ATI Comprehensive Predictor 2026 Exam | Verified Questions &
Rationales - 250 Questions
This exam assesses advanced knowledge in management of care, including delegation, prioritization, legal and
ethical issues, quality improvement, and resource management. Questions are designed to test clinical reasoning
and decision-making at the level expected for entry into professional practice. 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: Apply principles of
delegation and supervision to optimize team performance.; Prioritize patient care based on acuity, safety, and
resource availability.; Analyze legal and ethical dilemmas in healthcare management.; Evaluate quality
improvement processes and their impact on patient outcomes.. 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 75%. Aligned with Accredited by the Commission on Collegiate Nursing Education (CCNE) and
consistent with the NCLEX-RN test plan for Management of Care. standards and reflects the question style
Section 1: Management of Care (Questions 1-32)
1 A charge nurse is assigning care for four patients on a medical-surgical unit.
Which patient should be assigned to the most experienced registered nurse
(RN)?
A) A patient with pneumonia requiring intravenous antibiotics every 6 hours
and vital signs every 4 hours.
B) A patient with a new diagnosis of type 2 diabetes mellitus requiring initial
insulin dose adjustment and dietary teaching.
C) A patient with a history of chronic obstructive pulmonary disease
experiencing acute dyspnea with oxygen saturation of 88% on room air.
D) A patient with a urinary tract infection requiring a 3-day course of oral
antibiotics and discharge planning.
Answer: C
Rationale: The patient with acute dyspnea and hypoxia is unstable and requires
immediate assessment and intervention, which demands the highest level of
clinical judgment. Options A, B, and D are stable or routine and can be
managed by less experienced staff.
2 A nurse manager is implementing a quality improvement initiative to reduce
hospital-acquired pressure injuries. Which action should the manager take
first?
,A) Purchase new pressure-relieving mattresses for all beds.
B) Review current incidence data and compare with national benchmarks.
C) Educate staff on the latest wound care protocols.
D) Form a multidisciplinary committee to develop a prevention bundle.
Answer: B
Rationale: The first step in any quality improvement process is to assess the
current state and identify the gap. Reviewing incidence data provides baseline
information to guide interventions and measure improvement. Options A, C,
and D are subsequent steps that should be based on data analysis.
3 A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task should the nurse delegate?
A) Administering a scheduled oral medication to a stable patient.
B) Assessing a patient's surgical incision for signs of infection.
C) Ambulating a patient who had a hip replacement 2 days ago.
D) Teaching a patient how to self-administer insulin injections.
Answer: C
Rationale: Ambulation of a stable postoperative patient is within the scope of
UAP training and does not require clinical judgment. Administering
medications (A) and teaching (D) are nursing responsibilities. Assessment (B)
requires professional nursing judgment and cannot be delegated.
4 A nurse on a busy unit must prioritize care for four patients. Which patient
should the nurse see first?
A) A patient with a history of heart failure who reports a weight gain of 2 kg
over 2 days.
B) A patient with a fractured femur who is requesting pain medication.
C) A patient with a urinary catheter who has dark amber urine.
D) A patient with a nasogastric tube who has intermittent suction set at low.
Answer: A
Rationale: The patient with heart failure and rapid weight gain is at risk for
acute decompensation and pulmonary edema, requiring immediate assessment.
Requests for pain medication (B) and catheter issues (C) are important but not
life-threatening. The NG tube setting (D) is a routine check.
,5 A nurse is caring for a patient who refuses a prescribed blood transfusion due
to religious beliefs. Which action is most appropriate?
A) Explain the medical necessity and attempt to convince the patient.
B) Administer the transfusion while the patient is asleep.
C) Respect the patient's decision and document the refusal.
D) Contact the healthcare provider to obtain an alternative order.
Answer: C
Rationale: The patient has the right to refuse treatment based on informed
consent and autonomy. The nurse must respect this decision, document it, and
notify the provider. Attempting to coerce (A) or administering without consent
(B) violates ethical and legal standards. Option D may be considered but is not
the immediate priority; respecting the refusal is paramount.
6 A nurse is evaluating the effectiveness of a new fall prevention protocol.
Which outcome measure is most indicative of success?
A) Decreased number of fall-related injuries per month.
B) Increased staff compliance with hourly rounding.
C) Improved patient satisfaction scores regarding safety.
D) Reduced length of stay for patients at high fall risk.
