ATI Comprehensive Predictor & NCLEX Practice Question
Bank: 500+ Multiple-Choice Questions with Answers and
Rationales for Nursing Exam Success: Pass Your Nursing Exam
on the First Try
A nurse is caring for a client who is postoperative day 1 following abdominal surgery.
Which finding requires immediate intervention?
A. Heart rate of 92 bpm
B. Respiratory rate of 18
C. Wound edges with slight pink drainage
D. Temperature of 38.8°C (101.8°F)
Answer: D
Rationale: A temperature of 38.8°C on postoperative day 1 may indicate infection or
sepsis. Slight serous drainage is normal. Mild tachycardia is expected.
A nurse is preparing to insert an indwelling urinary catheter for a female client. Which
technique demonstrates correct sterile procedure?
A. Open the inner catheter wrapper before donning sterile gloves
B. Use the dominant hand to clean each labial fold with a single cotton ball
C. Insert the catheter 2.5–5 cm (1–2 inches) until urine flows
D. Inflate the balloon after seeing urine return, then advance another 2.5–5 cm
Answer: D
*Rationale: After urine return, advance the catheter an additional 2.5–5 cm to ensure
the balloon is fully inside the bladder before inflation. The non-dominant hand cleans
the labia. Female catheter insertion depth is typically 5–7.5 cm.*
A client with a nasogastric tube attached to low intermittent suction complains of
nausea and abdominal distention. What should the nurse do first?
A. Irrigate the NG tube with 30 mL of sterile water
B. Assess for bowel sounds
C. Increase the suction pressure
,D. Reposition the client on the left side
Answer: B
Rationale: The nurse should first assess bowel sounds to determine if the NG tube is
functioning or if there is an ileus. Irrigation requires a provider order. Increasing suction
could cause mucosal damage.
A nurse is calculating intake for a client with heart failure. The client drank 240 mL of
coffee, 120 mL of juice, and had 90 mL of ice chips. IV fluids infused at 50 mL/hr for 8
hours. What is the total intake in mL?
A. 450 mL
B. 720 mL
C. 850 mL
D. 1,000 mL
Answer: C
*Rationale: 240 + 120 = 360 mL liquids. Ice chips count as half volume: 90/2 = 45 mL.
IV: 50 x 8 = 400 mL. Total = 360 + 45 + 400 = 805 mL (closest to 850 mL).*
A nurse is providing discharge teaching to a client with a new colostomy. Which
statement indicates understanding?
A. "I will change my ostomy pouch every day to prevent infection."
B. "I can eat popcorn and nuts as long as I chew them well."
C. "I should avoid carbonated beverages to reduce gas."
D. "I will use an adhesive remover to peel off the old pouch."
Answer: D
Rationale: Adhesive remover prevents skin trauma. Ostomy pouches are changed every
3–7 days. Popcorn and nuts can cause blockage. Carbonated beverages increase gas
but avoiding them is correct; however, D shows better understanding of skin care.
A client has an advance directive refusing CPR. The client becomes unresponsive and
pulseless. What should the nurse do?
A. Begin CPR immediately
B. Call the provider to reverse the directive
C. Place the client in a supine position and provide comfort care
D. Ask the family for permission
Answer: C
,Rationale: Advance directives must be honored. The nurse should not initiate CPR.
Comfort care includes positioning, family presence, and supporting the natural dying
process.
A nurse is performing a skin assessment on an older adult. Which finding is an
expected age-related change?
A. Cherry angiomas and skin tags
B. Bruising on the forearms and shins
C. Diminished sensation to sharp touch
D. All of the above
Answer: D
Rationale: Aging skin shows cherry angiomas, skin tags, easy bruising (senile purpura),
and decreased sensory perception. However, new or unexplained bruising should still
be investigated for abuse or bleeding disorders.
A client receiving a blood transfusion develops chills, fever, and lower back pain 30
minutes after the start. What is the priority action?
A. Slow the infusion rate
B. Administer acetaminophen as ordered
C. Stop the transfusion and start normal saline
D. Obtain a urine sample
Answer: C
Rationale: These symptoms suggest an acute hemolytic reaction. Stop the transfusion
immediately, keep the IV line open with saline, notify the provider, and send the blood
bag to the lab.
