ATI RN Comprehensive Predictor 2026

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Free ATI RN Comprehensive Predictor 2026 Questions

1. A nurse is caring for a client who has an allergy to penicillin. The health care provider has prescribed amoxicillin. Which of the following actions should the nurse take?
  • Administer the medication as prescribed.
  • Discuss the prescription with the health care provider.
  • Call the pharmacist for clarification of the medication contraindications.
  • Place an incident report in the medical record.

Explanation

Amoxicillin is a derivative of penicillin and can trigger a severe allergic reaction in clients who are allergic to penicillin. The nurse must discuss this prescription with the health care provider before administration to ensure patient safety and prevent anaphylaxis. The provider may prescribe an alternative antibiotic that is not related to penicillin. Administering it without clarification could cause a serious adverse reaction.
2.

A public health nurse is investigating a recent outbreak of cryptosporidiosis in their community. Which of the following should the nurse identify as the mode of transmission for this communicable illness?

  • Sexual contact​
  • Waterborne​
  • Droplet​
  • Tick bite

Explanation

Explanation
Cryptosporidiosis is a parasitic infection most commonly transmitted through contaminated water, including drinking water, recreational water (pools, lakes), and sometimes food washed in contaminated water. The parasite is resistant to chlorine and spreads easily in water sources. Identifying the waterborne route helps guide prevention measures such as water testing, boil-water advisories, and public education.
3. The nurse is continuing to care for the client in the intensive care unit. The client was admitted following a diagnosis of Neuroleptic Malignant Syndrome (NMS) after receiving Haloperidol 5 mg IM stat then 3 mg PO three times a day and Lorazepam 2 mg IM stat then 0.3 mg PO three times a day. Vital signs have been as follows:

Day 1, 1715: Temperature 38.8°C (98.2°F), Heart rate 102/min, Respiratory rate 22/min, Blood pressure 145/78 mm Hg, Oxygen saturation 98% on room air.

Day 2, 0800: Temperature 37.2°C (99°F), Heart rate 88/min, Respiratory rate 18/min, Blood pressure 140/84 mm Hg, Oxygen saturation 98% on room air.

Day 2, 1000: Temperature 40.2°C (104.4°F), Heart rate 121/min, Respiratory rate 22/min, Blood pressure 168/97 mm Hg, Oxygen saturation 96% on room air.

Day 2, 1015: Temperature 40.2°C (104.4°F), Heart rate 148/min, Respiratory rate 22/min, Blood pressure 172/97 mm Hg.

The client has a history of asthma, one seizure as a teenager, a twin diagnosed with schizophrenia 2 years ago, and a father with Parkinson's disease. The client drinks red wine a few times per week and smokes marijuana daily. Select the 5 findings that indicate an improvement in the client's condition.

  • Skin findings

  • Blood pressure

  • Respiratory rate

  • Heart rate

  • Temperature

  • Heart rhythm

Explanation

Explanation
Correct Answers: (A) Skin findings, (B) Blood pressure, (C) Respiratory rate, (D) Heart rate, (E) Temperature
In Neuroleptic Malignant Syndrome (NMS), the hallmark features include hyperthermia, autonomic instability (tachycardia, hypertension, diaphoresis), and muscle rigidity. Improvement in the client's condition would be reflected by normalization of these findings.
A. Skin findings — NMS causes profuse diaphoresis (excessive sweating) due to autonomic dysfunction. Improvement would be indicated by resolution of diaphoresis and return of normal skin appearance and temperature.
B. Blood pressure — The client's blood pressure escalated from 145/78 mmHg to 172/97 mmHg, indicating worsening autonomic instability. A return toward normal blood pressure readings would indicate improvement.
C. Respiratory rate — The elevated respiratory rate (22/min) reflects the physiological stress of NMS and hyperthermia. A decrease toward the normal range (12–20/min) would signal improvement.
D. Heart rate — Tachycardia progressively worsened from 102/min to 148/min, a direct sign of autonomic instability in NMS. A declining heart rate toward normal (60–100/min) would indicate positive response to treatment.
E. Temperature — Hyperthermia is the most defining feature of NMS. The temperature rose to 40.2°C (104.4°F), and a return to normothermia (36–37.5°C) would be the clearest indicator of improvement.
Why the Other Option is Incorrect:
F. Heart rhythm — While cardiac monitoring is important in NMS, heart rhythm abnormalities are not among the primary diagnostic criteria for NMS. The question's clinical data does not document a specific dysrhythmia, making this the least relevant finding among the six options for tracking improvement in this client's condition.
4.

A nurse is caring for a client who is receiving intermittent enteral tube feedings. Which of the following factors places the client at risk for aspiration?

  • Receiving a high-osmolarity formula
  • A residual of 65 mL 1-hr postprandial
  • Sitting in high-Fowler's position during the feeding
  • A history of gastroesophageal reflux disease

Explanation

Explanation:

Correct Answer: (D) A history of gastroesophageal reflux disease Gastroesophageal reflux disease (GERD) causes the lower esophageal sphincter to be incompetent, allowing gastric contents to flow back up into the esophagus and potentially into the airway. In a client receiving enteral tube feedings, pre-existing GERD significantly increases the risk that formula or gastric contents will be regurgitated and aspirated into the lungs, making it a major aspiration risk factor.

