Ultimate ATI RN Comprehensive Predictor 2026 Study Guide: 150
NCLEX-Style Practice Questions with Answers & Rationales
Covering Med-Surg, Pharmacology, Pediatrics, Mental Health,
Leadership, Fundamentals, and Priority Nursing Care Concepts*
Question 1
A nurse is caring for a client with heart failure. Which lab value
requires immediate intervention?
A) Potassium 4.0 mEq/L
B) BNP 100 pg/mL
C) Creatinine 1.2 mg/dL
D) Potassium 5.9 mEq/L
Correct Answer: D
Rationale: Hyperkalemia (K+ >5.0 mEq/L) increases the risk of life-
threatening cardiac arrhythmias, especially in heart failure patients
taking ACE inhibitors or ARBs. Normal potassium is 3.5-5.0. BNP
100 is mildly elevated but not emergent. Creatinine 1.2 is within
normal range.
Question 2
A toddler is prescribed amoxicillin for otitis media. The parent asks
why the full bottle must be finished. Best response?
A) To prevent superinfection
B) To reduce antibiotic resistance
,C) To ensure complete eradication of bacteria
D) To decrease fever faster
Correct Answer: C
Rationale: Completing the full course of antibiotics ensures
complete eradication of the causative bacteria. Stopping early may
leave residual bacteria, leading to recurrence and contributing to
antibiotic resistance.
Question 3
A nurse manager observes a staff nurse documenting "patient
angry and uncooperative." What action is best?
A) Praise the nurse for detail
B) Tell the nurse to use only objective terms
C) File a disciplinary report
D) Ignore it as minor
Correct Answer: B
Rationale: Documentation must be objective, factual, and non-
judgmental. The nurse should document specific behaviors (e.g.,
"patient stated, 'I am angry' and refused to participate in care")
rather than subjective labels.
Question 4
Which client should a charge nurse assign to an LPN?
A) New MI with chest pain
B) Post-op day 3 hip replacement, stable
,C) New stroke with dysphagia
D) Septic shock on vasopressors
Correct Answer: B
Rationale: LPNs can care for stable clients with predictable
outcomes and unchanged conditions. Unstable patients (new MI,
new stroke, septic shock) require RN assessment and management.
Question 5
A client with schizophrenia says, "The FBI is poisoning my food."
Best therapeutic response?
A) "That’s not true, the FBI isn't here."
B) "You seem frightened. Tell me more about that."
C) "Let's talk about something else."
D) "I will check your food for poison."
Correct Answer: B
Rationale: This response acknowledges the client's feelings without
reinforcing the delusion. It uses therapeutic communication
techniques of validation and open-ended exploration. Option A
argues with the delusion; option D reinforces it.
Question 6
A nurse administers digoxin to a patient with HR 52. Next action?
A) Give the medication as ordered
B) Hold the dose and reassess in 30 minutes
, C) Hold the dose and notify the provider
D) Give atropine first
Correct Answer: C
Rationale: Digoxin is typically held for heart rate <60 bpm in adults
(or per facility protocol) to prevent digoxin toxicity. The provider
should be notified for further orders.
Question 7
A preschooler is admitted with dehydration. Which IV fluid is
preferred?
A) D5W
B) 0.9% NS with 20 mEq KCl/L
C) 0.45% NS
D) 3% NS
Correct Answer: B
Rationale: Isotonic saline (0.9% NS) with potassium (after urine
output is confirmed) corrects dehydration and electrolyte losses.
D5W is hypotonic; 0.45% NS is hypotonic; 3% NS is hypertonic and
used for severe hyponatremia only.
Question 8
A nurse finds a client on the floor after a fall. Priority action?
A) Call the provider
B) Assess the client for injuries
NCLEX-Style Practice Questions with Answers & Rationales
Covering Med-Surg, Pharmacology, Pediatrics, Mental Health,
Leadership, Fundamentals, and Priority Nursing Care Concepts*
Question 1
A nurse is caring for a client with heart failure. Which lab value
requires immediate intervention?
A) Potassium 4.0 mEq/L
B) BNP 100 pg/mL
C) Creatinine 1.2 mg/dL
D) Potassium 5.9 mEq/L
Correct Answer: D
Rationale: Hyperkalemia (K+ >5.0 mEq/L) increases the risk of life-
threatening cardiac arrhythmias, especially in heart failure patients
taking ACE inhibitors or ARBs. Normal potassium is 3.5-5.0. BNP
100 is mildly elevated but not emergent. Creatinine 1.2 is within
normal range.
Question 2
A toddler is prescribed amoxicillin for otitis media. The parent asks
why the full bottle must be finished. Best response?
A) To prevent superinfection
B) To reduce antibiotic resistance
,C) To ensure complete eradication of bacteria
D) To decrease fever faster
Correct Answer: C
Rationale: Completing the full course of antibiotics ensures
complete eradication of the causative bacteria. Stopping early may
leave residual bacteria, leading to recurrence and contributing to
antibiotic resistance.
Question 3
A nurse manager observes a staff nurse documenting "patient
angry and uncooperative." What action is best?
A) Praise the nurse for detail
B) Tell the nurse to use only objective terms
C) File a disciplinary report
D) Ignore it as minor
Correct Answer: B
Rationale: Documentation must be objective, factual, and non-
judgmental. The nurse should document specific behaviors (e.g.,
"patient stated, 'I am angry' and refused to participate in care")
rather than subjective labels.
Question 4
Which client should a charge nurse assign to an LPN?
A) New MI with chest pain
B) Post-op day 3 hip replacement, stable
,C) New stroke with dysphagia
D) Septic shock on vasopressors
Correct Answer: B
Rationale: LPNs can care for stable clients with predictable
outcomes and unchanged conditions. Unstable patients (new MI,
new stroke, septic shock) require RN assessment and management.
Question 5
A client with schizophrenia says, "The FBI is poisoning my food."
Best therapeutic response?
A) "That’s not true, the FBI isn't here."
B) "You seem frightened. Tell me more about that."
C) "Let's talk about something else."
D) "I will check your food for poison."
Correct Answer: B
Rationale: This response acknowledges the client's feelings without
reinforcing the delusion. It uses therapeutic communication
techniques of validation and open-ended exploration. Option A
argues with the delusion; option D reinforces it.
Question 6
A nurse administers digoxin to a patient with HR 52. Next action?
A) Give the medication as ordered
B) Hold the dose and reassess in 30 minutes
, C) Hold the dose and notify the provider
D) Give atropine first
Correct Answer: C
Rationale: Digoxin is typically held for heart rate <60 bpm in adults
(or per facility protocol) to prevent digoxin toxicity. The provider
should be notified for further orders.
Question 7
A preschooler is admitted with dehydration. Which IV fluid is
preferred?
A) D5W
B) 0.9% NS with 20 mEq KCl/L
C) 0.45% NS
D) 3% NS
Correct Answer: B
Rationale: Isotonic saline (0.9% NS) with potassium (after urine
output is confirmed) corrects dehydration and electrolyte losses.
D5W is hypotonic; 0.45% NS is hypotonic; 3% NS is hypertonic and
used for severe hyponatremia only.
Question 8
A nurse finds a client on the floor after a fall. Priority action?
A) Call the provider
B) Assess the client for injuries
