ATI RN Comprehensive Predictor 2026/2027
| NCLEX-RN Review & Next Gen Practice
Questions with Answers, Detailed Rationales
The ATI RN Comprehensive Predictor is a crucial exit exam designed to assess your
readiness for the NCLEX-RN. Research confirms it strongly aligns with the NCLEX test
plan, especially the increased focus on clinical judgment . This guide provides high-yield
practice questions, detailed rationales, and strategies to help you succeed.
Core Concepts & Prioritization Frameworks
Before diving into questions, master these foundational frameworks. These are essential
for answering priority, delegation, and clinical judgment items.
Key Frameworks for Prioritization
ABCs (Airway, Breathing, Circulation): Always the priority. Assess and address airway,
breathing, and circulation issues first .
Maslow's Hierarchy of Needs: Prioritize physiological needs (e.g., ABCs, pain,
elimination) before safety, psychosocial, or self-esteem needs .
Acute vs. Chronic: Address acute, life-threatening problems before chronic or stable
conditions .
, Assessment vs. Intervention: Assess the patient first unless a clear, life-threatening
intervention is needed (e.g., CPR, administering naloxone) .
Actual vs. Potential: Treat actual problems before potential ones .
Key Delegation Guidelines
RN to LPN/LVN:
o Can delegate to stable patients with predictable outcomes .
o Tasks include: administering medications (except IV push), monitoring tube feedings,
and performing sterile procedures .
o The RN is accountable for the overall care and cannot delegate the nursing
process (assessment, planning, evaluation) .
RN to UAP (Nursing Assistant):
o Tasks include: ADLs (bathing, feeding, toileting), vital signs on stable patients,
intake/output, and ambulation .
o Cannot delegate tasks requiring clinical judgment, such as assessments, teaching, or
evaluating responses to care.
Practice Questions with Rationales
Priority & Delegation
Question 1:
A charge nurse is making assignments for a medical-surgical unit. Which client should
be assigned to the most experienced RN?
A. A client scheduled for discharge who needs medication teaching.
B. A client who is 2 hours postoperative following an abdominal hysterectomy.
C. A client with a chest tube for a pneumothorax who reports sudden shortness of
, breath.
D. A client with a wound that has purulent drainage.
Correct Answer: C) A client with a chest tube for a pneumothorax who reports
sudden shortness of breath.
Rationale:
Why Correct: This client is unstable and experiencing a potential life-threatening
complication (tension pneumothorax). Sudden shortness of breath with a chest tube
requires immediate, skilled assessment and intervention. Using the ABCs, breathing is
compromised, making this the highest priority.
Distractors: Option B is a stable post-op client with predictable needs. Option A
requires teaching, a task an RN can do but is not the highest priority. Option D, while
needing monitoring, is less urgent than a potential airway compromise .
Question 2:
Which task is appropriate for a nurse to delegate to an LPN/LVN?
A. Performing a comprehensive admission assessment on a new client.
B. Teaching a client about a new medication.
C. Administering a tube feeding to a stable client.
D. Developing a plan of care for a client.
Correct Answer: C) Administering a tube feeding to a stable client.
Rationale:
Why Correct: Administering a tube feeding to a stable client is a standard task within
the LPN/LVN scope of practice .
Distractors: Options A, B, and D are all steps of the nursing process (assessment,
education, planning) that require the advanced clinical judgment of an RN and cannot
be delegated .
, Question 3:
A nurse is caring for a client who requires restraints. Which action is correct?
A. Apply the restraints securely with no slack.
B. Remove the restraints every 2 hours to assess the client's skin.
C. Obtain a PRN order for the restraints.
D. Apply restraints for the convenience of the staff.
Correct Answer: B) Remove the restraints every 2 hours to assess the client's skin.
Rationale:
Why Correct: Restraints must be removed every 2 hours to assess for skin breakdown,
provide ROM exercises, and meet the client's basic needs . You should also assess the
client's circulation, sensation, and movement.
Distractors: Restraints should have enough slack for 1-2 fingers to fit between the
restraint and the client. PRN orders for restraints are not allowed; you need a specific,
time-limited order. Restraints are only used for client safety, never for staff convenience .
Clinical Judgment & Next Gen (NGN) Style Questions
The NGN exam uses case studies and question formats like "Bow-Tie" and "Select All
That Apply" (SATA) to test your clinical judgment . This requires you to analyze a
scenario and identify the most appropriate actions.
