Level 3 Attempt Verified ATI RN Comprehensive Predictor Exit Assessment
Package, Excellence Package - ATI RN Comprehensive Predictor Exit
Assessment 2026 NGN Actual Exam
MANAGEMENT OF CARE (Questions 1-10)
Question 1 (SATA)
A nurse is delegating tasks to an assistive personnel (AP). Which tasks are appropriate to
delegate? (Select all that apply)
A) Ambulate a client who is post-operative day 1
B) Feed a client who has dysphagia
C) Measure intake and output for a client with heart failure
D) Assess a client's surgical incision for redness
E) Obtain vital signs for a client admitted with pneumonia
Correct Answers: A, C, E
Rationale: Ambulation (A), I&O (C), and vital signs (E) are standard, stable tasks appropriate
for AP delegation. Feeding a client with dysphagia (B) requires assessment for aspiration risk
and should be done by the nurse. Assessment (D) is a nursing responsibility that cannot be
delegated.
Question 2 (SATA)
A charge nurse is making assignments on a medical-surgical unit. Which clients should be
assigned to a registered nurse (RN) rather than a licensed practical nurse (LPN)? (Select all
that apply)
, A) A client with diabetes mellitus requiring insulin administration
B) A client with a new tracheostomy requiring frequent suctioning
C) A client with pneumonia requiring q4h vital signs
D) A client with chest tubes and new onset respiratory distress
E) A client with a urinary tract infection requiring IV antibiotics
Correct Answers: B, D
Rationale: A new tracheostomy requiring frequent suctioning (B) requires skilled assessment
and intervention. New onset respiratory distress with chest tubes (D) is unstable and requires
RN-level assessment. Insulin administration (A), routine vital signs (C), and IV antibiotics for
stable UTI (E) can be delegated to an LPN under RN supervision.
Question 3
A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
client's family requests that the transfusion be given anyway. What is the nurse's priority
action?
A) Administer the transfusion as the family requests
B) Notify the healthcare provider of the client's refusal
C) Contact the ethics committee for a consultation
D) Ask the client to reconsider the family's wishes
Correct Answer: B
Rationale: The nurse must respect the client's autonomy and right to refuse treatment. The
healthcare provider should be notified so alternative treatments can be considered. The
client's decision must be honored regardless of family wishes. An ethics committee
, consultation (C) may be needed later if conflict continues, but the priority is notifying the
provider.
Question 4 (SATA)
A nurse is preparing to discharge a client who speaks a different language than the nurse.
Which actions demonstrate culturally competent care? (Select all that apply)
A) Use a certified medical interpreter for discharge teaching
B) Ask the client's family member to translate
C) Provide written discharge instructions in the client's preferred language
D) Speak loudly and slowly in English to improve understanding
E) Use pictures and diagrams to supplement verbal instructions
Correct Answers: A, C, E
Rationale: Certified medical interpreters (A) ensure accurate communication. Written
materials in the client's language (C) and visual aids (E) enhance understanding. Family
members (B) should not be used as interpreters due to privacy concerns and potential
mistranslation. Speaking loudly (D) does not improve language comprehension.
Question 5 (SATA)
A nurse is caring for a client who has a living will. Which statements are true regarding
advance directives? (Select all that apply)
A) The client can change the living will at any time
B) A living will takes effect when the client is incapacitated
, C) The healthcare provider must approve all living will decisions
D) A durable power of attorney for healthcare appoints a surrogate decision-maker
E) The nurse is responsible for explaining the living will to the client
Correct Answers: A, B, D
Rationale: Clients can modify advance directives at any time (A). Living wills take effect
upon client incapacity (B). Durable power of attorney appoints a surrogate (D). The provider
does not need to approve the client's wishes (C is false). The provider (not the nurse) explains
advance directives (E is false).
Question 6
A nurse is assisting with mass casualty triage after a tornado. Which client should the nurse
tag as "immediate" (red)?
A) A client with massive head trauma and agonal breathing
B) A client with full-thickness burns to face and trunk
C) A client with hemorrhagic shock from a leg wound
D) A client with an open fracture of the femur
Correct Answer: C
Rationale: In mass casualty triage, hemorrhagic shock (C) is "immediate" (red tag) because it
is life-threatening but treatable with rapid intervention. Massive head trauma with agonal
breathing (A) is typically "expectant" (black tag). Full-thickness burns to face/trunk (B) may
be "immediate" but have poor prognosis. Open fracture (D) is "delayed" (yellow tag).