Why Other Options are Incorrect:

  • A. Receiving a high-osmolarity formula. High-osmolarity formulas can cause diarrhea or GI discomfort but are not a direct risk factor for aspiration. The osmolarity of the formula does not affect the mechanical risk of reflux or airway entry.
  • B. A residual of 65 mL 1-hr postprandial. A gastric residual of 65 mL at 1 hour after feeding is within an acceptable range for most clinical guidelines and does not indicate delayed gastric emptying or an increased aspiration risk at this level.
  • C. Sitting in high-Fowler's position during the feeding. Elevating the head of the bed to 30–45 degrees or higher during and after tube feedings is the recommended position to prevent aspiration. High-Fowler's position is protective, not a risk factor.
5. A nurse is assessing a client who was placed in restraints for aggressive behavior. The client is now calm and cooperative. Which of the following actions should the nurse take?
  • Encourage the client to attend a group therapy session.
  • Continue to monitor the client every 15 min.
  • Remove the restraints from the client.
  • Offer the client PRN pain medication.

Explanation

Once a client who was previously restrained becomes calm, cooperative, and no longer poses a threat to themselves or others, the nurse must remove the restraints immediately. Restraints should be used only for the shortest time necessary and discontinued as soon as the client’s behavior is safe. Keeping restraints longer than required violates the client’s rights and increases the risk of physical and psychological harm. After removal, the nurse should continue to monitor the client’s behavior and provide reassurance and emotional support.
6.

A nurse in the emergency department is assessing a client who has status asthmaticus. The nurse should expect which of the following findings?

  • Increase in peak expiratory rate flow
  • Bradycardia
  • Epigastric pain
  • Distended neck veins

Explanation

Explanation:

Correct Answer: (D) Distended neck veins Status asthmaticus is a severe, prolonged asthma attack that does not respond to standard bronchodilator therapy. Due to severe air trapping and increased intrathoracic pressure from prolonged expiratory obstruction, venous return to the heart is impaired, resulting in distended neck veins. This is a sign of the severe hemodynamic compromise associated with this life-threatening condition.

Why Other Options are Incorrect:

A. Increase in peak expiratory rate flow — In status asthmaticus, airflow is severely obstructed. Peak expiratory flow rate is markedly decreased, not increased, due to bronchospasm and airway inflammation.

B. Bradycardia — Status asthmaticus causes significant physiological stress, hypoxia, and the use of sympathomimetic bronchodilators, all of which result in tachycardia, not bradycardia.

C. Epigastric pain — Epigastric pain is associated with gastrointestinal conditions such as peptic ulcer disease, pancreatitis, or cardiac events. It is not a characteristic finding of status asthmaticus.

7.

A nurse is providing prenatal teaching about iron to a client who follows a vegetarian diet. The nurse should recommend that the client consume which of the following foods to enhance the absorption of nonheme iron?

  • Cheddar cheese
  • Boiled eggs
  • Mixed nuts
  • Orange slices

Explanation

Explanation:

Correct Answer: (D) Orange slices Nonheme iron — the type found in plant-based foods — has significantly lower bioavailability than heme iron from animal sources. Vitamin C (ascorbic acid), found abundantly in citrus fruits like oranges, dramatically enhances the absorption of nonheme iron by converting it from ferric (Fe³⁺) to ferrous (Fe²⁺) form, which is more readily absorbed in the small intestine. Consuming vitamin C-rich foods alongside iron-rich plant foods is a key dietary strategy for vegetarian clients, especially during pregnancy.

Why Other Options are Incorrect:

  • A. Cheddar cheese. Cheddar cheese is a dairy product that actually contains calcium, which can inhibit iron absorption when consumed simultaneously with iron-rich foods. It does not enhance nonheme iron absorption.
  • B. Boiled eggs. Eggs contain a protein called phosvitin that can actually inhibit iron absorption. They are not recommended as an enhancer of nonheme iron uptake.
  • C. Mixed nuts. While nuts contain some nonheme iron themselves, they do not contain significant amounts of vitamin C and therefore do not enhance nonheme iron absorption in the way that citrus foods do.
8.

A nurse is reviewing the medical record of a client who has bipolar disorder and has been prescribed lithium. Which of the following pre-existing health conditions should the nurse report to the provider before administering the medication?

  • Seizures​
  • Multiple sclerosis​
  • Asthma​
  • Cardiovascular disease

Explanation

Explanation
Lithium can significantly affect cardiac conduction, especially in patients with pre-existing cardiovascular disease. It may worsen arrhythmias, cause sinus node dysfunction, or alter electrolyte balance, which increases cardiac risk. Because lithium is closely tied to sodium and fluid regulation, any cardiac disorder may become unstable. The provider must be notified before administering lithium so risks can be evaluated and ECG monitoring may be ordered.
9. A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?
  • Select a vein on the back of the hand.
  • Clean the site using vigorous friction.
  • Use a 22-gauge catheter for insertion.
  • Apply a tourniquet firmly above the insertion site.

Explanation

Older adults often have fragile veins that are more prone to damage and infiltration. Using a smaller-gauge catheter, such as a 22-gauge, helps reduce trauma to the vessel while still allowing adequate flow for most IV therapies. The nurse should also use gentle technique and minimal tourniquet pressure. Veins on the back of the hand are more fragile and should be avoided. Vigorous cleaning can damage the skin, and applying the tourniquet too firmly may cause vein rupture or bruising.
10. A nurse is teaching a client who is to undergo placement of a nontunneled percutaneous central venous access device. Which of the following statements should the nurse include in the teaching?
  • "Placement of the catheter is confirmed by a CT scan."
  • "You will be under general anesthesia for this procedure."
  • "The provider will wear a mask while performing the procedure."
  • "Your head will be elevated as high as possible while the catheter is inserted."

Explanation

During the insertion of a nontunneled percutaneous central venous catheter (CVC), the procedure must be performed using strict sterile technique to prevent infection. The provider wears a mask, sterile gloves, and gown, while the client’s skin is cleansed with an antiseptic solution. A sterile drape covers the insertion area.

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