2026 ATI RN Comprehensive Predictor Actual
Exams | NGN-Style Questions | ATI Exit Nursing,
2026 Exam · 200 Questions · With Rationales
ati. ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing
2026
Question: 1 of 200
A patient with chronic kidney disease (CKD) stage 4 is admitted with hyperkalemia (serum potassium 6.2
mEq/L) and an ECG showing peaked T waves. The nurse notes that the patient is receiving lisinopril and
A. Administer sodium polystyrene sulfonate orally
B. Hold both lisinopril and spironolactone
C. Prepare for emergent hemodialysis
D. Administer intravenous calcium gluconate
PREVIOUS CONTINUE
A patient with chronic kidney disease (CKD) stage 4 is admitted with hyperkalemia (serum
potassium 6.2 mEq/L) and an ECG showing peaked T waves. The nurse notes that the
patient is receiving lisinopril and spironolactone. Which action should the nurse take
first?
A. Administer sodium polystyrene sulfonate orally
B. Hold both lisinopril and spironolactone
C. Prepare for emergent hemodialysis
' D. Administer intravenous calcium gluconate
Correct Answer: D
Intravenous calcium gluconate is the first-line intervention for life-threatening hyperkalemia with ECG changes
to stabilize the cardiac membrane. While holding medications that contribute to hyperkalemia (B) and
administering potassium-lowering agents (A) are important, they do not address immediate cardiac risk.
Hemodialysis (C) is definitive but not the first action in an emergency.
Page 1 | 2026 ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing 2026
, 2026 ATI RN Comprehensive Predictor Actual
Exams | NGN-Style Questions | ATI Exit Nursing,
2026 Exam · 200 Questions · With Rationales
ati. ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing
2026
Question: 2 of 200
A patient is receiving a continuous infusion of heparin for deep vein thrombosis. The current aPTT is 120
seconds (therapeutic range 60-80 seconds). The patient has no signs of bleeding. What is the nurse's priority
A. Decrease the heparin infusion rate by 50%
B. Stop the infusion and administer protamine sulfate
C. Continue the infusion at the same rate and recheck aPTT in 6 hours
D. Increase the infusion rate to achieve therapeutic range
PREVIOUS CONTINUE
A patient is receiving a continuous infusion of heparin for deep vein thrombosis. The
current aPTT is 120 seconds (therapeutic range 60-80 seconds). The patient has no signs
of bleeding. What is the nurse's priority action?
' A. Decrease the heparin infusion rate by 50%
B. Stop the infusion and administer protamine sulfate
C. Continue the infusion at the same rate and recheck aPTT in 6 hours
D. Increase the infusion rate to achieve therapeutic range
Correct Answer: A
An aPTT of 120 seconds indicates supratherapeutic anticoagulation, increasing bleeding risk. The standard
protocol is to decrease the infusion rate (often by 50%) and recheck aPTT per protocol. Stopping the infusion
and giving protamine (B) is reserved for active bleeding or critical aPTT values. Continuing at the same rate (C)
or increasing (D) would worsen the situation.
Page 2 | 2026 ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing 2026
, 2026 ATI RN Comprehensive Predictor Actual
Exams | NGN-Style Questions | ATI Exit Nursing,
2026 Exam · 200 Questions · With Rationales
ati. ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing
2026
Question: 3 of 200
A patient with a history of bipolar I disorder is admitted in a manic episode. The patient has been nonadherent
with lithium. Which laboratory finding would most concern the nurse if the patient resumes lithium therapy?
A. Serum sodium 148 mEq/L
B. Serum creatinine 1.8 mg/dL
C. Thyroid-stimulating hormone 4.2 mIU/L
D. White blood cell count 12,000/mm³
PREVIOUS CONTINUE
A patient with a history of bipolar I disorder is admitted in a manic episode. The patient
has been nonadherent with lithium. Which laboratory finding would most concern the
nurse if the patient resumes lithium therapy?
