ATI RN Comprehensive Predictor 2026/2027 Study
Guide | ATI Comprehensive Predictor Exit Exam
Prep | NGN Clinical Judgment Practice Questions &
Answers, Detailed Rationales, Case Studies,
Prioritization & Delegation, NCLEX-RN Readiness,
Comprehensive Nursing Review
Question 1: A nurse is caring for a client who is postoperative following a total
hip arthroplasty. Which of the following actions should the nurse take to
prevent dislocation of the new joint?
A. Position the client's legs in an adduction position.
B. Place a pillow between the client's legs while in bed.
C. Encourage the client to flex the hips to 120 degrees when sitting.
D. Instruct the client to cross their legs at the ankles when turning.
CORRECT ANSWER: B. Place a pillow between the client's legs while in bed.
Rationale: To prevent dislocation following a total hip arthroplasty, the nurse must
maintain the hip in a neutral position, avoiding adduction, internal rotation, and
excessive flexion (greater than 90 degrees). Placing an abduction pillow between the
client's legs keeps the hip abducted and prevents crossing the legs, which can lead to
dislocation.
Question 2: A nurse is teaching a client with a new diagnosis of type 1 diabetes
mellitus about insulin administration. Which of the following instructions
should the nurse include?
A. Store unopened vials of insulin in the freezer.
B. Rotate injection sites within the same anatomical region.
C. Administer insulin at a 45-degree angle using a ⅝-inch needle.
D. Rub the site vigorously after injection to promote absorption.
CORRECT ANSWER: B. Rotate injection sites within the same anatomical
region.
Rationale: Rotating injection sites within the same anatomical region (e.g., abdomen,
thigh, arm) prevents lipohypertrophy and ensures consistent insulin absorption.
Unopened insulin should be refrigerated, not frozen. The angle of injection depends on
needle length and subcutaneous tissue thickness.
Question 3: A nurse is assessing a client who has heart failure and is receiving
furosemide. Which of the following findings indicates the medication is having
a therapeutic effect?
A. Decrease in peripheral edema.
B. Increase in blood pressure.
,C. Increase in jugular venous distention.
D. Decrease in urine output.
CORRECT ANSWER: A. Decrease in peripheral edema.
Rationale: Furosemide is a loop diuretic used to manage fluid overload in heart failure. A
therapeutic effect is evidenced by a decrease in peripheral edema, dyspnea, and jugular
venous distention, as well as an increase in urine output and a decrease in blood
pressure.
Question 4: A nurse is preparing to administer a blood transfusion to a client.
Which of the following actions should the nurse take first?
A. Verify the client's blood type with a second nurse.
B. Assess the client's vital signs.
C. Obtain the unit of packed red blood cells from the blood bank.
D. Start an IV line with 0.9% sodium chloride.
CORRECT ANSWER: A. Verify the client's blood type with a second nurse.
Rationale: The first action the nurse should take is to verify the client's identification and
blood type with another qualified nurse to ensure the correct blood product is
administered, preventing a fatal hemolytic transfusion reaction. This is a critical safety
step before all other actions.
Question 5: A nurse is providing discharge teaching to a client who has a new
colostomy. Which of the following statements by the client indicates a need for
further teaching?
A. "I will irrigate my colostomy at the same time each day."
B. "I can expect the stoma to be pink and moist."
C. "I will avoid eating foods that cause gas formation."
D. "I will change the pouch when it is one-third full of stool."
CORRECT ANSWER: D. "I will change the pouch when it is one-third full of
stool."
Rationale: A colostomy pouch should be changed when it is one-half to two-thirds full to
prevent leakage and skin breakdown. Changing it when one-third full is too frequent and
unnecessary, indicating a need for further teaching about proper pouch management.
Question 6: A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which of the following findings should the nurse
expect?
,A. Diminished breath sounds.
B. Increased anterior-posterior (AP) chest diameter.
C. Prolonged expiratory phase.
D. All of the above.
CORRECT ANSWER: D. All of the above.
Rationale: COPD is characterized by hyperinflation of the lungs, leading to a barrel chest
(increased AP diameter), diminished breath sounds due to air trapping, and a prolonged
expiratory phase resulting from obstructed airways, making all options expected
findings.
Question 7: A nurse is caring for a client who is 2 hours postoperative
following a femoral popliteal bypass graft. Which of the following assessments
is the priority?
A. Pain level in the affected leg.
B. Pulse oximetry reading.
C. Capillary refill time in the toes.
D. Urinary output.
CORRECT ANSWER: C. Capillary refill time in the toes.
Rationale: The priority assessment following a peripheral vascular bypass is monitoring
graft patency. Capillary refill time, along with pulse checks and skin color/temperature,
provides immediate data on perfusion to the extremity, making it the most critical
assessment to detect early graft occlusion.
Question 8: A nurse is administering digoxin to a client who has heart failure.
Which of the following findings should indicate to the nurse that the client is at
risk for digoxin toxicity?
