1
RN Comprehensive Predictor 2019/2023/2026-Aligned
Test Bank | 200 Advanced NGN-Style Questions with
Verified Answers & Detailed Rationales | Complete
Review for ATI RN Predictor & NCLEX-RN Success |
Graded A+
The assessment provides a predicted probability of passing NCLEX-RN and guides remediation
efforts. This comprehensive test bank is updated for the latest NCLEX-RN test plan and ATI
guidelines, incorporating current evidence-based practice protocols.
SECTION 1: MANAGEMENT OF CARE – DELEGATION, PRIORITIZATION,
AND LEGAL/ETHICAL ISSUES (Questions 1–35)
1. A charge nurse is making client assignments on a medical-surgical
unit. Which client should the charge nurse assign to the LPN/LVN?
A. A client with a new tracheostomy requiring frequent suctioning
B. A client who is 1 hour post-hip replacement with a blood pressure of
88/52 mmHg
C. A client with diabetes who requires a sterile wound dressing change
D. A client with hypertension who needs oral medications administered
Valid answer: D
Rationale: LPNs can administer oral medications to stable clients. Clients
with new tracheostomies (unstable airway), post-surgical hypotension
,2
(unstable), and sterile wound dressing changes (requires RN assessment)
should be assigned to RNs. Task delegation must match scope of practice.
2. A nurse is caring for a client who has a living will stating "no CPR."
The client becomes pulseless and apneic. The client's family member
demands that the nurse "do everything." What should the nurse do
FIRST?
A. Initiate CPR immediately per the family's request
B. Respect the DNR order and provide comfort measures while supporting
the family
C. Page the provider for clarification of the DNR order
D. Call the hospital ethics committee for consultation
Valid answer: B
Rationale: A valid living will/DNR order must be respected. The nurse
should provide comfort measures and support the family, explaining the
DNR order compassionately. CPR should not be initiated against a valid
DNR.
3. A nurse receives handoff report on four clients. Which client should
the nurse assess FIRST?
A. A client with COPD and oxygen saturation of 88% on 2L nasal cannula
B. A client with diabetes with a blood glucose of 180 mg/dL
C. A client with a fractured femur reporting pain of 6 on a 0–10 scale
,3
D. A client with a urinary tract infection with a temperature of 100.4°F
(38°C)
Valid answer: A
Rationale: The client with an oxygen saturation of 88% is experiencing
significant hypoxia and requires immediate assessment and intervention
(ABCs—Airway, Breathing, Circulation). This is a priority over stable clients.
4. A nurse suspects a colleague is impaired due to the smell of alcohol
on their breath. What is the priority action?
A. Confront the colleague privately
B. Notify the nursing supervisor immediately
C. Ignore the situation to avoid conflict
D. Ask the colleague to go home for the day
Valid answer: B
Rationale: Patient safety is paramount. The nurse must report suspected
impairment to the nursing supervisor immediately to ensure patient safety
and follow legal and ethical obligations.
5. A client refuses a blood transfusion due to religious beliefs. What is
the nurse's BEST response?
A. Document the refusal and notify the provider
B. Explain the consequences of refusing the transfusion
, 4
C. Ask the family to convince the client to accept the transfusion
D. Administer the transfusion and document the client's objection
Valid answer: A
Rationale: The nurse must respect client autonomy. The provider should be
notified so alternatives can be discussed. The refusal should be
documented, and care should continue within the client's wishes.
6. A nurse manager is discussing "just culture" with staff. Which
statement reflects this concept?
A. "We analyze system failures, not just individual mistakes"
B. "All errors should result in disciplinary action"
C. "Staff should be blamed for all adverse events"
D. "Just culture means no one is ever held accountable"
Valid answer: A
Rationale: Just culture balances accountability with learning from errors
without punitive blame for honest mistakes. The focus is on system
improvements to prevent future errors.
7. A nurse is triaging after a mass casualty event. Which client should
be seen FIRST?
