Comprehensive ATI Nursing and NCLEX Practice
Exam and a champion test with question and answers
- Updated 2026 (Graded A+)
Subject: Nursing
Subtopic: ATI Comprehensive Predictor Exam 2026–2027
Question 1: A nurse is assessing a client with suspected hypovolemic shock
following gastrointestinal hemorrhage. Which assessment finding is most
indicative of early compensatory shock?
A) Bounding peripheral pulses and hypertension
B) Bradycardia with increased urine output
C) Tachycardia with cool clammy skin
D) Warm flushed skin with widened pulse pressure
Correct Answer: C) - Tachycardia with cool clammy skin
Rationale: Early compensatory hypovolemic shock is characterized by sympathetic
nervous system activation leading to tachycardia, peripheral vasoconstriction, cool
clammy skin, and decreased perfusion. Bounding pulses and warm flushed skin are
more characteristic of distributive shock states such as early septic shock.
Bradycardia is not typically an early compensatory response in hypovolemia.
Question 2: A nurse caring for a client receiving a blood transfusion observes
sudden dyspnea, flank pain, fever, and hypotension within minutes of initiation.
Which transfusion reaction should the nurse suspect first?
A) Febrile nonhemolytic reaction
B) Acute hemolytic transfusion reaction
C) Allergic transfusion reaction
D) Circulatory overload
Correct Answer: B) - Acute hemolytic transfusion reaction
Rationale: Acute hemolytic transfusion reactions are severe, life-threatening
events commonly caused by ABO incompatibility. Manifestations include fever,
chills, hypotension, dyspnea, flank pain, tachycardia, and hemoglobinuria. Febrile
reactions generally cause fever and chills without severe hemodynamic instability.
Allergic reactions more commonly involve urticaria and itching.
Question 3: A nurse is prioritizing care for four clients. Which client should the
nurse assess first?
A) A client 12 hr postoperative reporting pain rated 7/10
,Comprehensive ATI Nursing and NCLEX Practice
Exam and a champion test with question and answers
- Updated 2026 (Graded A+)
B) A client with COPD whose oxygen saturation decreased from 94% to 88%
C) A client requesting assistance ambulating to the bathroom
D) A client newly diagnosed with diabetes requesting dietary education
Correct Answer: B) - A client with COPD whose oxygen saturation decreased
from 94% to 88%
Rationale: Using airway, breathing, and circulation (ABC) prioritization, the client
with declining oxygen saturation presents the highest priority due to impaired
oxygenation and risk for respiratory compromise. Pain and education needs are
important but less urgent than physiologic instability.
Question 4: A nurse is teaching a client prescribed warfarin therapy. Which
statement by the client indicates understanding of the medication?
A) “I should increase my intake of green leafy vegetables.”
B) “I will use a soft toothbrush while taking this medication.”
C) “I can take aspirin if I develop a headache.”
D) “I do not need regular laboratory monitoring.”
Correct Answer: B) - “I will use a soft toothbrush while taking this medication.”
Rationale: Warfarin increases bleeding risk, making injury prevention strategies
such as using a soft toothbrush essential. Clients should maintain consistent—not
increased—vitamin K intake. Aspirin increases bleeding risk and should generally
be avoided unless prescribed. INR monitoring is required regularly.
Question 5: A nurse is caring for a client with increased intracranial pressure (ICP).
Which intervention is most appropriate?
A) Maintain the client in a Trendelenburg position
B) Suction the airway routinely every hour
C) Elevate the head of the bed approximately 30 degrees
D) Encourage frequent hip flexion exercises
Correct Answer: C) - Elevate the head of the bed approximately 30 degrees
Rationale: Elevating the head of the bed promotes venous drainage from the brain
and can reduce ICP. Trendelenburg positioning and hip flexion increase
intrathoracic and intracranial pressures. Excessive suctioning can transiently
elevate ICP and should be minimized.
,Comprehensive ATI Nursing and NCLEX Practice
Exam and a champion test with question and answers
- Updated 2026 (Graded A+)
Question 6: A nurse is assessing a client with diabetic ketoacidosis (DKA). Which
laboratory finding should the nurse expect?
A) Serum pH of 7.48
B) Blood glucose level of 420 mg/dL
C) Serum potassium level of 2.8 mEq/L without treatment influence
D) Decreased serum ketones
Correct Answer: B) - Blood glucose level of 420 mg/dL
Rationale: DKA is characterized by severe hyperglycemia, metabolic acidosis, and
ketone production. Elevated glucose levels commonly exceed 250 mg/dL.
Acidosis—not alkalosis—is expected. Potassium may initially appear elevated
despite total body depletion due to acidosis and insulin deficiency.
Question 7: A nurse is providing discharge teaching to a client following cataract
surgery. Which instruction should the nurse include?
A) “Avoid lifting objects heavier than 10 pounds.”
B) “Lie flat for 24 hours after surgery.”
C) “Expect severe eye pain for several days.”
D) “Resume driving immediately after discharge.”
