ATI PN Comprehensive Predictor 2026–2027 | ATI Practical
Nursing Comprehensive Predictor Proctored Exam Study
Guide & NCLEX-PN Readiness Review | ATI PN
Comprehensive Predictor Practice Questions, Answers &
Detailed Rationales | ATI Practical Nursing Content Mastery
Series Comprehensive Review, Adult Medical-Surgical
Nursing, Fundamentals, Pharmacology, Maternal-Newborn,
Pediatrics, Mental Health, Community Health, Nursing Care,
Patient Safety, Infection Control, Medication Administration,
Dosage Calculations, Prioritization, Delegation, Health
Promotion, Risk Reduction, Clinical Judgment, Physiological
Integrity, Psychosocial Integrity & NGN-Style Case-Based
Practice
Question 1: A PN is caring for four clients. Which client should the PN assess
FIRST?
A. A client with diabetes requesting pain medication for neuropathy.
B. A client with COPD who has a new onset of confusion and BP 88/50.
C. A client post-op day 2 requesting help to the bathroom.
D. A client with a fractured tibia asking for a PRN snack.
CORRECT ANSWER: B. A client with COPD who has a new onset of confusion
and BP 88/50.
Rationale: New-onset confusion combined with hypotension indicates a change in
neurological status and hemodynamic instability, which suggests shock (sepsis,
hemorrhage, or dehydration). Unstable clients always take priority over those with stable
or expected findings .
Question 2: A nurse is caring for a client with chronic heart failure who reports
increased shortness of breath and swelling in the ankles. Which intervention
should the nurse prioritize?
A. Encourage increased fluid intake.
B. Administer prescribed diuretic.
C. Provide a high-sodium snack.
D. Increase the room temperature.
CORRECT ANSWER: B. Administer prescribed diuretic.
Rationale: The symptoms indicate fluid overload. Administering a diuretic (e.g.,
furosemide) directly addresses the cause by reducing preload and pulmonary
congestion .
,Question 3: A client is admitted with a suspected stroke. Which action should
the nurse perform first?
A. Obtain a detailed neurological history.
B. Check the client's blood glucose level.
C. Prepare the client for a CT scan.
D. Administer aspirin 325 mg PO.
CORRECT ANSWER: B. Check the client's blood glucose level.
Rationale: Hypoglycemia can mimic stroke symptoms (slurred speech, weakness,
confusion). The nurse must quickly rule out low blood sugar before proceeding with a
stroke workup .
Question 4: A client with a new tracheostomy has thick, dry secretions and
difficulty breathing. What is the priority action?
A. Call respiratory therapy.
B. Change the inner cannula.
C. Instill normal saline and suction.
D. Increase oxygen flow rate.
CORRECT ANSWER: C. Instill normal saline and suction.
Rationale: The priority is always Airway (ABCs). Thick secretions are physically blocking
the airway. Immediate suctioning is required to clear the obstruction. Instilling saline
helps loosen the mucus for removal .
Question 5: A client is prescribed spironolactone. Which laboratory finding
should be reported immediately?
A. Sodium 135 mEq/L.
B. Potassium 5.8 mEq/L.
C. BUN 18 mg/dL.
D. Creatinine 0.9 mg/dL.
CORRECT ANSWER: B. Potassium 5.8 mEq/L.
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.8 is
above the normal range (3.5-5.0) and indicates hyperkalemia, which can cause life-
threatening cardiac dysrhythmias .
Question 6: A charge nurse is assigning staff for the shift. Which client should
be assigned to an RN rather than a PN?
A. A client with stable CHF receiving daily Lasix.
,B. A client requiring a blood transfusion for symptomatic anemia.
C. A client with a new diagnosis of diabetes needing insulin instruction.
D. A client with a PEG tube requiring intermittent feedings.
CORRECT ANSWER: C. A client with a new diagnosis of diabetes needing
insulin instruction.
Rationale: Client education (specifically initial instruction) falls under the scope of the
RN, as it requires complex assessment and evaluation of learning. PNs can reinforce
teaching but cannot perform initial patient teaching .
Question 7: A client with deep vein thrombosis (DVT) is on heparin. Which
finding suggests a complication?
A. Bruising at the IV site.
B. New chest pain and shortness of breath.
C. Hemoglobin 12 g/dL.
D. Mild headache.
CORRECT ANSWER: B. New chest pain and shortness of breath.
Rationale: New chest pain and dyspnea in a patient with DVT suggests a pulmonary
embolism (PE), where the clot has traveled to the lungs. This is a life-threatening
medical emergency .
