1|Page
ATI PN Comprehensive Predictor
2026–2027 | Real Exam-Style
Questions & Answers
1. A client with heart failure reports waking up short of breath during the night. Which
intervention should the nurse implement first?
a) Administer oxygen at 2 L/min via nasal cannula
b) Place the client in high-Fowler’s position
c) Notify the healthcare provider
d) Check the client’s oxygen saturation
Answer: b) Place the client in high-Fowler’s position
Rationale: High-Fowler’s position uses gravity to reduce venous return and pulmonary
congestion, relieving dyspnea immediately. Oxygen and sat checks are important but
positioning is the first action.
2. A postoperative client has a prescription for morphine 2 mg IV push. Which
assessment finding requires the nurse to hold the medication?
a) Pain rating of 8/10
b) Respiratory rate of 10 breaths/min
c) Heart rate of 88 beats/min
d) Blood pressure of 132/78 mm Hg
Answer: b) Respiratory rate of 10 breaths/min
Rationale: Morphine can cause respiratory depression. A rate below 12/min is a
contraindication; the nurse should hold and notify the provider.
, 2|Page
3. The nurse is caring for a client with a nasogastric tube set to low intermittent suction.
Which electrolyte imbalance is the client most at risk for?
a) Hyperkalemia
b) Hypernatremia
c) Hypokalemia
d) Hypercalcemia
Answer: c) Hypokalemia
Rationale: Gastric suction removes potassium and hydrogen ions, leading to metabolic
alkalosis and hypokalemia.
4. A client with diabetes mellitus type 2 has a blood glucose of 62 mg/dL and is alert.
What should the nurse administer first?
a) ½ cup (4 oz) of orange juice
b) 1 ampule of 50% dextrose IV
c) Glucagon 1 mg IM
d) 2 tablespoons of peanut butter
Answer: a) ½ cup (4 oz) of orange juice
Rationale: For a conscious client with hypoglycemia, the rule of 15—give 15 g of fast-
acting carbohydrate (e.g., 4 oz juice). IV dextrose and glucagon are for unconscious
clients.
5. Which finding indicates that a client with chronic obstructive pulmonary disease is
experiencing ineffective airway clearance?
a) Pink mucous membranes
b) Productive cough with thick green sputum
c) Oxygen saturation of 95%
d) Respiratory rate of 16 breaths/min
Answer: b) Productive cough with thick green sputum
Rationale: Thick, discolored sputum indicates retained secretions and infection,
hallmark signs of ineffective airway clearance.
6. The nurse is preparing to administer digoxin to a client with atrial fibrillation. Which
pulse rate should cause the nurse to withhold the medication?
a) 72 beats/min
b) 68 beats/min
c) 58 beats/min
d) 80 beats/min
Answer: c) 58 beats/min
Rationale: Digoxin is held if the apical pulse is below 60/min in an adult (or below 70
in some protocols) due to risk of bradycardia and toxicity.
7. A client is prescribed enoxaparin subcutaneously. Which technique is correct for
administration?
a) Aspirate before injecting
b) Massage the site after injection
c) Administer in the abdomen with the needle at a 90-degree angle
d) Use a 1.5-inch needle
, 3|Page
Answer: c) Administer in the abdomen with the needle at a 90-degree angle
Rationale: Enoxaparin is given deep SC in the abdominal fatty tissue, 90° angle, no
aspiration, no massage to prevent hematoma.
8. A client with a hip fracture is in Buck’s traction. Which nursing action is most
important?
a) Removing traction every 2 hours for skin care
b) Keeping the weights resting on the floor
c) Ensuring the rope is freely moving over the pulley
d) Placing the client in a supine flat position
Answer: c) Ensuring the rope is freely moving over the pulley
Rationale: Traction must have free-moving ropes and pulleys to maintain proper
counterforce; weights should hang freely, not touch the floor.
9. Which food choice indicates that a client on a low-sodium diet understands
teaching?
a) Canned vegetable soup
b) Grilled chicken breast with steamed broccoli
c) Pickled beets
d) Salted pretzels
Answer: b) Grilled chicken breast with steamed broccoli
Rationale: Fresh, unprocessed foods are naturally low in sodium; canned, pickled, and
salty snacks are high in sodium.
10. The nurse is assessing a client 1 hour after a thyroidectomy. Which finding is most
concerning?
a) Hoarse voice
b) Pain rated 4/10 at incision site
c) Stridor on inspiration
d) Slight swelling around the dressing
Answer: c) Stridor on inspiration
Rationale: Stridor indicates airway obstruction from laryngeal edema or hematoma, a
life-threatening emergency post-thyroidectomy.
11. A client with cirrhosis has jaundice and ascites. Which laboratory value would the
nurse expect to be elevated?
a) Serum albumin
b) Serum bilirubin
c) Hematocrit
d) Platelet count
Answer: b) Serum bilirubin
Rationale: In cirrhosis, the liver cannot conjugate bilirubin, leading to elevated serum
bilirubin and jaundice.
