GALEN COLLEGE OF NURSING
NSG 4800: TRANSITION TO PROFESSIONAL NURSING PRACTICE
ATI RN COMPREHENSIVE PREDICTOR PROCTORED ASSESSMENT EXAM
FALL 2026 FINAL ASSESSMENT — 150 PROCTORED MULTIPLE CHOICE QUESTIONS
Course: NSG 4800 Transition to
Professional Nursing Format: Multiple Choice (A, B, C, D)
Time Allowed: 180 Minutes Assessment: ATI Comprehensive Scoring: 1 Point / Question (Complete
Total Items: 150 Questions Predictor (Fall 2026) Key & Rationales)
Question 1. A nurse is caring for an adult client who refuses a scheduled intramuscular injection.
The nurse grabs the client's arm and forcibly administers the medication without consent. Which
of the following legal torts has the nurse committed?
A. Slander
B. Negligence
C. Assault
✔ D. Battery
Rationale: Battery is defined as non-consensual physical contact or 'hands-on' assault. Assault is the verbal threat of
physical harm that puts the client in fear. Negligence is failing to implement safety measures, while slander is verbal
defamation.
Question 2. A charge nurse on a medical-surgical unit is delegating tasks to an Assistive
Unlicensed Personnel (UAP). Which of the following tasks is appropriate to delegate to the UAP?
✔ A. Measuring routine intake and output and obtaining recheck vital signs on a stable client
B. Administering subcutaneous insulin to a client with diabetes
C. Performing the initial physical assessment upon admission
D. Reinforcing discharge teaching on a client with a newly placed colostomy
Rationale: UAPs may perform routine non-invasive tasks on stable clients, such as measuring I&O, obtaining routine or
recheck vital signs, hygiene, positioning, and specimen collection. Initial assessments, client teaching, and medication
administration cannot be delegated to UAPs.
Question 3. An RN is assigning tasks to a Licensed Practical Nurse (LPN/LVN). Which of the
following clients should be assigned to the LPN?
✔ A. A stable client requiring reinforcement of dressing change education and routine catheter care
B. A newly admitted client requiring initial health history collection and care plan formulation
C. A client receiving their first bag of intravenous blood product transfusion
D. An unstable client experiencing acute respiratory distress secondary to pneumonia
Rationale: LPNs/LVNs care for stable clients, reinforce previously initiated teaching, perform routine procedures (dressing
changes, urinary catheter care), and administer oral, SubQ, IM, and select piggyback medications. RNs must handle initial
assessments, initial teaching, blood product initial verification/transfusion, and unstable clients.
NSG 4800 TRANSITION TO PROFESSIONAL NURSING PRACTICE — ATI PROCTORED ASSESSMENT — Page 1 of 38
,GALEN COLLEGE OF NURSING | NSG 4800 ATI COMPREHENSIVE PREDICTOR (FALL 2026) Page 2 of 38
Question 4. A client who is alert and oriented x4 decides to leave the hospital against medical
advice (AMA). Which of the following actions should the nurse take first?
A. Administer a sedative to keep the client calm and cooperative
B. Place physical restraints on the client until the provider arrives
✔ C. Inform the client of the specific risks of leaving and request that they sign an AMA form
D. Call security to physically prevent the client from leaving the building
Rationale: An alert and oriented client has the right to refuse treatment and leave AMA. The nurse must educate the
client on the risks of leaving without treatment and request they sign an AMA form. Preventing a competent client from
leaving constitutes false imprisonment or battery.
Question 5. A nurse is completing an incident report after finding a client on the floor in their
room. Which of the following guidelines must the nurse follow regarding proper documentation?
