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) increases risk of cardiac arrest. Normal potassium is 3.5-5.0. BNP 100 is mildly
elevated; creatinine 1.2 is normal.
,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 ensures bacterial eradication. Stopping early causes recurrence and 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 and factual (e.g., "patient stated 'I am angry' and refused care").
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 care for stable clients with predictable outcomes. Unstable patients (MI, new stroke, septic shock)
require RNs.
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: Acknowledges feelings without reinforcing delusion. Therapeutic communication: validation + open-ended
exploration.
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 held for HR <60 in adults to prevent toxicity. Notify provider.
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 NS with potassium (after urine output confirmed) corrects dehydration and electrolyte loss.
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
C) Fill out an incident report
D) Help client back to bed
Correct Answer: B
Rationale: Assess ABCs and injuries first. Then move patient safely, then document.
Question 9
Which finding in a postpartum mother requires immediate intervention?
A) Fundus firm at umbilicus
B) Lochia rubra moderate
C) Saturating one pad per hour
D) Temperature 99.0°F (37.2°C)
Correct Answer: C
Rationale: Saturating >1 pad/hour indicates postpartum hemorrhage. Normal lochia rubra does not saturate >1
pad/hour.
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) increases risk of cardiac arrest. Normal potassium is 3.5-5.0. BNP 100 is mildly
elevated; creatinine 1.2 is normal.
,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 ensures bacterial eradication. Stopping early causes recurrence and 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 and factual (e.g., "patient stated 'I am angry' and refused care").
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 care for stable clients with predictable outcomes. Unstable patients (MI, new stroke, septic shock)
require RNs.
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: Acknowledges feelings without reinforcing delusion. Therapeutic communication: validation + open-ended
exploration.
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 held for HR <60 in adults to prevent toxicity. Notify provider.
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 NS with potassium (after urine output confirmed) corrects dehydration and electrolyte loss.
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
C) Fill out an incident report
D) Help client back to bed
Correct Answer: B
Rationale: Assess ABCs and injuries first. Then move patient safely, then document.
Question 9
Which finding in a postpartum mother requires immediate intervention?
A) Fundus firm at umbilicus
B) Lochia rubra moderate
C) Saturating one pad per hour
D) Temperature 99.0°F (37.2°C)
Correct Answer: C
Rationale: Saturating >1 pad/hour indicates postpartum hemorrhage. Normal lochia rubra does not saturate >1
pad/hour.
