ATI RN Comprehensive Predictor 2026/2027: Ultimate NGN Prep Bundle —
Verified Questions & Rationales (99% NCLEX Probability) 2026
This essential study resource is designed to help nursing students achieve a high
probability of passing the NCLEX on their first attempt by mastering the ATI RN
Comprehensive Predictor. It includes a detailed breakdown of Next Gen
NCLEX (NGN) question types, including case studies and "bow-tie" questions,
paired with comprehensive rationales for every answer. The guide covers all core
mastery areas, including Management of Care, Pharmacology, and Med-Surg, to
ensure you are prepared for the 180-question proctored exam. Fully updated for
the 2025/2026 academic year, this bundle serves as the ultimate remediation tool
to bridge your knowledge gaps and boost your exam confidence.
A nurse is receiving change-of-shift report for four clients. Which client should
the nurse assess first?
A) A client with pneumonia who has a pulse oximetry of 92% on 2L of oxygen.
B) A client who is 2 hours postoperative following an abdominal hysterectomy
and has a surgical drain.
C) A client with heart failure who reports a weight gain of 2 lb in the past 24
hours.
D) A client with a chest tube for a pneumothorax who reports sudden
shortness of breath and tracheal deviation.
D) A client with a chest tube for a pneumothorax who reports sudden
shortness of breath and tracheal deviation.
Rationale: Tracheal deviation is a hallmark sign of a tension pneumothorax,
which is a life-threatening emergency requiring immediate intervention.
The others are stable or expected findings.
A nurse is delegating tasks to an Assistive Personnel (AP). Which task is
appropriate for the nurse to delegate?
A) Checking a client's skin for breakdown during a bath.
B) Evaluating a client's response to pain medication.
C) Measuring a client's intake and output.
D) Providing discharge instructions to a client.
C) Measuring a client's intake and output.
, Rationale: Measuring I&O is a routine, non-invasive task. Evaluation,
assessment, and teaching require the specialized knowledge and
judgment of an RN.
A nurse is caring for a client who is in skeletal traction. Which of the following
actions should the nurse take?
A) Remove the weights for 5 minutes every 8 hours.
B) Ensure the weights are hanging freely off the floor.
C) Apply antibiotic ointment to the pin sites every 24 hours.
D) Lift the weights when the client is being repositioned.
B) Ensure the weights are hanging freely off the floor.
Rationale: For traction to be effective, weights must hang freely. Lifting or
removing weights can cause muscle spasms and interfere with the
treatment.
An RN is supervising a Licensed Practical Nurse (LPN). Which client should
the RN assign to the LPN?
A) A client with a new diagnosis of type 1 diabetes requiring initial education.
B) A stable client who is 3 days postoperative and requires a dressing
change.
C) A client who is experiencing a thyroid storm.
D) A client who just returned from a cardiac catheterization.
B) A stable client who is 3 days postoperative and requires a dressing
change.
Rationale: LPNs can care for stable clients with predictable outcomes. New
education and unstable/acute clients require the assessment skills of an
RN.
A nurse is caring for a client who is refusing a blood transfusion for religious
reasons. Which of the following actions should the nurse take?
A) Notify the chaplain to speak with the client.
B) Tell the client they might die without the transfusion.
C) Document the refusal and inform the provider.
D) Give the transfusion while the client is sleeping.
C) Document the refusal and inform the provider.
Rationale: According to the principle of autonomy, the nurse must respect the
client's right to refuse treatment once informed of the risks.
Section 2: Safety & Infection Control
,A nurse is caring for a client who has Clostridium difficile (C. diff). Which of the
following infection control precautions should the nurse implement?
A) Wearing an N95 respirator mask.
B) Placing the client in a positive-pressure room.
C) Using alcohol-based hand sanitizer after client contact.
D) Wearing a gown and gloves when providing care.
D) Wearing a gown and gloves when providing care.
Rationale: C. diff requires Contact Precautions. Additionally, hands must be
washed with soap and water; alcohol sanitizer is ineffective against C. diff
spores.
A nurse is preparing to administer an IM injection to a client. Which of the
following actions should the nurse take to prevent a needlestick injury?
A) Recap the needle using a two-handed technique.
B) Dispose of the needle in a puncture-resistant container.
C) Place the used needle in a biohazard bag.
D) Bend the needle before disposal.
B) Dispose of the needle in a puncture-resistant container.
Rationale: Used sharps should never be recapped, bent, or broken and must
be placed immediately into a designated sharps container.
A nurse enters a client's room and finds a small fire in the trash can. Which of the
following actions should the nurse take first?
A) Extinguish the fire.
