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ATI RN Comprehensive Predictor Questions And Correct
Answers (Verified Answers) Plus Rationales 2025 Q&A |
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The questions cover essential NCLEX-RN content areas: medical-surgical, maternity, pediatric, mental health, leadership, and pharmacology.
- A nurse is caring for a client who has heart failure and is prescribed furosemide. Which of the following findings should the nurse report to the provider? A. 2+ edema in lower extremities B. Serum potassium 2.9 mEq/L C. Blood pressure 138/84 mm Hg D. Urine output of 800 mL in 8 hours Rationale: Hypokalemia is a common and potentially dangerous side effect of furosemide. A potassium level of 2.9 is critically low and can lead to arrhythmias.
- A client who is postoperative is reporting pain at 8/10. Which of the following actions should the nurse take first? A. Reposition the client B. Administer pain medication as prescribed C. Assess the client’s pain level and characteristics D. Offer distraction techniques
Rationale: The first step in pain management is always assessment. Interventions should follow a complete evaluation.
- A nurse is caring for a client with major depressive disorder. Which of the following findings is the nurse’s priority? A. Reports of fatigue B. Expressions of hopelessness C. Poor appetite D. Lack of interest in hobbies Rationale: Hopelessness is a major risk factor for suicide and should be addressed immediately.
- A nurse is teaching a client who has a new prescription for digoxin. Which of the following statements by the client indicates an understanding of the teaching? A. "I should take this medication with an antacid." B. "I will call my provider if my pulse is below 60." C. "It’s okay to skip a dose if I feel fine." D. "Blurred vision is an expected side effect." Rationale: Clients should be instructed to monitor heart rate and not take digoxin if the pulse is below 60 bpm.
- A nurse is providing discharge teaching to a client following a total hip arthroplasty. Which of the following instructions should the nurse include? A. Cross your legs to improve circulation B. Bend at the waist when picking up objects C. Use a raised toilet seat
C. "I will stop taking insulin if I get sick." D. "I will shake the insulin bottle before using it." Rationale: The abdomen is the preferred site due to consistent absorption rates.
- A nurse is preparing to administer a blood transfusion. Which of the following actions should the nurse take? A. Prime the tubing with 5% dextrose B. Stay with the client for the first 15 minutes C. Obtain consent after starting the transfusion D. Infuse the blood over 6 hours Rationale: Most reactions occur within the first 15 minutes, so monitoring is critical during that time. 10.A nurse is reviewing the medication administration record for a client with schizophrenia. Which of the following medications requires monitoring for agranulocytosis? A. Risperidone B. Haloperidol C. Clozapine D. Olanzapine Rationale: Clozapine can cause agranulocytosis; regular WBC monitoring is required. 11.A nurse is assessing a client with fluid volume excess. Which of the following findings should the nurse expect?
A. Increased hematocrit B. Crackles in the lungs C. Hypotension D. Flattened neck veins Rationale: Crackles are a result of pulmonary congestion due to excess fluid. 12.A client with a DNR order becomes unresponsive and pulseless. Which of the following actions should the nurse take? A. Begin CPR immediately B. Notify the provider and document the death C. Call a code blue D. Administer oxygen and IV fluids Rationale: A DNR order legally prohibits CPR or resuscitative efforts. The appropriate action is to document and notify. 13.A nurse is caring for a client who is taking warfarin. Which of the following foods should the nurse instruct the client to avoid? A. Spinach B. Apples C. Chicken D. Potatoes Rationale: Spinach is high in vitamin K, which counteracts the effect of warfarin. 14.A nurse is planning care for a client in the manic phase of bipolar disorder. Which of the following should be included? A. Provide a low-stimulus environment B. Encourage group therapy sessions
D. Hemoglobin 9 g/dL Rationale: Therapeutic aPTT for heparin is 1.5–2.5 times the normal (approximately 60–80 seconds). 18.A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following medications should the nurse expect to administer? A. Lorazepam B. Disulfiram C. Naloxone D. Bupropion Rationale: Benzodiazepines like lorazepam are used to prevent seizures and reduce withdrawal symptoms. 19.A nurse is teaching about infection prevention to a client with neutropenia. Which of the following instructions should the nurse include? A. Eat fresh fruits and vegetables B. Avoid crowds and people who are sick C. Receive all live vaccines D. Take rectal temperatures daily Rationale: Clients with neutropenia are immunocompromised and must avoid sources of infection like crowds. 20.A nurse is caring for a client in Buck’s traction. Which of the following actions should the nurse take? A. Remove the weights every 2 hours B. Ensure the weights hang freely C. Elevate the leg above heart level
D. Turn the client every 1 hour Rationale: Weights should hang freely to maintain continuous traction and alignment. 21 – 30 21.A nurse is providing dietary teaching to a client with chronic kidney disease. Which of the following foods should the client limit? A. Bananas B. Rice C. Applesauce D. Green beans Rationale: Bananas are high in potassium, which should be limited in CKD. 22.A nurse is reviewing the electronic health record of a client who is 24 hours postoperative following a total knee arthroplasty. Which of the following findings requires intervention? A. Report of pain 4/ B. Temperature 38.5°C (101.3°F) C. Hemoglobin 13 g/dL D. Serosanguinous drainage on dressing Rationale: An elevated temperature may indicate infection and requires further evaluation. 23.A client newly diagnosed with tuberculosis is prescribed isoniazid. Which of the following lab values should be monitored?