Question 8: A client with acute pancreatitis. Which laboratory value is most
important for the nurse to monitor?
A. Potassium.
B. Amylase.
C. Glucose.
D. Hemoglobin.
CORRECT ANSWER: C. Glucose.
Rationale: While amylase is diagnostic for pancreatitis, glucose is critical to monitor
because the pancreas produces insulin. Pancreatitis can destroy insulin-producing cells,
leading to dangerous hyperglycemia .
Question 9: A postpartum client saturates a peripad in 15 minutes. Priority
action?
A. Fundal massage and notify provider.
B. Document the finding and reassess in 1 hour.
C. Ambulate the client to the bathroom.
, D. Administer a PRN analgesic.
CORRECT ANSWER: A. Fundal massage and notify provider.
Rationale: Saturating a peripad in 15 minutes indicates postpartum hemorrhage. The
priority is to massage the fundus to promote uterine contraction and notify the provider
immediately .
Question 10: A nurse is assisting with a lumbar puncture. After the procedure,
the client should be placed in which position?
A. High-Fowler's.
B. Prone with legs flexed.
C. Flat supine for several hours.
D. Trendelenburg.
CORRECT ANSWER: C. Flat supine for several hours.
Rationale: Keeping the client flat (supine) for 4 to 6 hours after a lumbar puncture helps
prevent a post-dural puncture headache (spinal headache) .
Question 11: A client is 4 hours post-operative following a thyroidectomy. The
client reports tingling around the mouth and fingertips. Which lab value is
most likely affected?
A. Sodium.
B. Potassium.
C. Calcium.
D. Glucose.
CORRECT ANSWER: C. Calcium.
Rationale: Tingling (paresthesia) around the mouth and digits is a sign of hypocalcemia,
often caused by accidental damage to the parathyroid glands during thyroid surgery .
Question 12: A client has an order for a 24-hour urine collection. Which action
by the PN is correct?
A. Ask the client to void at the start time, discard that specimen, and note the time.
B. Collect all urine in a sterile specimen container.
C. Keep the urine container in the bedside stand.
D. Save the first voided specimen and discard the rest.
CORRECT ANSWER: A. Ask the client to void at the start time, discard that
specimen, and note the time.
Nursing Comprehensive Predictor Proctored Exam Study
Guide & NCLEX-PN Readiness Review | ATI PN
Comprehensive Predictor Practice Questions, Answers &
Detailed Rationales | ATI Practical Nursing Content Mastery
Series Comprehensive Review, Adult Medical-Surgical
Nursing, Fundamentals, Pharmacology, Maternal-Newborn,
Pediatrics, Mental Health, Community Health, Nursing Care,
Patient Safety, Infection Control, Medication Administration,
Dosage Calculations, Prioritization, Delegation, Health
Promotion, Risk Reduction, Clinical Judgment, Physiological
Integrity, Psychosocial Integrity & NGN-Style Case-Based
Practice
Question 1: A PN is caring for four clients. Which client should the PN assess
FIRST?
A. A client with diabetes requesting pain medication for neuropathy.
B. A client with COPD who has a new onset of confusion and BP 88/50.
C. A client post-op day 2 requesting help to the bathroom.
D. A client with a fractured tibia asking for a PRN snack.
CORRECT ANSWER: B. A client with COPD who has a new onset of confusion
and BP 88/50.
Rationale: New-onset confusion combined with hypotension indicates a change in
neurological status and hemodynamic instability, which suggests shock (sepsis,
hemorrhage, or dehydration). Unstable clients always take priority over those with stable
or expected findings .
Question 2: A nurse is caring for a client with chronic heart failure who reports
increased shortness of breath and swelling in the ankles. Which intervention
should the nurse prioritize?
A. Encourage increased fluid intake.
B. Administer prescribed diuretic.
C. Provide a high-sodium snack.
D. Increase the room temperature.
CORRECT ANSWER: B. Administer prescribed diuretic.
Rationale: The symptoms indicate fluid overload. Administering a diuretic (e.g.,
furosemide) directly addresses the cause by reducing preload and pulmonary
congestion .
,Question 3: A client is admitted with a suspected stroke. Which action should
the nurse perform first?
A. Obtain a detailed neurological history.
B. Check the client's blood glucose level.
C. Prepare the client for a CT scan.
D. Administer aspirin 325 mg PO.
CORRECT ANSWER: B. Check the client's blood glucose level.
