ATI PN Exit Exam Practice: 200 Questions & Answers
with Rationales | Comprehensive Predictor Review
for NCLEX-PN Success
Introduction
The ATI PN Comprehensive Predictor Exit Exam is a standardized assessment
designed to evaluate your readiness for the NCLEX-PN. It consists of 180
questions, including Next Generation NCLEX (NGN) items such as case studies,
bow-tie questions, and matrix/grid formats. This exam covers all content areas
taught throughout your practical nursing program, including:
• Medical-Surgical Nursing
• Pharmacology
• Maternal-Newborn Nursing
• Pediatric Nursing
• Mental Health Nursing
• Fundamentals of Nursing
• Leadership, Delegation, and Management
• Nutrition and Fluid/Electrolyte Balance
.
1. Medical-Surgical: Cardiac
A nurse is caring for a client who is 2 hours post-myocardial infarction. Which
finding requires immediate intervention?
• A. Heart rate 98 beats/min
• B. Blood pressure 110/70 mm Hg
• C. Respiratory rate 20 breaths/min
• D. Premature ventricular contractions (PVCs) 12 per minute
,Correct Answer: D
Rationale: PVCs occurring at a rate of more than 6 per minute, especially in the
setting of a recent myocardial infarction, can be a precursor to ventricular
tachycardia or ventricular fibrillation. This dysrhythmia requires immediate
intervention to prevent cardiac arrest. The other vital signs are within normal
limits.
2. Pharmacology: Anticoagulants
A client is receiving heparin sodium by continuous IV infusion. The nurse should
have which medication readily available in case of overdose?
• A. Vitamin K
• B. Protamine sulfate
• C. Naloxone
• D. Flumazenil
Correct Answer: B
Rationale: Protamine sulfate is the specific reversal agent for heparin. Vitamin K
reverses warfarin (Coumadin). Naloxone reverses opioids, and flumazenil reverses
benzodiazepines.
3. Maternal-Newborn: Postpartum
A nurse is assessing a client who is 12 hours postpartum. The fundus is firm,
located 2 cm above the umbilicus, and deviated to the right. Which action should
the nurse take first?
• A. Notify the provider
• B. Massage the fundus
• C. Assist the client to void
• D. Administer oxytocin
,Correct Answer: C
Rationale: A displaced fundus (deviated to the right or left) typically indicates a
full bladder. The nurse should first assist the client to void, which allows the
uterus to return to midline and contract effectively. Massaging a firm fundus is
unnecessary, and oxytocin is not indicated unless the fundus is boggy.
4. Mental Health: Therapeutic Communication
A client with major depressive disorder states, "There is no point in going on.
Nothing matters anymore." Which response by the nurse is most therapeutic?
• A. "You have so much to live for."
• B. "Are you thinking about harming yourself?"
• C. "Everyone feels down sometimes."
• D. "Let's focus on the positive things."
Correct Answer: B
Rationale: The nurse must directly assess for suicidal ideation when a client makes
statements suggesting hopelessness. Asking about suicidal thoughts does not
plant the idea but allows for immediate safety planning. The other responses
minimize the client's feelings or offer false reassurance.
5. Pediatrics: Developmental Milestones
A nurse is assessing a 10-month-old infant. Which finding should the nurse report
to the provider?
• A. The infant sits without support
• B. The infant crawls on hands and knees
• C. The infant cannot pull to standing
• D. The infant uses a pincer grasp
Correct Answer: C
, Rationale: By 10 months, most infants can pull themselves to a standing position.
Failure to do so may indicate a developmental delay. Sitting without support is
expected by 8 months, crawling by 9 months, and the pincer grasp by 9-10
months.
6. Fundamentals: Infection Control
A client is admitted with active pulmonary tuberculosis. Which type of
precautions should the nurse implement?
• A. Contact precautions
• B. Droplet precautions
• C. Airborne precautions
• D. Standard precautions only
Correct Answer: C
Rationale: Pulmonary tuberculosis is transmitted via airborne droplet nuclei.
Airborne precautions require an N95 respirator (or higher) and a negative
pressure room. Contact precautions are for organisms like MRSA, and droplet
precautions are for infections like influenza or meningococcal disease.
7. Medical-Surgical: Respiratory
A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88% on room air. The nurse initiates oxygen at 2 L/min via nasal
cannula. Which finding indicates the client is responding appropriately?