A nurse is teaching a client about a low-sodium diet. Which meal choice indicates
understanding?
A. Grilled chicken salad with oil and vinegar, fresh fruit
B. Ham sandwich with pickles and potato chips
C. Canned vegetable soup with saltine crackers
D. Bacon and eggs with cheese
Answer: A
Rationale: Fresh chicken, salad, oil/vinegar, and fruit are naturally low in sodium. Ham,
pickles, chips, canned soups, bacon, and cheese are high-sodium foods.
, A client on fall precautions has a bedside commode. Which action is most important?
A. Keep the call light within reach
B. Place a fall mat next to the bed
C. Assist the client to the commode every hour
D. Use a vest restraint at night
Answer: A
Rationale: The call light allows the client to request assistance, preventing unsupervised
attempts that lead to falls. Restraints are last resort. Hourly toileting may not match
the client’s needs.
A nurse is providing oral care to an unconscious client. Which action is correct?
A. Place the client in a supine position
B. Use a toothbrush with firm bristles
C. Position the client on the side with the head lower than the body
D. Swab the mouth with lemon-glycerin swabs
Answer: C
Rationale: Side-lying with head lower than body (Trendelenburg) allows secretions to
drain and prevents aspiration. Supine increases aspiration risk. Firm bristles can injure
oral mucosa. Lemon-glycerin swabs dry mucous membranes.
A client has a prescription for a 24-hour urine collection. Which action by the nurse is
correct?
A. Discard the first void and start timing
B. Save the first void and start timing immediately
C. Collect all urine including the final void at 24 hours
D. Keep the urine container at room temperature
Answer: A
*Rationale: For a 24-hour urine, discard the first morning void, then collect all
subsequent voids including the final morning void next day. The container must be
refrigerated or on ice unless a preservative is added.*
A nurse is assessing a client’s peripheral IV site. Which finding indicates phlebitis?
A. Pallor and coolness around the site
B. Edema and hardness along the vein
C. Clear drainage from the insertion site
Bank: 500+ Multiple-Choice Questions with Answers and
Rationales for Nursing Exam Success: Pass Your Nursing Exam
on the First Try
A nurse is caring for a client who is postoperative day 1 following abdominal surgery.
Which finding requires immediate intervention?
A. Heart rate of 92 bpm
B. Respiratory rate of 18
C. Wound edges with slight pink drainage
D. Temperature of 38.8°C (101.8°F)
Answer: D
Rationale: A temperature of 38.8°C on postoperative day 1 may indicate infection or
sepsis. Slight serous drainage is normal. Mild tachycardia is expected.
A nurse is preparing to insert an indwelling urinary catheter for a female client. Which
technique demonstrates correct sterile procedure?
A. Open the inner catheter wrapper before donning sterile gloves
B. Use the dominant hand to clean each labial fold with a single cotton ball
C. Insert the catheter 2.5–5 cm (1–2 inches) until urine flows
D. Inflate the balloon after seeing urine return, then advance another 2.5–5 cm
Answer: D
*Rationale: After urine return, advance the catheter an additional 2.5–5 cm to ensure
the balloon is fully inside the bladder before inflation. The non-dominant hand cleans
the labia. Female catheter insertion depth is typically 5–7.5 cm.*
A client with a nasogastric tube attached to low intermittent suction complains of
nausea and abdominal distention. What should the nurse do first?
A. Irrigate the NG tube with 30 mL of sterile water
B. Assess for bowel sounds
C. Increase the suction pressure
,D. Reposition the client on the left side
Answer: B
Rationale: The nurse should first assess bowel sounds to determine if the NG tube is
functioning or if there is an ileus. Irrigation requires a provider order. Increasing suction
could cause mucosal damage.
A nurse is calculating intake for a client with heart failure. The client drank 240 mL of
coffee, 120 mL of juice, and had 90 mL of ice chips. IV fluids infused at 50 mL/hr for 8
hours. What is the total intake in mL?