A. Chart in the nursing notes that an incident report was submitted to the risk management department
B. Record assumptions in the incident report about what caused the client to fall
C. File a copy of the completed incident report directly into the client's permanent medical chart
✔ D. Document objective assessment findings and client condition in the medical record, but make no
reference to the incident report in the EMAR or chart
Rationale: Incident reports are confidential risk-management documents. The nurse must record factual, objective
observations and client assessment findings in the medical record, but must NEVER reference or place the incident report
in the client's medical chart/EMAR to avoid legal self-incrimination.
Question 6. A nurse is triaging victims following a mass casualty disaster event. Which of the
following clients should be assigned a RED triage tag (Emergent)?
A. A client with a closed ankle sprain and minor skin contusions
B. A client with an open leg fracture who has a clear distal pulse and stable vitals
✔ C. A client with a sucking chest wound and acute STEMI experiencing severe chest pain
D. An unresponsive client with fixed, dilated pupils and no palpable pulse
Rationale: RED tags (Emergent) are assigned to life-threatening injuries requiring immediate intervention with high
survival chance (e.g., sucking chest wound, STEMI, severe respiratory distress). Yellow is Urgent (open fracture with
pulse), Green is Nonurgent (closed fracture/sprain), and Black is Deceased/Expectant.
Question 7. During a mass casualty incident, the nurse must identify clients eligible for immediate
discharge to free up hospital beds. Which client is the best candidate for discharge?
A. A client 1 day postoperative from a hip replacement with a hemoglobin of 6.2 g/dL
B. A client who underwent an endoscopic retrograde cholangiopancreatography (ERCP) 1 hour ago and has
trouble swallowing
✔ C. A client with ulcerative colitis who is taking prednisone and having 3 to 4 loose stools daily
D. A client experiencing an acute exacerbation of severe asthma with silent chest sounds
Rationale: Clients who are non-emergent, medically stable, and able to manage care at home (such as a UC client on oral
prednisone with 3-4 stools daily) can be safely discharged during a disaster emergency to clear beds.
NSG 4800 TRANSITION TO PROFESSIONAL NURSING PRACTICE — ATI PROCTORED ASSESSMENT — Page 2 of 38
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Question 8. A nurse is providing discharge instruction to the parent of a school-age child
diagnosed with head lice (pediculosis capitis). Which instruction should the nurse include?
✔ A. Seal non-washable personal items in dark plastic bags for 14 days and boil hairbrushes in
medicated solution for 10 minutes
B. Administer a single application of pediculicide and assume no repeat treatment is needed
C. Treat all household pets with pediculicide shampoo immediately
D. Wash all bedding in cold water and air dry on a line outside
Rationale: Lice items that cannot be laundered in hot water should be sealed in airtight plastic bags for 14 days to kill
hatching nits. Brushes/combs should be soaked in boiling water or pediculicide for 10 minutes. Household pets do not
carry human lice and do not need treatment. Repeat treatment is typically done 7 days later.
Question 9. A nurse is preparing to care for a client admitted with active pulmonary tuberculosis
(TB). Which of the following isolation precautions and PPE are required?
A. Droplet precautions with a private room and standard surgical mask
✔ B. Airborne precautions with a negative-pressure room and N95 respirator mask
C. Contact precautions with gown and gloves only
D. Protective environment with positive-pressure airflow
Rationale: Airborne precautions (MTV: Measles, TB, Varicella/Shingles) require a negative-pressure private room and an
N95 respirator for healthcare personnel. Surgical masks are placed on the client only when transported.
Question 10. A nurse is instructing a student nurse on the correct sequence for doffing
(removing) Personal Protective Equipment (PPE). Which sequence is correct?
A. Goggles, Gloves, Mask, Gown
B. Mask, Gown, Goggles, Gloves
✔ C. Gloves, Goggles/Face Shield, Gown, Mask
D. Gown, Mask, Gloves, Goggles
Rationale: The correct sequence for doffing PPE follows alphabetical order: Gloves first (most contaminated), followed by
Goggles/Face Shield, Gown, and Mask last (removed outside or at doorway).
