ATI RN Comprehensive Predictor Exit Exam
2026/2027 – Complete 250 Q&A Test Bank
with NGN-Style Questions, Verified Answers
& Detailed Rationales | Versions 1–4 & Forms
A, B, C | 100% Pass Guarantee
SECTION 1: FUNDAMENTALS & PRIORITIZATION (Questions 1-30)
Question 1
A nurse is caring for four clients. Which client should the nurse assess first?
A) Client with COPD and SpO₂ 89% on 2L nasal cannula
B) Client post-appendectomy day 2 with temperature 38.3°C (101°F)
C) Client with heart failure and 3+ pitting edema
D) Client with new onset confusion and bounding pulse
Correct Answer: D
Rationale: New onset confusion with bounding pulse suggests hypercapnia or fluid
overload affecting cerebral perfusion. This is a change in neurological status, which is
always the priority . Option A is expected in COPD; Option B is post-op inflammation;
Option C is a chronic finding.
Question 2
A charge nurse is assigning staff. Which client should be assigned to the LPN?
A) Client 1 hour post-cardiac catheterization with bleeding
B) Client with stable diabetes requiring insulin and foot care
C) Client newly admitted with stroke and altered mental status
D) Client receiving IV heparin with PTT of 98 seconds
Correct Answer: B
,Rationale: LPNs can administer insulin, perform stable wound care, and monitor stable
clients. Options A, C, and D require RN assessment (bleeding, neurological changes,
critical lab monitoring) .
Question 3
A nurse delegates vital signs to an assistive personnel (AP). Which client should the AP
NOT be assigned to?
A) Client with pneumonia on room air
B) Client post-op day 3 with stable vitals
C) Client with frequent loose stools and orthostatic hypotension
D) Client with hypertension controlled on lisinopril
Correct Answer: C
Rationale: Orthostatic hypotension requires skilled assessment (measuring lying, sitting,
standing). APs can take routine vital signs but should not perform orthostatic checks on
unstable clients .
Question 4
A nurse is preparing to discharge a client. Which statement indicates understanding of
fall precautions?
A) "I will keep my walker close to my bed at night."
B) "I will wear socks without grippers to bed."
C) "I will dim the lights to reduce glare."
D) "I will remove my bed alarm since I feel safe now."
Correct Answer: A
Rationale: Keeping assistive devices close to the bed prevents falls during transfers.
Socks should have non-skid grips, lights should be adequate (not dimmed), and bed
alarms should remain in place as prescribed .
,Question 5
A nurse is caring for a client with heart failure who has crackles in lung bases, +3 edema,
and dyspnea on exertion. Which dietary instruction is most important?
A) Increase fluid intake to 3 L/day
B) Restrict sodium to 2 g/day
C) Increase potassium-rich foods
D) Limit carbohydrates to 50 g/day
Correct Answer: B
Rationale: Sodium restriction reduces fluid retention, decreases preload, and improves
symptoms of heart failure. Fluid restriction may also be indicated. Potassium-rich foods
may be needed if on diuretics, but sodium restriction is the priority for managing fluid
overload .
Question 6
A nurse is caring for a client who is receiving a continuous IV infusion of normal saline at
125 mL/hr. The nurse notes that the client's urine output has been 50 mL over the last 4
hours. What action should the nurse take first?
A) Notify the healthcare provider immediately
B) Assess the IV site for infiltration and patency
C) Continue to monitor as this is within normal limits
D) Increase the IV rate to 150 mL/hr
Correct Answer: B
Rationale: Oliguria (50 mL/4 hrs = 12.5 mL/hr, normal is 30 mL/hr) may indicate
decreased perfusion. Before notifying the provider, assess for a kinked, infiltrated, or
disconnected IV line .
Question 7
A nurse is caring for a client with heart failure who has been prescribed furosemide 40
mg IV twice daily. Which laboratory value requires immediate notification of the
provider?
, A) Serum sodium 135 mEq/L
B) Serum potassium 2.8 mEq/L
C) Serum creatinine 1.0 mg/dL
D) Blood glucose 110 mg/dL
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. A potassium of
2.8 mEq/L indicates severe hypokalemia, increasing the risk of cardiac dysrhythmias,
especially if the client is on digoxin .
Question 8
A client with cirrhosis has an ammonia level of 180 mcg/dL. Which medication should
the nurse prepare?
A) Naloxone
B) Lactulose
C) Protamine sulfate
D) Vitamin K
Correct Answer: B
Rationale: Lactulose is used to reduce ammonia levels in hepatic encephalopathy by
acidifying the colon and promoting ammonia excretion .
Question 9
A nurse is preparing to administer digoxin to a client with heart failure. Which finding
should prompt the nurse to withhold the medication?
