. "I will take an antacid with my digoxin if I experience heartburn."
CORRECT ANSWER: A. "I will take my pulse for 30 seconds and multiply it by 2
before taking my medication."
Rationale: Digoxin has a narrow therapeutic range. Clients should be taught to take
their apical pulse for a full minute before administration due to the risk of bradycardia.
However, taking it for 30 seconds and multiplying by 2 is the standard method if a full
minute is not feasible. A heart rate below 60 is a contraindication for administration, not
a reason to stop the medication independently. Blurred vision is a sign of toxicity, not a
side effect to expect. Antacids can decrease digoxin absorption and should be taken at
least 2 hours apart.
Question 3: A nurse is caring for a client with a chest tube connected to a closed-
chest drainage system. Which of the following findings requires immediate
intervention?
A. Continuous bubbling in the suction control chamber.
,B. Constant, vigorous bubbling in the water seal chamber.
C. Fluctuation of fluid in the water seal chamber with respirations.
D. A drainage output of 50 mL over the past 4 hours.
CORRECT ANSWER: B. Constant, vigorous bubbling in the water seal chamber.
Rationale: Constant, vigorous bubbling in the water seal chamber indicates an air leak
in the system, which requires immediate intervention to prevent the collapse of the lung
re-expansion. Continuous bubbling in the suction control chamber is an expected
finding. Fluctuation (tidaling) in the water seal chamber is a normal sign that the chest
tube is patent. A drainage output of 50 mL over 4 hours is within an expected range.
Question 4: A nurse is preparing to administer a blood transfusion of packed red
blood cells to a client. Which of the following IV solutions should the nurse prime
the blood administration set with?
A. Lactated Ringer's solution
B. 0.9% Sodium Chloride
C. 5% Dextrose in Water (D5W)
D. 0.45% Sodium Chloride
CORRECT ANSWER: B. 0.9% Sodium Chloride
Rationale: Normal saline (0.9% Sodium Chloride) is the only compatible IV solution for
priming the tubing and for concurrent infusion with blood products. Lactated Ringer's
and D5W contain calcium and dextrose, respectively, which can cause hemolysis or
clotting of the red blood cells. Hypotonic solutions (0.45% Sodium Chloride) can cause
lysis of the red blood cells.
Question 5: A nurse is assessing a client who is receiving a continuous morphine
infusion via a patient-controlled analgesia (PCA) pump. Which of the following
findings indicates a potential adverse effect of the medication?
A. A respiratory rate of 22 breaths per minute.
B. The client reports pain as a 3 on a 0-10 scale.
C. The client's oxygen saturation is 88%.
D. The client's heart rate is 80 beats per minute.
CORRECT ANSWER: C. The client's oxygen saturation is 88%.
Rationale: Morphine is a potent opioid analgesic that can cause respiratory depression.
An oxygen saturation of 88% indicates hypoxemia and is a sign of inadequate
oxygenation, which can be a direct result of opioid-induced respiratory depression. The
nurse should intervene immediately. A respiratory rate of 22 is within the normal range.
A pain level of 3 indicates effective analgesia. A heart rate of 80 is within normal limits.
Question 6: A nurse is providing discharge teaching to a client who has a new
colostomy. Which of the following dietary instructions should the nurse include?
A. "Increase your intake of carbonated beverages to help with odor control."
B. "Avoid foods like bananas and rice to prevent blockage."
C. "Chew your food thoroughly and eat slowly."
D. "Eat large meals to ensure adequate nutrition."
CORRECT ANSWER: C. "Chew your food thoroughly and eat slowly."
,Rationale: Chewing food thoroughly and eating slowly helps to break down food
particles, reducing the risk of a blockage in the colostomy. Carbonated beverages
increase gas. Bananas and rice are often recommended to help thicken stool. Eating
smaller, more frequent meals is generally preferred over large meals to manage output
and gas.
Question 7: A nurse is caring for a client in the immediate post-operative period
following a thyroidectomy. The nurse should place the client in which of the
following positions?
A. High-Fowler's position with the head in a neutral position.
B. Supine position with the head of the bed flat.
C. Semi-Fowler's position with the head and neck supported and slightly flexed.
D. Prone position to facilitate drainage.
CORRECT ANSWER: A. High-Fowler's position with the head in a neutral position.
