ATI COMPREHENSIVE TEST B
PRACTICE TEST 1
Assessment Technologies Institute (ATI)
Nursing Education Proctored Assessment
for NCLEX-RN Readiness
2026/2027 Edition
100 Questions | Multiple-Choice & NGN-Style Items
Approximately 120 Minutes | Passing Benchmark: 75–85%
,Table of Contents
Section 1: Nursing Process & Clinical Judgment (Q1–10)
Section 2: Cardiovascular Disorders (Q11–18)
Section 3: Respiratory Disorders (Q19–26)
Section 4: Gastrointestinal Disorders (Q27–32)
Section 5: Renal/Urinary Disorders (Q33–38)
Section 6: Endocrine Disorders (Q39–45)
Section 7: Neurological Disorders (Q46–53)
Section 8: Musculoskeletal & Immune/Hematologic Disorders (Q54–62)
Section 9: Maternal-Newborn Nursing: Antepartum (Q63–68)
Section 10: Maternal-Newborn Nursing: Intrapartum & Postpartum (Q69–74)
Section 11: Maternal-Newborn Nursing: Newborn (Q75–78)
Section 12: Pediatric Nursing (Q79–84)
Section 13: Mental Health Nursing (Q85–90)
Section 14: Fundamentals of Nursing (Q91–93)
Section 15: Leadership & Management (Q94–96)
Section 16: Pharmacology (Q97–98)
Section 17: NGN Critical Thinking Items (Q99–100)
Answer Key Summary
,Section 1: Nursing Process & Clinical Judgment (Q1–10)
1. A nurse is caring for a client who presents to the emergency department with chest pain,
diaphoresis, and shortness of breath. Which action should the nurse take first according to
the nursing process?
[Multiple Choice]
A) Obtain a 12-lead ECG
B) Administer prescribed sublingual nitroglycerin
C) Assess the client's vital signs
D) Review the client's medical history
Rationale: According to the nursing process, assessment is the first step. Obtaining a 12-lead ECG is
the priority assessment to evaluate for myocardial infarction (MI), as timely identification of ST-
segment changes guides immediate interventions such as reperfusion therapy. While vital signs and
medication administration are important, the ECG provides critical diagnostic data that must be
obtained within 10 minutes of arrival per ACC/AHA guidelines. This aligns with the NCSBN CJMM
step of Recognize Cues.
2. A nurse is using the NCSBN Clinical Judgment Measurement Model (CJMM). After
identifying that a postoperative client has a respiratory rate of 8 breaths/min and is
difficult to arouse, which CJMM step should the nurse perform next?
[Multiple Choice]
A) Take Action
B) Generate Solutions
C) Prioritize Hypotheses
D) Analyze Cues
Rationale: The nurse has already Recognized Cues (observing the abnormal respiratory rate and
altered level of consciousness). The next step in the CJMM framework is Analyze Cues, where the
nurse interprets the significance of these findings. A respiratory rate of 8 breaths/min with difficulty
arousing suggests opioid-induced respiratory depression, which requires immediate analysis before
prioritizing hypotheses or generating solutions. This systematic approach ensures that clinical
decisions are evidence-based and patient-centered.
3. A nurse is developing a care plan for a client with heart failure who has 3+ pitting edema
in the lower extremities. Which nursing diagnosis should the nurse identify as the
priority?
[Multiple Choice]
A) Impaired Gas Exchange
B) Fluid Volume Excess
C) Decreased Cardiac Output
D) Activity Intolerance
Rationale: While all diagnoses are applicable, Decreased Cardiac Output is the priority because the
heart's inability to pump effectively is the underlying pathophysiology causing both the fluid volume
excess and activity intolerance. Following the ABCs framework and Maslow's hierarchy, cardiac
output compromise threatens oxygenation to vital organs. The fluid retention (3+ edema) is a
manifestation of the heart failure, not the primary problem. Prioritizing Decreased Cardiac Output
addresses the root cause and guides interventions such as monitoring hemodynamic parameters,
administering inotropic agents, and reducing preload and afterload.
4. A nurse is evaluating the effectiveness of a client's pain management plan 2 hours after
administering morphine 4 mg IV. Which finding indicates the intervention was effective?
[Multiple Choice]
A) The client reports pain as 3/10 on the pain scale
, B) The client is sleeping peacefully
C) The client's respiratory rate is 14 breaths/min
D) The client's blood pressure is 130/80 mmHg
Rationale: Evaluation is the final step of the nursing process. The most direct indicator of pain
management effectiveness is the client's self-reported pain rating. A reduction to 3/10 from a
presumably higher baseline demonstrates the intervention achieved the desired outcome. While sleep
and stable vital signs are positive signs, they do not directly measure pain relief. The client could be
sleeping despite uncontrolled pain, and vital signs may remain stable even with moderate pain.
Patient self-report is considered the gold standard for pain assessment per evidence-based practice
guidelines.
