ATI Final Test 2026

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Sample questions from ATI Final Test 2026

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client is admitted to the medical-surgical unit with pneumonia. The client is newly confused, has a temperature of 39.2 C (102.6 F), heart rate 124/min, blood pressure 84/48 mm Hg, and oxygen saturation 89% on room air. Which action should the nurse take first?

   • A.Obtain a sputum specimen for culture
   • B.Apply oxygen and activate the rapid response system
   • C.Administer the prescribed acetaminophen
   • D.Encourage the client to drink oral fluids

   Rationale: The hypotension, tachycardia, hypoxemia, and acute confusion suggest sepsis with impaired perfusion, so oxygen and rapid escalation are priorities. A sputum culture is important but must not delay stabilization. Acetaminophen does not address the immediate threat, and oral fluids are not an adequate response to possible shock.

2. 2.A 76-year-old client is 1 day postoperative after hip replacement on an orthopedic unit. The client is alert, has a blood pressure of 132/76 mm Hg, and reports pain of 6/10; the surgical dressing is dry. Which task is appropriate for the registered nurse to delegate to an experienced unlicensed assistive personnel (UAP)?

   • A.Assess the client's pain after the prescribed analgesic
   • B.Teach the client how to use the incentive spirometer
   • C.Assist the client with ambulation after the nurse confirms the mobility plan
   • D.Evaluate the surgical incision for signs of infection

   Rationale: An experienced UAP may assist a stable client with routine ambulation when the nurse has established the plan and safety precautions. Pain reassessment requires nursing judgment, teaching is the nurse's responsibility, and wound evaluation requires assessment skills. The delegation takeaway is to assign predictable tasks while retaining assessment, teaching, and evaluation.

3. 3.A 59-year-old client with type 1 diabetes is admitted to the emergency department with vomiting and abdominal pain. The client is drowsy, has deep rapid respirations, glucose 486 mg/dL, potassium 5.6 mEq/L, and arterial pH 7.18. Which prescribed intervention should the nurse implement first?

   • A.Begin the prescribed isotonic IV fluid infusion
   • B.Administer subcutaneous long-acting insulin
   • C.Give oral potassium replacement
   • D.Restrict fluids to prevent cerebral edema

   Rationale: The findings indicate diabetic ketoacidosis with dehydration and acidosis; restoring intravascular volume with isotonic fluid is an immediate priority. Long-acting subcutaneous insulin is not the initial treatment for this emergency. Potassium is already elevated and must be monitored rather than replaced, while fluid restriction would worsen hypovolemia.

4. 4.A 34-year-old client arrives at an urgent care clinic after a bee sting and now has generalized hives, wheezing, facial swelling, and a blood pressure of 78/44 mm Hg. Which medication should the nurse administer first from the prescribed emergency medications?

   • A.Oral diphenhydramine
   • B.Intramuscular epinephrine
   • C.Inhaled corticosteroid
   • D.Intravenous famotidine

   Answer and rationale are in the full material.

5. 5.A 72-year-old client with heart failure is admitted to a telemetry unit with increasing dyspnea. The client is sitting upright, has crackles in both lung bases, oxygen saturation 86% on room air, and blood pressure 168/92 mm Hg. Which action should the nurse take first?

   • A.Place the client in high-Fowler position and apply prescribed oxygen
   • B.Obtain the client's daily weight
   • C.Provide a low-sodium meal
   • D.Teach the client to limit fluid intake

   Answer and rationale are in the full material.