Question 11. A nurse is caring for a client receiving external beam radiation therapy for lung
cancer. Which client statement indicates a need for FURTHER teaching?
A. I will avoid direct sunlight exposure to the treated skin for at least one year
✔ B. I will scrub the radiation site daily using a washcloth and antibacterial soap
C. I will wash the irradiated area gently with my hands using warm water and mild soap
D. I will take care not to rub or wash off the ink markings on my skin
Rationale: External radiation skin care requires gentle washing with warm water and mild soap using hands only (NO
washcloths or harsh rubbing). Ink markings must remain intact, and skin must be protected from direct sun for 1 year.
Antibacterial soap and washcloths cause severe skin breakdown.
NSG 4800 TRANSITION TO PROFESSIONAL NURSING PRACTICE — ATI PROCTORED ASSESSMENT — Page 3 of 38
, GALEN COLLEGE OF NURSING | NSG 4800 ATI COMPREHENSIVE PREDICTOR (FALL 2026) Page 4 of 38
Question 12. A client is receiving internal radiation therapy (brachytherapy) via a sealed radiation
implant. Which of the following nursing actions is appropriate?
A. Pick up a dislodged radiation seed with gloved hands and place it in the trash
B. Allow pregnant family members to visit for up to 1 hour per day if wearing a mask
✔ C. Wear a lead apron/shield and a dosimeter film badge throughout the shift, and limit visitor time
to 30 minutes daily at a 6-foot distance
D. Keep all dedicated diagnostic equipment inside the room permanently after the implant is removed
Rationale: Sealed radiation precautions include wearing a lead apron/shield and dosimeter badge, rotating staff,
prohibiting pregnant nurses/visitors and children <16, and limiting visitors to 30 min/day staying 6 feet away. Dislodged
seeds must be handled with long-handled metal tongs into a lead container.
Question 13. A nurse calculates the total burned body surface area (TBSA) for an adult client who
sustained deep partial-thickness burns to the entire right leg, entire left leg, and entire rear
torso. According to the Rule of Nines, what is the calculated TBSA?
✔ A. 54%
B. 63%
C. 36%
D. 45%
Rationale: According to the Rule of Nines: Entire right leg = 18%, Entire left leg = 18%, Entire rear torso (back) = 18%.
Total = 18 + 18 + 18 = 54% TBSA.
Question 14. A client weighing 70 kg has deep partial-thickness burns covering 50% TBSA. Using
the Parkland Formula (4 mL x kg x %TBSA), calculate the total fluid volume required in the first 24
hours, and state how much is infused in the first 8 hours.
A. 28,000 mL total; 14,000 mL infused in the first 8 hours
B. 7,000 mL total; 3,500 mL infused in the first 8 hours
C. 14,000 mL total; 3,500 mL infused in the first 8 hours
✔ D. 14,000 mL total; 7,000 mL infused in the first 8 hours
Rationale: Parkland Formula = 4 mL x 70 kg x 50% = 14,000 mL total IV fluid (Lactated Ringer's) in 24 hours. The first
half (7,000 mL) must be administered in the first 8 hours post-burn injury.
Question 15. A nurse is caring for a client with severe full-thickness burns covering 45% of the
body. Which assessment finding is the most sensitive non-invasive indicator of adequate cardiac
output and tissue perfusion?
A. Serum potassium level of 4.8 mEq/L
B. Baseline body temperature of 98.6°F
C. Systolic blood pressure of 110 mmHg
✔ D. Urinary output of 30 to 50 mL/hr
Rationale: Urinary output is the most reliable and sensitive non-invasive parameter for assessing cardiac output and
tissue perfusion during burn fluid resuscitation. Normal is 30-50 mL/hr. Output <30 mL/hr (or <45 mL over 2 hours)
indicates inadequate resuscitation.
