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ATI PN Comprehensive
Predictor 2026 | 600+ Q&A with
Rationales | Guaranteed Pass
1. A client with a history of chronic obstructive pulmonary disease is prescribed a
metered-dose inhaler. Which action indicates proper use of the inhaler?
a) Inhaling rapidly and deeply after activating the inhaler
b) Activating the inhaler before beginning inhalation
c) Holding the breath for 10 seconds after inhalation
d) Exhaling forcefully into the inhaler before use
Answer: c) Holding the breath for 10 seconds after inhalation
Rationale: Holding the breath for 5-10 seconds after inhalation allows the medication
to deposit in the airways. Activating before inhalation and rapid breathing reduce
deposition.
2. The nurse is caring for a client who is 1 day postoperative following an abdominal
hysterectomy. Which finding requires immediate intervention?
a) Serosanguineous drainage on the dressing
b) Absent bowel sounds in all four quadrants
c) Client reports passing flatus
d) Temperature of 99.2°F (37.3°C)
Answer: b) Absent bowel sounds in all four quadrants
Rationale: Absent bowel sounds 24 hours post-abdominal surgery may indicate ileus or
obstruction; serosanguineous drainage is expected; passing flatus is a positive sign;
low-grade fever is common.
3. A client with type 1 diabetes mellitus is experiencing nausea and vomiting and is
unable to tolerate oral intake. Which action should the nurse take first?
a) Administer subcutaneous insulin as prescribed
b) Check the client's blood glucose level
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c) Notify the healthcare provider
d) Encourage sips of clear liquids
Answer: b) Check the client's blood glucose level
Rationale: The first action is to assess blood glucose to determine if hypoglycemia or
hyperglycemia is present before giving insulin or other interventions.
4. A client is prescribed metoprolol for hypertension. Which assessment finding should
the nurse report to the healthcare provider?
a) Apical pulse of 54 beats/min
b) Blood pressure of 138/88 mm Hg
c) Respiratory rate of 16 breaths/min
d) Client reports mild dizziness when standing
Answer: a) Apical pulse of 54 beats/min
Rationale: Metoprolol is a beta-blocker that can cause bradycardia. A pulse below
60/min warrants holding the medication and notifying the provider. Mild dizziness and
BP of 138/88 may be expected.
5. The nurse is providing teaching to a client with a new colostomy. Which food should
the client avoid to reduce odor?
a) Yogurt
b) Parsley
c) Fish
d) Buttermilk
Answer: c) Fish
Rationale: Fish, eggs, and asparagus can increase stool odor. Yogurt, parsley, and
buttermilk help reduce odor.
6. A client with a head injury has a Glasgow Coma Scale score of 9. The nurse should
interpret this as:
a) Mild brain injury
b) Moderate brain injury
c) Severe brain injury
d) Normal neurological function
Answer: b) Moderate brain injury
Rationale: GCS of 9-12 indicates moderate brain injury; 13-15 is mild; 3-8 is severe.
7. The nurse is assessing a client who is taking lithium carbonate. Which finding
indicates lithium toxicity?
a) Fine hand tremors
b) Nausea and vomiting
c) Increased thirst
d) Polyuria
Answer: b) Nausea and vomiting
Rationale: Nausea, vomiting, diarrhea, and coarse tremors indicate lithium toxicity.
Fine tremors, thirst, and polyuria are common side effects within therapeutic range.
8. A client with chronic kidney disease has a phosphate level of 6.5 mg/dL. Which
medication should the nurse anticipate administering?
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a) Calcium acetate
b) Ferrous sulfate
c) Erythropoietin
d) Sodium polystyrene sulfonate
Answer: a) Calcium acetate
Rationale: Calcium acetate is a phosphate binder used to lower serum phosphate levels
in chronic kidney disease. Sodium polystyrene sulfonate lowers potassium;
erythropoietin treats anemia.
9. A client with pneumonia is prescribed ceftriaxone. Which statement by the client
indicates a need for further teaching?
a) "I will report any rash or itching to my nurse."
b) "I can stop taking the medication when I feel better."
c) "I should complete the full course of antibiotics."
d) "I will take the medication at the same time each day."
Answer: b) "I can stop taking the medication when I feel better."
Rationale: Antibiotics must be completed even if symptoms improve to prevent
resistance and recurrence.
10. The nurse is caring for a client with a nasogastric tube set to continuous suction.
Which electrolyte imbalance is the client at highest risk for?
a) Hypokalemia
b) Hyperkalemia
c) Hyponatremia
d) Hypercalcemia
Answer: a) Hypokalemia
Rationale: Nasogastric suction removes gastric fluids containing potassium and
hydrogen ions, leading to hypokalemia and metabolic alkalosis.
11. A client with a history of myocardial infarction is prescribed aspirin 81 mg daily. What
is the primary purpose of this medication?
a) To reduce fever
b) To prevent platelet aggregation
c) To relieve chest pain
d) To lower cholesterol levels
Answer: b) To prevent platelet aggregation
Rationale: Low-dose aspirin inhibits platelet aggregation, reducing the risk of recurrent
MI and stroke. It is not used for pain, fever, or cholesterol lowering at this dose.
