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ATI Comprehensive Predictor 2025 V2 | 200 NCLEX-
Style Questions with Rationales | Based on ATI &
Saunders 10th Ed | A+ Verified
Question 1
A nurse is caring for a postoperative client who has a PCA (patient-controlled analgesia) with
morphine following abdominal surgery. The client is drowsy and difficult to arouse, with a
respiratory rate of 8/min. What is the nurse’s priority action?
A. Discontinue the PCA infusion
B. Administer naloxone per protocol
C. Apply oxygen via nasal cannula
D. Attempt to awaken the client and reassess in 15 minutes
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Correct Answer: B. Administer naloxone per protocol
Rationale: A respiratory rate of 8/min and decreased level of consciousness indicates opioid-
induced respiratory depression, a life-threatening complication. Naloxone is an opioid antagonist
that should be administered immediately to reverse the effects. Oxygen may be initiated as
supportive care, but naloxone is the priority.
📚 Source: ATI RN Comprehensive Review, Ch. 3; Saunders NCLEX-RN 10th Ed., p. 268
Question 2
A nurse is preparing to administer digoxin to an older adult client with heart failure. Before
administration, the nurse assesses an apical pulse of 52 bpm and notes the client is experiencing
nausea and blurred vision. What should the nurse do next?
A. Administer the digoxin and monitor for improvement
B. Hold the dose and notify the provider
C. Recheck the pulse after 15 minutes
D. Give the medication with food to prevent nausea
Correct Answer: B. Hold the dose and notify the provider
Rationale: A heart rate below 60 bpm in adults, along with symptoms like nausea and visual
changes, suggests digoxin toxicity. The nurse must hold the medication and notify the provider
immediately. Continuing to administer it could worsen toxicity and cause arrhythmias.
📚 Source: ATI RN Pharmacology Review, Ch. 7; Saunders 10th Ed., p. 537
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Question 3
A client with newly diagnosed type 1 diabetes mellitus is being taught how to self-administer
insulin. The client asks why they need to rotate injection sites. What is the nurse’s best response?
A. “Rotating sites reduces the chance of bruising.”
B. “It ensures the insulin absorbs evenly.”
C. “It helps prevent infection at injection sites.”
D. “It improves the effect of long-acting insulin.”
Correct Answer: B. “It ensures the insulin absorbs evenly.”
Rationale: Rotating insulin injection sites prevents lipodystrophy, which can interfere with
insulin absorption. Repeated use of the same site can lead to tissue damage and inconsistent
insulin effects. Proper rotation within one anatomical area promotes optimal absorption and
glycemic control.
📚 Source: ATI RN Med-Surg, Endocrine System, Ch. 39; Saunders 10th Ed., p. 497
Question 4
A nurse is caring for a client receiving warfarin for atrial fibrillation. The client’s INR is 4.6.
What is the nurse’s priority action?
A. Notify the provider and prepare to administer vitamin K
B. Continue the dose and recheck the INR in the morning
C. Educate the client about avoiding leafy green vegetables
D. Increase the next dose to prevent clotting complications
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Correct Answer: A. Notify the provider and prepare to administer vitamin K
Rationale: An INR of 4.6 is critically elevated, increasing the risk of spontaneous bleeding.
The nurse must notify the provider immediately. Vitamin K is the antidote to warfarin and may
be required. Continuing the dose would worsen the problem.
📚 Source: ATI RN Pharmacology, Ch. 25 (Anticoagulants); Saunders 10th Ed., p. 478
Question 5
A nurse is reviewing the plan of care for a client who has a pressure injury on the sacrum with
exposed subcutaneous tissue. The nurse documents the wound as which stage?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Correct Answer: C. Stage III
Rationale: A Stage III pressure injury involves full-thickness skin loss, exposing subcutaneous
tissue, but not muscle or bone. Stage I includes only redness; Stage II shows partial-thickness
loss. Stage IV involves muscle, bone, or tendon exposure.