Answer: A
Rationale: The primary goal of a fall prevention protocol is to reduce actual
harm from falls. A decrease in fall-related injuries directly reflects
effectiveness. Staff compliance (B) and patient satisfaction (C) are process
measures, not outcomes. Length of stay (D) can be influenced by many factors
and is not a direct measure of fall prevention.
7 A nurse is preparing to discharge a patient with a new colostomy. Which
action is most important for ensuring continuity of care?
A) Provide written instructions on colostomy care.
B) Schedule a follow-up appointment with the surgeon.
C) Coordinate a home health nursing visit for the next day.
D) Teach the patient how to change the ostomy pouch.
Answer: C
Rationale: Continuity of care requires ensuring that the patient receives skilled
support after discharge. A home health visit provides assessment and
reinforcement of teaching. Written instructions (A) and teaching (D) are
, important but do not guarantee follow-through. Scheduling a follow-up (B) is
also important but does not address immediate post-discharge needs.
8 A nurse is leading a team during a cardiac arrest. Which action demonstrates
effective leadership?
A) Assigning one team member to document all interventions.
B) Performing chest compressions while directing others.
C) Allowing team members to perform tasks they prefer.
D) Speaking loudly to ensure commands are heard over noise.
Answer: A
Rationale: Effective leadership includes clear role assignment to ensure all
critical tasks are covered. Designating a documenter (A) maintains accurate
records and frees others for hands-on roles. Option B may compromise
compression quality. Option C ignores team strengths and needs. Option D is
important but not the best example of leadership; clear closed-loop
communication is preferred.
9 A nurse is reviewing a patient's medical record and notes a discrepancy
between the medication administration record and the provider's orders.
What is the nurse's priority action?
A) Administer the medication as per the administration record.
B) Contact the provider to clarify the correct order.
C) Notify the nursing supervisor of the discrepancy.
D) Document the discrepancy in the patient's chart.
Answer: B
Rationale: The nurse must verify the correct order before administering any
medication to prevent errors. Contacting the provider (B) is the direct and
appropriate action. Administering based on an inaccurate record (A) could
cause harm. Notifying a supervisor (C) may be secondary but does not resolve
the immediate need for clarification. Documentation (D) should occur after
clarification.
10 A nurse is evaluating the effectiveness of a new protocol for rapid response
team activation. Which data collection method is most appropriate?
A) Survey nursing staff on their satisfaction with the protocol.
Rationales - 250 Questions
This exam assesses advanced knowledge in management of care, including delegation, prioritization, legal and
ethical issues, quality improvement, and resource management. Questions are designed to test clinical reasoning
and decision-making at the level expected for entry into professional practice. 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: Apply principles of
delegation and supervision to optimize team performance.; Prioritize patient care based on acuity, safety, and
resource availability.; Analyze legal and ethical dilemmas in healthcare management.; Evaluate quality
improvement processes and their impact on patient outcomes.. 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 75%. Aligned with Accredited by the Commission on Collegiate Nursing Education (CCNE) and
consistent with the NCLEX-RN test plan for Management of Care. standards and reflects the question style
Section 1: Management of Care (Questions 1-32)
1 A charge nurse is assigning care for four patients on a medical-surgical unit.
Which patient should be assigned to the most experienced registered nurse
(RN)?
A) A patient with pneumonia requiring intravenous antibiotics every 6 hours
and vital signs every 4 hours.
B) A patient with a new diagnosis of type 2 diabetes mellitus requiring initial
insulin dose adjustment and dietary teaching.
C) A patient with a history of chronic obstructive pulmonary disease
experiencing acute dyspnea with oxygen saturation of 88% on room air.
D) A patient with a urinary tract infection requiring a 3-day course of oral
antibiotics and discharge planning.
Answer: C
Rationale: The patient with acute dyspnea and hypoxia is unstable and requires
immediate assessment and intervention, which demands the highest level of
clinical judgment. Options A, B, and D are stable or routine and can be
managed by less experienced staff.
2 A nurse manager is implementing a quality improvement initiative to reduce
hospital-acquired pressure injuries. Which action should the manager take
first?
,A) Purchase new pressure-relieving mattresses for all beds.
B) Review current incidence data and compare with national benchmarks.
C) Educate staff on the latest wound care protocols.
D) Form a multidisciplinary committee to develop a prevention bundle.
Answer: B
Rationale: The first step in any quality improvement process is to assess the
current state and identify the gap. Reviewing incidence data provides baseline
information to guide interventions and measure improvement. Options A, C,
and D are subsequent steps that should be based on data analysis.
3 A nurse is delegating tasks to an unlicensed assistive personnel (UAP).
Which task should the nurse delegate?
