ATI COMPREHENSIVE
PREDICTOR SIMULATION TEST –
REAL EXAM FORMAT||Questions
And Answers With Rationales/Graded
A+/2026 Update/100% Correct
/Instant Download
Latest 2026 Edition
Total Questions: 85
Time Limit: 3 hours (simulated)
Type: NCLEX-style, including multiple choice, SATA, ordered response, and
calculation
Instructions:
• Select the best answer(s).
• For SATA, select all that apply.
• Correct answer is highlighted in bold.
• Rationale provided after each question.
1. A nurse is assessing a client who is 2 hours post-upper GI endoscopy. Which
of the following findings requires immediate intervention?
A. Gag reflex present
B. Complaints of mild sore throat
C. Abdominal rigidity
D. Pulse oximetry 94% on room air
,Rationale: Abdominal rigidity suggests perforation (a medical emergency). Gag
reflex should return; mild sore throat and O2 sat 94% are expected.
2. A nurse is preparing to administer digoxin to a client with heart failure.
Which of the following findings should prompt the nurse to withhold the
medication? (SATA)
A. Apical pulse 52/min
B. Blood pressure 118/76 mm Hg
C. Serum potassium 3.2 mEq/L
D. Respiratory rate 18/min
E. Client reports nausea
Rationale: Digoxin is held for HR <60 (adult) and hypokalemia (increases
toxicity). Nausea can be a side effect but not automatically hold without other
signs.
3. A client with major depressive disorder is prescribed phenelzine. Which of
the following foods should the nurse instruct the client to avoid?
A. Broccoli
B. Yogurt
C. Aged cheese
D. Apples
Rationale: Phenelzine (MAOI) interacts with tyramine-rich foods (aged cheese,
cured meats, fermented products) → hypertensive crisis.
4. A nurse is caring for a client in active labor. The FHR tracing shows
recurrent late decelerations. Which of the following actions should the nurse
take first?
A. Change maternal position to left lateral
B. Increase IV oxytocin
C. Prepare for immediate cesarean section
D. Administer terbutaline
, Rationale: Late decels indicate uteroplacental insufficiency. First action: maternal
reposition to improve placental perfusion.
5. A nurse is providing discharge teaching to a client with a new colostomy.
Which statement indicates understanding?
A. “I will limit fluid intake to prevent diarrhea.”
B. “I should empty the pouch when it is one-third full.”
C. “I will change the entire appliance daily.”
D. “I can use oil-based lotions around the stoma.”
Rationale: Empty pouch at 1/3 full to prevent leakage. Daily appliance change is
unnecessary (can be 3-7 days). Avoid oils (prevent adhesion).
6–10: Select-All-That-Apply & Prioritization
6. A nurse is assessing a client with Cushing’s syndrome. Which findings are
expected? (SATA)
A. Moon face
B. Buffalo hump
C. Hyperglycemia
D. Hypotension
E. Purple striae
Rationale: Excess cortisol causes central obesity, hyperglycemia, hypertension
(not hypotension), skin changes.
7. A nurse is reviewing lab values for a client receiving heparin. Which value
requires immediate discontinuation of heparin?
A. aPTT 60 seconds
B. Platelets 200,000/mm³
C. Platelets 60,000/mm³
D. INR 1.2
Rationale: Sudden drop in platelets → HIT (heparin-induced thrombocytopenia).
Stop heparin immediately.
PREDICTOR SIMULATION TEST –
REAL EXAM FORMAT||Questions
And Answers With Rationales/Graded
A+/2026 Update/100% Correct
/Instant Download
Latest 2026 Edition
Total Questions: 85
Time Limit: 3 hours (simulated)
Type: NCLEX-style, including multiple choice, SATA, ordered response, and
calculation
Instructions:
• Select the best answer(s).
• For SATA, select all that apply.
• Correct answer is highlighted in bold.
• Rationale provided after each question.
1. A nurse is assessing a client who is 2 hours post-upper GI endoscopy. Which
of the following findings requires immediate intervention?
A. Gag reflex present
B. Complaints of mild sore throat
C. Abdominal rigidity
D. Pulse oximetry 94% on room air
,Rationale: Abdominal rigidity suggests perforation (a medical emergency). Gag
reflex should return; mild sore throat and O2 sat 94% are expected.
2. A nurse is preparing to administer digoxin to a client with heart failure.
Which of the following findings should prompt the nurse to withhold the
medication? (SATA)
A. Apical pulse 52/min
B. Blood pressure 118/76 mm Hg
C. Serum potassium 3.2 mEq/L
D. Respiratory rate 18/min
E. Client reports nausea
Rationale: Digoxin is held for HR <60 (adult) and hypokalemia (increases
toxicity). Nausea can be a side effect but not automatically hold without other
signs.
3. A client with major depressive disorder is prescribed phenelzine. Which of
the following foods should the nurse instruct the client to avoid?
A. Broccoli
B. Yogurt
C. Aged cheese
D. Apples
Rationale: Phenelzine (MAOI) interacts with tyramine-rich foods (aged cheese,
cured meats, fermented products) → hypertensive crisis.
4. A nurse is caring for a client in active labor. The FHR tracing shows
recurrent late decelerations. Which of the following actions should the nurse
take first?
A. Change maternal position to left lateral
B. Increase IV oxytocin
C. Prepare for immediate cesarean section
D. Administer terbutaline
, Rationale: Late decels indicate uteroplacental insufficiency. First action: maternal
reposition to improve placental perfusion.
5. A nurse is providing discharge teaching to a client with a new colostomy.
Which statement indicates understanding?
A. “I will limit fluid intake to prevent diarrhea.”
B. “I should empty the pouch when it is one-third full.”
C. “I will change the entire appliance daily.”
D. “I can use oil-based lotions around the stoma.”
Rationale: Empty pouch at 1/3 full to prevent leakage. Daily appliance change is
unnecessary (can be 3-7 days). Avoid oils (prevent adhesion).
6–10: Select-All-That-Apply & Prioritization
6. A nurse is assessing a client with Cushing’s syndrome. Which findings are
expected? (SATA)
A. Moon face
B. Buffalo hump
C. Hyperglycemia
D. Hypotension
E. Purple striae
Rationale: Excess cortisol causes central obesity, hyperglycemia, hypertension
(not hypotension), skin changes.
7. A nurse is reviewing lab values for a client receiving heparin. Which value
requires immediate discontinuation of heparin?
A. aPTT 60 seconds
B. Platelets 200,000/mm³
C. Platelets 60,000/mm³
D. INR 1.2
Rationale: Sudden drop in platelets → HIT (heparin-induced thrombocytopenia).
Stop heparin immediately.