📚 Source: ATI RN Fundamentals, Ch. 55 (Wound Healing); Saunders 10th Ed., p. 328
ATI Comprehensive Predictor 2025 V2 | 200 NCLEX-
Style Questions with Rationales | Based on ATI &
Saunders 10th Ed | A+ Verified
Question 1
A nurse is caring for a postoperative client who has a PCA (patient-controlled analgesia) with
morphine following abdominal surgery. The client is drowsy and difficult to arouse, with a
respiratory rate of 8/min. What is the nurse’s priority action?
A. Discontinue the PCA infusion
B. Administer naloxone per protocol
C. Apply oxygen via nasal cannula
D. Attempt to awaken the client and reassess in 15 minutes
,2
Correct Answer: B. Administer naloxone per protocol
Rationale: A respiratory rate of 8/min and decreased level of consciousness indicates opioid-
induced respiratory depression, a life-threatening complication. Naloxone is an opioid antagonist
that should be administered immediately to reverse the effects. Oxygen may be initiated as
supportive care, but naloxone is the priority.
📚 Source: ATI RN Comprehensive Review, Ch. 3; Saunders NCLEX-RN 10th Ed., p. 268
Question 2
A nurse is preparing to administer digoxin to an older adult client with heart failure. Before
administration, the nurse assesses an apical pulse of 52 bpm and notes the client is experiencing
nausea and blurred vision. What should the nurse do next?
A. Administer the digoxin and monitor for improvement
B. Hold the dose and notify the provider
C. Recheck the pulse after 15 minutes
D. Give the medication with food to prevent nausea
Correct Answer: B. Hold the dose and notify the provider
Rationale: A heart rate below 60 bpm in adults, along with symptoms like nausea and visual
changes, suggests digoxin toxicity. The nurse must hold the medication and notify the provider
immediately. Continuing to administer it could worsen toxicity and cause arrhythmias.
📚 Source: ATI RN Pharmacology Review, Ch. 7; Saunders 10th Ed., p. 537
,3
Question 3
A client with newly diagnosed type 1 diabetes mellitus is being taught how to self-administer
insulin. The client asks why they need to rotate injection sites. What is the nurse’s best response?
A. “Rotating sites reduces the chance of bruising.”
B. “It ensures the insulin absorbs evenly.”
C. “It helps prevent infection at injection sites.”
D. “It improves the effect of long-acting insulin.”
Correct Answer: B. “It ensures the insulin absorbs evenly.”
Rationale: Rotating insulin injection sites prevents lipodystrophy, which can interfere with
insulin absorption. Repeated use of the same site can lead to tissue damage and inconsistent
insulin effects. Proper rotation within one anatomical area promotes optimal absorption and
glycemic control.
📚 Source: ATI RN Med-Surg, Endocrine System, Ch. 39; Saunders 10th Ed., p. 497
Question 4
A nurse is caring for a client receiving warfarin for atrial fibrillation. The client’s INR is 4.6.
What is the nurse’s priority action?
A. Notify the provider and prepare to administer vitamin K
B. Continue the dose and recheck the INR in the morning
C. Educate the client about avoiding leafy green vegetables
D. Increase the next dose to prevent clotting complications
, 4
Correct Answer: A. Notify the provider and prepare to administer vitamin K
Rationale: An INR of 4.6 is critically elevated, increasing the risk of spontaneous bleeding.
The nurse must notify the provider immediately. Vitamin K is the antidote to warfarin and may
be required. Continuing the dose would worsen the problem.
📚 Source: ATI RN Pharmacology, Ch. 25 (Anticoagulants); Saunders 10th Ed., p. 478
Question 5
A nurse is reviewing the plan of care for a client who has a pressure injury on the sacrum with
exposed subcutaneous tissue. The nurse documents the wound as which stage?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Correct Answer: C. Stage III
Rationale: A Stage III pressure injury involves full-thickness skin loss, exposing subcutaneous
tissue, but not muscle or bone. Stage I includes only redness; Stage II shows partial-thickness
loss. Stage IV involves muscle, bone, or tendon exposure.
📚 Source: ATI RN Fundamentals, Ch. 55 (Wound Healing); Saunders 10th Ed., p. 328