Correct Answer: A) - “Avoid lifting objects heavier than 10 pounds.”
Rationale: Activities that increase intraocular pressure, such as heavy lifting,
bending, or straining, should be avoided following cataract surgery. Severe eye
pain may indicate complications such as increased intraocular pressure or
hemorrhage and should be reported immediately.
Question 8: A nurse is caring for a client prescribed furosemide. Which finding
requires immediate follow-up?
A) Blood pressure 118/74 mm Hg
B) Potassium level 2.9 mEq/L
C) Urine output 1,200 mL/day
D) Mild thirst after administration
Correct Answer: B) - Potassium level 2.9 mEq/L
Rationale: Furosemide is a loop diuretic associated with potassium loss. Severe
, Comprehensive ATI Nursing and NCLEX Practice
Exam and a champion test with question and answers
- Updated 2026 (Graded A+)
hypokalemia increases risk for dysrhythmias, muscle weakness, and cardiac
instability. The nurse should intervene promptly and notify the provider.
Question 9: A nurse is caring for a client with a chest tube connected to a closed
water-seal drainage system. Which finding requires immediate intervention?
A) Gentle tidaling in the water-seal chamber
B) Continuous bubbling in the water-seal chamber
C) Drainage of 50 mL serosanguineous fluid over 4 hr
D) Occlusive dressing intact at insertion site
Correct Answer: B) - Continuous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak
within the system, which can impair lung re-expansion and compromise
respiratory function. Gentle tidaling is expected in many clients with chest tubes.
Question 10: A nurse is assessing a client experiencing opioid overdose. Which
manifestation should the nurse expect?
A) Hypertension and tachycardia
B) Dilated pupils and agitation
C) Respiratory depression and pinpoint pupils
D) Hyperactive bowel sounds and diaphoresis
Correct Answer: C) - Respiratory depression and pinpoint pupils
Rationale: Classic opioid overdose manifestations include respiratory depression,
decreased level of consciousness, miosis (pinpoint pupils), and hypotension.
Dilated pupils and hyperactivity are more consistent with stimulant intoxication or
withdrawal syndromes.
Question 11: A nurse is caring for a client receiving heparin therapy. Which
laboratory value should the nurse monitor to evaluate therapeutic effectiveness?
A) International normalized ratio (INR)
B) Prothrombin time (PT)
C) Activated partial thromboplastin time (aPTT)
D) Platelet aggregation time
Correct Answer: C) - Activated partial thromboplastin time (aPTT)
Rationale: Heparin therapy is monitored using aPTT to assess anticoagulation
Exam and a champion test with question and answers
- Updated 2026 (Graded A+)
Subject: Nursing
Subtopic: ATI Comprehensive Predictor Exam 2026–2027
Question 1: A nurse is assessing a client with suspected hypovolemic shock
following gastrointestinal hemorrhage. Which assessment finding is most
indicative of early compensatory shock?
A) Bounding peripheral pulses and hypertension
B) Bradycardia with increased urine output
C) Tachycardia with cool clammy skin
D) Warm flushed skin with widened pulse pressure
Correct Answer: C) - Tachycardia with cool clammy skin
Rationale: Early compensatory hypovolemic shock is characterized by sympathetic
nervous system activation leading to tachycardia, peripheral vasoconstriction, cool
clammy skin, and decreased perfusion. Bounding pulses and warm flushed skin are
more characteristic of distributive shock states such as early septic shock.
Bradycardia is not typically an early compensatory response in hypovolemia.
Question 2: A nurse caring for a client receiving a blood transfusion observes
sudden dyspnea, flank pain, fever, and hypotension within minutes of initiation.
Which transfusion reaction should the nurse suspect first?
A) Febrile nonhemolytic reaction
B) Acute hemolytic transfusion reaction
C) Allergic transfusion reaction
D) Circulatory overload
Correct Answer: B) - Acute hemolytic transfusion reaction
Rationale: Acute hemolytic transfusion reactions are severe, life-threatening
events commonly caused by ABO incompatibility. Manifestations include fever,
chills, hypotension, dyspnea, flank pain, tachycardia, and hemoglobinuria. Febrile
reactions generally cause fever and chills without severe hemodynamic instability.
Allergic reactions more commonly involve urticaria and itching.
Question 3: A nurse is prioritizing care for four clients. Which client should the
nurse assess first?
A) A client 12 hr postoperative reporting pain rated 7/10
,Comprehensive ATI Nursing and NCLEX Practice
Exam and a champion test with question and answers
- Updated 2026 (Graded A+)
B) A client with COPD whose oxygen saturation decreased from 94% to 88%
C) A client requesting assistance ambulating to the bathroom
D) A client newly diagnosed with diabetes requesting dietary education
Correct Answer: B) - A client with COPD whose oxygen saturation decreased
from 94% to 88%
Rationale: Using airway, breathing, and circulation (ABC) prioritization, the client
with declining oxygen saturation presents the highest priority due to impaired
oxygenation and risk for respiratory compromise. Pain and education needs are
important but less urgent than physiologic instability.
