ATI RN VATI Comprehensive Predictor Exam
Study Guide 2026 – Complete 200 Questions with
Verified Correct Answers & Explanations
Below is the complete set of all 200 questions. The correct answer is marked with ✓
Pharmacology & Parenteral Therapies
Question 1
A client taking warfarin has an INR of 5.8. The nurse should prepare to administer which
antidote?
A. Protamine sulfate
B. Vitamin K ✓
C. Naloxone
D. Flumazenil
Explanation: Vitamin K is the antidote for warfarin, used to reverse its anticoagulant effects
when INR is dangerously elevated (therapeutic INR is typically 2.0-3.0 for most indications).
Protamine sulfate reverses heparin. Naloxone reverses opioids. Flumazenil reverses
benzodiazepines.
Question 2
Before administering intravenous (IV) dopamine, the nurse's priority assessment is:
A. Lung sounds
B. Blood pressure ✓
C. Level of consciousness
D. Urine output
Explanation: Dopamine is a vasopressor used to treat hypotension. The priority assessment
before administration is blood pressure to ensure it is indicated and to establish a baseline for
monitoring response. Lung sounds, LOC, and urine output are important but not the priority
before administration.
Page | 1
,Question 3
A client with myasthenia gravis is experiencing increased muscle weakness 1 hour after taking
pyridostigmine. The nurse should suspect:
A. A therapeutic response
B. Cholinergic crisis ✓
C. Myasthenic crisis
D. An allergic reaction
Explanation: Cholinergic crisis occurs when there is excessive acetylcholine (too much
medication), causing muscle weakness. It typically occurs 30-60 minutes after taking
pyridostigmine. Myasthenic crisis occurs when there is insufficient medication (under-
medicated). Differentiating between the two is critical because treatment is opposite.
Question 4
The nurse administers propranolol to a client. Which finding requires immediate intervention?
A. Heart rate of 58 bpm
B. Blood pressure of 110/70 mmHg
C. Wheezing and shortness of breath ✓
D. Report of mild fatigue
Explanation: Propranolol is a non-selective beta-blocker that blocks beta-2 receptors in the
lungs, causing bronchospasm. Wheezing and shortness of breath indicate bronchospasm, which
can be life-threatening, especially in clients with asthma or COPD. HR of 58 is expected; BP
110/70 is normal; mild fatigue is a common side effect.
Question 5
A client is receiving a first dose of IV vancomycin. The nurse should monitor most closely for:
A. Red man syndrome ✓
B. Blue-green discoloration of urine
C. Crystal formation in the IV tubing
D. Ototoxicity
Explanation: Red man syndrome (flushing, rash, pruritus, hypotension) is a common infusion-
related reaction to vancomycin, especially with the first dose or rapid infusion. Ototoxicity is a
serious concern but occurs with prolonged use or high trough levels, not immediately with the
first dose.
Page | 2
,Question 6
A client is prescribed lithium for bipolar disorder. Which laboratory test should the nurse monitor
periodically?
A. Liver function tests
B. Thyroid function tests ✓
C. Renal function tests
D. Complete blood count
Explanation: Lithium can cause hypothyroidism and goiter. Thyroid function tests (TSH, T3,
T4) should be monitored every 6-12 months. Renal function is also monitored (lithium is
nephrotoxic), but thyroid is a more specific adverse effect.
Question 7
A client receiving IV heparin has an aPTT of 120 seconds. The nurse should anticipate
administering:
A. Vitamin K
B. Protamine sulfate ✓
C. Naloxone
D. Flumazenil
Explanation: Protamine sulfate is the antidote for heparin. aPTT should be 1.5-2.5 times normal
(approximately 60-80 seconds). An aPTT of 120 seconds indicates excessive anticoagulation and
bleeding risk. Vitamin K is for warfarin reversal.
Question 8
A client is prescribed metformin for type 2 diabetes. The nurse should teach the client to report
which finding immediately?
A. Nausea and diarrhea
B. Weight gain
C. Muscle pain and fatigue ✓
D. Headache
Explanation: Metformin can cause lactic acidosis (rare but serious). Signs include muscle pain,
weakness, fatigue, difficulty breathing, abdominal pain, and hypothermia. Nausea and diarrhea
are common side effects but not immediately dangerous.
Page | 3
, Question 9
The nurse administers furosemide IV push to a client with heart failure. Which finding indicates
the medication is effective?
A. Increased blood pressure
B. Decreased weight ✓
C. Decreased heart rate
D. Increased respiratory rate
Explanation: Furosemide is a loop diuretic that reduces fluid volume. Effectiveness is indicated
by weight loss (fluid loss), decreased edema, and decreased dyspnea. Blood pressure may
decrease slightly. Heart rate should decrease as workload decreases.
Question 10
A client is prescribed albuterol via nebulizer. The nurse should monitor for which side effect?
A. Bradycardia
B. Tachycardia ✓
C. Hypotension
D. Drowsiness
Explanation: Albuterol is a beta-2 agonist that can cause tachycardia, palpitations, nervousness,
tremors, and hypokalemia due to beta-1 effects. It should be used with caution in clients with
cardiac disease.
Management of Care & Safety
Question 11
A nurse discovers a fire in a client's room. What is the nurse's first action?
A. Activate the fire alarm. ✓
B. Use the fire extinguisher.
C. Remove the client from the room.
D. Close all doors on the unit.
Explanation: RACE: Rescue (remove clients in immediate danger), Alarm (activate fire alarm),
Confine (close doors), Extinguish (use fire extinguisher). Activating the alarm is the first action
to alert others and get help.
