ATI RN COMPREHENSIVE EXIT EXAM 180 NGN QUESTIONS AND VERIFIED
ANSWERS WELL GRADED BEST ATI COMPREHENSIVE NEW 2026 UPDATE 2026
┌─────────────────────────────────────────┐
│ ATI RN COMPREHENSIVE PREDICTOR EXAM │
└────────────────────┬────────────────────┘
│
┌─────────────────────────────┼─────────────────────────────┐
▼ ▼ ▼
┌─────────────────┐ ┌─────────────────┐
┌─────────────────┐
│ MANAGEMENT OF │ │ PHYSIOLOGICAL │ │
PHARMACOLOGICAL │
│ CARE │ │ ADAPTATION │ │ THERAPIES
│
│ (17-23% Items) │ │ (11-17% Items) │ │ (12-18%
Items) │
└─────────────────┘ └─────────────────┘
└─────────────────┘
🛠️ Safe and Effective Care Environment
Management of Care (17–23% of items): Focuses on advance directives, client rights,
advocacy, organ donation, confidentiality, and information technology. It heavily
evaluates delegation rules to Licensed Practical Nurses (LPNs) and Assistive Personnel
(AP), alongside setting clinical priorities via ABC and Maslow frameworks.
Safety and Infection Control (9–15% of items): Assesses surgical and medical
asepsis, correct handling of hazardous materials, proper deployment of mechanical
restraints, and strict implementation of transmission-based isolation precautions
(Airborne, Droplet, Contact).
🧬 Health Promotion and Maintenance (6–12% of items)
Covers the human lifespan from prenatal care through the aging process. Items
evaluate infant developmental milestones, pregnancy complications, physical
assessment techniques, high-risk lifestyle behaviors, health screening
recommendations, and disease prevention education.
🧬 Psychosocial Integrity (6–12% of items)
Tests your mastery of therapeutic communication techniques. It covers behavior
management, chemical dependency/substance withdrawal interventions, crisis
intervention, coping mechanisms, care for cognitive impairments (Dementia, Delirium),
and acute psychiatric disorders.
🧬 Physiological Integrity (The Largest Segment)
, Basic Care and Comfort (6–12% of items): Assesses non-pharmacological comfort
interventions, assistive mobility devices, elimination management, nutritional alterations,
sleep hygiene, and post-operative positioning.
Pharmacological and Parenteral Therapies (12–18% of items): Evaluates high-risk
drug management (heparin, insulin, digoxin, lithium), medication math calculations,
central line care, blood product transfusions, and parental nutrition (TPN).
Reduction of Risk Potential (9–15% of items): Evaluates laboratory value trends
(electrolytes, arterial blood gases, complete blood counts), diagnostic test protocols,
system-specific assessment findings, and therapeutic procedures.
Physiological Adaptation (11–17% of items): Focuses on acute medical-surgical
crises, hemodynamics, pathophysiology, fluid and electrolyte shocks, burns, and
emergency-level patient care.
1.A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
A. Maintain the client's affected hip in adduction.
B. Place an abduction pillow between the client's legs when turning.
C. Instruct the client to bend forward at the waist to put on socks.
D. Keep the head of the bed elevated at 90 degrees during meals.
Rationale: An abduction pillow prevents adduction and subsequent dislocation of the
new prosthetic joint. Bending forward at the waist or elevating the bed to 90 degrees
flexes the hip past 90 degrees, which is contraindicated.
2. A nurse is reviewing the laboratory results of a client who is receiving a
continuous IV infusion of heparin. Which of the following values should the nurse
report to the provider?
A. aPTT of 65 seconds
B. Platelet count of 180,000/mm³
C. aPTT of 110 seconds
D. INR of 1.2
Rationale: An aPTT of 110 seconds is significantly above the expected therapeutic
range for heparin therapy (typically 1.5 to 2.5 times the normal control value of 30 to 40
seconds, making the therapeutic target roughly 60 to 80 seconds). This places the client
at a high risk for spontaneous bleeding.
3. A nurse in an emergency department is assessing a client who has a leaking
abdominal aortic aneurysm (AAA). Which of the following findings should the
nurse expect?
