ATI PN CMS COMPREHENSIVE PREDICTOR
2026 MASTER REVIEW WITH NGN
SCREENSHOTS — COMPLETE PN
QUESTIONS, ANSWERS AND RATIONALES
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
• Management of Care and Prioritization
• Safety and Infection Control
• Pharmacological and Parenteral Therapies
• Physiological Adaptation and Medical-Surgical Nursing
• Reduction of Risk Potential
• Health Promotion and Maintenance
• Psychosocial Integrity
• Maternal-Newborn and Pediatric Nursing
• Clinical Judgment and NGN Case Studies
Introduction
The ATI PN Comprehensive Predictor 2026 is designed to assess a practical
nursing student’s readiness for the NCLEX-PN and entry into professional
practice. This comprehensive proctored assessment evaluates accumulated
knowledge across the practical nursing curriculum, emphasizing safe,
effective client care and clinical judgment. The exam utilizes multiple-choice
and Next Generation NCLEX (NGN) style case scenarios, including unfolding
,case studies and bow-tie questions, requiring the application of the Clinical
Judgment Measurement Model. It challenges candidates to prioritize actions,
delegate appropriately, and make sound clinical decisions based on evidence-
based practice. This master review tool measures the ability to integrate
foundational theory with real-world professional decision-making to achieve
Level 3 performance.
Section One: Questions 1–180
1. A charge nurse is assigning staff for the shift. Which client should be
assigned to an RN rather than a PN (LPN)?
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
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. Task (B) involves hanging blood, which requires RN monitoring.
Tasks (A) and (D) are stable and within PN scope.
2. A PN is caring for four clients. Which client should the PN assess
FIRST?
A. Post-op day 2 client requesting pain medication for 4/10 pain
B. Client with COPD with a new onset of confusion and BP 88/50
C. Client with diabetes requesting a PRN snack due to hunger
D. Client with a fractured tibia asking for help to the bathroom
RATIONALE: New onset confusion combined with hypotension is a
classic sign of shock (sepsis, hemorrhage, or dehydration). This represents a
change in neurological status and hemodynamic instability, which is the
priority.
,3. 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
RATIONALE: The symptoms indicate fluid overload. Administering a
diuretic (e.g., furosemide) directly addresses the cause by reducing preload
and pulmonary congestion.
4. A client is admitted with suspected stroke. Which action should the
nurse perform first?
A. Obtain a detailed neurological history
B. Check blood glucose level
C. Prepare for CT scan
D. Administer aspirin
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.
5. 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
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.
, 6. A postpartum client saturates a peripad in 15 minutes. Priority
action?
A. Fundal massage and notify provider
B. Reassure the client that this is normal
C. Document the finding and continue to monitor
D. Encourage the client to ambulate
RATIONALE: Saturating a peripad in 15 minutes indicates postpartum
hemorrhage. Fundal massage is the first intervention to stimulate uterine
contraction, followed by provider notification.
7. A client with 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
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.
8. A client is prescribed spironolactone. Which lab finding requires
immediate intervention?
A. Sodium 135 mEq/L
B. Potassium 5.8 mEq/L
C. BUN 18 mg/dL
D. Creatinine 0.9 mg/dL
RATIONALE: Spironolactone is a potassium-sparing diuretic. A
potassium level of 5.8 is above the normal range (3.5-5.0) and puts the client
at risk for fatal cardiac dysrhythmias.
2026 MASTER REVIEW WITH NGN
SCREENSHOTS — COMPLETE PN
QUESTIONS, ANSWERS AND RATIONALES
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
• Management of Care and Prioritization
• Safety and Infection Control
• Pharmacological and Parenteral Therapies
• Physiological Adaptation and Medical-Surgical Nursing
• Reduction of Risk Potential
• Health Promotion and Maintenance
• Psychosocial Integrity
• Maternal-Newborn and Pediatric Nursing
• Clinical Judgment and NGN Case Studies
Introduction
The ATI PN Comprehensive Predictor 2026 is designed to assess a practical
nursing student’s readiness for the NCLEX-PN and entry into professional
practice. This comprehensive proctored assessment evaluates accumulated
knowledge across the practical nursing curriculum, emphasizing safe,
effective client care and clinical judgment. The exam utilizes multiple-choice
and Next Generation NCLEX (NGN) style case scenarios, including unfolding
,case studies and bow-tie questions, requiring the application of the Clinical
Judgment Measurement Model. It challenges candidates to prioritize actions,
delegate appropriately, and make sound clinical decisions based on evidence-
based practice. This master review tool measures the ability to integrate
foundational theory with real-world professional decision-making to achieve
Level 3 performance.
Section One: Questions 1–180
1. A charge nurse is assigning staff for the shift. Which client should be
assigned to an RN rather than a PN (LPN)?
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
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. Task (B) involves hanging blood, which requires RN monitoring.
Tasks (A) and (D) are stable and within PN scope.
2. A PN is caring for four clients. Which client should the PN assess
FIRST?
A. Post-op day 2 client requesting pain medication for 4/10 pain
B. Client with COPD with a new onset of confusion and BP 88/50
C. Client with diabetes requesting a PRN snack due to hunger
D. Client with a fractured tibia asking for help to the bathroom
RATIONALE: New onset confusion combined with hypotension is a
classic sign of shock (sepsis, hemorrhage, or dehydration). This represents a
change in neurological status and hemodynamic instability, which is the
priority.
,3. 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
RATIONALE: The symptoms indicate fluid overload. Administering a
diuretic (e.g., furosemide) directly addresses the cause by reducing preload
and pulmonary congestion.
4. A client is admitted with suspected stroke. Which action should the
nurse perform first?
A. Obtain a detailed neurological history
B. Check blood glucose level
C. Prepare for CT scan
D. Administer aspirin
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.
5. 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
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.
, 6. A postpartum client saturates a peripad in 15 minutes. Priority
action?
A. Fundal massage and notify provider
B. Reassure the client that this is normal
C. Document the finding and continue to monitor
D. Encourage the client to ambulate
RATIONALE: Saturating a peripad in 15 minutes indicates postpartum
hemorrhage. Fundal massage is the first intervention to stimulate uterine
contraction, followed by provider notification.
7. A client with 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
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.
8. A client is prescribed spironolactone. Which lab finding requires
immediate intervention?
A. Sodium 135 mEq/L
B. Potassium 5.8 mEq/L
C. BUN 18 mg/dL
D. Creatinine 0.9 mg/dL
RATIONALE: Spironolactone is a potassium-sparing diuretic. A
potassium level of 5.8 is above the normal range (3.5-5.0) and puts the client
at risk for fatal cardiac dysrhythmias.