• A. SpO2 increases to 92%
• B. Respiratory rate decreases from 24 to 12
• C. The client reports headache
• D. The client becomes lethargic
Correct Answer: A
with Rationales | Comprehensive Predictor Review
for NCLEX-PN Success
Introduction
The ATI PN Comprehensive Predictor Exit Exam is a standardized assessment
designed to evaluate your readiness for the NCLEX-PN. It consists of 180
questions, including Next Generation NCLEX (NGN) items such as case studies,
bow-tie questions, and matrix/grid formats. This exam covers all content areas
taught throughout your practical nursing program, including:
• Medical-Surgical Nursing
• Pharmacology
• Maternal-Newborn Nursing
• Pediatric Nursing
• Mental Health Nursing
• Fundamentals of Nursing
• Leadership, Delegation, and Management
• Nutrition and Fluid/Electrolyte Balance
.
1. Medical-Surgical: Cardiac
A nurse is caring for a client who is 2 hours post-myocardial infarction. Which
finding requires immediate intervention?
• A. Heart rate 98 beats/min
• B. Blood pressure 110/70 mm Hg
• C. Respiratory rate 20 breaths/min
• D. Premature ventricular contractions (PVCs) 12 per minute
,Correct Answer: D
Rationale: PVCs occurring at a rate of more than 6 per minute, especially in the
setting of a recent myocardial infarction, can be a precursor to ventricular
tachycardia or ventricular fibrillation. This dysrhythmia requires immediate
intervention to prevent cardiac arrest. The other vital signs are within normal
limits.
2. Pharmacology: Anticoagulants
A client is receiving heparin sodium by continuous IV infusion. The nurse should
have which medication readily available in case of overdose?
• A. Vitamin K
• B. Protamine sulfate
• C. Naloxone
• D. Flumazenil
Correct Answer: B
Rationale: Protamine sulfate is the specific reversal agent for heparin. Vitamin K
reverses warfarin (Coumadin). Naloxone reverses opioids, and flumazenil reverses
benzodiazepines.
3. Maternal-Newborn: Postpartum
A nurse is assessing a client who is 12 hours postpartum. The fundus is firm,
located 2 cm above the umbilicus, and deviated to the right. Which action should
the nurse take first?
• A. Notify the provider
• B. Massage the fundus
• C. Assist the client to void
• D. Administer oxytocin
,Correct Answer: C
Rationale: A displaced fundus (deviated to the right or left) typically indicates a
full bladder. The nurse should first assist the client to void, which allows the
uterus to return to midline and contract effectively. Massaging a firm fundus is
unnecessary, and oxytocin is not indicated unless the fundus is boggy.
4. Mental Health: Therapeutic Communication
A client with major depressive disorder states, "There is no point in going on.
Nothing matters anymore." Which response by the nurse is most therapeutic?
• A. "You have so much to live for."
• B. "Are you thinking about harming yourself?"
• C. "Everyone feels down sometimes."
• D. "Let's focus on the positive things."
Correct Answer: B
Rationale: The nurse must directly assess for suicidal ideation when a client makes
statements suggesting hopelessness. Asking about suicidal thoughts does not
plant the idea but allows for immediate safety planning. The other responses
minimize the client's feelings or offer false reassurance.
5. Pediatrics: Developmental Milestones
A nurse is assessing a 10-month-old infant. Which finding should the nurse report
to the provider?
• A. The infant sits without support
• B. The infant crawls on hands and knees
• C. The infant cannot pull to standing
• D. The infant uses a pincer grasp
Correct Answer: C
, Rationale: By 10 months, most infants can pull themselves to a standing position.
Failure to do so may indicate a developmental delay. Sitting without support is
expected by 8 months, crawling by 9 months, and the pincer grasp by 9-10
months.
6. Fundamentals: Infection Control
A client is admitted with active pulmonary tuberculosis. Which type of
precautions should the nurse implement?
• A. Contact precautions
• B. Droplet precautions
• C. Airborne precautions
• D. Standard precautions only
Correct Answer: C
Rationale: Pulmonary tuberculosis is transmitted via airborne droplet nuclei.
Airborne precautions require an N95 respirator (or higher) and a negative
pressure room. Contact precautions are for organisms like MRSA, and droplet
precautions are for infections like influenza or meningococcal disease.
7. Medical-Surgical: Respiratory
A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88% on room air. The nurse initiates oxygen at 2 L/min via nasal
cannula. Which finding indicates the client is responding appropriately?
• A. SpO2 increases to 92%
• B. Respiratory rate decreases from 24 to 12
• C. The client reports headache
• D. The client becomes lethargic
Correct Answer: A
