ATI RN Comprehensive Predictor Exit Exam 2026 | Latest
Version - 250 Questions
This section of the exam assesses the nurse's ability to manage client care, including priority setting, delegation,
supervision, legal and ethical issues, and interprofessional collaboration. Questions require synthesis of complex
clinical scenarios and application of management principles. It contains 250 multiple-choice questions, each with
four distractors and a fully worked rationale that explains why the keyed answer is correct. Content is organized
into 8 focused sections: Management of Care, Safety and Infection Control, Health Promotion and Maintenance,
Psychosocial Integrity, Basic Care and Comfort, Pharmacological Therapies, Reduction of Risk Potential,
Physiological Adaptation. Targeted learning outcomes include: Prioritize nursing interventions based on client
acuity and resource availability.; Apply legal and ethical frameworks to nursing practice decisions.; Delegate and
supervise care tasks appropriately to licensed and unlicensed personnel.. Every item has been reviewed for
clinical accuracy, current guidelines, and clarity so that students can study with confidence and self-correct as
they work through the bank. Use it as a high-yield review immediately before the exam, or as a structured practice
tool during the unit - the rationales double as concise teaching notes. The recommended writing time is 3 hours,
with a passing score of 80%. Aligned with This exam meets the standards of the National Council of State Boards
of Nursing (NCSBN) and is designed to reflect the rigor of top US university nursing programs. standards and
reflects the question style commonly seen on accredited program examinations. Students consistently achieving
Section 1: Management of Care (Questions 1-32)
1 A charge nurse on a medical-surgical unit is making assignments for the next
shift. Which client should be assigned to the most experienced registered
nurse (RN)?
A) A client with chronic obstructive pulmonary disease requiring scheduled
nebulizer treatments
B) A client with a new diagnosis of diabetes mellitus requiring insulin dose
adjustment
C) A client with a history of heart failure who is receiving furosemide and
has a potassium level of 3.2 mEq/L
D) A client with a urinary tract infection who is receiving intravenous
antibiotics every 8 hours
Answer: C
Rationale: The client with hypokalemia (3.2 mEq/L) while on furosemide is at
risk for cardiac dysrhythmias and requires close monitoring and expert
assessment. The experienced RN is best suited to manage this unstable client.
The other clients are more stable and can be managed by less experienced staff.
2 A nurse is preparing to delegate a task to a licensed practical nurse (LPN).
Which task is within the LPN's scope of practice and appropriate to delegate?
,A) Administer a blood transfusion to a client with a history of transfusion
reactions
B) Perform a comprehensive admission assessment for a newly admitted
client
C) Administer a prescribed oral medication to a client with a nasogastric tube
D) Reinforce teaching about wound care to a client who is being discharged
Answer: C
Rationale: Administering oral medications via nasogastric tube is within the
LPN's scope of practice, provided the LPN has been trained and the facility
policy allows it. Blood transfusions and comprehensive assessments are
typically RN responsibilities. Reinforcing teaching is an RN task as it requires
evaluation of client understanding.
3 A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The
client's family requests that all life-sustaining treatments be continued.
Which action should the nurse take?
A) Honor the family's request and continue all treatments
B) Contact the provider to clarify the DNR order and discuss the family's
concerns
C) Explain to the family that the DNR order must be followed as written
D) Suspend the DNR order until the family agrees with the plan
Answer: B
Rationale: The DNR order specifically addresses resuscitation, not other
life-sustaining treatments. The nurse should clarify the provider's orders
regarding other treatments and facilitate a discussion between the provider and
family to address concerns. The DNR order remains in effect unless explicitly
rescinded by the provider.
4 A nurse is triaging clients in the emergency department. Which client should
be assessed first?
A) A client reporting chest pain that is relieved with rest and nitroglycerin
B) A client with a laceration on the forearm that is bleeding profusely
C) A client with a history of asthma who is wheezing and has an oxygen
saturation of 89%
D) A client with a fractured ankle who is in moderate pain
Answer: C
,Rationale: The client with wheezing and hypoxia (SpO2 89%) is experiencing
respiratory distress and requires immediate intervention. Chest pain relieved
with rest is stable angina. Profuse bleeding can be controlled with direct
pressure. Fractured ankle is non-urgent.
5 A nurse discovers that a colleague has been diverting controlled substances.
Which action should the nurse take first?
A) Confront the colleague about the suspected diversion
B) Report the suspicion to the nurse manager immediately
C) Document the observation in the colleague's personnel file
D) Ignore the behavior to avoid conflict
Answer: B
Rationale: The nurse has a legal and ethical duty to report suspected diversion
to protect client safety. Confronting the colleague is not appropriate and may
escalate the situation. Documentation should follow the facility's reporting
chain, and ignoring the behavior is a breach of duty.
