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2026 ATI RN COMPREHENSIVE PREDICTOR EXAM | 200 QUESTIONS + RATIONALES | NCLEX-STYLE PRACTICE TEST

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Pass Your ATI Comprehensive Predictor and NCLEX on the First Try! This comprehensive practice exam features 200 realistic NCLEX-style questions and answers with detailed rationales, directly aligned with the latest 2026 ATI RN Comprehensive Predictor blueprint. Covers all core content areas: medical-surgical nursing (COPD, heart failure, pancreatitis, DKA, hyperkalemia, GI bleeding, CVA, MI, CKD), pharmacology (lisinopril, warfarin, digoxin, furosemide, metformin, insulin, vancomycin, enoxaparin, heparin, magnesium sulfate, betamethasone, oxytocin, RhoGAM), maternal-newborn (preterm labor, placenta previa, preeclampsia, magnesium toxicity, postpartum hemorrhage, APGAR, newborn hypoglycemia, NAS), pediatrics (croup, Kawasaki, pyloric stenosis, intussusception, CF, ADHD, nephrotic syndrome, VP shunt), mental health (major depression, bipolar mania, panic disorder, PTSD, schizophrenia, borderline PD, anorexia nervosa, alcohol withdrawal, clozapine agranulocytosis), leadership/delegation (RN/LPN/UAP assignment, advance directives, restraints, informed consent, ethical principles), infection control (tuberculosis, shingles, C. diff, neutropenic precautions), and 50+ priority-scenario questions (cardiac cath bleeding, chest tube air leak, transfusion reactions, heparin aPTT 140, epidural hypotension, fetal monitoring (late decels, Category I, II, III), DKA management, GI bleed stabilization, and autonomic dysreflexia). Written for nursing students—master prioritization (ABCs), delegation, medication calculations, and safety protocols. Includes questions 1–200 with complete answer key and rationales. No fluff—just exam-focused preparation!

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2026 ATI RN COMPREHENSIVE
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2026 ATI RN COMPREHENSIVE

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Page 1 of 173



Revised Study Guide with ATI Questions and

Answers | 2026 Update | 100% Correct -

Eastwick College

Q1. A nurse is caring for four clients. Which client should be

seen first?

A. Client with COPD and SpO₂ 89% on 2 L nasal cannula

B. Client post-appendectomy day 2 with temperature 38.3°C

(101°F)

C. Client with heart failure and 3+ pitting edema

D. Client with new-onset confusion and bounding pulse

Answer: D

Rationale: New-onset confusion with a bounding pulse suggests

hypercapnia or fluid overload affecting cerebral perfusion. A

change in neurological status is always the priority. The client

with COPD has a SpO₂ of 89% which is expected for that

,Page 2 of 173


population, the post-op fever is likely inflammatory, and chronic

edema does not take precedence over an acute mental status

change.




Q2. A charge nurse is assigning staff. Which client should be

assigned to the LPN?

A. Client 1 hour post-cardiac catheterization with bleeding

B. Client with stable diabetes requiring insulin and foot care

C. Client newly admitted with stroke and altered mental status

D. Client receiving IV heparin with PTT of 98 seconds

Answer: B

Rationale: LPNs can administer insulin, perform stable wound

care, and monitor stable clients. Options A, C, and D require RN

assessment (bleeding, neurological changes, critical lab

monitoring).

,Page 3 of 173


Q3. A nurse is observing a client interacting with her newborn.

Which action requires the nurse to intervene?

A. Holding the newborn in the en face position

B. Asking the father to change the newborn’s diaper

C. Requesting the nurse take the newborn to the nursery so she

can rest

D. Viewing the newborn’s actions as uncooperative

Answer: D

Rationale: Viewing the newborn as “uncooperative” indicates the

mother is interpreting the newborn’s behavior negatively, which

can interfere with healthy bonding. The nurse should explore the

mother’s feelings and provide teaching about normal newborn

behavior. En face positioning, paternal involvement, and

requesting a break are all adaptive behaviors.

, Page 4 of 173


Q4. A nurse is assessing a client in the PACU. Which finding

indicates decreased cardiac output?

A. Shivering

B. Oliguria

C. Bradypnea

D. Constricted pupils

Answer: B

Rationale: Oliguria (urine output less than 0.5 mL/kg/hour) is a

late sign of decreased cardiac output due to reduced renal

perfusion. Shivering is a response to hypothermia, bradypnea

may be opioid-induced, and constricted pupils are also

opioid-related. None of these directly point to low cardiac

output.




Q5. A nurse is caring for a client who just received the first dose

of lisinopril. Which intervention is most appropriate?

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2026 ATI RN COMPREHENSIVE
Course
2026 ATI RN COMPREHENSIVE

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