B) Pull the fire alarm.
C) Move the client to the hallway.
D) Close the door to the room.
C) Move the client to the hallway.
Rationale: Using the RACE acronym (Rescue, Alarm, Confine, Extinguish),
the priority is always to rescue/remove the client from immediate danger.
A nurse is caring for a client who has bacterial meningitis. Which of the following
precautions should the nurse take?
A) Wear a mask when within 3 feet of the client.
B) Keep the door to the room closed at all times.
C) Wear an N95 respirator.
D) Place the client in a room with negative airflow.
A) Wear a mask when within 3 feet of the client.
, Rationale: Bacterial meningitis requires Droplet Precautions, which include
wearing a surgical mask when in close proximity to the client.
A nurse is preparing a sterile field for a dressing change. Which of the following
actions indicates a break in sterile technique?
A) Placing sterile items in the center of the sterile field.
B) Keeping the sterile field in sight at all times.
C) Reaching across the sterile field to pick up an instrument.
D) Dropping a sterile gauze onto the field from 6 inches above.
C) Reaching across the sterile field to pick up an instrument.
Rationale: Reaching over a sterile field contaminates it because
microorganisms can fall from the nurse's clothing or skin onto the field.
Section 3: Pharmacology & Parenteral Therapies
A nurse is preparing to administer Digoxin to a client. For which of the following
findings should the nurse withhold the medication?
A) Blood pressure 140/90 mmHg.
B) Apical pulse 52/min.
C) Respiratory rate 16/min.
D) Temperature 37.2 C (99 F).
B) Apical pulse 52/min.
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. It should
be withheld if the apical pulse is less than 60/min in an adult.
A nurse is providing teaching to a client who has a new prescription for Warfarin.
Which of the following instructions should the nurse include?
A) "Take ibuprofen for minor headaches."
B) "Use a straight-edge razor for shaving."
C) "Consistency in your intake of green leafy vegetables is important."
D) "You will need to have your aPTT levels checked weekly."
C) "Consistency in your intake of green leafy vegetables is important."
Rationale: Vitamin K is the antidote for Warfarin. Dramatic changes in Vitamin
K intake (found in leafy greens) can fluctuate the drug's effectiveness.
A client is receiving a continuous IV infusion of Heparin. Which of the following
laboratory values should the nurse monitor?
A) PT
B) INR
C) aPTT
Verified Questions & Rationales (99% NCLEX Probability) 2026
This essential study resource is designed to help nursing students achieve a high
probability of passing the NCLEX on their first attempt by mastering the ATI RN
Comprehensive Predictor. It includes a detailed breakdown of Next Gen
NCLEX (NGN) question types, including case studies and "bow-tie" questions,
paired with comprehensive rationales for every answer. The guide covers all core
mastery areas, including Management of Care, Pharmacology, and Med-Surg, to
ensure you are prepared for the 180-question proctored exam. Fully updated for
the 2025/2026 academic year, this bundle serves as the ultimate remediation tool
to bridge your knowledge gaps and boost your exam confidence.
A nurse is receiving change-of-shift report for four clients. Which client should
the nurse assess first?
A) A client with pneumonia who has a pulse oximetry of 92% on 2L of oxygen.
B) A client who is 2 hours postoperative following an abdominal hysterectomy
and has a surgical drain.
C) A client with heart failure who reports a weight gain of 2 lb in the past 24
hours.
D) A client with a chest tube for a pneumothorax who reports sudden
shortness of breath and tracheal deviation.
D) A client with a chest tube for a pneumothorax who reports sudden
shortness of breath and tracheal deviation.
Rationale: Tracheal deviation is a hallmark sign of a tension pneumothorax,
which is a life-threatening emergency requiring immediate intervention.
The others are stable or expected findings.
A nurse is delegating tasks to an Assistive Personnel (AP). Which task is
appropriate for the nurse to delegate?
A) Checking a client's skin for breakdown during a bath.
B) Evaluating a client's response to pain medication.
C) Measuring a client's intake and output.
D) Providing discharge instructions to a client.
C) Measuring a client's intake and output.
, Rationale: Measuring I&O is a routine, non-invasive task. Evaluation,
assessment, and teaching require the specialized knowledge and
judgment of an RN.
A nurse is caring for a client who is in skeletal traction. Which of the following
actions should the nurse take?
A) Remove the weights for 5 minutes every 8 hours.
B) Ensure the weights are hanging freely off the floor.
C) Apply antibiotic ointment to the pin sites every 24 hours.
D) Lift the weights when the client is being repositioned.
B) Ensure the weights are hanging freely off the floor.