5. A nurse is caring for a client with type 2 diabetes mellitus who has a blood glucose level
of 52 mg/dL. Which intervention should the nurse implement first?
[Multiple Choice]
A) Administer 15 g of fast-acting carbohydrates
B) Recheck the blood glucose in 15 minutes
C) Document the hypoglycemic event
D) Notify the healthcare provider
Rationale: Following the CJMM Take Action step and the nursing process Implementation phase, the
nurse must first treat the hypoglycemia. The American Diabetes Association recommends
administering 15–20 g of fast-acting carbohydrates (e.g., 4 oz juice, glucose tablets) for blood
glucose below 70 mg/dL. A level of 52 mg/dL requires immediate intervention to prevent
progression to severe hypoglycemia, seizures, or loss of consciousness. Rechecking in 15 minutes,
documenting, and notifying the provider are subsequent steps but must not delay treatment. This
follows the ABC (Airway, Breathing, Circulation) priority framework in the context of metabolic
emergencies.
6. A nurse is caring for a postoperative client who reports abdominal pain rated 7/10. The
client received morphine 2 mg IV 30 minutes ago. Which action should the nurse take next
in the CJMM framework?
[Multiple Choice]
A) Recognize Cues: Assess the surgical incision site
B) Generate Solutions: Consider alternative pain management strategies
C) Evaluate Outcomes: Document that pain remains uncontrolled
D) Prioritize Hypotheses: Determine if pain is related to complications
Rationale: The nurse has already Taken Action (administering morphine). Since the pain remains at
7/10 after 30 minutes, the nurse should move to Prioritize Hypotheses—determining whether this is
expected postoperative pain or indicative of a complication such as internal bleeding, infection, or
obstruction. This analysis guides whether to increase the opioid dose, add adjuvant medications, or
escalate concern. Simply documenting uncontrolled pain without analysis or reassessing the incision
without clinical reasoning would not advance the CJMM process effectively.
7. A nurse is planning care for a client with a new diagnosis of chronic obstructive
pulmonary disease (COPD). Which intervention should the nurse include in the plan to
promote effective airway clearance?
[Multiple Choice]
A) Instruct the client to inhale deeply and cough forcefully
B) Encourage the client to drink 2–3 liters of fluid daily unless contraindicated
C) Position the client supine during breathing treatments
D) Restrict physical activity to conserve energy
Rationale: Adequate hydration (2–3 L/day unless fluid-restricted) thins respiratory secretions,
facilitating mobilization and expectoration. This evidence-based intervention directly addresses the
PRACTICE TEST 1
Assessment Technologies Institute (ATI)
Nursing Education Proctored Assessment
for NCLEX-RN Readiness
2026/2027 Edition
100 Questions | Multiple-Choice & NGN-Style Items
Approximately 120 Minutes | Passing Benchmark: 75–85%
,Table of Contents
Section 1: Nursing Process & Clinical Judgment (Q1–10)
Section 2: Cardiovascular Disorders (Q11–18)
Section 3: Respiratory Disorders (Q19–26)
Section 4: Gastrointestinal Disorders (Q27–32)
Section 5: Renal/Urinary Disorders (Q33–38)
Section 6: Endocrine Disorders (Q39–45)
Section 7: Neurological Disorders (Q46–53)
Section 8: Musculoskeletal & Immune/Hematologic Disorders (Q54–62)
Section 9: Maternal-Newborn Nursing: Antepartum (Q63–68)
Section 10: Maternal-Newborn Nursing: Intrapartum & Postpartum (Q69–74)
Section 11: Maternal-Newborn Nursing: Newborn (Q75–78)
Section 12: Pediatric Nursing (Q79–84)
Section 13: Mental Health Nursing (Q85–90)
Section 14: Fundamentals of Nursing (Q91–93)
Section 15: Leadership & Management (Q94–96)
Section 16: Pharmacology (Q97–98)
Section 17: NGN Critical Thinking Items (Q99–100)
Answer Key Summary
,Section 1: Nursing Process & Clinical Judgment (Q1–10)
1. A nurse is caring for a client who presents to the emergency department with chest pain,
diaphoresis, and shortness of breath. Which action should the nurse take first according to
the nursing process?
[Multiple Choice]
A) Obtain a 12-lead ECG
B) Administer prescribed sublingual nitroglycerin
C) Assess the client's vital signs
D) Review the client's medical history
Rationale: According to the nursing process, assessment is the first step. Obtaining a 12-lead ECG is
the priority assessment to evaluate for myocardial infarction (MI), as timely identification of ST-
segment changes guides immediate interventions such as reperfusion therapy. While vital signs and
medication administration are important, the ECG provides critical diagnostic data that must be
obtained within 10 minutes of arrival per ACC/AHA guidelines. This aligns with the NCSBN CJMM
step of Recognize Cues.
2. A nurse is using the NCSBN Clinical Judgment Measurement Model (CJMM). After
identifying that a postoperative client has a respiratory rate of 8 breaths/min and is
difficult to arouse, which CJMM step should the nurse perform next?
