Ultimate ATI Predictor Review –
NCLEX-Style Questions A & B with
Detailed Rationales
Practice Questions
1. A nurse is preparing to administer an intramuscular (IM) injection to an adult
client. Which site is most appropriate to use?
A. Dorsogluteal muscle
B. Deltoid muscle
C. Vastus lateralis muscle
D. Ventrogluteal muscle
Correct Answer: D. Ventrogluteal muscle
Rationale: The ventrogluteal site is preferred in adults because it is free of major
nerves and blood vessels and provides adequate muscle mass.
2. A nurse is caring for a client with a pressure injury on the sacrum. Which
nursing intervention best promotes wound healing?
A. Keeping the wound open to air
B. Repositioning the client every 2 hours
C. Massaging the reddened area
D. Limiting protein intake
Correct Answer: B. Repositioning the client every 2 hours
Rationale: Repositioning relieves pressure, improves circulation, and prevents
further tissue damage.
3. A nurse is performing hand hygiene. Which action is most effective in
preventing the spread of infection?
,A. Wearing gloves at all times
B. Using alcohol-based sanitizer after removing gloves
C. Washing hands only when visibly soiled
D. Drying hands with a shared towel
Correct Answer: B. Using alcohol-based sanitizer after removing gloves
Rationale: Hand hygiene before and after client contact, including after glove
removal, is the most effective method to prevent infection transmission.
4. A nurse is administering digoxin to a client with heart failure. Which finding
should the nurse report to the provider?
A. Apical pulse of 58/min
B. Blood pressure of 130/80 mmHg
C. Respiratory rate of 18/min
D. Potassium level of 4.0 mEq/L
Correct Answer: A. Apical pulse of 58/min
Rationale: Digoxin can cause bradycardia; the medication should be withheld if the
apical pulse is below 60/min.
5. A nurse is teaching a client about opioid analgesics. Which statement indicates
understanding?
A. "I should expect increased energy."
B. "Constipation is a common side effect."
C. "I will have difficulty sleeping."
D. "My appetite will increase."
Correct Answer: B. "Constipation is a common side effect."
Rationale: Opioids slow gastrointestinal motility, making constipation a common
adverse effect.
6. A nurse is caring for a client with chronic obstructive pulmonary disease
(COPD). Which intervention is the priority?
,A. Encourage fluid intake
B. Monitor oxygen saturation
C. Teach pursed-lip breathing
D. Assist with ambulation
Correct Answer: B. Monitor oxygen saturation
Rationale: Oxygenation is the priority for clients with COPD; monitoring
saturation guides treatment.
7. A client is admitted with hypovolemic shock. Which assessment finding
supports this diagnosis?
A. Bounding pulse
B. Warm, flushed skin
C. Decreased urine output
D. Elevated blood pressure
Correct Answer: C. Decreased urine output
Rationale: Reduced circulating volume decreases renal perfusion, leading to
oliguria.
8. A nurse assesses a postpartum client 1 hour after delivery. Which finding
requires immediate intervention?
A. Firm uterine fundus
B. Moderate lochia rubra
C. Boggy uterus
D. Blood pressure of 120/78 mmHg
Correct Answer: C. Boggy uterus
Rationale: A boggy uterus indicates uterine atony and increases the risk of
postpartum hemorrhage.
9. A client with major depressive disorder states, "I feel like everyone would be
better off without me." What is the nurse’s priority action?
, A. Encourage positive thinking
B. Ask about suicidal ideation
C. Change the subject
D. Provide reassurance
Correct Answer: B. Ask about suicidal ideation
Rationale: Statements of hopelessness require immediate suicide risk assessment.
10. A charge nurse is delegating tasks to a licensed practical nurse (LPN). Which
task is appropriate?
A. Initial client assessment
B. Teaching insulin administration
C. Administering oral medications
D. Developing a nursing care plan
Correct Answer: C. Administering oral medications
Rationale: LPNs may administer medications to stable clients but cannot perform
initial assessments or teaching.
11. A nurse is caring for a client receiving IV potassium chloride. Which action is
the highest priority?
A. Administer the medication by IV push
B. Ensure adequate urine output
C. Dilute the medication with normal saline
D. Monitor blood pressure before administration
Correct Answer: B. Ensure adequate urine output
Rationale: Potassium is excreted by the kidneys; adequate urine output must be
confirmed to prevent hyperkalemia.
12. A nurse is caring for a client with diabetes mellitus. Which finding indicates
hypoglycemia?
