Package, Excellence Package - ATI RN Comprehensive Predictor Exit
Assessment 2026 NGN Actual Exam
SECTION 1: MANAGEMENT OF CARE (Questions 1-20)
Question 1
A charge nurse is making client assignments on a medical-surgical unit. Which
client should be assigned to the most experienced RN?
A) A client with diabetes mellitus requiring insulin administration
B) A client with pneumonia requiring q4h vital signs
C) A client with chest tubes and new onset of respiratory distress
D) A client with a urinary tract infection requiring IV antibiotics
Answer: C
Rationale: The client with chest tubes and respiratory distress is unstable and
requires complex assessment and intervention. This client should be assigned
to the most experienced RN. Stable clients with routine care (A, B, D) can be
assigned to LPNs or less experienced RNs under supervision .
,Question 2
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
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 .
Question 3
A nurse manager is reviewing informed consent with staff. Which statement
by a staff member indicates understanding?
,A) "The nurse is responsible for explaining the procedure to the client."
B) "A witness signature confirms the client gave voluntary consent."
C) "Informed consent is only required for surgical procedures."
D) "A family member can sign consent for any adult client."
Answer: B
Rationale: The witness signature confirms the client signed voluntarily and
appeared competent. The provider (not nurse) is responsible for explaining
the procedure (A). Consent is required for invasive procedures, not just
surgery (C). Family can only sign if the client is incapacitated and a durable
power of attorney is in place (D) .
Question 4
A nurse is assisting with mass casualty triage after an explosion. Which client
should the nurse identify as the priority?
A) A client with massive head trauma
B) A client with full-thickness burns to face and trunk
C) A client with indications of hypovolemic shock
D) A client with an open fracture of the lower extremity
Answer: C
, Rationale: In mass casualty triage, clients with hypovolemic shock are
"immediate" (red tag) because they have life-threatening injuries that are
treatable with rapid intervention. Massive head trauma (A) is typically
"expectant" (black tag). Full-thickness burns to face/trunk (B) may be
"immediate" but hypovolemic shock requires faster intervention. Open
fracture (D) is "delayed" (yellow tag) .
Question 5
A nurse is caring for four clients. Which client should the nurse assess first?
A) A client with a fractured femur reporting pain of 6/10
B) A client with pneumonia with a pulse oximetry of 91%
C) A client with diabetes mellitus requesting insulin
D) A client post-appendectomy with a temperature of 99.8°F (37.7°C)
Answer: B
Rationale: The client with pneumonia and hypoxia (SpO2 91%) is at risk for
respiratory compromise. This is an ABC priority. Pain (A), insulin request (C),
and low-grade fever (D) are stable and can wait .