Question 4: A nurse is teaching a client prescribed warfarin therapy. Which
statement by the client indicates understanding of the medication?
A) “I should increase my intake of green leafy vegetables.”
B) “I will use a soft toothbrush while taking this medication.”
C) “I can take aspirin if I develop a headache.”
D) “I do not need regular laboratory monitoring.”
Correct Answer: B) - “I will use a soft toothbrush while taking this medication.”
Rationale: Warfarin increases bleeding risk, making injury prevention strategies
such as using a soft toothbrush essential. Clients should maintain consistent—not
increased—vitamin K intake. Aspirin increases bleeding risk and should generally
be avoided unless prescribed. INR monitoring is required regularly.
Question 5: A nurse is caring for a client with increased intracranial pressure (ICP).
Which intervention is most appropriate?
A) Maintain the client in a Trendelenburg position
B) Suction the airway routinely every hour
C) Elevate the head of the bed approximately 30 degrees
D) Encourage frequent hip flexion exercises
Correct Answer: C) - Elevate the head of the bed approximately 30 degrees
Rationale: Elevating the head of the bed promotes venous drainage from the brain
and can reduce ICP. Trendelenburg positioning and hip flexion increase
intrathoracic and intracranial pressures. Excessive suctioning can transiently
elevate ICP and should be minimized.
,Comprehensive ATI Nursing and NCLEX Practice
Exam and a champion test with question and answers
- Updated 2026 (Graded A+)
Question 6: A nurse is assessing a client with diabetic ketoacidosis (DKA). Which
laboratory finding should the nurse expect?
A) Serum pH of 7.48
B) Blood glucose level of 420 mg/dL
C) Serum potassium level of 2.8 mEq/L without treatment influence
D) Decreased serum ketones
Correct Answer: B) - Blood glucose level of 420 mg/dL
Rationale: DKA is characterized by severe hyperglycemia, metabolic acidosis, and
ketone production. Elevated glucose levels commonly exceed 250 mg/dL.
Acidosis—not alkalosis—is expected. Potassium may initially appear elevated
despite total body depletion due to acidosis and insulin deficiency.
Question 7: A nurse is providing discharge teaching to a client following cataract
surgery. Which instruction should the nurse include?
A) “Avoid lifting objects heavier than 10 pounds.”
B) “Lie flat for 24 hours after surgery.”
C) “Expect severe eye pain for several days.”
D) “Resume driving immediately after discharge.”
Correct Answer: A) - “Avoid lifting objects heavier than 10 pounds.”
Rationale: Activities that increase intraocular pressure, such as heavy lifting,
bending, or straining, should be avoided following cataract surgery. Severe eye
pain may indicate complications such as increased intraocular pressure or
hemorrhage and should be reported immediately.
Question 8: A nurse is caring for a client prescribed furosemide. Which finding
requires immediate follow-up?
A) Blood pressure 118/74 mm Hg
B) Potassium level 2.9 mEq/L
C) Urine output 1,200 mL/day
D) Mild thirst after administration
Correct Answer: B) - Potassium level 2.9 mEq/L
Rationale: Furosemide is a loop diuretic associated with potassium loss. Severe
, Comprehensive ATI Nursing and NCLEX Practice
Exam and a champion test with question and answers
- Updated 2026 (Graded A+)
hypokalemia increases risk for dysrhythmias, muscle weakness, and cardiac
instability. The nurse should intervene promptly and notify the provider.
Question 9: A nurse is caring for a client with a chest tube connected to a closed
water-seal drainage system. Which finding requires immediate intervention?
A) Gentle tidaling in the water-seal chamber
B) Continuous bubbling in the water-seal chamber
C) Drainage of 50 mL serosanguineous fluid over 4 hr
D) Occlusive dressing intact at insertion site
Correct Answer: B) - Continuous bubbling in the water-seal chamber
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak
within the system, which can impair lung re-expansion and compromise
respiratory function. Gentle tidaling is expected in many clients with chest tubes.
Question 10: A nurse is assessing a client experiencing opioid overdose. Which
manifestation should the nurse expect?
A) Hypertension and tachycardia
B) Dilated pupils and agitation
C) Respiratory depression and pinpoint pupils
D) Hyperactive bowel sounds and diaphoresis
Correct Answer: C) - Respiratory depression and pinpoint pupils
Rationale: Classic opioid overdose manifestations include respiratory depression,
decreased level of consciousness, miosis (pinpoint pupils), and hypotension.
Dilated pupils and hyperactivity are more consistent with stimulant intoxication or
withdrawal syndromes.
Question 11: A nurse is caring for a client receiving heparin therapy. Which
laboratory value should the nurse monitor to evaluate therapeutic effectiveness?
A) International normalized ratio (INR)
B) Prothrombin time (PT)
C) Activated partial thromboplastin time (aPTT)
D) Platelet aggregation time
Correct Answer: C) - Activated partial thromboplastin time (aPTT)
Rationale: Heparin therapy is monitored using aPTT to assess anticoagulation
