ATI RN COMPREHENSIVE PREDICTOR
Final Exam Prep Sets
2026/2027 | 50 Questions in 5 Sets | Full Rationales
⬤ EASY ⬤ MEDIUM ⬤ HARD
INSTRUCTIONS: Answer each question before reading the rationale. Track your
score per set. Review any set below 70% before exam day.
SCORE TRACKER
Set Topic Score (/10) % Correct
A Cardiovascular & Respiratory
B Maternal-Newborn & Pediatrics
C Mental Health & Pharmacology
D Leadership, Delegation & Safety
E Mixed NGN-Style Questions
,SET A: CARDIOVASCULAR & RESPIRATORY
Q1. [Hard] Cardiovascular
A nurse is caring for a client receiving heparin for DVT. The client has
platelet count 48,000/mm³. What is the nurse's priority action?
• A. Continue heparin at the current rate
• B. Hold the heparin and notify the provider
• C. Administer protamine sulfate immediately
• D. Increase monitoring frequency to every 2 hours
✅ Answer: B | Rationale:
Platelet count <50,000 in a client on heparin may indicate heparin-induced
thrombocytopenia (HIT). Hold heparin immediately and notify provider. Protamine
reverses heparin, but assessment/notification comes first.
Q2. [Medium] Cardiovascular
A client with acute heart failure is prescribed furosemide 80 mg IV. Which
lab result should the nurse check BEFORE administering?
• A. Serum sodium
• B. Serum potassium
• C. BUN
• D. Platelet count
✅ Answer: B | Rationale:
Furosemide causes potassium loss. Hypokalemia increases risk of fatal cardiac
dysrhythmias. Always check K⁺ before loop diuretics.
Q3. [Hard] Cardiovascular
A nurse is caring for a client post cardiac catheterization via right femoral
artery. Which finding requires immediate intervention?
• A. Small amount of bruising at the site
, • B. Client reports needing to void
• C. Absence of right pedal pulse
• D. Blood pressure 132/78 mm Hg
✅ Answer: C | Rationale:
Absent pedal pulse post-femoral catheterization = arterial occlusion or hematoma
compressing the artery. Immediate intervention required to prevent limb ischemia.
Q4. [Hard] Respiratory
A client with COPD has ABG results: pH 7.33, PaCO₂ 58, HCO₃ 30, PaO₂ 62.
Which interpretation is correct?
• A. Respiratory alkalosis – uncompensated
• B. Metabolic acidosis – compensated
• C. Respiratory acidosis – partially compensated
• D. Metabolic alkalosis – uncompensated
✅ Answer: C | Rationale:
pH acidic (7.33) + high PaCO₂ (58) = respiratory acidosis. Elevated HCO₃ (30)
shows the kidneys are compensating but pH not yet normal = partially
compensated respiratory acidosis.
Q5. [Hard] Respiratory
A nurse is caring for a client with a chest tube. Which finding requires
immediate intervention?
• A. Tidaling with respirations
• B. Continuous bubbling in the water-seal chamber
• C. 100 mL sanguineous drainage in the first hour
• D. Tube secured with tape to the client's chest
✅ Answer: B | Rationale:
Final Exam Prep Sets
2026/2027 | 50 Questions in 5 Sets | Full Rationales
⬤ EASY ⬤ MEDIUM ⬤ HARD
INSTRUCTIONS: Answer each question before reading the rationale. Track your
score per set. Review any set below 70% before exam day.
SCORE TRACKER
Set Topic Score (/10) % Correct
A Cardiovascular & Respiratory
B Maternal-Newborn & Pediatrics
C Mental Health & Pharmacology
D Leadership, Delegation & Safety
E Mixed NGN-Style Questions
,SET A: CARDIOVASCULAR & RESPIRATORY
Q1. [Hard] Cardiovascular
A nurse is caring for a client receiving heparin for DVT. The client has
platelet count 48,000/mm³. What is the nurse's priority action?
• A. Continue heparin at the current rate
• B. Hold the heparin and notify the provider
• C. Administer protamine sulfate immediately
• D. Increase monitoring frequency to every 2 hours
✅ Answer: B | Rationale:
Platelet count <50,000 in a client on heparin may indicate heparin-induced
thrombocytopenia (HIT). Hold heparin immediately and notify provider. Protamine
reverses heparin, but assessment/notification comes first.
Q2. [Medium] Cardiovascular
A client with acute heart failure is prescribed furosemide 80 mg IV. Which
lab result should the nurse check BEFORE administering?
• A. Serum sodium
• B. Serum potassium
• C. BUN
• D. Platelet count
✅ Answer: B | Rationale:
Furosemide causes potassium loss. Hypokalemia increases risk of fatal cardiac
dysrhythmias. Always check K⁺ before loop diuretics.
Q3. [Hard] Cardiovascular
A nurse is caring for a client post cardiac catheterization via right femoral
artery. Which finding requires immediate intervention?
• A. Small amount of bruising at the site
, • B. Client reports needing to void
• C. Absence of right pedal pulse
• D. Blood pressure 132/78 mm Hg
✅ Answer: C | Rationale:
Absent pedal pulse post-femoral catheterization = arterial occlusion or hematoma
compressing the artery. Immediate intervention required to prevent limb ischemia.
Q4. [Hard] Respiratory
A client with COPD has ABG results: pH 7.33, PaCO₂ 58, HCO₃ 30, PaO₂ 62.
Which interpretation is correct?
• A. Respiratory alkalosis – uncompensated
• B. Metabolic acidosis – compensated
• C. Respiratory acidosis – partially compensated
• D. Metabolic alkalosis – uncompensated
✅ Answer: C | Rationale:
pH acidic (7.33) + high PaCO₂ (58) = respiratory acidosis. Elevated HCO₃ (30)
shows the kidneys are compensating but pH not yet normal = partially
compensated respiratory acidosis.
Q5. [Hard] Respiratory
A nurse is caring for a client with a chest tube. Which finding requires
immediate intervention?
• A. Tidaling with respirations
• B. Continuous bubbling in the water-seal chamber
• C. 100 mL sanguineous drainage in the first hour
• D. Tube secured with tape to the client's chest
✅ Answer: B | Rationale:
