,ATI RN Comprehensive Predictor 2026 – 300
Practice Q&A with Rationales for Nursing
Students
Q1. A nurse is caring for a client with new-onset confusion, bounding peripheral pulses,
and jugular vein distention. Which intervention should the nurse implement first?
A) Administer oxygen via nasal cannula at 2 L/min.
*B) Place the client in a high-Fowler's position. *
C) Restrict oral fluids to 1,500 mL per day.
D) Prepare for insertion of a central venous catheter.
Rationale: High-Fowler's position promotes venous return to the heart and reduces
jugular vein distention, easing respiratory effort. Oxygen may be needed but positioning
is the immediate priority.
Q2. A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an assistive
personnel (AP). Which client should the charge nurse assign to the LPN?
A) A client requiring a bed bath and oral care.
*B) A client with diabetes mellitus requiring a fingerstick blood glucose check and
insulin administration. *
C) A client with a new tracheostomy requiring suctioning.
D) A client admitted with chest pain needing a 12-lead EKG.
Rationale: LPNs can administer insulin and perform fingerstick glucose checks.
Tracheostomy suctioning and new chest pain assessments require an RN. Bed bath is
appropriate for AP.
,Q3. A nurse is reviewing a client's morning laboratory results. Which finding requires
immediate notification of the healthcare provider?
A) Serum sodium of 135 mEq/L.
B) Serum potassium of 3.8 mEq/L.
*C) Serum potassium of 5.8 mEq/L. *
D) Serum glucose of 110 mg/dL.
Rationale: Normal potassium is 3.5–5.0 mEq/L. 5.8 mEq/L indicates hyperkalemia, which
can cause cardiac dysrhythmias and requires immediate intervention.
Q4. A client with a living will refuses a life-saving blood transfusion due to religious
beliefs. What is the nurse's appropriate action?
A) Notify the hospital ethics committee to override the decision.
B) Ask the client's family to persuade the client to accept the transfusion.
*C) Respect the client's decision and document the refusal in the medical record. *
D) Administer the transfusion anyway to preserve life.
Rationale: A living will is a legally binding document. The client's autonomy must be
respected. The nurse should document the refusal and notify the provider.
Q5. A nurse is providing teaching to a client with a new prescription for enoxaparin
(Lovenox). Which statement by the client indicates a need for further teaching?
A) "I will need to inject this medication into my abdomen."
B) "I should avoid taking aspirin while on this medication."
*C) "I can stop this medication once my swelling goes down." *
D) "I will watch for unusual bruising or bleeding."
Rationale: Enoxaparin is an anticoagulant that must be taken for the full prescribed
, course, not stopped when symptoms improve. Stopping early increases the risk of
thromboembolism.
Q6. A nurse is performing a head-to-toe assessment on a client 12 hours post-operative
from abdominal surgery. Which finding is the earliest sign of hypovolemic shock?
A) Blood pressure of 90/60 mm Hg.
B) Urine output of 20 mL/hr.
*C) Heart rate of 110 bpm and slight anxiety. *
D) Cold, clammy skin.
Rationale: Tachycardia and anxiety are early compensatory responses to decreased
circulating volume. Hypotension, oliguria, and cool skin are late signs.
Q7. A client is prescribed digoxin (Lanoxin) and furosemide (Lasix). Which laboratory
value places the client at the highest risk for digoxin toxicity?
A) Serum sodium of 130 mEq/L.
*B) Serum potassium of 3.0 mEq/L. *
C) Serum calcium of 10.5 mg/dL.
D) Serum magnesium of 2.0 mEq/L.
Rationale: Furosemide causes potassium wasting. Hypokalemia (below 3.5 mEq/L)
increases the risk of digoxin toxicity, leading to dysrhythmias.
Q8. A nurse is caring for a client with a nasogastric (NG) tube set to low intermittent
suction. Which finding indicates the client is at risk for metabolic alkalosis?
A) Deep, rapid respirations.