Rationale: High-Fowler's position (head of bed elevated 45-90 degrees) promotes
venous drainage from the head and neck, reducing edema and the risk of hemorrhage.
The client's head should be in a neutral position to avoid hyperextension or excessive
flexion of the neck, which could put tension on the suture line. A semi-Fowler's position
with a flexed neck could place tension on the incision site.
Question 8: A nurse is performing a neurological assessment on a client who is
post-stroke. Which of the following findings is most indicative of damage to the
right hemisphere of the brain?
A. Aphasia
B. Inability to recognize familiar objects (agnosia)
C. Neglect of the left side of the body
D. Slow, cautious behavior
CORRECT ANSWER: C. Neglect of the left side of the body
Rationale: The right hemisphere of the brain is responsible for visuospatial awareness.
Damage to this area often results in left-sided neglect, where the client is unaware of or
ignores stimuli on the left side of their body and environment. Aphasia is associated
with left-hemisphere damage. Agnosia can occur with damage to the parietal lobe,
often on the right, but left-sided neglect is a more classic and specific hallmark of right
hemisphere stroke. Impulsive (rather than slow) behavior is more common with right
hemisphere damage.
Question 9: A nurse is educating a client with a new diagnosis of diabetes mellitus
type 2 about foot care. Which of the following instructions is a priority?
A. Apply lotion between the toes to prevent dryness.
B. Soak feet in warm water daily for 20 minutes.
C. Use a heating pad on the feet if they feel cold.
D. Wear well-fitting, closed-toe shoes at all times.
CORRECT ANSWER: D. Wear well-fitting, closed-toe shoes at all times.
Rationale: Wearing well-fitting, closed-toe shoes is the highest priority foot care
instruction to prevent injury and ulceration. Diabetic clients often have peripheral
, neuropathy and decreased sensation, making them at high risk for foot trauma. Lotion
should not be applied between the toes as it can lead to maceration and fungal
infections. Feet should be washed daily but not soaked. Heating pads should be
avoided due to the risk of burns from decreased sensation.
Question 10: A client has a prescription for a 24-hour urine collection. Which of the
following actions should the nurse take to ensure accurate results?
A. Discard the first voiding of the collection period and note the time.
B. Save all urine, including the first voiding of the collection period.
C. Instruct the client to increase fluid intake to 3L during the collection.
D. Keep the urine specimen at room temperature for the duration.
CORRECT ANSWER: A. Discard the first voiding of the collection period and note
the time.
Rationale: For a 24-hour urine collection, the collection begins after the client voids
and discards the first specimen. This marks the start time. All subsequent urine for the
next 24 hours is collected, including the final voiding at the end of the 24-hour period.
The specimen should be kept refrigerated or on ice unless otherwise specified. Fluid
intake is not altered to maintain test accuracy, unless specifically instructed by the
provider.
Question 11: A nurse is administering an enteral feeding via a nasogastric tube.
Which of the following actions should the nurse take prior to initiating the feeding?
A. Flush the tube with 50 mL of cold water.
B. Verify tube placement by auscultating for air insufflated over the stomach.
C. Place the client in a supine position.
D. Check for residual gastric volume and flush with 30 mL of warm water.
CORRECT ANSWER: D. Check for residual gastric volume and flush with 30 mL of
warm water.
Rationale: Prior to feeding, the nurse should check the residual volume to assess
gastric emptying and reduce the risk of aspiration. The tube should also be flushed with
30 mL of warm (not cold) water to clear the tube and verify patency. The most reliable
method to verify placement is an x-ray, but auscultation is a less reliable method and is
not recommended as the sole confirmation method. The client should be placed in a
semi-Fowler's (not supine) position to prevent aspiration.
Question 12: A nurse is reviewing the arterial blood gas (ABG) results for a client.
The results are: pH 7.31, PaCO2 50 mm Hg, and HCO3- 24 mEq/L. The nurse should
interpret these findings as indicating which of the following acid-base imbalances?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
CORRECT ANSWER: C. Respiratory acidosis
Rationale: A pH of 7.31 indicates acidemia. The PaCO2 is elevated at 50 mm Hg,
indicating respiratory involvement (carbon dioxide retention). The HCO3- is normal at 24