A. “I should take bubble baths daily.” B. “I will wipe from front to back after voiding.” C. “I will wear tight-fitting underwear.” D. “I should hold urine until my bladder is full.” Rationale: Wiping front to back helps prevent the introduction of bacteria into the urethra. 27.A nurse is caring for a client with a pressure injury that has full-thickness skin and visible subcutaneous tissue. What stage is this wound? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4 Rationale: Stage 3 pressure injuries extend into subcutaneous tissue but not muscle or bone. 28.A nurse is providing care for a client with a new tracheostomy. Which of the following actions should the nurse take? A. Remove the inner cannula daily B. Use surgical asepsis for suctioning C. Change tracheostomy ties daily without assistance D. Perform chest physiotherapy before suctioning Rationale: Suctioning a tracheostomy is a sterile procedure to reduce infection risk. 29.A client is experiencing mild anxiety. Which of the following should the nurse expect?
A. Inability to complete tasks B. Heightened perceptual field C. Hallucinations D. Panic and sense of dread Rationale: Mild anxiety sharpens perception and can enhance performance. 30.A nurse is reviewing a client’s medications and notes a prescription for lithium. Which of the following instructions should be given? A. “Maintain consistent sodium intake.” B. “Restrict fluids to prevent toxicity.” C. “Take an antacid with each dose.” D. “Avoid eating dairy products.” Rationale: Sodium levels affect lithium excretion; inconsistent intake may cause toxicity. 31.A nurse is teaching a client who has a new prescription for ferrous sulfate. Which of the following should the nurse include? A. Take with dairy to increase absorption B. Expect dark-colored stools C. Take with antacids to reduce GI upset D. Limit intake of vitamin C Rationale: Dark stools are an expected effect of iron; it is not harmful. 32.A nurse is caring for a client who has C. difficile. Which of the following precautions should the nurse implement?
A. Calcium B. Sodium C. Potassium D. Magnesium Rationale: Spironolactone is a potassium-sparing diuretic and can lead to hyperkalemia. 36.A nurse is caring for a client who is scheduled for an amniocentesis. Which of the following is a priority action post-procedure? A. Monitor for headache B. Monitor fetal heart tones C. Encourage ambulation D. Administer Rh immunoglobulin to all mothers Rationale: Fetal monitoring ensures the baby tolerated the procedure without complications like distress. 37.A nurse is caring for a client receiving TPN. Which of the following actions should the nurse take? A. Check residual every 4 hours B. Monitor blood glucose every 6 hours C. Administer through a peripheral IV D. Shake the TPN solution before administration Rationale: TPN contains dextrose, which can affect glucose levels and must be monitored closely. 38.A nurse is reinforcing teaching with a client who has a new prescription for alendronate. Which of the following statements indicates understanding?