A. Serum sodium 148 mEq/L
' B. Serum creatinine 1.8 mg/dL
C. Thyroid-stimulating hormone 4.2 mIU/L
D. White blood cell count 12,000/mm³
Correct Answer: B
Lithium is excreted by the kidneys, and impaired renal function (elevated creatinine) increases the risk of lithium
toxicity. Hypernatremia (A) can affect lithium levels but is less directly concerning. Elevated TSH (C) is a
common side effect of lithium but not an acute toxicity risk. Leukocytosis (D) is not a contraindication.
Page 3 | 2026 ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing 2026
, 2026 ATI RN Comprehensive Predictor Actual
Exams | NGN-Style Questions | ATI Exit Nursing,
2026 Exam · 200 Questions · With Rationales
ati. ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing
2026
Question: 4 of 200
A patient with acute respiratory distress syndrome (ARDS) is on mechanical ventilation with a lung-protective
strategy. The nurse notes a plateau pressure of 32 cm H2O and a PaO2 of 55 mmHg on 80% FiO2. Which
A. Increase positive end-expiratory pressure (PEEP)
B. Decrease tidal volume to 4 mL/kg predicted body weight
C. Administer a neuromuscular blocking agent
D. Prepare for prone positioning
PREVIOUS CONTINUE
A patient with acute respiratory distress syndrome (ARDS) is on mechanical ventilation
with a lung-protective strategy. The nurse notes a plateau pressure of 32 cm H2O and a
PaO2 of 55 mmHg on 80% FiO2. Which intervention should the nurse anticipate?
A. Increase positive end-expiratory pressure (PEEP)
B. Decrease tidal volume to 4 mL/kg predicted body weight
C. Administer a neuromuscular blocking agent
' D. Prepare for prone positioning
Correct Answer: D
Prone positioning improves oxygenation in severe ARDS by recruiting dependent lung regions. Plateau
pressure is already elevated (32 cm H2O, target <30), so increasing PEEP (A) could worsen lung injury.
Decreasing tidal volume (B) may further reduce ventilation. Neuromuscular blockers (C) may be used but prone
positioning is a more direct intervention for refractory hypoxemia.
Page 4 | 2026 ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing 2026
Exams | NGN-Style Questions | ATI Exit Nursing,
2026 Exam · 200 Questions · With Rationales
ati. ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing
2026
Question: 1 of 200
A patient with chronic kidney disease (CKD) stage 4 is admitted with hyperkalemia (serum potassium 6.2
mEq/L) and an ECG showing peaked T waves. The nurse notes that the patient is receiving lisinopril and
A. Administer sodium polystyrene sulfonate orally
B. Hold both lisinopril and spironolactone
C. Prepare for emergent hemodialysis
D. Administer intravenous calcium gluconate
PREVIOUS CONTINUE
A patient with chronic kidney disease (CKD) stage 4 is admitted with hyperkalemia (serum
potassium 6.2 mEq/L) and an ECG showing peaked T waves. The nurse notes that the
patient is receiving lisinopril and spironolactone. Which action should the nurse take
first?
A. Administer sodium polystyrene sulfonate orally
B. Hold both lisinopril and spironolactone
C. Prepare for emergent hemodialysis
' D. Administer intravenous calcium gluconate
Correct Answer: D
Intravenous calcium gluconate is the first-line intervention for life-threatening hyperkalemia with ECG changes
to stabilize the cardiac membrane. While holding medications that contribute to hyperkalemia (B) and
administering potassium-lowering agents (A) are important, they do not address immediate cardiac risk.
Hemodialysis (C) is definitive but not the first action in an emergency.
Page 1 | 2026 ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing 2026
, 2026 ATI RN Comprehensive Predictor Actual
Exams | NGN-Style Questions | ATI Exit Nursing,
2026 Exam · 200 Questions · With Rationales
ati. ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing
2026
Question: 2 of 200
A patient is receiving a continuous infusion of heparin for deep vein thrombosis. The current aPTT is 120
seconds (therapeutic range 60-80 seconds). The patient has no signs of bleeding. What is the nurse's priority
A. Decrease the heparin infusion rate by 50%
B. Stop the infusion and administer protamine sulfate
C. Continue the infusion at the same rate and recheck aPTT in 6 hours
D. Increase the infusion rate to achieve therapeutic range
PREVIOUS CONTINUE
A patient is receiving a continuous infusion of heparin for deep vein thrombosis. The
current aPTT is 120 seconds (therapeutic range 60-80 seconds). The patient has no signs
of bleeding. What is the nurse's priority action?