A. Heart rate of 60 beats per minute.
B. Serum potassium level of 3.2 mEq/L.
C. Serum creatinine of 1.0 mg/dL.
D. Blood pressure of 132/78 mm Hg.
CORRECT ANSWER: B. Serum potassium level of 3.2 mEq/L.
Rationale: Hypokalemia (serum potassium < 3.5 mEq/L) increases the risk of digoxin
toxicity because digoxin competes with potassium for binding sites on the sodium-
potassium pump. The nurse should monitor potassium levels and report low levels to
the provider.
, Question 9: A nurse is planning care for a client who has a new diagnosis of
deep vein thrombosis (DVT). Which of the following interventions should the
nurse include?
A. Apply sequential compression devices to both legs.
B. Maintain the client on bed rest with the affected leg elevated.
C. Massage the affected leg to promote venous return.
D. Apply cold compresses to the affected leg.
CORRECT ANSWER: B. Maintain the client on bed rest with the affected leg
elevated.
Rationale: For a client with a DVT, bed rest with the affected leg elevated above the
heart level promotes venous return and reduces edema. Massaging the leg could
dislodge the clot, and compression devices are not recommended for an acute DVT.
Question 10: A nurse is assessing a client who is receiving morphine sulfate
via patient-controlled analgesia (PCA). Which of the following findings is the
priority for the nurse to report?
A. Respiratory rate of 10 breaths per minute.
B. Blood pressure of 110/70 mm Hg.
C. Pain rating of 4 on a scale of 0 to 10.
D. Nausea and vomiting.
CORRECT ANSWER: A. Respiratory rate of 10 breaths per minute.
Rationale: Morphine, an opioid analgesic, can cause respiratory depression. A
respiratory rate of 10 breaths per minute is below the expected range (12-20) and
indicates a potentially life-threatening adverse effect, which is the priority for the nurse
to report to the provider.
Question 11: A nurse is providing teaching to a client who is to start taking
metformin for type 2 diabetes mellitus. The nurse should instruct the client to
watch for which of the following adverse effects?
A. Weight gain.
B. Hypoglycemia.
C. Lactic acidosis.
D. Tachycardia.
CORRECT ANSWER: C. Lactic acidosis.
Rationale: Metformin, a biguanide, carries a rare but serious risk of lactic acidosis,
particularly in clients with renal impairment, liver disease, or acute conditions. The
nurse should instruct the client to report symptoms such as muscle pain, weakness, and
difficulty breathing.
Guide | ATI Comprehensive Predictor Exit Exam
Prep | NGN Clinical Judgment Practice Questions &
Answers, Detailed Rationales, Case Studies,
Prioritization & Delegation, NCLEX-RN Readiness,
Comprehensive Nursing Review
Question 1: A nurse is caring for a client who is postoperative following a total
hip arthroplasty. Which of the following actions should the nurse take to
prevent dislocation of the new joint?
A. Position the client's legs in an adduction position.
B. Place a pillow between the client's legs while in bed.
C. Encourage the client to flex the hips to 120 degrees when sitting.
D. Instruct the client to cross their legs at the ankles when turning.
CORRECT ANSWER: B. Place a pillow between the client's legs while in bed.
Rationale: To prevent dislocation following a total hip arthroplasty, the nurse must
maintain the hip in a neutral position, avoiding adduction, internal rotation, and
excessive flexion (greater than 90 degrees). Placing an abduction pillow between the
client's legs keeps the hip abducted and prevents crossing the legs, which can lead to
dislocation.
Question 2: A nurse is teaching a client with a new diagnosis of type 1 diabetes
mellitus about insulin administration. Which of the following instructions
should the nurse include?
A. Store unopened vials of insulin in the freezer.
B. Rotate injection sites within the same anatomical region.
C. Administer insulin at a 45-degree angle using a ⅝-inch needle.
D. Rub the site vigorously after injection to promote absorption.
CORRECT ANSWER: B. Rotate injection sites within the same anatomical
region.
Rationale: Rotating injection sites within the same anatomical region (e.g., abdomen,
thigh, arm) prevents lipohypertrophy and ensures consistent insulin absorption.
Unopened insulin should be refrigerated, not frozen. The angle of injection depends on
needle length and subcutaneous tissue thickness.
Question 3: A nurse is assessing a client who has heart failure and is receiving
furosemide. Which of the following findings indicates the medication is having
a therapeutic effect?
A. Decrease in peripheral edema.
B. Increase in blood pressure.
,C. Increase in jugular venous distention.
D. Decrease in urine output.
CORRECT ANSWER: A. Decrease in peripheral edema.
Rationale: Furosemide is a loop diuretic used to manage fluid overload in heart failure. A
therapeutic effect is evidenced by a decrease in peripheral edema, dyspnea, and jugular
venous distention, as well as an increase in urine output and a decrease in blood
pressure.
Question 4: A nurse is preparing to administer a blood transfusion to a client.