A. “I will take this medication with orange juice.” B. “I will sit upright for 30 minutes after taking it.” C. “I can take it before bedtime.” D. “I’ll take it with my calcium supplement.” Rationale: Upright positioning prevents esophageal irritation, a common side effect. 39.A nurse is caring for a client with a cervical implant for internal radiation therapy. Which of the following precautions should the nurse implement? A. Limit visitor time to 30 minutes/day B. Place the client in a semiprivate room C. Wear a lead apron only when close to the client D. Allow pregnant staff to provide care with shielding Rationale: Radiation exposure is minimized by limiting time and maintaining distance from the source. 40.A nurse is teaching a client who has a new ileostomy. Which of the following statements by the client indicates understanding? A. “I will expect my stool to be formed.” B. “I will empty my pouch when it is one-third full.” C. “I will irrigate my stoma daily.” D. “My stoma should be pale pink.” Rationale: Pouches should be emptied when one-third full to prevent leakage and discomfort. 41 – 50
Rationale: Acute angle-closure glaucoma presents suddenly and is a medical emergency. 44.A nurse is caring for a client with a stage IV pressure injury. Which of the following interventions is appropriate? A. Apply a hydrocolloid dressing B. Clean with alcohol-based solutions C. Debride the wound with dry gauze D. Position client on back to promote healing Rationale: Hydrocolloid dressings help maintain a moist wound environment. 45.A nurse is teaching a client about a low-sodium diet. Which of the following food selections indicates understanding? A. Canned soup B. Fresh fruit salad C. Pickled cucumbers D. Salted nuts Rationale: Fresh fruits are naturally low in sodium and appropriate for this diet. 46.A nurse is caring for a client who is receiving chemotherapy. Which of the following lab values should be reported? A. Hematocrit 40% B. Platelets 200,000/mm³ C. WBC 2,000/mm³ D. Absolute neutrophil count (ANC) 800/mm³ Rationale: An ANC <1,000 indicates neutropenia and increased infection risk.
47.A nurse is reinforcing teaching to a client with a new prescription for nitroglycerin. Which statement indicates understanding? A. “I can take up to 5 tablets in 15 minutes.” B. “I will store the tablets in the original container.” C. “I will take one every 10 minutes if I have chest pain.” D. “I should swallow the tablet whole.” Rationale: Nitroglycerin should be stored in a dark, tightly closed container to maintain potency. 48.A nurse is preparing to administer ear drops to an adult client. Which of the following actions is correct? A. Pull the pinna up and back B. Pull the pinna down and back C. Place the dropper into the ear canal D. Hold the dropper 0.5 inch from the tragus Rationale: Pulling up and back straightens the ear canal in adults for proper medication delivery. 49.A nurse is teaching about diet to a client who is prescribed phenelzine. Which of the following foods should be avoided? A. Broccoli B. Aged cheese C. Whole wheat bread D. Fresh fish Rationale: MAOIs like phenelzine require avoiding tyramine-rich foods such as aged cheese to prevent hypertensive crisis.
Rationale: An ANC below 1,000 indicates neutropenia and a high risk for infection. 53.A nurse is providing teaching to a client prescribed metformin. Which of the following statements indicates understanding? A. “I will take it on an empty stomach.” B. “I may lose some weight while taking this medication.” C. “I need to avoid green leafy vegetables.” D. “This will make my pancreas release more insulin.” Rationale: Metformin often causes mild weight loss and works by decreasing hepatic glucose production, not stimulating insulin release. 54.A nurse is assessing a client who received IV morphine. Which of the following findings requires immediate intervention? A. Respiratory rate of 8/min B. BP 102/64 mm Hg C. Pain level of 6/ D. Sedation score of 2 Rationale: A respiratory rate <12/min indicates respiratory depression, a life- threatening effect of opioids. 55.A nurse is preparing to administer a blood transfusion. Which of the following actions should the nurse take first? A. Start the IV infusion with NS B. Verify the client's identity and blood compatibility C. Document baseline vital signs D. Prime the tubing with blood
Rationale: Verification of the correct client and blood product is the highest priority to prevent a transfusion reaction. 56.A nurse is caring for a client with increased intracranial pressure. Which of the following findings is an early indication? A. Decerebrate posturing B. Widening pulse pressure C. Bradycardia D. Disorientation Rationale: Changes in level of consciousness, such as disorientation, are early signs of increased ICP. 57.A nurse is assessing a client with right-sided heart failure. Which of the following findings should the nurse expect? A. Crackles in the lungs B. Frothy sputum C. Peripheral edema D. Orthopnea Rationale: Right-sided heart failure leads to systemic venous congestion, resulting in peripheral edema. 58.A nurse is teaching a client about foods to avoid while taking lithium. Which of the following should be avoided? A. Lettuce B. Low sodium diet C. Bananas D. Grapefruit juice