NSG 4800 TRANSITION TO PROFESSIONAL NURSING PRACTICE — ATI PROCTORED ASSESSMENT — Page 4 of 38
NSG 4800: TRANSITION TO PROFESSIONAL NURSING PRACTICE
ATI RN COMPREHENSIVE PREDICTOR PROCTORED ASSESSMENT EXAM
FALL 2026 FINAL ASSESSMENT — 150 PROCTORED MULTIPLE CHOICE QUESTIONS
Course: NSG 4800 Transition to
Professional Nursing Format: Multiple Choice (A, B, C, D)
Time Allowed: 180 Minutes Assessment: ATI Comprehensive Scoring: 1 Point / Question (Complete
Total Items: 150 Questions Predictor (Fall 2026) Key & Rationales)
Question 1. A nurse is caring for an adult client who refuses a scheduled intramuscular injection.
The nurse grabs the client's arm and forcibly administers the medication without consent. Which
of the following legal torts has the nurse committed?
A. Slander
B. Negligence
C. Assault
✔ D. Battery
Rationale: Battery is defined as non-consensual physical contact or 'hands-on' assault. Assault is the verbal threat of
physical harm that puts the client in fear. Negligence is failing to implement safety measures, while slander is verbal
defamation.
Question 2. A charge nurse on a medical-surgical unit is delegating tasks to an Assistive
Unlicensed Personnel (UAP). Which of the following tasks is appropriate to delegate to the UAP?
✔ A. Measuring routine intake and output and obtaining recheck vital signs on a stable client
B. Administering subcutaneous insulin to a client with diabetes
C. Performing the initial physical assessment upon admission
D. Reinforcing discharge teaching on a client with a newly placed colostomy
Rationale: UAPs may perform routine non-invasive tasks on stable clients, such as measuring I&O, obtaining routine or
recheck vital signs, hygiene, positioning, and specimen collection. Initial assessments, client teaching, and medication
administration cannot be delegated to UAPs.
Question 3. An RN is assigning tasks to a Licensed Practical Nurse (LPN/LVN). Which of the
following clients should be assigned to the LPN?
✔ A. A stable client requiring reinforcement of dressing change education and routine catheter care
B. A newly admitted client requiring initial health history collection and care plan formulation
C. A client receiving their first bag of intravenous blood product transfusion
D. An unstable client experiencing acute respiratory distress secondary to pneumonia
Rationale: LPNs/LVNs care for stable clients, reinforce previously initiated teaching, perform routine procedures (dressing
changes, urinary catheter care), and administer oral, SubQ, IM, and select piggyback medications. RNs must handle initial
assessments, initial teaching, blood product initial verification/transfusion, and unstable clients.
NSG 4800 TRANSITION TO PROFESSIONAL NURSING PRACTICE — ATI PROCTORED ASSESSMENT — Page 1 of 38
,GALEN COLLEGE OF NURSING | NSG 4800 ATI COMPREHENSIVE PREDICTOR (FALL 2026) Page 2 of 38
Question 4. A client who is alert and oriented x4 decides to leave the hospital against medical
advice (AMA). Which of the following actions should the nurse take first?
A. Administer a sedative to keep the client calm and cooperative
B. Place physical restraints on the client until the provider arrives
✔ C. Inform the client of the specific risks of leaving and request that they sign an AMA form
D. Call security to physically prevent the client from leaving the building
Rationale: An alert and oriented client has the right to refuse treatment and leave AMA. The nurse must educate the
client on the risks of leaving without treatment and request they sign an AMA form. Preventing a competent client from
leaving constitutes false imprisonment or battery.
Question 5. A nurse is completing an incident report after finding a client on the floor in their
room. Which of the following guidelines must the nurse follow regarding proper documentation?
A. Chart in the nursing notes that an incident report was submitted to the risk management department
B. Record assumptions in the incident report about what caused the client to fall
C. File a copy of the completed incident report directly into the client's permanent medical chart
✔ D. Document objective assessment findings and client condition in the medical record, but make no
reference to the incident report in the EMAR or chart
Rationale: Incident reports are confidential risk-management documents. The nurse must record factual, objective
observations and client assessment findings in the medical record, but must NEVER reference or place the incident report
in the client's medical chart/EMAR to avoid legal self-incrimination.
