ATI COMPREHENSIVE PREDICTOR
THE ULTIMATE 200-QUESTION
NCLEX READINESS EXAM
1. A nurse is caring for a client who is 24 hours postoperative
following an abdominal surgery. Which of the following
findings is the priority to report to the provider?
A. Serosanguineous drainage on the dressing
B. Absence of bowel sounds in all four quadrants
C. Sudden onset of shortness of breath and chest pain
D. Pain level of 6 on a scale of 0 to 10
Rationale: Using the ABC (Airway, Breathing, Circulation) priority
framework, sudden shortness of breath and chest pain are indicative of
a pulmonary embolism, a life-threatening postoperative complication.
2. A nurse is preparing to administer digoxin to a client with
heart failure. Which of the following actions should the nurse
take first?
A. Measure the apical pulse for 1 full minute.
B. Check the client’s most recent serum potassium level.
C. Monitor the client for nausea and vomiting.
D. Assess the client’s blood pressure.
Rationale: Digoxin can cause bradycardia. The nurse must assess the
apical heart rate first; if it is below 60/min (adult), the medication
should be withheld and the provider notified.
3. A nurse is teaching a client who has a new prescription for
alendronate. Which of the following instructions should the
nurse include?
A. Take the medication with a full glass of milk.
B. Lie down for 30 minutes after taking the medication.
C. Take the medication on an empty stomach with 8 oz of
water.
D. Take the medication right before bedtime.
Rationale: Alendronate must be taken on an empty stomach with plain
,water to enhance absorption and the client must remain upright for 30
minutes to prevent esophageal irritation.
4. A nurse is assessing a client with preeclampsia who is
receiving magnesium sulfate. Which of the following findings
should the nurse report as magnesium toxicity?
A. Blood pressure 150/96 mmHg
B. Absence of deep tendon reflexes
C. Increased urinary output
D. Respiratory rate of 16/min
Rationale: Signs of magnesium toxicity include loss of deep tendon
reflexes (DTRs), respiratory depression (<12/min), and decreased urine
output.
5. A nurse is caring for a client who has a lithium level of 1.8
mEq/L. Which of the following actions should the nurse take?
A. Administer the next scheduled dose of lithium.
B. Hold the medication and notify the provider.
C. Increase the client’s fluid intake to 3,000 mL/day.
D. Assess the client for a fine hand tremor.
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level
of 1.8 mEq/L is toxic, and the medication must be held immediately.
6. A nurse is assessing a client with a chest tube. Which of the
following findings indicates a tension pneumothorax?
A. Continuous bubbling in the water seal chamber
B. Serosanguineous drainage in the collection chamber
C. Tracheal deviation to the unaffected side
D. Tidaling in the water seal chamber with respirations
Rationale: Tracheal deviation is a late and hallmark sign of a tension
pneumothorax, which is a medical emergency.
7. A nurse is teaching the parent of a child with cystic fibrosis.
Which of the following instructions should the nurse include?
A. Administer pancreatic enzymes with every meal and snack.
B. Limit the child's salt intake during the summer months.
C. Provide a diet low in protein and calories.
D. Perform chest physiotherapy only when the child has a cough.
Rationale: Clients with cystic fibrosis have pancreatic insufficiency and
require enzymes to digest and absorb fats and proteins.
8. A nurse is caring for a client in the manic phase of bipolar
disorder. Which of the following snacks is most appropriate?
,A. A bowl of chicken noodle soup
B. A cheese stick and an apple
C. A salad with vinaigrette dressing
D. A cup of yogurt with a spoon
Rationale: Manic clients have high activity levels and short attention
spans; "finger foods" allow them to maintain caloric intake while
moving.
9. A nurse is providing discharge teaching to a client with a
new permanent pacemaker. Which of the following statements
indicates understanding?
A. "I will be able to get an MRI if I ever need one."
B. "I should keep my cell phone in my shirt pocket on the side of the
pacemaker."
C. "I will check my pulse every morning and report if it is
lower than the set rate."
D. "I should avoid using a microwave oven at home."
Rationale: Clients must monitor their heart rate to ensure the
pacemaker is firing correctly. Modern microwaves are safe, but MRIs
are generally contraindicated.
10. A nurse is assessing a client with a fractured femur. Which
of the following findings is the priority?