A) Administering a scheduled oral medication to a stable patient.
B) Assessing a patient's surgical incision for signs of infection.
C) Ambulating a patient who had a hip replacement 2 days ago.
D) Teaching a patient how to self-administer insulin injections.
Answer: C
Rationale: Ambulation of a stable postoperative patient is within the scope of
UAP training and does not require clinical judgment. Administering
medications (A) and teaching (D) are nursing responsibilities. Assessment (B)
requires professional nursing judgment and cannot be delegated.
4 A nurse on a busy unit must prioritize care for four patients. Which patient
should the nurse see first?
A) A patient with a history of heart failure who reports a weight gain of 2 kg
over 2 days.
B) A patient with a fractured femur who is requesting pain medication.
C) A patient with a urinary catheter who has dark amber urine.
D) A patient with a nasogastric tube who has intermittent suction set at low.
Answer: A
Rationale: The patient with heart failure and rapid weight gain is at risk for
acute decompensation and pulmonary edema, requiring immediate assessment.
Requests for pain medication (B) and catheter issues (C) are important but not
life-threatening. The NG tube setting (D) is a routine check.
,5 A nurse is caring for a patient who refuses a prescribed blood transfusion due
to religious beliefs. Which action is most appropriate?
A) Explain the medical necessity and attempt to convince the patient.
B) Administer the transfusion while the patient is asleep.
C) Respect the patient's decision and document the refusal.
D) Contact the healthcare provider to obtain an alternative order.
Answer: C
Rationale: The patient has the right to refuse treatment based on informed
consent and autonomy. The nurse must respect this decision, document it, and
notify the provider. Attempting to coerce (A) or administering without consent
(B) violates ethical and legal standards. Option D may be considered but is not
the immediate priority; respecting the refusal is paramount.
6 A nurse is evaluating the effectiveness of a new fall prevention protocol.
Which outcome measure is most indicative of success?
A) Decreased number of fall-related injuries per month.
B) Increased staff compliance with hourly rounding.
C) Improved patient satisfaction scores regarding safety.
D) Reduced length of stay for patients at high fall risk.
Answer: A
Rationale: The primary goal of a fall prevention protocol is to reduce actual
harm from falls. A decrease in fall-related injuries directly reflects
effectiveness. Staff compliance (B) and patient satisfaction (C) are process
measures, not outcomes. Length of stay (D) can be influenced by many factors
and is not a direct measure of fall prevention.
7 A nurse is preparing to discharge a patient with a new colostomy. Which
action is most important for ensuring continuity of care?
A) Provide written instructions on colostomy care.
B) Schedule a follow-up appointment with the surgeon.
C) Coordinate a home health nursing visit for the next day.
D) Teach the patient how to change the ostomy pouch.
Answer: C
Rationale: Continuity of care requires ensuring that the patient receives skilled
support after discharge. A home health visit provides assessment and
reinforcement of teaching. Written instructions (A) and teaching (D) are
, important but do not guarantee follow-through. Scheduling a follow-up (B) is
also important but does not address immediate post-discharge needs.
8 A nurse is leading a team during a cardiac arrest. Which action demonstrates
effective leadership?
A) Assigning one team member to document all interventions.
B) Performing chest compressions while directing others.
C) Allowing team members to perform tasks they prefer.
D) Speaking loudly to ensure commands are heard over noise.
Answer: A
Rationale: Effective leadership includes clear role assignment to ensure all
critical tasks are covered. Designating a documenter (A) maintains accurate
records and frees others for hands-on roles. Option B may compromise
compression quality. Option C ignores team strengths and needs. Option D is
important but not the best example of leadership; clear closed-loop
communication is preferred.
9 A nurse is reviewing a patient's medical record and notes a discrepancy
between the medication administration record and the provider's orders.
What is the nurse's priority action?
A) Administer the medication as per the administration record.
B) Contact the provider to clarify the correct order.
C) Notify the nursing supervisor of the discrepancy.
D) Document the discrepancy in the patient's chart.
Answer: B
Rationale: The nurse must verify the correct order before administering any
medication to prevent errors. Contacting the provider (B) is the direct and
appropriate action. Administering based on an inaccurate record (A) could
cause harm. Notifying a supervisor (C) may be secondary but does not resolve
the immediate need for clarification. Documentation (D) should occur after
clarification.
10 A nurse is evaluating the effectiveness of a new protocol for rapid response
team activation. Which data collection method is most appropriate?
A) Survey nursing staff on their satisfaction with the protocol.