Question 6. A nurse is triaging victims following a mass casualty disaster event. Which of the
following clients should be assigned a RED triage tag (Emergent)?
A. A client with a closed ankle sprain and minor skin contusions
B. A client with an open leg fracture who has a clear distal pulse and stable vitals
✔ C. A client with a sucking chest wound and acute STEMI experiencing severe chest pain
D. An unresponsive client with fixed, dilated pupils and no palpable pulse
Rationale: RED tags (Emergent) are assigned to life-threatening injuries requiring immediate intervention with high
survival chance (e.g., sucking chest wound, STEMI, severe respiratory distress). Yellow is Urgent (open fracture with
pulse), Green is Nonurgent (closed fracture/sprain), and Black is Deceased/Expectant.
Question 7. During a mass casualty incident, the nurse must identify clients eligible for immediate
discharge to free up hospital beds. Which client is the best candidate for discharge?
A. A client 1 day postoperative from a hip replacement with a hemoglobin of 6.2 g/dL
B. A client who underwent an endoscopic retrograde cholangiopancreatography (ERCP) 1 hour ago and has
trouble swallowing
✔ C. A client with ulcerative colitis who is taking prednisone and having 3 to 4 loose stools daily
D. A client experiencing an acute exacerbation of severe asthma with silent chest sounds
Rationale: Clients who are non-emergent, medically stable, and able to manage care at home (such as a UC client on oral
prednisone with 3-4 stools daily) can be safely discharged during a disaster emergency to clear beds.
NSG 4800 TRANSITION TO PROFESSIONAL NURSING PRACTICE — ATI PROCTORED ASSESSMENT — Page 2 of 38
,GALEN COLLEGE OF NURSING | NSG 4800 ATI COMPREHENSIVE PREDICTOR (FALL 2026) Page 3 of 38
Question 8. A nurse is providing discharge instruction to the parent of a school-age child
diagnosed with head lice (pediculosis capitis). Which instruction should the nurse include?
✔ A. Seal non-washable personal items in dark plastic bags for 14 days and boil hairbrushes in
medicated solution for 10 minutes
B. Administer a single application of pediculicide and assume no repeat treatment is needed
C. Treat all household pets with pediculicide shampoo immediately
D. Wash all bedding in cold water and air dry on a line outside
Rationale: Lice items that cannot be laundered in hot water should be sealed in airtight plastic bags for 14 days to kill
hatching nits. Brushes/combs should be soaked in boiling water or pediculicide for 10 minutes. Household pets do not
carry human lice and do not need treatment. Repeat treatment is typically done 7 days later.
Question 9. A nurse is preparing to care for a client admitted with active pulmonary tuberculosis
(TB). Which of the following isolation precautions and PPE are required?
A. Droplet precautions with a private room and standard surgical mask
✔ B. Airborne precautions with a negative-pressure room and N95 respirator mask
C. Contact precautions with gown and gloves only
D. Protective environment with positive-pressure airflow
Rationale: Airborne precautions (MTV: Measles, TB, Varicella/Shingles) require a negative-pressure private room and an
N95 respirator for healthcare personnel. Surgical masks are placed on the client only when transported.
Question 10. A nurse is instructing a student nurse on the correct sequence for doffing
(removing) Personal Protective Equipment (PPE). Which sequence is correct?
A. Goggles, Gloves, Mask, Gown
B. Mask, Gown, Goggles, Gloves
✔ C. Gloves, Goggles/Face Shield, Gown, Mask
D. Gown, Mask, Gloves, Goggles
Rationale: The correct sequence for doffing PPE follows alphabetical order: Gloves first (most contaminated), followed by
Goggles/Face Shield, Gown, and Mask last (removed outside or at doorway).