Rationale: For traction to be effective, weights must hang freely. Lifting or
removing weights can cause muscle spasms and interfere with the
treatment.
An RN is supervising a Licensed Practical Nurse (LPN). Which client should
the RN assign to the LPN?
A) A client with a new diagnosis of type 1 diabetes requiring initial education.
B) A stable client who is 3 days postoperative and requires a dressing
change.
C) A client who is experiencing a thyroid storm.
D) A client who just returned from a cardiac catheterization.
B) A stable client who is 3 days postoperative and requires a dressing
change.
Rationale: LPNs can care for stable clients with predictable outcomes. New
education and unstable/acute clients require the assessment skills of an
RN.
A nurse is caring for a client who is refusing a blood transfusion for religious
reasons. Which of the following actions should the nurse take?
A) Notify the chaplain to speak with the client.
B) Tell the client they might die without the transfusion.
C) Document the refusal and inform the provider.
D) Give the transfusion while the client is sleeping.
C) Document the refusal and inform the provider.
Rationale: According to the principle of autonomy, the nurse must respect the
client's right to refuse treatment once informed of the risks.
Section 2: Safety & Infection Control
,A nurse is caring for a client who has Clostridium difficile (C. diff). Which of the
following infection control precautions should the nurse implement?
A) Wearing an N95 respirator mask.
B) Placing the client in a positive-pressure room.
C) Using alcohol-based hand sanitizer after client contact.
D) Wearing a gown and gloves when providing care.
D) Wearing a gown and gloves when providing care.
Rationale: C. diff requires Contact Precautions. Additionally, hands must be
washed with soap and water; alcohol sanitizer is ineffective against C. diff
spores.
A nurse is preparing to administer an IM injection to a client. Which of the
following actions should the nurse take to prevent a needlestick injury?
A) Recap the needle using a two-handed technique.
B) Dispose of the needle in a puncture-resistant container.
C) Place the used needle in a biohazard bag.
D) Bend the needle before disposal.
B) Dispose of the needle in a puncture-resistant container.
Rationale: Used sharps should never be recapped, bent, or broken and must
be placed immediately into a designated sharps container.
A nurse enters a client's room and finds a small fire in the trash can. Which of the
following actions should the nurse take first?
A) Extinguish the fire.
B) Pull the fire alarm.
C) Move the client to the hallway.
D) Close the door to the room.
C) Move the client to the hallway.
Rationale: Using the RACE acronym (Rescue, Alarm, Confine, Extinguish),
the priority is always to rescue/remove the client from immediate danger.
A nurse is caring for a client who has bacterial meningitis. Which of the following
precautions should the nurse take?
A) Wear a mask when within 3 feet of the client.
B) Keep the door to the room closed at all times.
C) Wear an N95 respirator.
D) Place the client in a room with negative airflow.
A) Wear a mask when within 3 feet of the client.
, Rationale: Bacterial meningitis requires Droplet Precautions, which include
wearing a surgical mask when in close proximity to the client.
A nurse is preparing a sterile field for a dressing change. Which of the following
actions indicates a break in sterile technique?
A) Placing sterile items in the center of the sterile field.
B) Keeping the sterile field in sight at all times.
C) Reaching across the sterile field to pick up an instrument.
D) Dropping a sterile gauze onto the field from 6 inches above.
C) Reaching across the sterile field to pick up an instrument.
Rationale: Reaching over a sterile field contaminates it because
microorganisms can fall from the nurse's clothing or skin onto the field.
Section 3: Pharmacology & Parenteral Therapies
A nurse is preparing to administer Digoxin to a client. For which of the following
findings should the nurse withhold the medication?
A) Blood pressure 140/90 mmHg.
B) Apical pulse 52/min.
C) Respiratory rate 16/min.
D) Temperature 37.2 C (99 F).
B) Apical pulse 52/min.
Rationale: Digoxin is a cardiac glycoside that slows the heart rate. It should
be withheld if the apical pulse is less than 60/min in an adult.
A nurse is providing teaching to a client who has a new prescription for Warfarin.
Which of the following instructions should the nurse include?
A) "Take ibuprofen for minor headaches."
B) "Use a straight-edge razor for shaving."
C) "Consistency in your intake of green leafy vegetables is important."
D) "You will need to have your aPTT levels checked weekly."
C) "Consistency in your intake of green leafy vegetables is important."
Rationale: Vitamin K is the antidote for Warfarin. Dramatic changes in Vitamin
K intake (found in leafy greens) can fluctuate the drug's effectiveness.
A client is receiving a continuous IV infusion of Heparin. Which of the following
laboratory values should the nurse monitor?
A) PT
B) INR
C) aPTT