' A. Decrease the heparin infusion rate by 50%
B. Stop the infusion and administer protamine sulfate
C. Continue the infusion at the same rate and recheck aPTT in 6 hours
D. Increase the infusion rate to achieve therapeutic range
Correct Answer: A
An aPTT of 120 seconds indicates supratherapeutic anticoagulation, increasing bleeding risk. The standard
protocol is to decrease the infusion rate (often by 50%) and recheck aPTT per protocol. Stopping the infusion
and giving protamine (B) is reserved for active bleeding or critical aPTT values. Continuing at the same rate (C)
or increasing (D) would worsen the situation.
Page 2 | 2026 ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing 2026
, 2026 ATI RN Comprehensive Predictor Actual
Exams | NGN-Style Questions | ATI Exit Nursing,
2026 Exam · 200 Questions · With Rationales
ati. ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing
2026
Question: 3 of 200
A patient with a history of bipolar I disorder is admitted in a manic episode. The patient has been nonadherent
with lithium. Which laboratory finding would most concern the nurse if the patient resumes lithium therapy?
A. Serum sodium 148 mEq/L
B. Serum creatinine 1.8 mg/dL
C. Thyroid-stimulating hormone 4.2 mIU/L
D. White blood cell count 12,000/mm³
PREVIOUS CONTINUE
A patient with a history of bipolar I disorder is admitted in a manic episode. The patient
has been nonadherent with lithium. Which laboratory finding would most concern the
nurse if the patient resumes lithium therapy?
A. Serum sodium 148 mEq/L
' B. Serum creatinine 1.8 mg/dL
C. Thyroid-stimulating hormone 4.2 mIU/L
D. White blood cell count 12,000/mm³
Correct Answer: B
Lithium is excreted by the kidneys, and impaired renal function (elevated creatinine) increases the risk of lithium
toxicity. Hypernatremia (A) can affect lithium levels but is less directly concerning. Elevated TSH (C) is a
common side effect of lithium but not an acute toxicity risk. Leukocytosis (D) is not a contraindication.
Page 3 | 2026 ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing 2026
, 2026 ATI RN Comprehensive Predictor Actual
Exams | NGN-Style Questions | ATI Exit Nursing,
2026 Exam · 200 Questions · With Rationales
ati. ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing
2026
Question: 4 of 200
A patient with acute respiratory distress syndrome (ARDS) is on mechanical ventilation with a lung-protective
strategy. The nurse notes a plateau pressure of 32 cm H2O and a PaO2 of 55 mmHg on 80% FiO2. Which
A. Increase positive end-expiratory pressure (PEEP)
B. Decrease tidal volume to 4 mL/kg predicted body weight
C. Administer a neuromuscular blocking agent
D. Prepare for prone positioning
PREVIOUS CONTINUE
A patient with acute respiratory distress syndrome (ARDS) is on mechanical ventilation
with a lung-protective strategy. The nurse notes a plateau pressure of 32 cm H2O and a
PaO2 of 55 mmHg on 80% FiO2. Which intervention should the nurse anticipate?
A. Increase positive end-expiratory pressure (PEEP)
B. Decrease tidal volume to 4 mL/kg predicted body weight
C. Administer a neuromuscular blocking agent
' D. Prepare for prone positioning
Correct Answer: D
Prone positioning improves oxygenation in severe ARDS by recruiting dependent lung regions. Plateau
pressure is already elevated (32 cm H2O, target <30), so increasing PEEP (A) could worsen lung injury.
Decreasing tidal volume (B) may further reduce ventilation. Neuromuscular blockers (C) may be used but prone
positioning is a more direct intervention for refractory hypoxemia.
Page 4 | 2026 ATI RN Comprehensive Predictor Actual Exams | NGN-Style Questions | ATI Exit Nursing, Exams of Nursing 2026