A. Ecchymosis over the fracture site
B. Pain reported as 8 on a scale of 0 to 10
C. Confusion and petechiae on the chest
D. 2+ pedal pulses on the affected extremity
Rationale: Confusion and petechiae on the chest/axilla are classic signs
of a Fat Embolism Syndrome, which can occur after a long bone
fracture.
(Due to length constraints, questions 11-50 continue with the same
format. To provide the best value, would you like me to focus the
remaining 40 questions on a specific weak area—
like Pharmacology or Pediatrics—or continue with a randomized
mix?)
Next Step: Should I continue the remaining 40 questions as
a randomized mix, or would you like to focus on a specific subject?
continue
, Ready to create a quiz?
Use Canvas to test your knowledge with a custom quiz
Get started
Continuing with questions 11–50, covering a randomized mix of Med-
Surg, Mental Health, Pediatrics, OB, and Pharmacology.
11. A nurse is caring for a client who is in the first trimester of
pregnancy and reports morning sickness. Which of the
following instructions should the nurse provide?
A. Drink a large glass of water with each meal.
B. Eat three large meals a day to maintain blood sugar.
C. Eat a few dry crackers before getting out of bed in the
morning.
D. Increase intake of high-fat foods for extra calories.
Rationale: Dry carbohydrates consumed before rising help settle the
stomach and mitigate nausea associated with morning sickness.
12. A nurse is reviewing the laboratory results of a client
receiving heparin via continuous IV infusion. Which of the
following results should the nurse report to the provider?
A. Vitamin K level of 100 ng/mL
B. INR of 1.1
C. aPTT of 95 seconds
D. Platelet count of 300,000/mm³
Rationale: The expected therapeutic range for aPTT on heparin is 1.5 to
2.5 times the control (usually 60-80 seconds). A value of 95 seconds
indicates a high risk for bleeding.
13. A nurse is caring for a client with a history of alcohol use
disorder who is experiencing transitions of withdrawal. Which
of the following is the priority assessment?
A. Degree of hand tremors
B. Level of orientation
C. Vital signs and cardiac rhythm
D. Nutritional status
Rationale: Alcohol withdrawal can lead to autonomic hyperactivity
(tachycardia, hypertension) and dysrhythmias, which can be life-
threatening.
THE ULTIMATE 200-QUESTION
NCLEX READINESS EXAM
1. A nurse is caring for a client who is 24 hours postoperative
following an abdominal surgery. Which of the following
findings is the priority to report to the provider?
A. Serosanguineous drainage on the dressing
B. Absence of bowel sounds in all four quadrants
C. Sudden onset of shortness of breath and chest pain
D. Pain level of 6 on a scale of 0 to 10
Rationale: Using the ABC (Airway, Breathing, Circulation) priority
framework, sudden shortness of breath and chest pain are indicative of
a pulmonary embolism, a life-threatening postoperative complication.
2. A nurse is preparing to administer digoxin to a client with
heart failure. Which of the following actions should the nurse
take first?
A. Measure the apical pulse for 1 full minute.
B. Check the client’s most recent serum potassium level.
C. Monitor the client for nausea and vomiting.
D. Assess the client’s blood pressure.
Rationale: Digoxin can cause bradycardia. The nurse must assess the
apical heart rate first; if it is below 60/min (adult), the medication
should be withheld and the provider notified.
3. A nurse is teaching a client who has a new prescription for
alendronate. Which of the following instructions should the
nurse include?
A. Take the medication with a full glass of milk.
B. Lie down for 30 minutes after taking the medication.
C. Take the medication on an empty stomach with 8 oz of
water.
D. Take the medication right before bedtime.
Rationale: Alendronate must be taken on an empty stomach with plain
,water to enhance absorption and the client must remain upright for 30
minutes to prevent esophageal irritation.
4. A nurse is assessing a client with preeclampsia who is
receiving magnesium sulfate. Which of the following findings
should the nurse report as magnesium toxicity?
A. Blood pressure 150/96 mmHg
B. Absence of deep tendon reflexes
C. Increased urinary output
D. Respiratory rate of 16/min
Rationale: Signs of magnesium toxicity include loss of deep tendon
reflexes (DTRs), respiratory depression (<12/min), and decreased urine
output.
5. A nurse is caring for a client who has a lithium level of 1.8
mEq/L. Which of the following actions should the nurse take?
