2026 ATI RN Comprehensive Predictor 2026 Exam with NGN
180 Questions & Answers — 199 Questions and Answers Already
Graded A+ Premium Exam Tested And Verified
Subject Area Nursing (Comprehensive Predictor)
Description This exam assesses advanced nursing knowledge and clinical reasoning across
major content areas including pharmacology, medical-surgical, maternal-newborn,
pediatrics, mental health, and leadership. Questions require synthesis of complex
concepts, interpretation of clinical data, and application of evidence-based
practice.
Expected Grade A+
Total Questions 50
Duration 3 hours
Learning Outcomes 1. Apply critical thinking to prioritize nursing interventions in complex clinical
scenarios.
2. Interpret diagnostic data and adjust care plans accordingly.
3. Identify adverse drug reactions and implement appropriate monitoring.
4. Demonstrate knowledge of infection control and emergency preparedness.
5. Synthesize legal and ethical principles in nursing practice.
Accreditation Aligns with AACN Essentials and NCLEX-RN test plan standards for top-tier US
nursing programs.
Page 1
,1. A client with a history of chronic heart failure is admitted with acute pulmonary
edema. The nurse notes the client has a new prescription for nesiritide. Which of the
following parameters should the nurse prioritize monitoring during the infusion?
A. Serum potassium levels
B. Blood pressure and heart rate
C. Urine output and serum creatinine
D. Respiratory rate and oxygen saturation
Answer: B. Blood pressure and heart rate
Nesiritide is a recombinant B-type natriuretic peptide that causes vasodilation and
diuresis; its primary adverse effect is hypotension. While all options are relevant, blood
pressure and heart rate monitoring are priority due to the risk of symptomatic
hypotension. Potassium and renal function are important but secondary; respiratory
status is already being addressed.
2. A nurse is assessing a client with suspected left-sided heart failure. Which finding
is most indicative of this condition?
A. Jugular venous distention
B. Hepatomegaly
C. Crackles in the lung bases
D. Peripheral edema
Answer: C. Crackles in the lung bases
Left-sided heart failure leads to pulmonary congestion due to increased pressure in the
pulmonary veins, resulting in crackles on auscultation. Jugular venous distention,
hepatomegaly, and peripheral edema are classic signs of right-sided heart failure.
3. A nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which statement by the client indicates a need for further teaching?
A. I will use an electric razor to shave.
B. I will avoid eating large amounts of green leafy vegetables.
C. I will take aspirin if I get a headache.
D. I will report any red or black stools to my provider.
Answer: C. I will take aspirin if I get a headache.
Aspirin is an antiplatelet agent that increases the risk of bleeding when combined with
warfarin. Clients should avoid aspirin and NSAIDs unless prescribed. The other
statements reflect appropriate safety measures: using a soft razor, consistent vitamin K
intake (leafy greens), and monitoring for signs of bleeding.
Page 2
,4. A nurse is caring for a client who has a chest tube connected to a dry suction water
seal drainage system. The nurse notes continuous bubbling in the water seal
chamber. Which action should the nurse take first?
A. Clamp the chest tube near the insertion site.
B. Check the tubing connections for leaks.
C. Increase the suction pressure setting.
D. Notify the provider immediately.
Answer: B. Check the tubing connections for leaks.
Continuous bubbling in the water seal chamber indicates an air leak, which is often due
to loose connections or a dislodged tube. The first step is to assess the system for leaks
by checking connections. Clamping is not recommended as it can cause tension
pneumothorax; increasing suction does not fix a leak.
5. A nurse is assessing a client who has just undergone a lumbar puncture. Which
finding requires immediate intervention?
A. Client reports a headache when sitting up.
B. Clear fluid leaking from the puncture site.
C. Mild tenderness at the puncture site.
D. Client is lying flat in bed.
Answer: B. Clear fluid leaking from the puncture site.
Clear fluid leaking from the puncture site suggests a cerebrospinal fluid leak, which
increases the risk of infection and requires immediate intervention. Headache when
sitting up is common after lumbar puncture (post-dural puncture headache) and is
managed with lying flat and hydration. Tenderness is expected.
6. A nurse is caring for a client with major depressive disorder who has been
prescribed phenelzine. Which of the following foods should the nurse instruct the
client to avoid?