,A. Sudden, severe back or flank pain
B. Increased blood pressure and bounding pulses
C. Hyperactive bowel sounds in all four quadrants
D. Warm, flushed extremities
Rationale: A leaking or rupturing AAA typically presents with sudden, intense, tearing
abdominal, back, or flank pain, accompanied by manifestations of hypovolemic shock
(hypotension, tachycardia, cold/clammy skin).
4. A nurse is preparing to administer an intramuscular injection to an infant who
is 6 months old. Which of the following sites should the nurse select?
A. Dorsogluteal
B. Deltoid
C. Vastus lateralis
D. Ventrogluteal
Rationale: The vastus lateralis muscle is the safest, most well-developed injection site
for infants under 12 months of age because it lacks major nerves and blood vessels.
5. A charge nurse is observing a newly licensed nurse suctioning a client's
tracheostomy tube. Which of the following actions by the newly licensed nurse
requires intervention?
A. Hyperoxygenating the client with 100% oxygen before insertion.
B. Applying intermittent suction while inserting the catheter.
C. Limiting the total suctioning time to 10 seconds.
D. Allowing 1 minute of rest between suctioning passes.
Rationale: Suction should never be applied during insertion of the catheter, as this
causes mucosal trauma and deprives the client of oxygen. Suction must only be applied
intermittently while withdrawing the catheter.
6. A nurse is assessing a client who has hypokalemia. Which of the following
clinical manifestations should the nurse expect?
A. Hyperactive deep tendon reflexes
B. Peaked T waves on an ECG
C. Muscle weakness and hyporeflexia
D. Diarrhea and abdominal cramping
Rationale: Hypokalemia causes decreased neuromuscular excitability, leading to
muscle weakness, diminished deep tendon reflexes, and cardiac dysrhythmias (such as
flattened T waves or U waves).
7. A nurse is caring for a client who is experiencing a panic attack. Which of the
following actions should the nurse take first?
A. Stay with the client and remain calm.
B. Administer a PRN dose of lorazepam.
C. Teach the client deep-breathing exercises.
D. Ask the client to identify the trigger of the panic attack.
Rationale: The priority action during a panic attack is ensuring safety and reducing
, anxiety by remaining with the client. Educational interventions or finding triggers cannot
be processed by a client experiencing severe or panic-level anxiety.
8. A nurse is caring for a client who has a prescription for a clear liquid diet.
Which of the following items should the nurse offer the client?
A. Vanilla pudding
B. Orange juice with pulp
C. Chicken broth
D. Oatmeal
Rationale: Clear liquids are items that are transparent and liquid at room temperature.
Chicken broth, apple juice, and gelatin qualify. Pudding, pulp, and oatmeal are not clear
liquids.
9. A nurse is preparing a sterile field for a dressing change. Which of the
following actions compromises the sterility of the field?
A. Opening the first flap of the sterile package away from the body.
B. Keeping the sterile field in sight and above waist level.
C. Pouring sterile saline into a container while holding the bottle cap down on an
unsterile surface.
D. Maintaining a 2.5 cm (1 inch) border around the edge of the field.
Rationale: The inside of a bottle cap must be placed facing upward on a clean surface
to preserve its sterility. Placing it face down contaminates the cap and subsequently the
fluid poured from it.
10. A nurse is monitoring a client who is receiving magnesium sulfate via
continuous IV infusion for preeclampsia. Which of the following findings
indicates toxicity?
A. Blood pressure of 142/90 mm Hg
B. Absence of deep tendon reflexes
C. Urinary output of 40 mL/hr
D. Respiratory rate of 16/min
Rationale: Magnesium sulfate is a central nervous system depressant. Signs of toxicity
include loss of deep tendon reflexes, a respiratory rate below 12/min, and urinary output
below 30 mL/hr.
11. A nurse is prioritizing care for four clients. Which of the following clients
should the nurse assess first?
A. A client with chronic bronchitis who has an SpO2 of 91% on room air.
B. A client with diabetes mellitus who has a fasting blood glucose of 145 mg/dL.
C. A client who had a subtotal thyroidectomy 12 hours ago and is experiencing
laryngeal stridor.
D. A client with appendicitis who reports localized right lower quadrant pain.
Rationale: Laryngeal stridor indicates an acute airway obstruction or severe muscle
spasms caused by hypocalcemia (accidental parathyroid removal), which is an
immediate life-threatening emergency.