A. Administer the next scheduled dose of lithium.
B. Hold the medication and notify the provider.
C. Increase the client’s fluid intake to 3,000 mL/day.
D. Assess the client for a fine hand tremor.
Rationale: The therapeutic range for lithium is 0.6 to 1.2 mEq/L. A level
of 1.8 mEq/L is toxic, and the medication must be held immediately.
6. A nurse is assessing a client with a chest tube. Which of the
following findings indicates a tension pneumothorax?
A. Continuous bubbling in the water seal chamber
B. Serosanguineous drainage in the collection chamber
C. Tracheal deviation to the unaffected side
D. Tidaling in the water seal chamber with respirations
Rationale: Tracheal deviation is a late and hallmark sign of a tension
pneumothorax, which is a medical emergency.
7. A nurse is teaching the parent of a child with cystic fibrosis.
Which of the following instructions should the nurse include?
A. Administer pancreatic enzymes with every meal and snack.
B. Limit the child's salt intake during the summer months.
C. Provide a diet low in protein and calories.
D. Perform chest physiotherapy only when the child has a cough.
Rationale: Clients with cystic fibrosis have pancreatic insufficiency and
require enzymes to digest and absorb fats and proteins.
8. A nurse is caring for a client in the manic phase of bipolar
disorder. Which of the following snacks is most appropriate?
,A. A bowl of chicken noodle soup
B. A cheese stick and an apple
C. A salad with vinaigrette dressing
D. A cup of yogurt with a spoon
Rationale: Manic clients have high activity levels and short attention
spans; "finger foods" allow them to maintain caloric intake while
moving.
9. A nurse is providing discharge teaching to a client with a
new permanent pacemaker. Which of the following statements
indicates understanding?
A. "I will be able to get an MRI if I ever need one."
B. "I should keep my cell phone in my shirt pocket on the side of the
pacemaker."
C. "I will check my pulse every morning and report if it is
lower than the set rate."
D. "I should avoid using a microwave oven at home."
Rationale: Clients must monitor their heart rate to ensure the
pacemaker is firing correctly. Modern microwaves are safe, but MRIs
are generally contraindicated.
10. A nurse is assessing a client with a fractured femur. Which
of the following findings is the priority?
A. Ecchymosis over the fracture site
B. Pain reported as 8 on a scale of 0 to 10
C. Confusion and petechiae on the chest
D. 2+ pedal pulses on the affected extremity
Rationale: Confusion and petechiae on the chest/axilla are classic signs
of a Fat Embolism Syndrome, which can occur after a long bone
fracture.
(Due to length constraints, questions 11-50 continue with the same
format. To provide the best value, would you like me to focus the
remaining 40 questions on a specific weak area—
like Pharmacology or Pediatrics—or continue with a randomized
mix?)
Next Step: Should I continue the remaining 40 questions as
a randomized mix, or would you like to focus on a specific subject?
continue
, Ready to create a quiz?
Use Canvas to test your knowledge with a custom quiz
Get started
Continuing with questions 11–50, covering a randomized mix of Med-
Surg, Mental Health, Pediatrics, OB, and Pharmacology.
11. A nurse is caring for a client who is in the first trimester of
pregnancy and reports morning sickness. Which of the
following instructions should the nurse provide?
A. Drink a large glass of water with each meal.
B. Eat three large meals a day to maintain blood sugar.
C. Eat a few dry crackers before getting out of bed in the
morning.
D. Increase intake of high-fat foods for extra calories.
Rationale: Dry carbohydrates consumed before rising help settle the
stomach and mitigate nausea associated with morning sickness.
12. A nurse is reviewing the laboratory results of a client
receiving heparin via continuous IV infusion. Which of the
following results should the nurse report to the provider?
A. Vitamin K level of 100 ng/mL
B. INR of 1.1
C. aPTT of 95 seconds
D. Platelet count of 300,000/mm³
Rationale: The expected therapeutic range for aPTT on heparin is 1.5 to
2.5 times the control (usually 60-80 seconds). A value of 95 seconds
indicates a high risk for bleeding.
13. A nurse is caring for a client with a history of alcohol use
disorder who is experiencing transitions of withdrawal. Which
of the following is the priority assessment?
A. Degree of hand tremors
B. Level of orientation
C. Vital signs and cardiac rhythm
D. Nutritional status
Rationale: Alcohol withdrawal can lead to autonomic hyperactivity
(tachycardia, hypertension) and dysrhythmias, which can be life-
threatening.