6 A charge nurse is evaluating the effectiveness of a new staffing model.
Which metric is most indicative of successful care management?
A) Decreased length of stay for clients with pneumonia
B) Increased number of nursing hours per patient day
C) Reduced incidence of hospital-acquired pressure injuries
D) Higher scores on the Hospital Consumer Assessment of Healthcare
Providers and Systems (HCAHPS) survey
Answer: C
Rationale: Reduced incidence of hospital-acquired pressure injuries reflects
direct improvement in care quality and patient safety, which is a key outcome
of effective staffing. Length of stay and HCAHPS scores are influenced by
many factors. Nursing hours per patient day is a structural measure, not an
outcome.
7 A nurse is caring for a client who refuses a prescribed medication. The nurse
explains the risks of refusal, but the client remains adamant. Which action
should the nurse take?
A) Administer the medication anyway to ensure the client's health
B) Document the refusal and notify the provider
, C) Ask the client's family to persuade the client
D) Place the medication in the client's food without their knowledge
Answer: B
Rationale: The client has the right to refuse treatment. The nurse must respect
this right, document the refusal, and notify the provider for further orders.
Covert administration violates autonomy and is unethical. Family persuasion
may be considered but is not the nurse's primary action.
8 A nurse is leading a quality improvement project to reduce
catheter-associated urinary tract infections (CAUTIs). Which intervention
should be implemented first?
A) Implement a protocol for daily review of catheter necessity
B) Educate staff on proper insertion technique
C) Use silver-alloy catheters for all clients
D) Obtain urine cultures for all clients with catheters weekly
Answer: A
Rationale: Daily review of catheter necessity is the most effective
evidence-based strategy to reduce CAUTI by prompting early removal.
Education on insertion is important but secondary. Silver-alloy catheters may
help but are not a first-line intervention. Routine cultures are not
recommended.
9 A nurse is caring for a client who is postoperative and has a
patient-controlled analgesia (PCA) pump. The client's respiratory rate is 8
breaths/min. What is the nurse's priority action?
A) Administer naloxone as prescribed
B) Stop the PCA pump and call the provider
C) Increase the oxygen flow rate
D) Stimulate the client to breathe
Answer: A
Rationale: A respiratory rate of 8 indicates respiratory depression from opioid
analgesia. The priority is to reverse the opioid effect with naloxone. Stopping
the PCA is important but not as immediate as administering naloxone. Oxygen
and stimulation are supportive but not primary.
Version - 250 Questions
This section of the exam assesses the nurse's ability to manage client care, including priority setting, delegation,
supervision, legal and ethical issues, and interprofessional collaboration. Questions require synthesis of complex
clinical scenarios and application of management principles. It contains 250 multiple-choice questions, each with
four distractors and a fully worked rationale that explains why the keyed answer is correct. Content is organized
into 8 focused sections: Management of Care, Safety and Infection Control, Health Promotion and Maintenance,
Psychosocial Integrity, Basic Care and Comfort, Pharmacological Therapies, Reduction of Risk Potential,
Physiological Adaptation. Targeted learning outcomes include: Prioritize nursing interventions based on client
acuity and resource availability.; Apply legal and ethical frameworks to nursing practice decisions.; Delegate and
supervise care tasks appropriately to licensed and unlicensed personnel.. Every item has been reviewed for
clinical accuracy, current guidelines, and clarity so that students can study with confidence and self-correct as
they work through the bank. Use it as a high-yield review immediately before the exam, or as a structured practice
tool during the unit - the rationales double as concise teaching notes. The recommended writing time is 3 hours,
with a passing score of 80%. Aligned with This exam meets the standards of the National Council of State Boards
of Nursing (NCSBN) and is designed to reflect the rigor of top US university nursing programs. standards and
reflects the question style commonly seen on accredited program examinations. Students consistently achieving
Section 1: Management of Care (Questions 1-32)
1 A charge nurse on a medical-surgical unit is making assignments for the next
shift. Which client should be assigned to the most experienced registered
nurse (RN)?
A) A client with chronic obstructive pulmonary disease requiring scheduled
nebulizer treatments
B) A client with a new diagnosis of diabetes mellitus requiring insulin dose
adjustment
C) A client with a history of heart failure who is receiving furosemide and
has a potassium level of 3.2 mEq/L
D) A client with a urinary tract infection who is receiving intravenous
antibiotics every 8 hours
Answer: C
Rationale: The client with hypokalemia (3.2 mEq/L) while on furosemide is at
risk for cardiac dysrhythmias and requires close monitoring and expert
assessment. The experienced RN is best suited to manage this unstable client.
The other clients are more stable and can be managed by less experienced staff.
2 A nurse is preparing to delegate a task to a licensed practical nurse (LPN).
Which task is within the LPN's scope of practice and appropriate to delegate?