ANSWERS WELL GRADED BEST ATI COMPREHENSIVE NEW 2026 UPDATE 2026
┌─────────────────────────────────────────┐
│ ATI RN COMPREHENSIVE PREDICTOR EXAM │
└────────────────────┬────────────────────┘
│
┌─────────────────────────────┼─────────────────────────────┐
▼ ▼ ▼
┌─────────────────┐ ┌─────────────────┐
┌─────────────────┐
│ MANAGEMENT OF │ │ PHYSIOLOGICAL │ │
PHARMACOLOGICAL │
│ CARE │ │ ADAPTATION │ │ THERAPIES
│
│ (17-23% Items) │ │ (11-17% Items) │ │ (12-18%
Items) │
└─────────────────┘ └─────────────────┘
└─────────────────┘
🛠️ Safe and Effective Care Environment
Management of Care (17–23% of items): Focuses on advance directives, client rights,
advocacy, organ donation, confidentiality, and information technology. It heavily
evaluates delegation rules to Licensed Practical Nurses (LPNs) and Assistive Personnel
(AP), alongside setting clinical priorities via ABC and Maslow frameworks.
Safety and Infection Control (9–15% of items): Assesses surgical and medical
asepsis, correct handling of hazardous materials, proper deployment of mechanical
restraints, and strict implementation of transmission-based isolation precautions
(Airborne, Droplet, Contact).
🧬 Health Promotion and Maintenance (6–12% of items)
Covers the human lifespan from prenatal care through the aging process. Items
evaluate infant developmental milestones, pregnancy complications, physical
assessment techniques, high-risk lifestyle behaviors, health screening
recommendations, and disease prevention education.
🧬 Psychosocial Integrity (6–12% of items)
Tests your mastery of therapeutic communication techniques. It covers behavior
management, chemical dependency/substance withdrawal interventions, crisis
intervention, coping mechanisms, care for cognitive impairments (Dementia, Delirium),
and acute psychiatric disorders.
🧬 Physiological Integrity (The Largest Segment)
, Basic Care and Comfort (6–12% of items): Assesses non-pharmacological comfort
interventions, assistive mobility devices, elimination management, nutritional alterations,
sleep hygiene, and post-operative positioning.
Pharmacological and Parenteral Therapies (12–18% of items): Evaluates high-risk
drug management (heparin, insulin, digoxin, lithium), medication math calculations,
central line care, blood product transfusions, and parental nutrition (TPN).
Reduction of Risk Potential (9–15% of items): Evaluates laboratory value trends
(electrolytes, arterial blood gases, complete blood counts), diagnostic test protocols,
system-specific assessment findings, and therapeutic procedures.
Physiological Adaptation (11–17% of items): Focuses on acute medical-surgical
crises, hemodynamics, pathophysiology, fluid and electrolyte shocks, burns, and
emergency-level patient care.
1.A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
A. Maintain the client's affected hip in adduction.
B. Place an abduction pillow between the client's legs when turning.
C. Instruct the client to bend forward at the waist to put on socks.
D. Keep the head of the bed elevated at 90 degrees during meals.
Rationale: An abduction pillow prevents adduction and subsequent dislocation of the
new prosthetic joint. Bending forward at the waist or elevating the bed to 90 degrees
flexes the hip past 90 degrees, which is contraindicated.
2. A nurse is reviewing the laboratory results of a client who is receiving a
continuous IV infusion of heparin. Which of the following values should the nurse
report to the provider?
A. aPTT of 65 seconds
B. Platelet count of 180,000/mm³
C. aPTT of 110 seconds
D. INR of 1.2
Rationale: An aPTT of 110 seconds is significantly above the expected therapeutic
range for heparin therapy (typically 1.5 to 2.5 times the normal control value of 30 to 40
seconds, making the therapeutic target roughly 60 to 80 seconds). This places the client
at a high risk for spontaneous bleeding.
3. A nurse in an emergency department is assessing a client who has a leaking
abdominal aortic aneurysm (AAA). Which of the following findings should the
nurse expect?
