Level 3 Attempt Verified ATI RN Comprehensive Predictor Exit
Assessment Package, Excellence Package - ATI RN
Comprehensive Predictor Exit Assessment 2026 NGN Actual
Exam
SECTION 1: MANAGEMENT OF CARE (Questions 1–15)
1. A charge nurse is assigning client rooms. Which client is most appropriate for
a negative-pressure airborne infection isolation room?
A) Client with bacterial meningitis
B) Client with active pulmonary tuberculosis
C) Client with methicillin-resistant Staphylococcus aureus (MRSA) wound infection
D) Client with Clostridioides difficile (C. diff)
Answer: B
Rationale: Active pulmonary tuberculosis (TB) requires airborne precautions with
a negative-pressure room (AIIR). Bacterial meningitis requires droplet
precautions. MRSA and C. diff require contact precautions.
2. A nurse notes a client’s lithium level is 1.9 mEq/L. Which provider order
should the nurse implement first?
A) Hold the next dose of lithium
B) Prepare the client for hemodialysis
C) Increase fluid intake to 4 L/day
D) Administer polystyrene sulfonate
Answer: A
Rationale: The therapeutic range for lithium is 0.6–1.2 mEq/L. A level of 1.9
mEq/L indicates toxicity. The first action is to hold the next dose to prevent
further elevation.
3. A client with terminal cancer refuses further treatment and asks to go home
on hospice care. The provider recommends continued chemotherapy. Which
action should the nurse take?
A) Respect the client’s decision and support the request for hospice
B) Persuade the client to follow the provider’s recommendation
,C) Consult the ethics committee before taking action
D) Have the client’s family make the final decision
Answer: A
Rationale: Competent adults have the right to refuse treatment, including life-
sustaining measures. The nurse must advocate for the client’s autonomy and
informed decision.
4. A nurse is supervising a newly licensed nurse who is caring for a client with a
chest tube. Which action requires intervention?
A) Clamping the chest tube before ambulating the client
B) Keeping the drainage system below chest level
C) Assessing for tidaling in the water seal chamber
D) Reporting continuous bubbling in the water seal chamber
Answer: A
Rationale: Clamping a chest tube is dangerous and can lead to tension
pneumothorax unless ordered for a specific purpose (e.g., changing the system).
Ambulation does not require clamping.
5. A charge nurse is preparing the shift assignment. Which client should be
assigned to a float RN from the postpartum unit?
A) A client 1 hour post-cardiac catheterization with a femoral sheath in place
B) A client with pneumonia requiring IV antibiotics every 6 hours
C) A client receiving a continuous IV heparin infusion for DVT
D) A client with a chest tube for a spontaneous pneumothorax
Answer: B
Rationale: A stable client with routine antibiotics is least complex and most
appropriate for a float nurse from another specialty. Cardiac cath, IV heparin
(requires titration and aPTT monitoring), and chest tube clients require higher
acuity nursing experience.
6. A nurse is caring for a client who has a new prescription for wrist restraints.
Which action is appropriate?
A) Tie the restraint straps to the movable bed rail
B) Obtain a provider’s order within 1 hour of application
, C) Remove the restraint every 4 hours for skin assessment
D) Apply the restraint tightly to prevent movement
Answer: B
Rationale: A provider’s order must be obtained within 1 hour for restraints.
Restraints are tied to the bed frame (not side rails), removed every 2 hours, and
applied snugly but not tightly.
7. During change-of-shift report, the nurse learns about four clients. Which
client should the nurse assess first?
A) A client with heart failure who has new-onset confusion and crackles
B) A client with diabetes requesting pain medication for neuropathy
C) A client with chronic kidney disease due for a hemodialysis appointment
D) A client with hypertension with a BP of 148/90
Answer: A
Rationale: New-onset confusion in a client with heart failure suggests worsening
oxygenation or cerebral hypoperfusion (possible acute decompensation). This is a
priority over stable or routine needs.
8. A nurse is preparing to obtain informed consent from a client who does not
speak English. Which action is appropriate?
A) Obtain consent using a medical interpreter
B) Have the client’s adult child translate
C) Ask the client to sign the form without an interpreter
D) Delay the procedure until the client learns English
Answer: A
Rationale: A trained medical interpreter ensures accurate communication of risks,
benefits, and alternatives. Family members may introduce errors or bias.
9. A client tells the nurse, “I want to leave the hospital against medical advice.”
The client is alert and oriented. What is the nurse’s priority action?
