Legit PN ATI
Comprehensive Predictor
Exit 2026 Package- 4
Versions
1. A PN is caring for four clients at the start of the shift. Which client should be
assessed FIRST?
A) Client with diabetes requesting pain medication for neuropathy
B) Client with COPD who has a new cough producing green sputum
C) Client post-op day 1 with new-onset confusion and BP 88/50
D) Client with a fractured tibia requesting help to the bathroom
Correct Answer: C
Rationale: New-onset confusion accompanied by hypotension suggests possible
sepsis, hemorrhage, or shock—an unstable priority. Airway and circulation
precede stable complaints .
2. A charge nurse is assigning staff for the shift. Which client should be assigned
to an RN rather than a PN?
A) Client with stable CHF receiving daily Lasix
B) Client requiring a blood transfusion for symptomatic anemia
C) Client with a new diagnosis of diabetes needing insulin instruction
D) Client with a PEG tube requiring intermittent feedings
Correct Answer: C
Rationale: Initial 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 .
3. A PN is delegating tasks to assistive personnel (AP). Which task is appropriate
to delegate?
A) Assessing a client's capillary refill
,B) Teaching a client how to keep a cast dry
C) Assisting a client with ambulation to the bathroom
D) Evaluating a client's pain level
Correct Answer: C
Rationale: Assisting with ambulation is a standard, stable task that falls within the
scope of AP practice. The PN cannot delegate assessment, evaluation, or teaching
as these require professional nursing judgment .
4. A client is placed on airborne precautions for active tuberculosis. Which
action is required?
A) Place the client in a room with positive pressure
B) Wear a surgical mask when entering the room
C) Place the client in a negative pressure room
D) Keep the door open for ventilation
Correct Answer: C
Rationale: TB is an airborne pathogen spread via droplet nuclei that remain
suspended in the air. Airborne precautions require a negative pressure room and
the use of an N95 respirator by healthcare providers .
5. A client with dementia has a physician's order for bilateral soft wrist
restraints. Which action is correct?
A) Secure the restraint ties to the side rails
B) Apply the restraint snugly against the skin
C) Obtain a written prescription for the restraint application
D) Observe the client every 60 minutes after application
Correct Answer: C
Rationale: Restraints require a physician's written order, specifying the duration
and reason. Ties must never be secured to the side rails (A) because they can
cause injury if the rails are lowered. The restraint should allow for two fingers of
width (B) to prevent circulation impairment. Observations must be made every 15
to 30 minutes (D), not hourly .
6. A client is postoperative day 1 following a total knee replacement. The client
reports pain of 7/10 and is due for hydromorphone 2 mg IV PRN. What is the
PN's priority action?
A) Administer the prescribed hydromorphone immediately
,B) Apply ice to the surgical site and elevate the leg
C) Encourage the client to use relaxation techniques
D) Notify the RN regarding the medication request
Correct Answer: A
Rationale: The client has a valid prescription for pain medication, is due for the
dose (over 4 hours since last dose), and is reporting significant pain. Administering
the medication is the priority intervention to relieve pain. Ice and elevation (B)
are adjunctive but not the primary priority .
7. A PN is preparing to insert an indwelling urinary catheter for a female client.
Which action is most important to prevent infection?
A) Using sterile technique throughout the procedure
B) Inflating the balloon with 30 mL of sterile water
C) Applying lubricant to the first 2 inches of the catheter
D) Securing the catheter to the client's thigh
Correct Answer: A
Rationale: Strict sterile technique during insertion is the most important
intervention to prevent a catheter-associated urinary tract infection (CAUTI). The
balloon should be inflated with the amount specified by the manufacturer
(usually 10 mL), not 30 mL. Lubricant should be applied to the first 5–7 inches for
a female .
8. A client is prescribed a clear liquid diet. Which item is appropriate to include?
A) Orange juice with pulp
B) Skim milk
C) Chicken broth
D) Cream of wheat
Correct Answer: C
Rationale: A clear liquid diet includes transparent liquids that leave minimal
residue: water, broth, clear juices (apple, cranberry, grape), gelatin, and popsicles.
