VIRTUAL ATI GREEN LIGHT COMPREHENSIVE NCLEX PREDICTOR ASSESSMENT
COMPLETE PRACTICE TEST BANK QUESTIONS AND ANSWERS | VERIFIED
RATIONALES | UPDATED 2026/2027 NCLEX-RN REVIEW GUIDE
Examiner/Administrator: Assessment Technologies Institute (ATI Nursing Education)
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
VIRTUAL ATI GREEN LIGHT
COMPREHENSIVE NCLEX PREDICTOR ASSESSMENT
2026/2027 EDITION
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
COMPLETE PRACTICE EXAM
180+ COMPREHENSIVE QUESTIONS
EXACT OFFICIAL-STYLE EXAM PREPARATION
PASSING SCORE: 70% OR HIGHER
TESTING TIME: 210 MINUTES
ATI NURSING EDUCATION || ALIGNED WITH CURRENT NCLEX-RN TESTING
BLUEPRINTS || COMPREHENSIVE PREDICTOR ASSESSMENT || PROFESSIONAL STUDY
GUIDE || UPDATED 2026/2027 EXAM PREP || VERIFIED PRACTICE QUESTIONS &
RATIONALES || CRITICAL THINKING & CLINICAL JUDGMENT FOCUSED || PREPARED
FOR NCLEX-RN SUCCESS || PROFESSIONAL NURSING EXAMINATION USE ONLY
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
Adult Health Nursing & Medical-Surgical Nursing
Q1. A nurse in the emergency department is caring for a client who reports crushing
substernal chest pain radiating to the left arm and jaw. The client is diaphoretic and
anxious. Which action should the nurse prioritize first?
A. Obtain a complete cardiovascular history
B. Administer prescribed nitroglycerin
C. Place the client on continuous cardiac monitoring
D. Encourage the client to perform deep breathing exercises
Correct Answer: 🔴 C. Place the client on continuous cardiac monitoring
,Explanation: 🔹 Continuous cardiac monitoring is the priority because the client is
exhibiting manifestations consistent with acute coronary syndrome or myocardial
infarction, placing them at immediate risk for life-threatening dysrhythmias. Monitoring
allows rapid identification of ventricular tachycardia, ventricular fibrillation, or ST-
segment changes requiring urgent intervention. Although nitroglycerin may reduce
ischemic pain, the nurse must first establish cardiac surveillance and assess stability.
Obtaining a full history is important but not the initial lifesaving priority. Deep breathing
exercises do not address the underlying ischemia and could delay emergency treatment.
Q2. A nurse is caring for a postoperative client 12 hours after abdominal surgery. The
client suddenly becomes restless, tachycardic, and reports shortness of breath. Oxygen
saturation decreases to 86% on room air. Which complication should the nurse
suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumothorax
D. Aspiration pneumonia
Correct Answer: 🔴 B. Pulmonary embolism
Explanation: 🔹 The sudden onset of dyspnea, tachycardia, hypoxemia, and restlessness
in a postoperative client strongly suggests pulmonary embolism (PE). Surgical clients are
at elevated risk for venous thromboembolism due to immobility and hypercoagulability.
Atelectasis generally develops gradually and is accompanied by diminished breath
sounds and low-grade fever. Pneumothorax usually occurs after thoracic trauma or
invasive chest procedures. Aspiration pneumonia commonly presents with fever,
productive cough, and abnormal lung sounds rather than abrupt cardiopulmonary
compromise.
Q3. A nurse is reviewing laboratory results for a client with chronic kidney disease.
Which finding requires immediate intervention?
A. Potassium 6.2 mEq/L
B. Calcium 8.2 mg/dL
,C. Hemoglobin 10 g/dL
D. Creatinine 3.1 mg/dL
Correct Answer: 🔴 A. Potassium 6.2 mEq/L
Explanation: 🔹 Hyperkalemia is the priority because potassium levels above 6.0 mEq/L
can precipitate fatal cardiac dysrhythmias such as ventricular fibrillation or asystole.
Chronic kidney disease impairs potassium excretion, increasing risk for life-threatening
complications. Mild hypocalcemia and anemia are common chronic findings in renal
disease but are not immediately fatal. Elevated creatinine reflects renal impairment but
does not require the same urgent response as severe hyperkalemia.
Q4. A nurse is teaching a client newly diagnosed with heart failure about reducing fluid
retention. Which statement by the client indicates understanding?
A. “I should weigh myself once a week.”
B. “I will increase my sodium intake if I feel weak.”
C. “I should report a weight gain of 2 pounds in one day.”
D. “I can stop taking diuretics once the swelling improves.”
Correct Answer: 🔴 C. “I should report a weight gain of 2 pounds in one day.”