A. Aged cheese
B. Fresh fruits
C. Whole grain bread
D. Lean chicken
Answer: A. Aged cheese
Phenelzine is a monoamine oxidase inhibitor (MAOI) that requires avoidance of
tyramine-rich foods to prevent hypertensive crisis. Aged cheese is high in tyramine.
Fresh fruits, whole grains, and lean chicken are low in tyramine and safe.
Page 3
, 7. A nurse is providing care to a client who has a magnesium level of 1.2 mEq/L.
Which assessment finding should the nurse anticipate?
A. Hyperactive deep tendon reflexes
B. Positive Trousseau's sign
C. Bradycardia
D. Hypotension
Answer: B. Positive Trousseau's sign
A magnesium level of 1.2 mEq/L indicates hypomagnesemia (normal 1.3-2.1 mEq/L).
Hypomagnesemia causes neuromuscular irritability, leading to positive Trousseau's
sign (carpopedal spasm with BP cuff inflation) and Chvostek's sign. Hyperactive
reflexes may occur but Trousseau's is more specific. Bradycardia and hypotension are
not typical.
8. A nurse is assessing a client who has a potassium level of 5.8 mEq/L. Which
electrocardiographic change should the nurse expect?
A. Flattened T waves
B. Prominent U waves
C. Peaked T waves
D. Prolonged QT interval
Answer: C. Peaked T waves
Hyperkalemia (K+ 5.8 mEq/L) typically presents with peaked T waves on ECG.
Flattened T waves and prominent U waves are associated with hypokalemia. Prolonged
QT interval can occur with hypocalcemia or certain medications, not hyperkalemia.
9. A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions is most important in preventing a transfusion reaction?
A. Obtaining informed consent from the client.
B. Using a 22-gauge IV catheter for administration.
C. Verifying the client's identity with two identifiers.
D. Administering the blood within 30 minutes of obtaining it from the blood bank.
Answer: C. Verifying the client's identity with two identifiers.
The most critical step in preventing a hemolytic transfusion reaction is verifying the
client's identity with two identifiers to ensure the correct blood product is given to the
correct recipient. While informed consent and timely administration are important,
they do not directly prevent mistransfusion. Catheter size should be at least 20-gauge
for blood.
Page 4
180 Questions & Answers — 199 Questions and Answers Already
Graded A+ Premium Exam Tested And Verified
Subject Area Nursing (Comprehensive Predictor)
Description This exam assesses advanced nursing knowledge and clinical reasoning across
major content areas including pharmacology, medical-surgical, maternal-newborn,
pediatrics, mental health, and leadership. Questions require synthesis of complex
concepts, interpretation of clinical data, and application of evidence-based
practice.
Expected Grade A+
Total Questions 50
Duration 3 hours
Learning Outcomes 1. Apply critical thinking to prioritize nursing interventions in complex clinical
scenarios.
2. Interpret diagnostic data and adjust care plans accordingly.
3. Identify adverse drug reactions and implement appropriate monitoring.
4. Demonstrate knowledge of infection control and emergency preparedness.
5. Synthesize legal and ethical principles in nursing practice.
Accreditation Aligns with AACN Essentials and NCLEX-RN test plan standards for top-tier US
nursing programs.
Page 1
,1. A client with a history of chronic heart failure is admitted with acute pulmonary
edema. The nurse notes the client has a new prescription for nesiritide. Which of the
following parameters should the nurse prioritize monitoring during the infusion?
A. Serum potassium levels
B. Blood pressure and heart rate
C. Urine output and serum creatinine
D. Respiratory rate and oxygen saturation
Answer: B. Blood pressure and heart rate
Nesiritide is a recombinant B-type natriuretic peptide that causes vasodilation and
diuresis; its primary adverse effect is hypotension. While all options are relevant, blood
pressure and heart rate monitoring are priority due to the risk of symptomatic
hypotension. Potassium and renal function are important but secondary; respiratory
status is already being addressed.
2. A nurse is assessing a client with suspected left-sided heart failure. Which finding
is most indicative of this condition?
A. Jugular venous distention
B. Hepatomegaly
C. Crackles in the lung bases
D. Peripheral edema
Answer: C. Crackles in the lung bases
Left-sided heart failure leads to pulmonary congestion due to increased pressure in the
pulmonary veins, resulting in crackles on auscultation. Jugular venous distention,
hepatomegaly, and peripheral edema are classic signs of right-sided heart failure.