Package, Excellence Package - ATI RN Comprehensive Predictor Exit
Assessment 2026 NGN Actual Exam
MANAGEMENT OF CARE (Questions 1-10)
Question 1 (SATA)
A nurse is delegating tasks to an assistive personnel (AP). Which tasks are appropriate to
delegate? (Select all that apply)
A) Ambulate a client who is post-operative day 1
B) Feed a client who has dysphagia
C) Measure intake and output for a client with heart failure
D) Assess a client's surgical incision for redness
E) Obtain vital signs for a client admitted with pneumonia
Correct Answers: A, C, E
Rationale: Ambulation (A), I&O (C), and vital signs (E) are standard, stable tasks appropriate
for AP delegation. Feeding a client with dysphagia (B) requires assessment for aspiration risk
and should be done by the nurse. Assessment (D) is a nursing responsibility that cannot be
delegated.
Question 2 (SATA)
A charge nurse is making assignments on a medical-surgical unit. Which clients should be
assigned to a registered nurse (RN) rather than a licensed practical nurse (LPN)? (Select all
that apply)
, A) A client with diabetes mellitus requiring insulin administration
B) A client with a new tracheostomy requiring frequent suctioning
C) A client with pneumonia requiring q4h vital signs
D) A client with chest tubes and new onset respiratory distress
E) A client with a urinary tract infection requiring IV antibiotics
Correct Answers: B, D
Rationale: A new tracheostomy requiring frequent suctioning (B) requires skilled assessment
and intervention. New onset respiratory distress with chest tubes (D) is unstable and requires
RN-level assessment. Insulin administration (A), routine vital signs (C), and IV antibiotics for
stable UTI (E) can be delegated to an LPN under RN supervision.
Question 3
A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
client's family requests that the transfusion be given anyway. What is the nurse's priority
action?
A) Administer the transfusion as the family requests
B) Notify the healthcare provider of the client's refusal
C) Contact the ethics committee for a consultation
D) Ask the client to reconsider the family's wishes
Correct Answer: B
Rationale: The nurse must respect the client's autonomy and right to refuse treatment. The
healthcare provider should be notified so alternative treatments can be considered. The
client's decision must be honored regardless of family wishes. An ethics committee
, consultation (C) may be needed later if conflict continues, but the priority is notifying the
provider.
Question 4 (SATA)
A nurse is preparing to discharge a client who speaks a different language than the nurse.
Which actions demonstrate culturally competent care? (Select all that apply)
A) Use a certified medical interpreter for discharge teaching
B) Ask the client's family member to translate
C) Provide written discharge instructions in the client's preferred language
D) Speak loudly and slowly in English to improve understanding
E) Use pictures and diagrams to supplement verbal instructions
Correct Answers: A, C, E
Rationale: Certified medical interpreters (A) ensure accurate communication. Written
materials in the client's language (C) and visual aids (E) enhance understanding. Family
members (B) should not be used as interpreters due to privacy concerns and potential
mistranslation. Speaking loudly (D) does not improve language comprehension.
Question 5 (SATA)
A nurse is caring for a client who has a living will. Which statements are true regarding
advance directives? (Select all that apply)
A) The client can change the living will at any time
B) A living will takes effect when the client is incapacitated
, C) The healthcare provider must approve all living will decisions
D) A durable power of attorney for healthcare appoints a surrogate decision-maker
E) The nurse is responsible for explaining the living will to the client
Correct Answers: A, B, D
Rationale: Clients can modify advance directives at any time (A). Living wills take effect
upon client incapacity (B). Durable power of attorney appoints a surrogate (D). The provider
does not need to approve the client's wishes (C is false). The provider (not the nurse) explains
advance directives (E is false).
Question 6
A nurse is assisting with mass casualty triage after a tornado. Which client should the nurse
tag as "immediate" (red)?
A) A client with massive head trauma and agonal breathing
B) A client with full-thickness burns to face and trunk
C) A client with hemorrhagic shock from a leg wound
D) A client with an open fracture of the femur
Correct Answer: C
Rationale: In mass casualty triage, hemorrhagic shock (C) is "immediate" (red tag) because it
is life-threatening but treatable with rapid intervention. Massive head trauma with agonal
breathing (A) is typically "expectant" (black tag). Full-thickness burns to face/trunk (B) may
be "immediate" but have poor prognosis. Open fracture (D) is "delayed" (yellow tag).