Explanation: 🔹 Rapid weight gain is an early indicator of fluid retention and worsening
heart failure. Clients should report gains of approximately 2 pounds in 24 hours or 5
pounds in one week. Daily weights are recommended rather than weekly measurements.
Sodium restriction helps minimize fluid overload, so increasing sodium intake is
inappropriate. Diuretics should not be discontinued without provider direction because
edema may recur rapidly.
Q5. A nurse is caring for a client receiving morphine via PCA pump after surgery.
Which finding requires immediate nursing intervention?
A. Respiratory rate of 8/min
B. Pain rating of 4 on a 0–10 scale
C. Blood pressure of 138/82 mm Hg
D. Heart rate of 88/min
, Correct Answer: 🔴 A. Respiratory rate of 8/min
Explanation: 🔹 Opioid-induced respiratory depression is a life-threatening complication
requiring immediate intervention. A respiratory rate below 10/min indicates significant
central nervous system depression and may necessitate stopping the PCA infusion,
stimulating the client, administering oxygen, and preparing naloxone. The other findings
are within acceptable postoperative ranges and do not indicate emergent deterioration.
Q6. A nurse is caring for a client with chronic obstructive pulmonary disease (COPD).
Which assessment finding requires immediate follow-up?
A. Barrel-shaped chest
B. Oxygen saturation of 89%
C. Productive cough with thick sputum
D. Sudden onset confusion and drowsiness
Correct Answer: 🔴 D. Sudden onset confusion and drowsiness
Explanation: 🔹 Acute confusion and drowsiness may indicate severe hypercapnia and
respiratory failure in clients with COPD. Carbon dioxide retention can rapidly depress
neurologic function and compromise ventilation. A barrel chest and chronic productive
cough are expected manifestations of COPD. Oxygen saturation values in the high 80s
may be acceptable for some COPD clients, depending on baseline function.
Q7. A nurse is assessing a client receiving a blood transfusion. Which manifestation
indicates an acute hemolytic transfusion reaction?
A. Low-grade fever and chills
B. Hypertension and bradycardia
C. Flank pain and hypotension
D. Mild headache and fatigue
Correct Answer: 🔴 C. Flank pain and hypotension
Explanation: 🔹 Acute hemolytic reactions are severe transfusion emergencies caused by
ABO incompatibility. Classic manifestations include fever, chills, hypotension,
COMPLETE PRACTICE TEST BANK QUESTIONS AND ANSWERS | VERIFIED
RATIONALES | UPDATED 2026/2027 NCLEX-RN REVIEW GUIDE
Examiner/Administrator: Assessment Technologies Institute (ATI Nursing Education)
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
VIRTUAL ATI GREEN LIGHT
COMPREHENSIVE NCLEX PREDICTOR ASSESSMENT
2026/2027 EDITION
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
COMPLETE PRACTICE EXAM
180+ COMPREHENSIVE QUESTIONS
EXACT OFFICIAL-STYLE EXAM PREPARATION
PASSING SCORE: 70% OR HIGHER
TESTING TIME: 210 MINUTES
ATI NURSING EDUCATION || ALIGNED WITH CURRENT NCLEX-RN TESTING
BLUEPRINTS || COMPREHENSIVE PREDICTOR ASSESSMENT || PROFESSIONAL STUDY
GUIDE || UPDATED 2026/2027 EXAM PREP || VERIFIED PRACTICE QUESTIONS &
RATIONALES || CRITICAL THINKING & CLINICAL JUDGMENT FOCUSED || PREPARED
FOR NCLEX-RN SUCCESS || PROFESSIONAL NURSING EXAMINATION USE ONLY
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
Adult Health Nursing & Medical-Surgical Nursing
Q1. A nurse in the emergency department is caring for a client who reports crushing
substernal chest pain radiating to the left arm and jaw. The client is diaphoretic and
anxious. Which action should the nurse prioritize first?
A. Obtain a complete cardiovascular history
B. Administer prescribed nitroglycerin
C. Place the client on continuous cardiac monitoring
D. Encourage the client to perform deep breathing exercises
Correct Answer: 🔴 C. Place the client on continuous cardiac monitoring
,Explanation: 🔹 Continuous cardiac monitoring is the priority because the client is
exhibiting manifestations consistent with acute coronary syndrome or myocardial
infarction, placing them at immediate risk for life-threatening dysrhythmias. Monitoring
allows rapid identification of ventricular tachycardia, ventricular fibrillation, or ST-
segment changes requiring urgent intervention. Although nitroglycerin may reduce
ischemic pain, the nurse must first establish cardiac surveillance and assess stability.