Question 11. A nurse is caring for a client receiving external beam radiation therapy for lung
cancer. Which client statement indicates a need for FURTHER teaching?
A. I will avoid direct sunlight exposure to the treated skin for at least one year
✔ B. I will scrub the radiation site daily using a washcloth and antibacterial soap
C. I will wash the irradiated area gently with my hands using warm water and mild soap
D. I will take care not to rub or wash off the ink markings on my skin
Rationale: External radiation skin care requires gentle washing with warm water and mild soap using hands only (NO
washcloths or harsh rubbing). Ink markings must remain intact, and skin must be protected from direct sun for 1 year.
Antibacterial soap and washcloths cause severe skin breakdown.
NSG 4800 TRANSITION TO PROFESSIONAL NURSING PRACTICE — ATI PROCTORED ASSESSMENT — Page 3 of 38
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Question 12. A client is receiving internal radiation therapy (brachytherapy) via a sealed radiation
implant. Which of the following nursing actions is appropriate?
A. Pick up a dislodged radiation seed with gloved hands and place it in the trash
B. Allow pregnant family members to visit for up to 1 hour per day if wearing a mask
✔ C. Wear a lead apron/shield and a dosimeter film badge throughout the shift, and limit visitor time
to 30 minutes daily at a 6-foot distance
D. Keep all dedicated diagnostic equipment inside the room permanently after the implant is removed
Rationale: Sealed radiation precautions include wearing a lead apron/shield and dosimeter badge, rotating staff,
prohibiting pregnant nurses/visitors and children <16, and limiting visitors to 30 min/day staying 6 feet away. Dislodged
seeds must be handled with long-handled metal tongs into a lead container.
Question 13. A nurse calculates the total burned body surface area (TBSA) for an adult client who
sustained deep partial-thickness burns to the entire right leg, entire left leg, and entire rear
torso. According to the Rule of Nines, what is the calculated TBSA?
✔ A. 54%
B. 63%
C. 36%
D. 45%
Rationale: According to the Rule of Nines: Entire right leg = 18%, Entire left leg = 18%, Entire rear torso (back) = 18%.
Total = 18 + 18 + 18 = 54% TBSA.
Question 14. A client weighing 70 kg has deep partial-thickness burns covering 50% TBSA. Using
the Parkland Formula (4 mL x kg x %TBSA), calculate the total fluid volume required in the first 24
hours, and state how much is infused in the first 8 hours.
A. 28,000 mL total; 14,000 mL infused in the first 8 hours
B. 7,000 mL total; 3,500 mL infused in the first 8 hours
C. 14,000 mL total; 3,500 mL infused in the first 8 hours
✔ D. 14,000 mL total; 7,000 mL infused in the first 8 hours
Rationale: Parkland Formula = 4 mL x 70 kg x 50% = 14,000 mL total IV fluid (Lactated Ringer's) in 24 hours. The first
half (7,000 mL) must be administered in the first 8 hours post-burn injury.
Question 15. A nurse is caring for a client with severe full-thickness burns covering 45% of the
body. Which assessment finding is the most sensitive non-invasive indicator of adequate cardiac
output and tissue perfusion?
A. Serum potassium level of 4.8 mEq/L
B. Baseline body temperature of 98.6°F
C. Systolic blood pressure of 110 mmHg
✔ D. Urinary output of 30 to 50 mL/hr
Rationale: Urinary output is the most reliable and sensitive non-invasive parameter for assessing cardiac output and
tissue perfusion during burn fluid resuscitation. Normal is 30-50 mL/hr. Output <30 mL/hr (or <45 mL over 2 hours)
indicates inadequate resuscitation.
NSG 4800 TRANSITION TO PROFESSIONAL NURSING PRACTICE — ATI PROCTORED ASSESSMENT — Page 4 of 38