,A. Sudden, severe back or flank pain
B. Increased blood pressure and bounding pulses
C. Hyperactive bowel sounds in all four quadrants
D. Warm, flushed extremities
Rationale: A leaking or rupturing AAA typically presents with sudden, intense, tearing
abdominal, back, or flank pain, accompanied by manifestations of hypovolemic shock
(hypotension, tachycardia, cold/clammy skin).
4. A nurse is preparing to administer an intramuscular injection to an infant who
is 6 months old. Which of the following sites should the nurse select?
A. Dorsogluteal
B. Deltoid
C. Vastus lateralis
D. Ventrogluteal
Rationale: The vastus lateralis muscle is the safest, most well-developed injection site
for infants under 12 months of age because it lacks major nerves and blood vessels.
5. A charge nurse is observing a newly licensed nurse suctioning a client's
tracheostomy tube. Which of the following actions by the newly licensed nurse
requires intervention?
A. Hyperoxygenating the client with 100% oxygen before insertion.
B. Applying intermittent suction while inserting the catheter.
C. Limiting the total suctioning time to 10 seconds.
D. Allowing 1 minute of rest between suctioning passes.
Rationale: Suction should never be applied during insertion of the catheter, as this
causes mucosal trauma and deprives the client of oxygen. Suction must only be applied
intermittently while withdrawing the catheter.
6. A nurse is assessing a client who has hypokalemia. Which of the following
clinical manifestations should the nurse expect?
A. Hyperactive deep tendon reflexes
B. Peaked T waves on an ECG
C. Muscle weakness and hyporeflexia
D. Diarrhea and abdominal cramping
Rationale: Hypokalemia causes decreased neuromuscular excitability, leading to
muscle weakness, diminished deep tendon reflexes, and cardiac dysrhythmias (such as
flattened T waves or U waves).
7. A nurse is caring for a client who is experiencing a panic attack. Which of the
following actions should the nurse take first?
A. Stay with the client and remain calm.
B. Administer a PRN dose of lorazepam.
C. Teach the client deep-breathing exercises.
D. Ask the client to identify the trigger of the panic attack.
Rationale: The priority action during a panic attack is ensuring safety and reducing
, anxiety by remaining with the client. Educational interventions or finding triggers cannot
be processed by a client experiencing severe or panic-level anxiety.
8. A nurse is caring for a client who has a prescription for a clear liquid diet.
Which of the following items should the nurse offer the client?
A. Vanilla pudding
B. Orange juice with pulp
C. Chicken broth
D. Oatmeal
Rationale: Clear liquids are items that are transparent and liquid at room temperature.
Chicken broth, apple juice, and gelatin qualify. Pudding, pulp, and oatmeal are not clear
liquids.
9. A nurse is preparing a sterile field for a dressing change. Which of the
following actions compromises the sterility of the field?
A. Opening the first flap of the sterile package away from the body.
B. Keeping the sterile field in sight and above waist level.
C. Pouring sterile saline into a container while holding the bottle cap down on an
unsterile surface.
D. Maintaining a 2.5 cm (1 inch) border around the edge of the field.
Rationale: The inside of a bottle cap must be placed facing upward on a clean surface
to preserve its sterility. Placing it face down contaminates the cap and subsequently the
fluid poured from it.
10. A nurse is monitoring a client who is receiving magnesium sulfate via
continuous IV infusion for preeclampsia. Which of the following findings
indicates toxicity?
A. Blood pressure of 142/90 mm Hg
B. Absence of deep tendon reflexes
C. Urinary output of 40 mL/hr
D. Respiratory rate of 16/min
Rationale: Magnesium sulfate is a central nervous system depressant. Signs of toxicity
include loss of deep tendon reflexes, a respiratory rate below 12/min, and urinary output
below 30 mL/hr.
11. A nurse is prioritizing care for four clients. Which of the following clients
should the nurse assess first?
A. A client with chronic bronchitis who has an SpO2 of 91% on room air.
B. A client with diabetes mellitus who has a fasting blood glucose of 145 mg/dL.
C. A client who had a subtotal thyroidectomy 12 hours ago and is experiencing
laryngeal stridor.
D. A client with appendicitis who reports localized right lower quadrant pain.
Rationale: Laryngeal stridor indicates an acute airway obstruction or severe muscle
spasms caused by hypocalcemia (accidental parathyroid removal), which is an
immediate life-threatening emergency.