12. The nurse is assessing a client with a spinal cord injury at T4. Which finding indicates
autonomic dysreflexia?
a) Hypotension and tachycardia
b) Flaccid paralysis
c) Severe headache and hypertension
d) Warm, dry skin
Answer: c) Severe headache and hypertension
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Rationale: Autonomic dysreflexia (above T6) causes sudden severe hypertension,
pounding headache, bradycardia, and diaphoresis above the injury level.
13. A client with heart failure has a daily weight gain of 3 pounds (1.4 kg) in 24 hours.
What should the nurse do first?
a) Restrict oral fluids to 500 mL per day
b) Administer furosemide as prescribed
c) Assess for peripheral edema and lung sounds
d) Notify the healthcare provider
Answer: c) Assess for peripheral edema and lung sounds
Rationale: Rapid weight gain indicates fluid retention; the nurse should first assess for
signs of worsening heart failure (edema, crackles) before notifying the provider or
giving diuretics.
14. A client is prescribed enoxaparin subcutaneously. Which technique is correct for
administration?
a) Aspirate gently before injecting
b) Massage the site after injection
c) Inject into the abdomen at a 90-degree angle
d) Use a 1.5-inch needle for deep intramuscular injection
Answer: c) Inject into the abdomen at a 90-degree angle
Rationale: Enoxaparin is given subcutaneously in the abdominal fatty tissue with a 90-
degree angle using a small needle. Do not aspirate or massage.
15. The nurse is teaching a client about a low-residue diet. Which food should the client
avoid?
a) White rice
b) Tender cooked chicken
c) Whole-grain bread
d) Applesauce
Answer: c) Whole-grain bread
Rationale: Low-residue diets restrict high-fiber foods like whole grains, nuts, seeds, and
raw vegetables. White rice, applesauce, and tender meats are allowed.
16. A client with a urinary tract infection is prescribed phenazopyridine. Which
instruction should the nurse provide?
a) "This medication will cure your infection."
b) "Your urine may turn a reddish-orange color."
c) "Take this medication on an empty stomach."
d) "You should limit your fluid intake."
Answer: b) "Your urine may turn a reddish-orange color."
Rationale: Phenazopyridine is a urinary analgesic that stains urine orange/red. It does
not treat the infection; clients should increase fluid intake.
17. The nurse is caring for a client with a chest tube. Which finding indicates the chest
tube system has an air leak?
a) Tidaling in the water seal chamber with respirations
b) Continuous bubbling in the water seal chamber
ATI PN Comprehensive
Predictor 2026 | 600+ Q&A with
Rationales | Guaranteed Pass
1. A client with a history of chronic obstructive pulmonary disease is prescribed a
metered-dose inhaler. Which action indicates proper use of the inhaler?
a) Inhaling rapidly and deeply after activating the inhaler
b) Activating the inhaler before beginning inhalation
c) Holding the breath for 10 seconds after inhalation
d) Exhaling forcefully into the inhaler before use
Answer: c) Holding the breath for 10 seconds after inhalation
Rationale: Holding the breath for 5-10 seconds after inhalation allows the medication
to deposit in the airways. Activating before inhalation and rapid breathing reduce
deposition.
2. The nurse is caring for a client who is 1 day postoperative following an abdominal
hysterectomy. Which finding requires immediate intervention?
a) Serosanguineous drainage on the dressing
b) Absent bowel sounds in all four quadrants
c) Client reports passing flatus
d) Temperature of 99.2°F (37.3°C)
Answer: b) Absent bowel sounds in all four quadrants
Rationale: Absent bowel sounds 24 hours post-abdominal surgery may indicate ileus or
obstruction; serosanguineous drainage is expected; passing flatus is a positive sign;
low-grade fever is common.
3. A client with type 1 diabetes mellitus is experiencing nausea and vomiting and is
unable to tolerate oral intake. Which action should the nurse take first?
a) Administer subcutaneous insulin as prescribed
b) Check the client's blood glucose level
, 2|Page
c) Notify the healthcare provider
d) Encourage sips of clear liquids
Answer: b) Check the client's blood glucose level
Rationale: The first action is to assess blood glucose to determine if hypoglycemia or
hyperglycemia is present before giving insulin or other interventions.
4. A client is prescribed metoprolol for hypertension. Which assessment finding should
the nurse report to the healthcare provider?
a) Apical pulse of 54 beats/min
b) Blood pressure of 138/88 mm Hg
c) Respiratory rate of 16 breaths/min
d) Client reports mild dizziness when standing
Answer: a) Apical pulse of 54 beats/min
Rationale: Metoprolol is a beta-blocker that can cause bradycardia. A pulse below
60/min warrants holding the medication and notifying the provider. Mild dizziness and
BP of 138/88 may be expected.
5. The nurse is providing teaching to a client with a new colostomy. Which food should
the client avoid to reduce odor?
a) Yogurt
b) Parsley
c) Fish
d) Buttermilk
Answer: c) Fish
Rationale: Fish, eggs, and asparagus can increase stool odor. Yogurt, parsley, and
buttermilk help reduce odor.