[Multiple Choice]
A) Take Action
B) Generate Solutions
C) Prioritize Hypotheses
D) Analyze Cues
Rationale: The nurse has already Recognized Cues (observing the abnormal respiratory rate and
altered level of consciousness). The next step in the CJMM framework is Analyze Cues, where the
nurse interprets the significance of these findings. A respiratory rate of 8 breaths/min with difficulty
arousing suggests opioid-induced respiratory depression, which requires immediate analysis before
prioritizing hypotheses or generating solutions. This systematic approach ensures that clinical
decisions are evidence-based and patient-centered.
3. A nurse is developing a care plan for a client with heart failure who has 3+ pitting edema
in the lower extremities. Which nursing diagnosis should the nurse identify as the
priority?
[Multiple Choice]
A) Impaired Gas Exchange
B) Fluid Volume Excess
C) Decreased Cardiac Output
D) Activity Intolerance
Rationale: While all diagnoses are applicable, Decreased Cardiac Output is the priority because the
heart's inability to pump effectively is the underlying pathophysiology causing both the fluid volume
excess and activity intolerance. Following the ABCs framework and Maslow's hierarchy, cardiac
output compromise threatens oxygenation to vital organs. The fluid retention (3+ edema) is a
manifestation of the heart failure, not the primary problem. Prioritizing Decreased Cardiac Output
addresses the root cause and guides interventions such as monitoring hemodynamic parameters,
administering inotropic agents, and reducing preload and afterload.
4. A nurse is evaluating the effectiveness of a client's pain management plan 2 hours after
administering morphine 4 mg IV. Which finding indicates the intervention was effective?
[Multiple Choice]
A) The client reports pain as 3/10 on the pain scale
, B) The client is sleeping peacefully
C) The client's respiratory rate is 14 breaths/min
D) The client's blood pressure is 130/80 mmHg
Rationale: Evaluation is the final step of the nursing process. The most direct indicator of pain
management effectiveness is the client's self-reported pain rating. A reduction to 3/10 from a
presumably higher baseline demonstrates the intervention achieved the desired outcome. While sleep
and stable vital signs are positive signs, they do not directly measure pain relief. The client could be
sleeping despite uncontrolled pain, and vital signs may remain stable even with moderate pain.
Patient self-report is considered the gold standard for pain assessment per evidence-based practice
guidelines.
5. A nurse is caring for a client with type 2 diabetes mellitus who has a blood glucose level
of 52 mg/dL. Which intervention should the nurse implement first?
[Multiple Choice]
A) Administer 15 g of fast-acting carbohydrates
B) Recheck the blood glucose in 15 minutes
C) Document the hypoglycemic event
D) Notify the healthcare provider
Rationale: Following the CJMM Take Action step and the nursing process Implementation phase, the
nurse must first treat the hypoglycemia. The American Diabetes Association recommends
administering 15–20 g of fast-acting carbohydrates (e.g., 4 oz juice, glucose tablets) for blood
glucose below 70 mg/dL. A level of 52 mg/dL requires immediate intervention to prevent
progression to severe hypoglycemia, seizures, or loss of consciousness. Rechecking in 15 minutes,
documenting, and notifying the provider are subsequent steps but must not delay treatment. This
follows the ABC (Airway, Breathing, Circulation) priority framework in the context of metabolic
emergencies.
6. A nurse is caring for a postoperative client who reports abdominal pain rated 7/10. The
client received morphine 2 mg IV 30 minutes ago. Which action should the nurse take next
in the CJMM framework?
[Multiple Choice]
A) Recognize Cues: Assess the surgical incision site
B) Generate Solutions: Consider alternative pain management strategies
C) Evaluate Outcomes: Document that pain remains uncontrolled
D) Prioritize Hypotheses: Determine if pain is related to complications
Rationale: The nurse has already Taken Action (administering morphine). Since the pain remains at
7/10 after 30 minutes, the nurse should move to Prioritize Hypotheses—determining whether this is
expected postoperative pain or indicative of a complication such as internal bleeding, infection, or
obstruction. This analysis guides whether to increase the opioid dose, add adjuvant medications, or
escalate concern. Simply documenting uncontrolled pain without analysis or reassessing the incision
without clinical reasoning would not advance the CJMM process effectively.
7. A nurse is planning care for a client with a new diagnosis of chronic obstructive
pulmonary disease (COPD). Which intervention should the nurse include in the plan to
promote effective airway clearance?
[Multiple Choice]
A) Instruct the client to inhale deeply and cough forcefully
B) Encourage the client to drink 2–3 liters of fluid daily unless contraindicated
C) Position the client supine during breathing treatments
D) Restrict physical activity to conserve energy
Rationale: Adequate hydration (2–3 L/day unless fluid-restricted) thins respiratory secretions,
facilitating mobilization and expectoration. This evidence-based intervention directly addresses the