A) Notify security to prevent the client from leaving
B) Ask the client to sign the AMA form
C) Determine whether the client understands the risks of leaving
D) Call the provider to request a psychiatric consult
Assessment Package, Excellence Package - ATI RN
Comprehensive Predictor Exit Assessment 2026 NGN Actual
Exam
SECTION 1: MANAGEMENT OF CARE (Questions 1–15)
1. A charge nurse is assigning client rooms. Which client is most appropriate for
a negative-pressure airborne infection isolation room?
A) Client with bacterial meningitis
B) Client with active pulmonary tuberculosis
C) Client with methicillin-resistant Staphylococcus aureus (MRSA) wound infection
D) Client with Clostridioides difficile (C. diff)
Answer: B
Rationale: Active pulmonary tuberculosis (TB) requires airborne precautions with
a negative-pressure room (AIIR). Bacterial meningitis requires droplet
precautions. MRSA and C. diff require contact precautions.
2. A nurse notes a client’s lithium level is 1.9 mEq/L. Which provider order
should the nurse implement first?
A) Hold the next dose of lithium
B) Prepare the client for hemodialysis
C) Increase fluid intake to 4 L/day
D) Administer polystyrene sulfonate
Answer: A
Rationale: The therapeutic range for lithium is 0.6–1.2 mEq/L. A level of 1.9
mEq/L indicates toxicity. The first action is to hold the next dose to prevent
further elevation.
3. A client with terminal cancer refuses further treatment and asks to go home
on hospice care. The provider recommends continued chemotherapy. Which
action should the nurse take?
A) Respect the client’s decision and support the request for hospice
B) Persuade the client to follow the provider’s recommendation
,C) Consult the ethics committee before taking action
D) Have the client’s family make the final decision
Answer: A
Rationale: Competent adults have the right to refuse treatment, including life-
sustaining measures. The nurse must advocate for the client’s autonomy and
informed decision.
4. A nurse is supervising a newly licensed nurse who is caring for a client with a
chest tube. Which action requires intervention?
A) Clamping the chest tube before ambulating the client
B) Keeping the drainage system below chest level
C) Assessing for tidaling in the water seal chamber
D) Reporting continuous bubbling in the water seal chamber
Answer: A
Rationale: Clamping a chest tube is dangerous and can lead to tension
pneumothorax unless ordered for a specific purpose (e.g., changing the system).
Ambulation does not require clamping.
5. A charge nurse is preparing the shift assignment. Which client should be
assigned to a float RN from the postpartum unit?
A) A client 1 hour post-cardiac catheterization with a femoral sheath in place
B) A client with pneumonia requiring IV antibiotics every 6 hours
C) A client receiving a continuous IV heparin infusion for DVT
D) A client with a chest tube for a spontaneous pneumothorax
Answer: B
Rationale: A stable client with routine antibiotics is least complex and most
appropriate for a float nurse from another specialty. Cardiac cath, IV heparin
(requires titration and aPTT monitoring), and chest tube clients require higher
acuity nursing experience.
6. A nurse is caring for a client who has a new prescription for wrist restraints.
Which action is appropriate?
A) Tie the restraint straps to the movable bed rail
B) Obtain a provider’s order within 1 hour of application
, C) Remove the restraint every 4 hours for skin assessment
D) Apply the restraint tightly to prevent movement
Answer: B
Rationale: A provider’s order must be obtained within 1 hour for restraints.
Restraints are tied to the bed frame (not side rails), removed every 2 hours, and
applied snugly but not tightly.
7. During change-of-shift report, the nurse learns about four clients. Which
client should the nurse assess first?
A) A client with heart failure who has new-onset confusion and crackles
B) A client with diabetes requesting pain medication for neuropathy
C) A client with chronic kidney disease due for a hemodialysis appointment
D) A client with hypertension with a BP of 148/90
Answer: A
Rationale: New-onset confusion in a client with heart failure suggests worsening
oxygenation or cerebral hypoperfusion (possible acute decompensation). This is a
priority over stable or routine needs.
8. A nurse is preparing to obtain informed consent from a client who does not
speak English. Which action is appropriate?
A) Obtain consent using a medical interpreter
B) Have the client’s adult child translate
C) Ask the client to sign the form without an interpreter
D) Delay the procedure until the client learns English
Answer: A
Rationale: A trained medical interpreter ensures accurate communication of risks,
benefits, and alternatives. Family members may introduce errors or bias.
9. A client tells the nurse, “I want to leave the hospital against medical advice.”
The client is alert and oriented. What is the nurse’s priority action?
A) Notify security to prevent the client from leaving
B) Ask the client to sign the AMA form
C) Determine whether the client understands the risks of leaving
D) Call the provider to request a psychiatric consult