Page | 4
Study Guide 2026 – Complete 200 Questions with
Verified Correct Answers & Explanations
Below is the complete set of all 200 questions. The correct answer is marked with ✓
Pharmacology & Parenteral Therapies
Question 1
A client taking warfarin has an INR of 5.8. The nurse should prepare to administer which
antidote?
A. Protamine sulfate
B. Vitamin K ✓
C. Naloxone
D. Flumazenil
Explanation: Vitamin K is the antidote for warfarin, used to reverse its anticoagulant effects
when INR is dangerously elevated (therapeutic INR is typically 2.0-3.0 for most indications).
Protamine sulfate reverses heparin. Naloxone reverses opioids. Flumazenil reverses
benzodiazepines.
Question 2
Before administering intravenous (IV) dopamine, the nurse's priority assessment is:
A. Lung sounds
B. Blood pressure ✓
C. Level of consciousness
D. Urine output
Explanation: Dopamine is a vasopressor used to treat hypotension. The priority assessment
before administration is blood pressure to ensure it is indicated and to establish a baseline for
monitoring response. Lung sounds, LOC, and urine output are important but not the priority
before administration.
Page | 1
,Question 3
A client with myasthenia gravis is experiencing increased muscle weakness 1 hour after taking
pyridostigmine. The nurse should suspect:
A. A therapeutic response
B. Cholinergic crisis ✓
C. Myasthenic crisis
D. An allergic reaction
Explanation: Cholinergic crisis occurs when there is excessive acetylcholine (too much
medication), causing muscle weakness. It typically occurs 30-60 minutes after taking
pyridostigmine. Myasthenic crisis occurs when there is insufficient medication (under-
medicated). Differentiating between the two is critical because treatment is opposite.
Question 4
The nurse administers propranolol to a client. Which finding requires immediate intervention?
A. Heart rate of 58 bpm
B. Blood pressure of 110/70 mmHg
C. Wheezing and shortness of breath ✓
D. Report of mild fatigue
Explanation: Propranolol is a non-selective beta-blocker that blocks beta-2 receptors in the
lungs, causing bronchospasm. Wheezing and shortness of breath indicate bronchospasm, which
can be life-threatening, especially in clients with asthma or COPD. HR of 58 is expected; BP
110/70 is normal; mild fatigue is a common side effect.
Question 5
A client is receiving a first dose of IV vancomycin. The nurse should monitor most closely for:
A. Red man syndrome ✓
B. Blue-green discoloration of urine
C. Crystal formation in the IV tubing
D. Ototoxicity
Explanation: Red man syndrome (flushing, rash, pruritus, hypotension) is a common infusion-
related reaction to vancomycin, especially with the first dose or rapid infusion. Ototoxicity is a
serious concern but occurs with prolonged use or high trough levels, not immediately with the
first dose.
Page | 2
,Question 6
A client is prescribed lithium for bipolar disorder. Which laboratory test should the nurse monitor
periodically?
A. Liver function tests
B. Thyroid function tests ✓
C. Renal function tests
D. Complete blood count
Explanation: Lithium can cause hypothyroidism and goiter. Thyroid function tests (TSH, T3,
T4) should be monitored every 6-12 months. Renal function is also monitored (lithium is
nephrotoxic), but thyroid is a more specific adverse effect.
Question 7
A client receiving IV heparin has an aPTT of 120 seconds. The nurse should anticipate
administering:
A. Vitamin K
B. Protamine sulfate ✓
C. Naloxone
D. Flumazenil
Explanation: Protamine sulfate is the antidote for heparin. aPTT should be 1.5-2.5 times normal
(approximately 60-80 seconds). An aPTT of 120 seconds indicates excessive anticoagulation and
bleeding risk. Vitamin K is for warfarin reversal.
Question 8
A client is prescribed metformin for type 2 diabetes. The nurse should teach the client to report
which finding immediately?
A. Nausea and diarrhea
B. Weight gain
C. Muscle pain and fatigue ✓
D. Headache
Explanation: Metformin can cause lactic acidosis (rare but serious). Signs include muscle pain,
weakness, fatigue, difficulty breathing, abdominal pain, and hypothermia. Nausea and diarrhea
are common side effects but not immediately dangerous.
Page | 3
, Question 9
The nurse administers furosemide IV push to a client with heart failure. Which finding indicates
the medication is effective?
A. Increased blood pressure
B. Decreased weight ✓
C. Decreased heart rate
D. Increased respiratory rate
Explanation: Furosemide is a loop diuretic that reduces fluid volume. Effectiveness is indicated
by weight loss (fluid loss), decreased edema, and decreased dyspnea. Blood pressure may
decrease slightly. Heart rate should decrease as workload decreases.
Question 10
A client is prescribed albuterol via nebulizer. The nurse should monitor for which side effect?
A. Bradycardia
B. Tachycardia ✓
C. Hypotension
D. Drowsiness
Explanation: Albuterol is a beta-2 agonist that can cause tachycardia, palpitations, nervousness,
tremors, and hypokalemia due to beta-1 effects. It should be used with caution in clients with
cardiac disease.
Management of Care & Safety
Question 11
A nurse discovers a fire in a client's room. What is the nurse's first action?
A. Activate the fire alarm. ✓
B. Use the fire extinguisher.
C. Remove the client from the room.
D. Close all doors on the unit.
Explanation: RACE: Rescue (remove clients in immediate danger), Alarm (activate fire alarm),
Confine (close doors), Extinguish (use fire extinguisher). Activating the alarm is the first action
to alert others and get help.
Page | 4