Orange juice contains pulp, milk and cream of wheat are not clear liquids .
9. A PN is reinforcing teaching about fire safety. Which action should the PN
instruct clients to take first in the event of a fire?
A) Confine the fire by closing doors
B) Rescue anyone in immediate danger
, C) Extinguish the fire using a fire extinguisher
D) Activate the fire alarm
Correct Answer: B
Rationale: The mnemonic RACE guides fire response: Rescue anyone in
immediate danger, Alarm (activate the fire alarm), Confine the fire by closing
doors and windows, and Extinguish if possible using a fire extinguisher. Rescue is
always the first priority .
10. A PN is caring for a client who is 2 hours post-appendectomy and reports
pain of 8 on a 0–10 scale. Which action should the PN take first?
A) Administer prescribed PRN analgesic
B) Reposition the client for comfort
C) Assess the client's vital signs and surgical site
D) Apply a warm compress to the incision
Correct Answer: C
Rationale: The nurse must first assess the client to ensure the pain is not a sign of
a complication (such as bleeding or infection) before administering medication .
11. A nurse is caring for a client who is receiving digoxin for heart failure. Which
laboratory result increases the risk for digoxin toxicity?
A) Calcium 9.5 mg/dL
B) Magnesium 2.0 mEq/L
C) Sodium 138 mEq/L
D) Potassium 3.2 mEq/L
Correct Answer: D
Rationale: Hypokalemia (potassium level below 3.5 mEq/L) increases the risk of
digoxin toxicity because low potassium levels enhance the effects of digoxin on
the heart .
12. A nurse is reviewing the plan of care for a client who has a prescription for
soft wrist restraints. Which action should the nurse include in the plan?
A) Tie the restraints to the side rails of the bed
B) Renew the prescription every 48 hours
C) Ensure the restraint is tight enough to prevent one finger from fitting
underneath
D) Remove the restraints every 2 hours to assess skin integrity
Comprehensive Predictor
Exit 2026 Package- 4
Versions
1. A PN is caring for four clients at the start of the shift. Which client should be
assessed FIRST?
A) Client with diabetes requesting pain medication for neuropathy
B) Client with COPD who has a new cough producing green sputum
C) Client post-op day 1 with new-onset confusion and BP 88/50
D) Client with a fractured tibia requesting help to the bathroom
Correct Answer: C
Rationale: New-onset confusion accompanied by hypotension suggests possible
sepsis, hemorrhage, or shock—an unstable priority. Airway and circulation
precede stable complaints .
2. A charge nurse is assigning staff for the shift. Which client should be assigned
to an RN rather than a PN?
A) Client with stable CHF receiving daily Lasix
B) Client requiring a blood transfusion for symptomatic anemia
C) Client with a new diagnosis of diabetes needing insulin instruction
D) Client with a PEG tube requiring intermittent feedings
Correct Answer: C
Rationale: Initial 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 .
3. A PN is delegating tasks to assistive personnel (AP). Which task is appropriate
to delegate?
A) Assessing a client's capillary refill
,B) Teaching a client how to keep a cast dry
C) Assisting a client with ambulation to the bathroom
D) Evaluating a client's pain level
Correct Answer: C
Rationale: Assisting with ambulation is a standard, stable task that falls within the
scope of AP practice. The PN cannot delegate assessment, evaluation, or teaching
as these require professional nursing judgment .
4. A client is placed on airborne precautions for active tuberculosis. Which
action is required?
A) Place the client in a room with positive pressure
B) Wear a surgical mask when entering the room
C) Place the client in a negative pressure room
D) Keep the door open for ventilation
Correct Answer: C
Rationale: TB is an airborne pathogen spread via droplet nuclei that remain
suspended in the air. Airborne precautions require a negative pressure room and
the use of an N95 respirator by healthcare providers .
5. A client with dementia has a physician's order for bilateral soft wrist
restraints. Which action is correct?