A) Heart rate 58 bpm
B) Blood pressure 118/76 mm Hg
C) Potassium 4.0 mEq/L
D) Respiratory rate 18/min
Correct Answer: A
2026/2027 – Complete 250 Q&A Test Bank
with NGN-Style Questions, Verified Answers
& Detailed Rationales | Versions 1–4 & Forms
A, B, C | 100% Pass Guarantee
SECTION 1: FUNDAMENTALS & PRIORITIZATION (Questions 1-30)
Question 1
A nurse is caring for four clients. Which client should the nurse assess first?
A) Client with COPD and SpO₂ 89% on 2L nasal cannula
B) Client post-appendectomy day 2 with temperature 38.3°C (101°F)
C) Client with heart failure and 3+ pitting edema
D) Client with new onset confusion and bounding pulse
Correct Answer: D
Rationale: New onset confusion with bounding pulse suggests hypercapnia or fluid
overload affecting cerebral perfusion. This is a change in neurological status, which is
always the priority . Option A is expected in COPD; Option B is post-op inflammation;
Option C is a chronic finding.
Question 2
A charge nurse is assigning staff. Which client should be assigned to the LPN?
A) Client 1 hour post-cardiac catheterization with bleeding
B) Client with stable diabetes requiring insulin and foot care
C) Client newly admitted with stroke and altered mental status
D) Client receiving IV heparin with PTT of 98 seconds
Correct Answer: B
,Rationale: LPNs can administer insulin, perform stable wound care, and monitor stable
clients. Options A, C, and D require RN assessment (bleeding, neurological changes,
critical lab monitoring) .
Question 3
A nurse delegates vital signs to an assistive personnel (AP). Which client should the AP
NOT be assigned to?
A) Client with pneumonia on room air
B) Client post-op day 3 with stable vitals
C) Client with frequent loose stools and orthostatic hypotension
D) Client with hypertension controlled on lisinopril
Correct Answer: C
Rationale: Orthostatic hypotension requires skilled assessment (measuring lying, sitting,
standing). APs can take routine vital signs but should not perform orthostatic checks on
unstable clients .
Question 4
A nurse is preparing to discharge a client. Which statement indicates understanding of
fall precautions?
A) "I will keep my walker close to my bed at night."
B) "I will wear socks without grippers to bed."
C) "I will dim the lights to reduce glare."
D) "I will remove my bed alarm since I feel safe now."
Correct Answer: A
Rationale: Keeping assistive devices close to the bed prevents falls during transfers.
Socks should have non-skid grips, lights should be adequate (not dimmed), and bed
alarms should remain in place as prescribed .
,Question 5
A nurse is caring for a client with heart failure who has crackles in lung bases, +3 edema,
and dyspnea on exertion. Which dietary instruction is most important?
A) Increase fluid intake to 3 L/day
B) Restrict sodium to 2 g/day
C) Increase potassium-rich foods
D) Limit carbohydrates to 50 g/day
Correct Answer: B
Rationale: Sodium restriction reduces fluid retention, decreases preload, and improves
symptoms of heart failure. Fluid restriction may also be indicated. Potassium-rich foods
may be needed if on diuretics, but sodium restriction is the priority for managing fluid
overload .
Question 6
A nurse is caring for a client who is receiving a continuous IV infusion of normal saline at
125 mL/hr. The nurse notes that the client's urine output has been 50 mL over the last 4
hours. What action should the nurse take first?
A) Notify the healthcare provider immediately
B) Assess the IV site for infiltration and patency
C) Continue to monitor as this is within normal limits
D) Increase the IV rate to 150 mL/hr
Correct Answer: B
Rationale: Oliguria (50 mL/4 hrs = 12.5 mL/hr, normal is 30 mL/hr) may indicate
decreased perfusion. Before notifying the provider, assess for a kinked, infiltrated, or
disconnected IV line .
Question 7
A nurse is caring for a client with heart failure who has been prescribed furosemide 40
mg IV twice daily. Which laboratory value requires immediate notification of the
provider?
, A) Serum sodium 135 mEq/L
B) Serum potassium 2.8 mEq/L
C) Serum creatinine 1.0 mg/dL
D) Blood glucose 110 mg/dL
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes potassium wasting. A potassium of
2.8 mEq/L indicates severe hypokalemia, increasing the risk of cardiac dysrhythmias,
especially if the client is on digoxin .
Question 8
A client with cirrhosis has an ammonia level of 180 mcg/dL. Which medication should
the nurse prepare?
A) Naloxone
B) Lactulose
C) Protamine sulfate
D) Vitamin K
Correct Answer: B
Rationale: Lactulose is used to reduce ammonia levels in hepatic encephalopathy by
acidifying the colon and promoting ammonia excretion .
Question 9
A nurse is preparing to administer digoxin to a client with heart failure. Which finding
should prompt the nurse to withhold the medication?
A) Heart rate 58 bpm
B) Blood pressure 118/76 mm Hg
C) Potassium 4.0 mEq/L
D) Respiratory rate 18/min
Correct Answer: A