A. Polyuria
B. Fruity breath odor
C. Diaphoresis and shakiness
D. Deep, rapid respirations
NCLEX-Style Questions A & B with
Detailed Rationales
Practice Questions
1. A nurse is preparing to administer an intramuscular (IM) injection to an adult
client. Which site is most appropriate to use?
A. Dorsogluteal muscle
B. Deltoid muscle
C. Vastus lateralis muscle
D. Ventrogluteal muscle
Correct Answer: D. Ventrogluteal muscle
Rationale: The ventrogluteal site is preferred in adults because it is free of major
nerves and blood vessels and provides adequate muscle mass.
2. A nurse is caring for a client with a pressure injury on the sacrum. Which
nursing intervention best promotes wound healing?
A. Keeping the wound open to air
B. Repositioning the client every 2 hours
C. Massaging the reddened area
D. Limiting protein intake
Correct Answer: B. Repositioning the client every 2 hours
Rationale: Repositioning relieves pressure, improves circulation, and prevents
further tissue damage.
3. A nurse is performing hand hygiene. Which action is most effective in
preventing the spread of infection?
,A. Wearing gloves at all times
B. Using alcohol-based sanitizer after removing gloves
C. Washing hands only when visibly soiled
D. Drying hands with a shared towel
Correct Answer: B. Using alcohol-based sanitizer after removing gloves
Rationale: Hand hygiene before and after client contact, including after glove
removal, is the most effective method to prevent infection transmission.
4. A nurse is administering digoxin to a client with heart failure. Which finding
should the nurse report to the provider?
A. Apical pulse of 58/min
B. Blood pressure of 130/80 mmHg
C. Respiratory rate of 18/min
D. Potassium level of 4.0 mEq/L
Correct Answer: A. Apical pulse of 58/min
Rationale: Digoxin can cause bradycardia; the medication should be withheld if the
apical pulse is below 60/min.
5. A nurse is teaching a client about opioid analgesics. Which statement indicates
understanding?
A. "I should expect increased energy."
B. "Constipation is a common side effect."
C. "I will have difficulty sleeping."
D. "My appetite will increase."
Correct Answer: B. "Constipation is a common side effect."
Rationale: Opioids slow gastrointestinal motility, making constipation a common
adverse effect.
6. A nurse is caring for a client with chronic obstructive pulmonary disease
(COPD). Which intervention is the priority?
,A. Encourage fluid intake
B. Monitor oxygen saturation
C. Teach pursed-lip breathing
D. Assist with ambulation
Correct Answer: B. Monitor oxygen saturation
Rationale: Oxygenation is the priority for clients with COPD; monitoring
saturation guides treatment.
7. A client is admitted with hypovolemic shock. Which assessment finding
supports this diagnosis?
A. Bounding pulse
B. Warm, flushed skin
C. Decreased urine output
D. Elevated blood pressure
Correct Answer: C. Decreased urine output
Rationale: Reduced circulating volume decreases renal perfusion, leading to
oliguria.
8. A nurse assesses a postpartum client 1 hour after delivery. Which finding
requires immediate intervention?
A. Firm uterine fundus
B. Moderate lochia rubra
C. Boggy uterus
D. Blood pressure of 120/78 mmHg
Correct Answer: C. Boggy uterus
Rationale: A boggy uterus indicates uterine atony and increases the risk of
postpartum hemorrhage.
9. A client with major depressive disorder states, "I feel like everyone would be
better off without me." What is the nurse’s priority action?
, A. Encourage positive thinking
B. Ask about suicidal ideation
C. Change the subject
D. Provide reassurance
Correct Answer: B. Ask about suicidal ideation
Rationale: Statements of hopelessness require immediate suicide risk assessment.
10. A charge nurse is delegating tasks to a licensed practical nurse (LPN). Which
task is appropriate?
A. Initial client assessment
B. Teaching insulin administration
C. Administering oral medications
D. Developing a nursing care plan
Correct Answer: C. Administering oral medications
Rationale: LPNs may administer medications to stable clients but cannot perform
initial assessments or teaching.
11. A nurse is caring for a client receiving IV potassium chloride. Which action is
the highest priority?
A. Administer the medication by IV push
B. Ensure adequate urine output
C. Dilute the medication with normal saline
D. Monitor blood pressure before administration
Correct Answer: B. Ensure adequate urine output
Rationale: Potassium is excreted by the kidneys; adequate urine output must be
confirmed to prevent hyperkalemia.
12. A nurse is caring for a client with diabetes mellitus. Which finding indicates
hypoglycemia?
A. Polyuria
B. Fruity breath odor
C. Diaphoresis and shakiness
D. Deep, rapid respirations