A) Secure the restraint ties to the side rails
B) Apply the restraint snugly against the skin
C) Obtain a written prescription for the restraint application
D) Observe the client every 60 minutes after application
Correct Answer: C
Rationale: Restraints require a physician's written order, specifying the duration
and reason. Ties must never be secured to the side rails (A) because they can
cause injury if the rails are lowered. The restraint should allow for two fingers of
width (B) to prevent circulation impairment. Observations must be made every 15
to 30 minutes (D), not hourly .
6. A client is postoperative day 1 following a total knee replacement. The client
reports pain of 7/10 and is due for hydromorphone 2 mg IV PRN. What is the
PN's priority action?
A) Administer the prescribed hydromorphone immediately
,B) Apply ice to the surgical site and elevate the leg
C) Encourage the client to use relaxation techniques
D) Notify the RN regarding the medication request
Correct Answer: A
Rationale: The client has a valid prescription for pain medication, is due for the
dose (over 4 hours since last dose), and is reporting significant pain. Administering
the medication is the priority intervention to relieve pain. Ice and elevation (B)
are adjunctive but not the primary priority .
7. A PN is preparing to insert an indwelling urinary catheter for a female client.
Which action is most important to prevent infection?
A) Using sterile technique throughout the procedure
B) Inflating the balloon with 30 mL of sterile water
C) Applying lubricant to the first 2 inches of the catheter
D) Securing the catheter to the client's thigh
Correct Answer: A
Rationale: Strict sterile technique during insertion is the most important
intervention to prevent a catheter-associated urinary tract infection (CAUTI). The
balloon should be inflated with the amount specified by the manufacturer
(usually 10 mL), not 30 mL. Lubricant should be applied to the first 5–7 inches for
a female .
8. A client is prescribed a clear liquid diet. Which item is appropriate to include?
A) Orange juice with pulp
B) Skim milk
C) Chicken broth
D) Cream of wheat
Correct Answer: C
Rationale: A clear liquid diet includes transparent liquids that leave minimal
residue: water, broth, clear juices (apple, cranberry, grape), gelatin, and popsicles.
Orange juice contains pulp, milk and cream of wheat are not clear liquids .
9. A PN is reinforcing teaching about fire safety. Which action should the PN
instruct clients to take first in the event of a fire?
A) Confine the fire by closing doors
B) Rescue anyone in immediate danger
, C) Extinguish the fire using a fire extinguisher
D) Activate the fire alarm
Correct Answer: B
Rationale: The mnemonic RACE guides fire response: Rescue anyone in
immediate danger, Alarm (activate the fire alarm), Confine the fire by closing
doors and windows, and Extinguish if possible using a fire extinguisher. Rescue is
always the first priority .
10. A PN is caring for a client who is 2 hours post-appendectomy and reports
pain of 8 on a 0–10 scale. Which action should the PN take first?
A) Administer prescribed PRN analgesic
B) Reposition the client for comfort
C) Assess the client's vital signs and surgical site
D) Apply a warm compress to the incision
Correct Answer: C
Rationale: The nurse must first assess the client to ensure the pain is not a sign of
a complication (such as bleeding or infection) before administering medication .
11. A nurse is caring for a client who is receiving digoxin for heart failure. Which
laboratory result increases the risk for digoxin toxicity?
A) Calcium 9.5 mg/dL
B) Magnesium 2.0 mEq/L
C) Sodium 138 mEq/L
D) Potassium 3.2 mEq/L
Correct Answer: D
Rationale: Hypokalemia (potassium level below 3.5 mEq/L) increases the risk of
digoxin toxicity because low potassium levels enhance the effects of digoxin on
the heart .
12. A nurse is reviewing the plan of care for a client who has a prescription for
soft wrist restraints. Which action should the nurse include in the plan?
A) Tie the restraints to the side rails of the bed
B) Renew the prescription every 48 hours
C) Ensure the restraint is tight enough to prevent one finger from fitting
underneath
D) Remove the restraints every 2 hours to assess skin integrity