3. A nurse is providing discharge teaching to a client who has a new prescription for
warfarin. Which statement by the client indicates a need for further teaching?
A. I will use an electric razor to shave.
B. I will avoid eating large amounts of green leafy vegetables.
C. I will take aspirin if I get a headache.
D. I will report any red or black stools to my provider.
Answer: C. I will take aspirin if I get a headache.
Aspirin is an antiplatelet agent that increases the risk of bleeding when combined with
warfarin. Clients should avoid aspirin and NSAIDs unless prescribed. The other
statements reflect appropriate safety measures: using a soft razor, consistent vitamin K
intake (leafy greens), and monitoring for signs of bleeding.
Page 2
,4. A nurse is caring for a client who has a chest tube connected to a dry suction water
seal drainage system. The nurse notes continuous bubbling in the water seal
chamber. Which action should the nurse take first?
A. Clamp the chest tube near the insertion site.
B. Check the tubing connections for leaks.
C. Increase the suction pressure setting.
D. Notify the provider immediately.
Answer: B. Check the tubing connections for leaks.
Continuous bubbling in the water seal chamber indicates an air leak, which is often due
to loose connections or a dislodged tube. The first step is to assess the system for leaks
by checking connections. Clamping is not recommended as it can cause tension
pneumothorax; increasing suction does not fix a leak.
5. A nurse is assessing a client who has just undergone a lumbar puncture. Which
finding requires immediate intervention?
A. Client reports a headache when sitting up.
B. Clear fluid leaking from the puncture site.
C. Mild tenderness at the puncture site.
D. Client is lying flat in bed.
Answer: B. Clear fluid leaking from the puncture site.
Clear fluid leaking from the puncture site suggests a cerebrospinal fluid leak, which
increases the risk of infection and requires immediate intervention. Headache when
sitting up is common after lumbar puncture (post-dural puncture headache) and is
managed with lying flat and hydration. Tenderness is expected.
6. A nurse is caring for a client with major depressive disorder who has been
prescribed phenelzine. Which of the following foods should the nurse instruct the
client to avoid?
A. Aged cheese
B. Fresh fruits
C. Whole grain bread
D. Lean chicken
Answer: A. Aged cheese
Phenelzine is a monoamine oxidase inhibitor (MAOI) that requires avoidance of
tyramine-rich foods to prevent hypertensive crisis. Aged cheese is high in tyramine.
Fresh fruits, whole grains, and lean chicken are low in tyramine and safe.
Page 3
, 7. A nurse is providing care to a client who has a magnesium level of 1.2 mEq/L.
Which assessment finding should the nurse anticipate?
A. Hyperactive deep tendon reflexes
B. Positive Trousseau's sign
C. Bradycardia
D. Hypotension
Answer: B. Positive Trousseau's sign
A magnesium level of 1.2 mEq/L indicates hypomagnesemia (normal 1.3-2.1 mEq/L).
Hypomagnesemia causes neuromuscular irritability, leading to positive Trousseau's
sign (carpopedal spasm with BP cuff inflation) and Chvostek's sign. Hyperactive
reflexes may occur but Trousseau's is more specific. Bradycardia and hypotension are
not typical.
8. A nurse is assessing a client who has a potassium level of 5.8 mEq/L. Which
electrocardiographic change should the nurse expect?
A. Flattened T waves
B. Prominent U waves
C. Peaked T waves
D. Prolonged QT interval
Answer: C. Peaked T waves
Hyperkalemia (K+ 5.8 mEq/L) typically presents with peaked T waves on ECG.
Flattened T waves and prominent U waves are associated with hypokalemia. Prolonged
QT interval can occur with hypocalcemia or certain medications, not hyperkalemia.
9. A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions is most important in preventing a transfusion reaction?
A. Obtaining informed consent from the client.
B. Using a 22-gauge IV catheter for administration.
C. Verifying the client's identity with two identifiers.
D. Administering the blood within 30 minutes of obtaining it from the blood bank.
Answer: C. Verifying the client's identity with two identifiers.
The most critical step in preventing a hemolytic transfusion reaction is verifying the
client's identity with two identifiers to ensure the correct blood product is given to the
correct recipient. While informed consent and timely administration are important,
they do not directly prevent mistransfusion. Catheter size should be at least 20-gauge
for blood.
Page 4