Question 4:
Scenario: A nurse is caring for a client who is 4 hours post-operative following a
thyroidectomy. The client's voice is hoarse, and they report a "funny feeling" in their
throat. On assessment, the nurse notes laryngeal stridor.
| NCLEX-RN Review & Next Gen Practice
Questions with Answers, Detailed Rationales
The ATI RN Comprehensive Predictor is a crucial exit exam designed to assess your
readiness for the NCLEX-RN. Research confirms it strongly aligns with the NCLEX test
plan, especially the increased focus on clinical judgment . This guide provides high-yield
practice questions, detailed rationales, and strategies to help you succeed.
Core Concepts & Prioritization Frameworks
Before diving into questions, master these foundational frameworks. These are essential
for answering priority, delegation, and clinical judgment items.
Key Frameworks for Prioritization
ABCs (Airway, Breathing, Circulation): Always the priority. Assess and address airway,
breathing, and circulation issues first .
Maslow's Hierarchy of Needs: Prioritize physiological needs (e.g., ABCs, pain,
elimination) before safety, psychosocial, or self-esteem needs .
Acute vs. Chronic: Address acute, life-threatening problems before chronic or stable
conditions .
, Assessment vs. Intervention: Assess the patient first unless a clear, life-threatening
intervention is needed (e.g., CPR, administering naloxone) .
Actual vs. Potential: Treat actual problems before potential ones .
Key Delegation Guidelines
RN to LPN/LVN:
o Can delegate to stable patients with predictable outcomes .
o Tasks include: administering medications (except IV push), monitoring tube feedings,
and performing sterile procedures .
o The RN is accountable for the overall care and cannot delegate the nursing
process (assessment, planning, evaluation) .
RN to UAP (Nursing Assistant):
o Tasks include: ADLs (bathing, feeding, toileting), vital signs on stable patients,
intake/output, and ambulation .
o Cannot delegate tasks requiring clinical judgment, such as assessments, teaching, or
evaluating responses to care.
Practice Questions with Rationales
Priority & Delegation
Question 1:
A charge nurse is making assignments for a medical-surgical unit. Which client should
be assigned to the most experienced RN?
A. A client scheduled for discharge who needs medication teaching.
B. A client who is 2 hours postoperative following an abdominal hysterectomy.
C. A client with a chest tube for a pneumothorax who reports sudden shortness of
, breath.
D. A client with a wound that has purulent drainage.
Correct Answer: C) A client with a chest tube for a pneumothorax who reports
sudden shortness of breath.
Rationale:
Why Correct: This client is unstable and experiencing a potential life-threatening
complication (tension pneumothorax). Sudden shortness of breath with a chest tube
requires immediate, skilled assessment and intervention. Using the ABCs, breathing is
compromised, making this the highest priority.
Distractors: Option B is a stable post-op client with predictable needs. Option A
requires teaching, a task an RN can do but is not the highest priority. Option D, while
needing monitoring, is less urgent than a potential airway compromise .
Question 2:
Which task is appropriate for a nurse to delegate to an LPN/LVN?
A. Performing a comprehensive admission assessment on a new client.
B. Teaching a client about a new medication.
C. Administering a tube feeding to a stable client.
D. Developing a plan of care for a client.
Correct Answer: C) Administering a tube feeding to a stable client.
Rationale:
Why Correct: Administering a tube feeding to a stable client is a standard task within
the LPN/LVN scope of practice .
Distractors: Options A, B, and D are all steps of the nursing process (assessment,
education, planning) that require the advanced clinical judgment of an RN and cannot
be delegated .
, Question 3:
A nurse is caring for a client who requires restraints. Which action is correct?
A. Apply the restraints securely with no slack.
B. Remove the restraints every 2 hours to assess the client's skin.
C. Obtain a PRN order for the restraints.
D. Apply restraints for the convenience of the staff.
Correct Answer: B) Remove the restraints every 2 hours to assess the client's skin.
Rationale:
Why Correct: Restraints must be removed every 2 hours to assess for skin breakdown,
provide ROM exercises, and meet the client's basic needs . You should also assess the
client's circulation, sensation, and movement.
Distractors: Restraints should have enough slack for 1-2 fingers to fit between the
restraint and the client. PRN orders for restraints are not allowed; you need a specific,
time-limited order. Restraints are only used for client safety, never for staff convenience .
Clinical Judgment & Next Gen (NGN) Style Questions
The NGN exam uses case studies and question formats like "Bow-Tie" and "Select All
That Apply" (SATA) to test your clinical judgment . This requires you to analyze a
scenario and identify the most appropriate actions.
Question 4:
Scenario: A nurse is caring for a client who is 4 hours post-operative following a
thyroidectomy. The client's voice is hoarse, and they report a "funny feeling" in their
throat. On assessment, the nurse notes laryngeal stridor.