A. 450 mL
B. 720 mL
C. 850 mL
D. 1,000 mL
Answer: C
*Rationale: 240 + 120 = 360 mL liquids. Ice chips count as half volume: 90/2 = 45 mL.
IV: 50 x 8 = 400 mL. Total = 360 + 45 + 400 = 805 mL (closest to 850 mL).*
A nurse is providing discharge teaching to a client with a new colostomy. Which
statement indicates understanding?
A. "I will change my ostomy pouch every day to prevent infection."
B. "I can eat popcorn and nuts as long as I chew them well."
C. "I should avoid carbonated beverages to reduce gas."
D. "I will use an adhesive remover to peel off the old pouch."
Answer: D
Rationale: Adhesive remover prevents skin trauma. Ostomy pouches are changed every
3–7 days. Popcorn and nuts can cause blockage. Carbonated beverages increase gas
but avoiding them is correct; however, D shows better understanding of skin care.
A client has an advance directive refusing CPR. The client becomes unresponsive and
pulseless. What should the nurse do?
A. Begin CPR immediately
B. Call the provider to reverse the directive
C. Place the client in a supine position and provide comfort care
D. Ask the family for permission
Answer: C
,Rationale: Advance directives must be honored. The nurse should not initiate CPR.
Comfort care includes positioning, family presence, and supporting the natural dying
process.
A nurse is performing a skin assessment on an older adult. Which finding is an
expected age-related change?
A. Cherry angiomas and skin tags
B. Bruising on the forearms and shins
C. Diminished sensation to sharp touch
D. All of the above
Answer: D
Rationale: Aging skin shows cherry angiomas, skin tags, easy bruising (senile purpura),
and decreased sensory perception. However, new or unexplained bruising should still
be investigated for abuse or bleeding disorders.
A client receiving a blood transfusion develops chills, fever, and lower back pain 30
minutes after the start. What is the priority action?
A. Slow the infusion rate
B. Administer acetaminophen as ordered
C. Stop the transfusion and start normal saline
D. Obtain a urine sample
Answer: C
Rationale: These symptoms suggest an acute hemolytic reaction. Stop the transfusion
immediately, keep the IV line open with saline, notify the provider, and send the blood
bag to the lab.
A nurse is teaching a client about a low-sodium diet. Which meal choice indicates
understanding?
A. Grilled chicken salad with oil and vinegar, fresh fruit
B. Ham sandwich with pickles and potato chips
C. Canned vegetable soup with saltine crackers
D. Bacon and eggs with cheese
Answer: A
Rationale: Fresh chicken, salad, oil/vinegar, and fruit are naturally low in sodium. Ham,
pickles, chips, canned soups, bacon, and cheese are high-sodium foods.
, A client on fall precautions has a bedside commode. Which action is most important?
A. Keep the call light within reach
B. Place a fall mat next to the bed
C. Assist the client to the commode every hour
D. Use a vest restraint at night
Answer: A
Rationale: The call light allows the client to request assistance, preventing unsupervised
attempts that lead to falls. Restraints are last resort. Hourly toileting may not match
the client’s needs.
A nurse is providing oral care to an unconscious client. Which action is correct?
A. Place the client in a supine position
B. Use a toothbrush with firm bristles
C. Position the client on the side with the head lower than the body
D. Swab the mouth with lemon-glycerin swabs
Answer: C
Rationale: Side-lying with head lower than body (Trendelenburg) allows secretions to
drain and prevents aspiration. Supine increases aspiration risk. Firm bristles can injure
oral mucosa. Lemon-glycerin swabs dry mucous membranes.
A client has a prescription for a 24-hour urine collection. Which action by the nurse is
correct?
A. Discard the first void and start timing
B. Save the first void and start timing immediately
C. Collect all urine including the final void at 24 hours
D. Keep the urine container at room temperature
Answer: A
*Rationale: For a 24-hour urine, discard the first morning void, then collect all
subsequent voids including the final morning void next day. The container must be
refrigerated or on ice unless a preservative is added.*
A nurse is assessing a client’s peripheral IV site. Which finding indicates phlebitis?
A. Pallor and coolness around the site
B. Edema and hardness along the vein
C. Clear drainage from the insertion site