6. A client with a head injury has a Glasgow Coma Scale score of 9. The nurse should
interpret this as:
a) Mild brain injury
b) Moderate brain injury
c) Severe brain injury
d) Normal neurological function
Answer: b) Moderate brain injury
Rationale: GCS of 9-12 indicates moderate brain injury; 13-15 is mild; 3-8 is severe.
7. The nurse is assessing a client who is taking lithium carbonate. Which finding
indicates lithium toxicity?
a) Fine hand tremors
b) Nausea and vomiting
c) Increased thirst
d) Polyuria
Answer: b) Nausea and vomiting
Rationale: Nausea, vomiting, diarrhea, and coarse tremors indicate lithium toxicity.
Fine tremors, thirst, and polyuria are common side effects within therapeutic range.
8. A client with chronic kidney disease has a phosphate level of 6.5 mg/dL. Which
medication should the nurse anticipate administering?
, 3|Page
a) Calcium acetate
b) Ferrous sulfate
c) Erythropoietin
d) Sodium polystyrene sulfonate
Answer: a) Calcium acetate
Rationale: Calcium acetate is a phosphate binder used to lower serum phosphate levels
in chronic kidney disease. Sodium polystyrene sulfonate lowers potassium;
erythropoietin treats anemia.
9. A client with pneumonia is prescribed ceftriaxone. Which statement by the client
indicates a need for further teaching?
a) "I will report any rash or itching to my nurse."
b) "I can stop taking the medication when I feel better."
c) "I should complete the full course of antibiotics."
d) "I will take the medication at the same time each day."
Answer: b) "I can stop taking the medication when I feel better."
Rationale: Antibiotics must be completed even if symptoms improve to prevent
resistance and recurrence.
10. The nurse is caring for a client with a nasogastric tube set to continuous suction.
Which electrolyte imbalance is the client at highest risk for?
a) Hypokalemia
b) Hyperkalemia
c) Hyponatremia
d) Hypercalcemia
Answer: a) Hypokalemia
Rationale: Nasogastric suction removes gastric fluids containing potassium and
hydrogen ions, leading to hypokalemia and metabolic alkalosis.
11. A client with a history of myocardial infarction is prescribed aspirin 81 mg daily. What
is the primary purpose of this medication?
a) To reduce fever
b) To prevent platelet aggregation
c) To relieve chest pain
d) To lower cholesterol levels
Answer: b) To prevent platelet aggregation
Rationale: Low-dose aspirin inhibits platelet aggregation, reducing the risk of recurrent
MI and stroke. It is not used for pain, fever, or cholesterol lowering at this dose.
12. The nurse is assessing a client with a spinal cord injury at T4. Which finding indicates
autonomic dysreflexia?
a) Hypotension and tachycardia
b) Flaccid paralysis
c) Severe headache and hypertension
d) Warm, dry skin
Answer: c) Severe headache and hypertension
, 4|Page
Rationale: Autonomic dysreflexia (above T6) causes sudden severe hypertension,
pounding headache, bradycardia, and diaphoresis above the injury level.
13. A client with heart failure has a daily weight gain of 3 pounds (1.4 kg) in 24 hours.
What should the nurse do first?
a) Restrict oral fluids to 500 mL per day
b) Administer furosemide as prescribed
c) Assess for peripheral edema and lung sounds
d) Notify the healthcare provider
Answer: c) Assess for peripheral edema and lung sounds
Rationale: Rapid weight gain indicates fluid retention; the nurse should first assess for
signs of worsening heart failure (edema, crackles) before notifying the provider or
giving diuretics.
14. A client is prescribed enoxaparin subcutaneously. Which technique is correct for
administration?
a) Aspirate gently before injecting
b) Massage the site after injection
c) Inject into the abdomen at a 90-degree angle
d) Use a 1.5-inch needle for deep intramuscular injection
Answer: c) Inject into the abdomen at a 90-degree angle
Rationale: Enoxaparin is given subcutaneously in the abdominal fatty tissue with a 90-
degree angle using a small needle. Do not aspirate or massage.
15. The nurse is teaching a client about a low-residue diet. Which food should the client
avoid?
a) White rice
b) Tender cooked chicken
c) Whole-grain bread
d) Applesauce
Answer: c) Whole-grain bread
Rationale: Low-residue diets restrict high-fiber foods like whole grains, nuts, seeds, and
raw vegetables. White rice, applesauce, and tender meats are allowed.
16. A client with a urinary tract infection is prescribed phenazopyridine. Which
instruction should the nurse provide?
a) "This medication will cure your infection."
b) "Your urine may turn a reddish-orange color."
c) "Take this medication on an empty stomach."
d) "You should limit your fluid intake."
Answer: b) "Your urine may turn a reddish-orange color."
Rationale: Phenazopyridine is a urinary analgesic that stains urine orange/red. It does
not treat the infection; clients should increase fluid intake.
17. The nurse is caring for a client with a chest tube. Which finding indicates the chest
tube system has an air leak?
a) Tidaling in the water seal chamber with respirations
b) Continuous bubbling in the water seal chamber