12. The nurse is teaching a client about warfarin therapy. Which statement indicates a
need for further teaching?
a) “I will avoid eating large amounts of spinach.”
b) “I will use a soft-bristled toothbrush.”
, 4|Page
c) “I will take ibuprofen for my headaches.”
d) “I will have my INR checked regularly.”
Answer: c) “I will take ibuprofen for my headaches.”
Rationale: NSAIDs like ibuprofen increase bleeding risk with warfarin. Acetaminophen
is the preferred analgesic.
13. A client with an indwelling urinary catheter has dark, cloudy urine with sediment.
What should the nurse do first?
a) Irrigate the catheter with sterile saline
b) Increase the client’s oral fluid intake
c) Obtain a urine culture and sensitivity
d) Replace the entire catheter system
Answer: c) Obtain a urine culture and sensitivity
Rationale: Cloudy, sediment-filled urine suggests infection; culturing identifies the
pathogen before starting antibiotics.
14. The nurse is performing a mental status exam on an older adult. Which finding is
considered normal age-related change?
a) Disorientation to time and place
b) Difficulty finding the right word occasionally
c) Inability to recall events from 10 years ago
d) Impaired judgment
Answer: b) Difficulty finding the right word occasionally
Rationale: Mild word-finding difficulty is a normal part of aging; disorientation and
impaired judgment are not.
15. A client receiving total parenteral nutrition (TPN) has a blood glucose of 210 mg/dL.
What is the nurse’s priority action?
a) Slow the TPN infusion rate
b) Notify the healthcare provider for insulin coverage
c) Stop the TPN immediately
d) Check urine for ketones
Answer: b) Notify the healthcare provider for insulin coverage
Rationale: Hyperglycemia is common with TPN; regular insulin may be added to the
TPN or given SC. Never abruptly stop TPN.
16. The nurse is caring for a client with a chest tube. Which finding indicates an air leak?
a) Continuous bubbling in the water seal chamber
b) Intermittent bubbling in the suction control chamber
c) Tidaling in the water seal chamber with respirations
d) Bloody drainage of 50 mL in 1 hour
Answer: a) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling indicates an air leak in the system or from the lung;
intermittent bubbling with respirations is normal.
17. A client is receiving IV vancomycin. Which adverse effect requires immediate nursing
intervention?
a) Red man syndrome
ATI PN Comprehensive Predictor
2026–2027 | Real Exam-Style
Questions & Answers
1. A client with heart failure reports waking up short of breath during the night. Which
intervention should the nurse implement first?
a) Administer oxygen at 2 L/min via nasal cannula
b) Place the client in high-Fowler’s position
c) Notify the healthcare provider
d) Check the client’s oxygen saturation
Answer: b) Place the client in high-Fowler’s position
Rationale: High-Fowler’s position uses gravity to reduce venous return and pulmonary
congestion, relieving dyspnea immediately. Oxygen and sat checks are important but
positioning is the first action.
2. A postoperative client has a prescription for morphine 2 mg IV push. Which
assessment finding requires the nurse to hold the medication?
a) Pain rating of 8/10
b) Respiratory rate of 10 breaths/min
c) Heart rate of 88 beats/min
d) Blood pressure of 132/78 mm Hg
Answer: b) Respiratory rate of 10 breaths/min
Rationale: Morphine can cause respiratory depression. A rate below 12/min is a
contraindication; the nurse should hold and notify the provider.
, 2|Page
3. The nurse is caring for a client with a nasogastric tube set to low intermittent suction.
Which electrolyte imbalance is the client most at risk for?
a) Hyperkalemia
b) Hypernatremia
c) Hypokalemia
d) Hypercalcemia
Answer: c) Hypokalemia
Rationale: Gastric suction removes potassium and hydrogen ions, leading to metabolic
alkalosis and hypokalemia.
4. A client with diabetes mellitus type 2 has a blood glucose of 62 mg/dL and is alert.
What should the nurse administer first?
a) ½ cup (4 oz) of orange juice
b) 1 ampule of 50% dextrose IV
c) Glucagon 1 mg IM
d) 2 tablespoons of peanut butter
Answer: a) ½ cup (4 oz) of orange juice
Rationale: For a conscious client with hypoglycemia, the rule of 15—give 15 g of fast-
acting carbohydrate (e.g., 4 oz juice). IV dextrose and glucagon are for unconscious
clients.
5. Which finding indicates that a client with chronic obstructive pulmonary disease is
experiencing ineffective airway clearance?
a) Pink mucous membranes
b) Productive cough with thick green sputum
c) Oxygen saturation of 95%
d) Respiratory rate of 16 breaths/min
Answer: b) Productive cough with thick green sputum
Rationale: Thick, discolored sputum indicates retained secretions and infection,
hallmark signs of ineffective airway clearance.