,A) Administer a blood transfusion to a client with a history of transfusion
reactions
B) Perform a comprehensive admission assessment for a newly admitted
client
C) Administer a prescribed oral medication to a client with a nasogastric tube
D) Reinforce teaching about wound care to a client who is being discharged
Answer: C
Rationale: Administering oral medications via nasogastric tube is within the
LPN's scope of practice, provided the LPN has been trained and the facility
policy allows it. Blood transfusions and comprehensive assessments are
typically RN responsibilities. Reinforcing teaching is an RN task as it requires
evaluation of client understanding.
3 A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The
client's family requests that all life-sustaining treatments be continued.
Which action should the nurse take?
A) Honor the family's request and continue all treatments
B) Contact the provider to clarify the DNR order and discuss the family's
concerns
C) Explain to the family that the DNR order must be followed as written
D) Suspend the DNR order until the family agrees with the plan
Answer: B
Rationale: The DNR order specifically addresses resuscitation, not other
life-sustaining treatments. The nurse should clarify the provider's orders
regarding other treatments and facilitate a discussion between the provider and
family to address concerns. The DNR order remains in effect unless explicitly
rescinded by the provider.
4 A nurse is triaging clients in the emergency department. Which client should
be assessed first?
A) A client reporting chest pain that is relieved with rest and nitroglycerin
B) A client with a laceration on the forearm that is bleeding profusely
C) A client with a history of asthma who is wheezing and has an oxygen
saturation of 89%
D) A client with a fractured ankle who is in moderate pain
Answer: C
,Rationale: The client with wheezing and hypoxia (SpO2 89%) is experiencing
respiratory distress and requires immediate intervention. Chest pain relieved
with rest is stable angina. Profuse bleeding can be controlled with direct
pressure. Fractured ankle is non-urgent.
5 A nurse discovers that a colleague has been diverting controlled substances.
Which action should the nurse take first?
A) Confront the colleague about the suspected diversion
B) Report the suspicion to the nurse manager immediately
C) Document the observation in the colleague's personnel file
D) Ignore the behavior to avoid conflict
Answer: B
Rationale: The nurse has a legal and ethical duty to report suspected diversion
to protect client safety. Confronting the colleague is not appropriate and may
escalate the situation. Documentation should follow the facility's reporting
chain, and ignoring the behavior is a breach of duty.
6 A charge nurse is evaluating the effectiveness of a new staffing model.
Which metric is most indicative of successful care management?
A) Decreased length of stay for clients with pneumonia
B) Increased number of nursing hours per patient day
C) Reduced incidence of hospital-acquired pressure injuries
D) Higher scores on the Hospital Consumer Assessment of Healthcare
Providers and Systems (HCAHPS) survey
Answer: C
Rationale: Reduced incidence of hospital-acquired pressure injuries reflects
direct improvement in care quality and patient safety, which is a key outcome
of effective staffing. Length of stay and HCAHPS scores are influenced by
many factors. Nursing hours per patient day is a structural measure, not an
outcome.
7 A nurse is caring for a client who refuses a prescribed medication. The nurse
explains the risks of refusal, but the client remains adamant. Which action
should the nurse take?
A) Administer the medication anyway to ensure the client's health
B) Document the refusal and notify the provider
, C) Ask the client's family to persuade the client
D) Place the medication in the client's food without their knowledge
Answer: B
Rationale: The client has the right to refuse treatment. The nurse must respect
this right, document the refusal, and notify the provider for further orders.
Covert administration violates autonomy and is unethical. Family persuasion
may be considered but is not the nurse's primary action.
8 A nurse is leading a quality improvement project to reduce
catheter-associated urinary tract infections (CAUTIs). Which intervention
should be implemented first?
A) Implement a protocol for daily review of catheter necessity
B) Educate staff on proper insertion technique
C) Use silver-alloy catheters for all clients
D) Obtain urine cultures for all clients with catheters weekly
Answer: A
Rationale: Daily review of catheter necessity is the most effective
evidence-based strategy to reduce CAUTI by prompting early removal.
Education on insertion is important but secondary. Silver-alloy catheters may
help but are not a first-line intervention. Routine cultures are not
recommended.
9 A nurse is caring for a client who is postoperative and has a
patient-controlled analgesia (PCA) pump. The client's respiratory rate is 8
breaths/min. What is the nurse's priority action?
A) Administer naloxone as prescribed
B) Stop the PCA pump and call the provider
C) Increase the oxygen flow rate
D) Stimulate the client to breathe
Answer: A
Rationale: A respiratory rate of 8 indicates respiratory depression from opioid
analgesia. The priority is to reverse the opioid effect with naloxone. Stopping
the PCA is important but not as immediate as administering naloxone. Oxygen
and stimulation are supportive but not primary.