Rationale: Hypoglycemia can mimic stroke symptoms (slurred speech, weakness,
confusion). The nurse must quickly rule out low blood sugar before proceeding with a
stroke workup .
Question 4: A client with a new tracheostomy has thick, dry secretions and
difficulty breathing. What is the priority action?
A. Call respiratory therapy.
B. Change the inner cannula.
C. Instill normal saline and suction.
D. Increase oxygen flow rate.
CORRECT ANSWER: C. Instill normal saline and suction.
Rationale: The priority is always Airway (ABCs). Thick secretions are physically blocking
the airway. Immediate suctioning is required to clear the obstruction. Instilling saline
helps loosen the mucus for removal .
Question 5: A client is prescribed spironolactone. Which laboratory finding
should be reported immediately?
A. Sodium 135 mEq/L.
B. Potassium 5.8 mEq/L.
C. BUN 18 mg/dL.
D. Creatinine 0.9 mg/dL.
CORRECT ANSWER: B. Potassium 5.8 mEq/L.
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.8 is
above the normal range (3.5-5.0) and indicates hyperkalemia, which can cause life-
threatening cardiac dysrhythmias .
Question 6: A charge nurse is assigning staff for the shift. Which client should
be assigned to an RN rather than a PN?
A. A client with stable CHF receiving daily Lasix.
,B. A client requiring a blood transfusion for symptomatic anemia.
C. A client with a new diagnosis of diabetes needing insulin instruction.
D. A client with a PEG tube requiring intermittent feedings.
CORRECT ANSWER: C. A client with a new diagnosis of diabetes needing
insulin instruction.
Rationale: Client education (specifically initial instruction) falls under the scope of the
RN, as it requires complex assessment and evaluation of learning. PNs can reinforce
teaching but cannot perform initial patient teaching .
Question 7: A client with deep vein thrombosis (DVT) is on heparin. Which
finding suggests a complication?
A. Bruising at the IV site.
B. New chest pain and shortness of breath.
C. Hemoglobin 12 g/dL.
D. Mild headache.
CORRECT ANSWER: B. New chest pain and shortness of breath.
Rationale: New chest pain and dyspnea in a patient with DVT suggests a pulmonary
embolism (PE), where the clot has traveled to the lungs. This is a life-threatening
medical emergency .
Question 8: A client with acute pancreatitis. Which laboratory value is most
important for the nurse to monitor?
A. Potassium.
B. Amylase.
C. Glucose.
D. Hemoglobin.
CORRECT ANSWER: C. Glucose.
Rationale: While amylase is diagnostic for pancreatitis, glucose is critical to monitor
because the pancreas produces insulin. Pancreatitis can destroy insulin-producing cells,
leading to dangerous hyperglycemia .
Question 9: A postpartum client saturates a peripad in 15 minutes. Priority
action?
A. Fundal massage and notify provider.
B. Document the finding and reassess in 1 hour.
C. Ambulate the client to the bathroom.
, D. Administer a PRN analgesic.
CORRECT ANSWER: A. Fundal massage and notify provider.
Rationale: Saturating a peripad in 15 minutes indicates postpartum hemorrhage. The
priority is to massage the fundus to promote uterine contraction and notify the provider
immediately .
Question 10: A nurse is assisting with a lumbar puncture. After the procedure,
the client should be placed in which position?
A. High-Fowler's.
B. Prone with legs flexed.
C. Flat supine for several hours.
D. Trendelenburg.
CORRECT ANSWER: C. Flat supine for several hours.
Rationale: Keeping the client flat (supine) for 4 to 6 hours after a lumbar puncture helps
prevent a post-dural puncture headache (spinal headache) .
Question 11: A client is 4 hours post-operative following a thyroidectomy. The
client reports tingling around the mouth and fingertips. Which lab value is
most likely affected?
A. Sodium.
B. Potassium.
C. Calcium.
D. Glucose.
CORRECT ANSWER: C. Calcium.
Rationale: Tingling (paresthesia) around the mouth and digits is a sign of hypocalcemia,
often caused by accidental damage to the parathyroid glands during thyroid surgery .
Question 12: A client has an order for a 24-hour urine collection. Which action
by the PN is correct?
A. Ask the client to void at the start time, discard that specimen, and note the time.
B. Collect all urine in a sterile specimen container.
C. Keep the urine container in the bedside stand.
D. Save the first voided specimen and discard the rest.
CORRECT ANSWER: A. Ask the client to void at the start time, discard that
specimen, and note the time.