A. A client with a sucking chest wound and stridor
B. A client with a minor laceration on the arm
RN Comprehensive Predictor 2019/2023/2026-Aligned
Test Bank | 200 Advanced NGN-Style Questions with
Verified Answers & Detailed Rationales | Complete
Review for ATI RN Predictor & NCLEX-RN Success |
Graded A+
The assessment provides a predicted probability of passing NCLEX-RN and guides remediation
efforts. This comprehensive test bank is updated for the latest NCLEX-RN test plan and ATI
guidelines, incorporating current evidence-based practice protocols.
SECTION 1: MANAGEMENT OF CARE – DELEGATION, PRIORITIZATION,
AND LEGAL/ETHICAL ISSUES (Questions 1–35)
1. A charge nurse is making client assignments on a medical-surgical
unit. Which client should the charge nurse assign to the LPN/LVN?
A. A client with a new tracheostomy requiring frequent suctioning
B. A client who is 1 hour post-hip replacement with a blood pressure of
88/52 mmHg
C. A client with diabetes who requires a sterile wound dressing change
D. A client with hypertension who needs oral medications administered
Valid answer: D
Rationale: LPNs can administer oral medications to stable clients. Clients
with new tracheostomies (unstable airway), post-surgical hypotension
,2
(unstable), and sterile wound dressing changes (requires RN assessment)
should be assigned to RNs. Task delegation must match scope of practice.
2. A nurse is caring for a client who has a living will stating "no CPR."
The client becomes pulseless and apneic. The client's family member
demands that the nurse "do everything." What should the nurse do
FIRST?
A. Initiate CPR immediately per the family's request
B. Respect the DNR order and provide comfort measures while supporting
the family
C. Page the provider for clarification of the DNR order
D. Call the hospital ethics committee for consultation
Valid answer: B
Rationale: A valid living will/DNR order must be respected. The nurse
should provide comfort measures and support the family, explaining the
DNR order compassionately. CPR should not be initiated against a valid
DNR.
3. A nurse receives handoff report on four clients. Which client should
the nurse assess FIRST?
A. A client with COPD and oxygen saturation of 88% on 2L nasal cannula
B. A client with diabetes with a blood glucose of 180 mg/dL
C. A client with a fractured femur reporting pain of 6 on a 0–10 scale
,3
D. A client with a urinary tract infection with a temperature of 100.4°F
(38°C)
Valid answer: A
Rationale: The client with an oxygen saturation of 88% is experiencing
significant hypoxia and requires immediate assessment and intervention
(ABCs—Airway, Breathing, Circulation). This is a priority over stable clients.
4. A nurse suspects a colleague is impaired due to the smell of alcohol
on their breath. What is the priority action?
A. Confront the colleague privately
B. Notify the nursing supervisor immediately
C. Ignore the situation to avoid conflict
D. Ask the colleague to go home for the day
Valid answer: B
Rationale: Patient safety is paramount. The nurse must report suspected
impairment to the nursing supervisor immediately to ensure patient safety
and follow legal and ethical obligations.
5. A client refuses a blood transfusion due to religious beliefs. What is
the nurse's BEST response?
A. Document the refusal and notify the provider
B. Explain the consequences of refusing the transfusion
, 4
C. Ask the family to convince the client to accept the transfusion
D. Administer the transfusion and document the client's objection
Valid answer: A
Rationale: The nurse must respect client autonomy. The provider should be
notified so alternatives can be discussed. The refusal should be
documented, and care should continue within the client's wishes.
6. A nurse manager is discussing "just culture" with staff. Which
statement reflects this concept?
A. "We analyze system failures, not just individual mistakes"
B. "All errors should result in disciplinary action"
C. "Staff should be blamed for all adverse events"
D. "Just culture means no one is ever held accountable"
Valid answer: A
Rationale: Just culture balances accountability with learning from errors
without punitive blame for honest mistakes. The focus is on system
improvements to prevent future errors.
7. A nurse is triaging after a mass casualty event. Which client should
be seen FIRST?
A. A client with a sucking chest wound and stridor
B. A client with a minor laceration on the arm