Which of the following actions should the nurse take first?
A. Verify the client's blood type with a second nurse.
B. Assess the client's vital signs.
C. Obtain the unit of packed red blood cells from the blood bank.
D. Start an IV line with 0.9% sodium chloride.
CORRECT ANSWER: A. Verify the client's blood type with a second nurse.
Rationale: The first action the nurse should take is to verify the client's identification and
blood type with another qualified nurse to ensure the correct blood product is
administered, preventing a fatal hemolytic transfusion reaction. This is a critical safety
step before all other actions.
Question 5: A nurse is providing discharge teaching to a client who has a new
colostomy. Which of the following statements by the client indicates a need for
further teaching?
A. "I will irrigate my colostomy at the same time each day."
B. "I can expect the stoma to be pink and moist."
C. "I will avoid eating foods that cause gas formation."
D. "I will change the pouch when it is one-third full of stool."
CORRECT ANSWER: D. "I will change the pouch when it is one-third full of
stool."
Rationale: A colostomy pouch should be changed when it is one-half to two-thirds full to
prevent leakage and skin breakdown. Changing it when one-third full is too frequent and
unnecessary, indicating a need for further teaching about proper pouch management.
Question 6: A nurse is assessing a client who has chronic obstructive
pulmonary disease (COPD). Which of the following findings should the nurse
expect?
,A. Diminished breath sounds.
B. Increased anterior-posterior (AP) chest diameter.
C. Prolonged expiratory phase.
D. All of the above.
CORRECT ANSWER: D. All of the above.
Rationale: COPD is characterized by hyperinflation of the lungs, leading to a barrel chest
(increased AP diameter), diminished breath sounds due to air trapping, and a prolonged
expiratory phase resulting from obstructed airways, making all options expected
findings.
Question 7: A nurse is caring for a client who is 2 hours postoperative
following a femoral popliteal bypass graft. Which of the following assessments
is the priority?
A. Pain level in the affected leg.
B. Pulse oximetry reading.
C. Capillary refill time in the toes.
D. Urinary output.
CORRECT ANSWER: C. Capillary refill time in the toes.
Rationale: The priority assessment following a peripheral vascular bypass is monitoring
graft patency. Capillary refill time, along with pulse checks and skin color/temperature,
provides immediate data on perfusion to the extremity, making it the most critical
assessment to detect early graft occlusion.
Question 8: A nurse is administering digoxin to a client who has heart failure.
Which of the following findings should indicate to the nurse that the client is at
risk for digoxin toxicity?
A. Heart rate of 60 beats per minute.
B. Serum potassium level of 3.2 mEq/L.
C. Serum creatinine of 1.0 mg/dL.
D. Blood pressure of 132/78 mm Hg.
CORRECT ANSWER: B. Serum potassium level of 3.2 mEq/L.
Rationale: Hypokalemia (serum potassium < 3.5 mEq/L) increases the risk of digoxin
toxicity because digoxin competes with potassium for binding sites on the sodium-
potassium pump. The nurse should monitor potassium levels and report low levels to
the provider.
, Question 9: A nurse is planning care for a client who has a new diagnosis of
deep vein thrombosis (DVT). Which of the following interventions should the
nurse include?
A. Apply sequential compression devices to both legs.
B. Maintain the client on bed rest with the affected leg elevated.
C. Massage the affected leg to promote venous return.
D. Apply cold compresses to the affected leg.
CORRECT ANSWER: B. Maintain the client on bed rest with the affected leg
elevated.
Rationale: For a client with a DVT, bed rest with the affected leg elevated above the
heart level promotes venous return and reduces edema. Massaging the leg could
dislodge the clot, and compression devices are not recommended for an acute DVT.
Question 10: A nurse is assessing a client who is receiving morphine sulfate
via patient-controlled analgesia (PCA). Which of the following findings is the
priority for the nurse to report?
A. Respiratory rate of 10 breaths per minute.
B. Blood pressure of 110/70 mm Hg.
C. Pain rating of 4 on a scale of 0 to 10.
D. Nausea and vomiting.
CORRECT ANSWER: A. Respiratory rate of 10 breaths per minute.
Rationale: Morphine, an opioid analgesic, can cause respiratory depression. A
respiratory rate of 10 breaths per minute is below the expected range (12-20) and
indicates a potentially life-threatening adverse effect, which is the priority for the nurse
to report to the provider.
Question 11: A nurse is providing teaching to a client who is to start taking
metformin for type 2 diabetes mellitus. The nurse should instruct the client to
watch for which of the following adverse effects?
A. Weight gain.
B. Hypoglycemia.
C. Lactic acidosis.
D. Tachycardia.
CORRECT ANSWER: C. Lactic acidosis.
Rationale: Metformin, a biguanide, carries a rare but serious risk of lactic acidosis,
particularly in clients with renal impairment, liver disease, or acute conditions. The
nurse should instruct the client to report symptoms such as muscle pain, weakness, and
difficulty breathing.