Obtaining a full history is important but not the initial lifesaving priority. Deep breathing
exercises do not address the underlying ischemia and could delay emergency treatment.
Q2. A nurse is caring for a postoperative client 12 hours after abdominal surgery. The
client suddenly becomes restless, tachycardic, and reports shortness of breath. Oxygen
saturation decreases to 86% on room air. Which complication should the nurse
suspect first?
A. Atelectasis
B. Pulmonary embolism
C. Pneumothorax
D. Aspiration pneumonia
Correct Answer: 🔴 B. Pulmonary embolism
Explanation: 🔹 The sudden onset of dyspnea, tachycardia, hypoxemia, and restlessness
in a postoperative client strongly suggests pulmonary embolism (PE). Surgical clients are
at elevated risk for venous thromboembolism due to immobility and hypercoagulability.
Atelectasis generally develops gradually and is accompanied by diminished breath
sounds and low-grade fever. Pneumothorax usually occurs after thoracic trauma or
invasive chest procedures. Aspiration pneumonia commonly presents with fever,
productive cough, and abnormal lung sounds rather than abrupt cardiopulmonary
compromise.
Q3. A nurse is reviewing laboratory results for a client with chronic kidney disease.
Which finding requires immediate intervention?
A. Potassium 6.2 mEq/L
B. Calcium 8.2 mg/dL
,C. Hemoglobin 10 g/dL
D. Creatinine 3.1 mg/dL
Correct Answer: 🔴 A. Potassium 6.2 mEq/L
Explanation: 🔹 Hyperkalemia is the priority because potassium levels above 6.0 mEq/L
can precipitate fatal cardiac dysrhythmias such as ventricular fibrillation or asystole.
Chronic kidney disease impairs potassium excretion, increasing risk for life-threatening
complications. Mild hypocalcemia and anemia are common chronic findings in renal
disease but are not immediately fatal. Elevated creatinine reflects renal impairment but
does not require the same urgent response as severe hyperkalemia.
Q4. A nurse is teaching a client newly diagnosed with heart failure about reducing fluid
retention. Which statement by the client indicates understanding?
A. “I should weigh myself once a week.”
B. “I will increase my sodium intake if I feel weak.”
C. “I should report a weight gain of 2 pounds in one day.”
D. “I can stop taking diuretics once the swelling improves.”
Correct Answer: 🔴 C. “I should report a weight gain of 2 pounds in one day.”
Explanation: 🔹 Rapid weight gain is an early indicator of fluid retention and worsening
heart failure. Clients should report gains of approximately 2 pounds in 24 hours or 5
pounds in one week. Daily weights are recommended rather than weekly measurements.
Sodium restriction helps minimize fluid overload, so increasing sodium intake is
inappropriate. Diuretics should not be discontinued without provider direction because
edema may recur rapidly.
Q5. A nurse is caring for a client receiving morphine via PCA pump after surgery.
Which finding requires immediate nursing intervention?
A. Respiratory rate of 8/min
B. Pain rating of 4 on a 0–10 scale
C. Blood pressure of 138/82 mm Hg
D. Heart rate of 88/min
, Correct Answer: 🔴 A. Respiratory rate of 8/min
Explanation: 🔹 Opioid-induced respiratory depression is a life-threatening complication
requiring immediate intervention. A respiratory rate below 10/min indicates significant
central nervous system depression and may necessitate stopping the PCA infusion,
stimulating the client, administering oxygen, and preparing naloxone. The other findings
are within acceptable postoperative ranges and do not indicate emergent deterioration.
Q6. A nurse is caring for a client with chronic obstructive pulmonary disease (COPD).
Which assessment finding requires immediate follow-up?
A. Barrel-shaped chest
B. Oxygen saturation of 89%
C. Productive cough with thick sputum
D. Sudden onset confusion and drowsiness
Correct Answer: 🔴 D. Sudden onset confusion and drowsiness
Explanation: 🔹 Acute confusion and drowsiness may indicate severe hypercapnia and
respiratory failure in clients with COPD. Carbon dioxide retention can rapidly depress
neurologic function and compromise ventilation. A barrel chest and chronic productive
cough are expected manifestations of COPD. Oxygen saturation values in the high 80s
may be acceptable for some COPD clients, depending on baseline function.
Q7. A nurse is assessing a client receiving a blood transfusion. Which manifestation
indicates an acute hemolytic transfusion reaction?
A. Low-grade fever and chills
B. Hypertension and bradycardia
C. Flank pain and hypotension
D. Mild headache and fatigue
Correct Answer: 🔴 C. Flank pain and hypotension
Explanation: 🔹 Acute hemolytic reactions are severe transfusion emergencies caused by
ABO incompatibility. Classic manifestations include fever, chills, hypotension,