6. The nurse is preparing to administer digoxin to a client with atrial fibrillation. Which
pulse rate should cause the nurse to withhold the medication?
a) 72 beats/min
b) 68 beats/min
c) 58 beats/min
d) 80 beats/min
Answer: c) 58 beats/min
Rationale: Digoxin is held if the apical pulse is below 60/min in an adult (or below 70
in some protocols) due to risk of bradycardia and toxicity.
7. A client is prescribed enoxaparin subcutaneously. Which technique is correct for
administration?
a) Aspirate before injecting
b) Massage the site after injection
c) Administer in the abdomen with the needle at a 90-degree angle
d) Use a 1.5-inch needle
, 3|Page
Answer: c) Administer in the abdomen with the needle at a 90-degree angle
Rationale: Enoxaparin is given deep SC in the abdominal fatty tissue, 90° angle, no
aspiration, no massage to prevent hematoma.
8. A client with a hip fracture is in Buck’s traction. Which nursing action is most
important?
a) Removing traction every 2 hours for skin care
b) Keeping the weights resting on the floor
c) Ensuring the rope is freely moving over the pulley
d) Placing the client in a supine flat position
Answer: c) Ensuring the rope is freely moving over the pulley
Rationale: Traction must have free-moving ropes and pulleys to maintain proper
counterforce; weights should hang freely, not touch the floor.
9. Which food choice indicates that a client on a low-sodium diet understands
teaching?
a) Canned vegetable soup
b) Grilled chicken breast with steamed broccoli
c) Pickled beets
d) Salted pretzels
Answer: b) Grilled chicken breast with steamed broccoli
Rationale: Fresh, unprocessed foods are naturally low in sodium; canned, pickled, and
salty snacks are high in sodium.
10. The nurse is assessing a client 1 hour after a thyroidectomy. Which finding is most
concerning?
a) Hoarse voice
b) Pain rated 4/10 at incision site
c) Stridor on inspiration
d) Slight swelling around the dressing
Answer: c) Stridor on inspiration
Rationale: Stridor indicates airway obstruction from laryngeal edema or hematoma, a
life-threatening emergency post-thyroidectomy.
11. A client with cirrhosis has jaundice and ascites. Which laboratory value would the
nurse expect to be elevated?
a) Serum albumin
b) Serum bilirubin
c) Hematocrit
d) Platelet count
Answer: b) Serum bilirubin
Rationale: In cirrhosis, the liver cannot conjugate bilirubin, leading to elevated serum
bilirubin and jaundice.
12. The nurse is teaching a client about warfarin therapy. Which statement indicates a
need for further teaching?
a) “I will avoid eating large amounts of spinach.”
b) “I will use a soft-bristled toothbrush.”
, 4|Page
c) “I will take ibuprofen for my headaches.”
d) “I will have my INR checked regularly.”
Answer: c) “I will take ibuprofen for my headaches.”
Rationale: NSAIDs like ibuprofen increase bleeding risk with warfarin. Acetaminophen
is the preferred analgesic.
13. A client with an indwelling urinary catheter has dark, cloudy urine with sediment.
What should the nurse do first?
a) Irrigate the catheter with sterile saline
b) Increase the client’s oral fluid intake
c) Obtain a urine culture and sensitivity
d) Replace the entire catheter system
Answer: c) Obtain a urine culture and sensitivity
Rationale: Cloudy, sediment-filled urine suggests infection; culturing identifies the
pathogen before starting antibiotics.
14. The nurse is performing a mental status exam on an older adult. Which finding is
considered normal age-related change?
a) Disorientation to time and place
b) Difficulty finding the right word occasionally
c) Inability to recall events from 10 years ago
d) Impaired judgment
Answer: b) Difficulty finding the right word occasionally
Rationale: Mild word-finding difficulty is a normal part of aging; disorientation and
impaired judgment are not.
15. A client receiving total parenteral nutrition (TPN) has a blood glucose of 210 mg/dL.
What is the nurse’s priority action?
a) Slow the TPN infusion rate
b) Notify the healthcare provider for insulin coverage
c) Stop the TPN immediately
d) Check urine for ketones
Answer: b) Notify the healthcare provider for insulin coverage
Rationale: Hyperglycemia is common with TPN; regular insulin may be added to the
TPN or given SC. Never abruptly stop TPN.
16. The nurse is caring for a client with a chest tube. Which finding indicates an air leak?
a) Continuous bubbling in the water seal chamber
b) Intermittent bubbling in the suction control chamber
c) Tidaling in the water seal chamber with respirations
d) Bloody drainage of 50 mL in 1 hour
Answer: a) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling indicates an air leak in the system or from the lung;
intermittent bubbling with respirations is normal.
17. A client is receiving IV vancomycin. Which adverse effect requires immediate nursing
intervention?
a) Red man syndrome