Practice Q&A with Rationales for Nursing
Students
Q1. A nurse is caring for a client with new-onset confusion, bounding peripheral pulses,
and jugular vein distention. Which intervention should the nurse implement first?
A) Administer oxygen via nasal cannula at 2 L/min.
*B) Place the client in a high-Fowler's position. *
C) Restrict oral fluids to 1,500 mL per day.
D) Prepare for insertion of a central venous catheter.
Rationale: High-Fowler's position promotes venous return to the heart and reduces
jugular vein distention, easing respiratory effort. Oxygen may be needed but positioning
is the immediate priority.
Q2. A charge nurse is assigning tasks to a licensed practical nurse (LPN) and an assistive
personnel (AP). Which client should the charge nurse assign to the LPN?
A) A client requiring a bed bath and oral care.
*B) A client with diabetes mellitus requiring a fingerstick blood glucose check and
insulin administration. *
C) A client with a new tracheostomy requiring suctioning.
D) A client admitted with chest pain needing a 12-lead EKG.
Rationale: LPNs can administer insulin and perform fingerstick glucose checks.
Tracheostomy suctioning and new chest pain assessments require an RN. Bed bath is
appropriate for AP.
,Q3. A nurse is reviewing a client's morning laboratory results. Which finding requires
immediate notification of the healthcare provider?
A) Serum sodium of 135 mEq/L.
B) Serum potassium of 3.8 mEq/L.
*C) Serum potassium of 5.8 mEq/L. *
D) Serum glucose of 110 mg/dL.
Rationale: Normal potassium is 3.5–5.0 mEq/L. 5.8 mEq/L indicates hyperkalemia, which
can cause cardiac dysrhythmias and requires immediate intervention.
Q4. A client with a living will refuses a life-saving blood transfusion due to religious
beliefs. What is the nurse's appropriate action?
A) Notify the hospital ethics committee to override the decision.
B) Ask the client's family to persuade the client to accept the transfusion.
*C) Respect the client's decision and document the refusal in the medical record. *
D) Administer the transfusion anyway to preserve life.
Rationale: A living will is a legally binding document. The client's autonomy must be
respected. The nurse should document the refusal and notify the provider.
Q5. A nurse is providing teaching to a client with a new prescription for enoxaparin
(Lovenox). Which statement by the client indicates a need for further teaching?
A) "I will need to inject this medication into my abdomen."
B) "I should avoid taking aspirin while on this medication."
*C) "I can stop this medication once my swelling goes down." *
D) "I will watch for unusual bruising or bleeding."
Rationale: Enoxaparin is an anticoagulant that must be taken for the full prescribed
, course, not stopped when symptoms improve. Stopping early increases the risk of
thromboembolism.
Q6. A nurse is performing a head-to-toe assessment on a client 12 hours post-operative
from abdominal surgery. Which finding is the earliest sign of hypovolemic shock?
A) Blood pressure of 90/60 mm Hg.
B) Urine output of 20 mL/hr.
*C) Heart rate of 110 bpm and slight anxiety. *
D) Cold, clammy skin.
Rationale: Tachycardia and anxiety are early compensatory responses to decreased
circulating volume. Hypotension, oliguria, and cool skin are late signs.
Q7. A client is prescribed digoxin (Lanoxin) and furosemide (Lasix). Which laboratory
value places the client at the highest risk for digoxin toxicity?
A) Serum sodium of 130 mEq/L.
*B) Serum potassium of 3.0 mEq/L. *
C) Serum calcium of 10.5 mg/dL.
D) Serum magnesium of 2.0 mEq/L.
Rationale: Furosemide causes potassium wasting. Hypokalemia (below 3.5 mEq/L)
increases the risk of digoxin toxicity, leading to dysrhythmias.
Q8. A nurse is caring for a client with a nasogastric (NG) tube set to low intermittent
suction. Which finding indicates the client is at risk for metabolic alkalosis?
A) Deep, rapid respirations.
