ATI RN Comprehensive Predictor Exit Proctored
Exam 2026 with NGN Package | 180 Real Exam
Questions & Answers | Comprehensive Study
Guide and Practice Test
ATI RN Comprehensive Predictor 2026 Exit Proctored Exam with NGN Package
180 Real Exam Questions & Answers | Comprehensive Study Guide and Practice Test
Q1. A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess
first?
A. A client with a chronic obstructive pulmonary disease who reports a headache
B. A client two days postoperative who reports calf pain and new-onset shortness of breath
C. A client with diabetes mellitus who is requesting a snack
D. A client with a leg cast who reports mild itching under the cast
Correct Answer: B
Rationale: Calf pain in a postoperative client, combined with sudden shortness of breath, is highly
suggestive of a deep vein thrombosis that has embolized to the lungs, forming a pulmonary
embolism. This is a life-threatening emergency requiring immediate assessment and intervention.
The other clients have non-urgent concerns. The COPD client's headache may warrant follow-up for
possible carbon dioxide retention, but it is not the priority when a suspected PE is present.
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate for
the nurse to delegate?
A. Teaching a client about a new insulin regimen
B. Ambulating a stable client to the bathroom
C. Assessing a client's surgical wound for signs of infection
D. Administering a PRN pain medication
Correct Answer: B
Rationale: Ambulating a stable client is a routine, non-invasive task with a predictable outcome,
which falls within the scope of UAP practice. Client teaching, wound assessment, and medication
administration all require the clinical judgment and licensure of a registered nurse. Delegation
decisions must always consider the stability of the client, the complexity of the task, and the scope
of practice of the delegatee.
Q3. A nurse is receiving report on four clients. Which client requires immediate intervention?
pg. 1
,A. A client with pneumonia who has a temperature of 101.2°F (38.4°C)
B. A client four hours postoperative following a cholecystectomy who reports 7/10 incisional pain
C. A client with a chest tube for a pneumothorax who has new-onset crepitus around the insertion
site
D. A client with chronic kidney disease whose latest creatinine is 2.4 mg/dL
Correct Answer: C
Rationale: New-onset crepitus (subcutaneous emphysema) around a chest tube insertion site
indicates a leak in the chest tube system or worsening pneumothorax, which requires immediate
intervention to prevent respiratory compromise. The other findings are concerning but do not
represent immediate life-threatening emergencies. The postoperative client's pain should be
addressed but is not the priority over a potentially compromised airway.
Q4. A nurse is triaging clients following a mass casualty event. Using disaster triage principles, which
client should receive care first?
A. A client with a tension pneumothorax
B. A client with an open femur fracture and active bleeding
C. A client with a sprained ankle
D. A client with a minor laceration
Correct Answer: B
Rationale: Under disaster triage systems, clients are categorized based on the likelihood of survival
with immediate intervention. A client with an open femur fracture and active bleeding has a life-
threatening but survivable injury that requires rapid hemorrhage control and stabilization, placing
them in the immediate (red) category. While a tension pneumothorax is also critical, in mass
casualty triage, the client with the survivable injury who will deteriorate without rapid intervention
is prioritized. The sprained ankle and minor laceration are non-urgent (green).
Q5. A nurse is preparing to administer medications to a client with a new prescription for warfarin.
Which laboratory value should the nurse monitor to evaluate therapeutic effectiveness?
A. Platelet count
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Hemoglobin and hematocrit
Correct Answer: B
Rationale: Warfarin is an anticoagulant that inhibits vitamin K-dependent clotting factors,
prolonging the prothrombin time (PT). The INR is a standardized measure of PT used specifically to
monitor warfarin therapy, with a typical therapeutic range of 2.0–3.0 for most indications. Platelet
count assesses for thrombocytopenia, aPTT monitors heparin therapy, and hemoglobin/hematocrit
assess for bleeding or anemia but do not directly measure warfarin's therapeutic effect.
pg. 2
,Q6. A nurse is teaching a client who has a new prescription for warfarin. Which statement by the
client indicates understanding of the teaching?
A. "I will increase my intake of leafy green vegetables to improve my diet."
B. "I will use an electric razor to shave instead of a disposable razor."
C. "I will take aspirin for headaches instead of acetaminophen."
D. "I will stop taking the medication if I notice any bruising."
Correct Answer: B
Rationale: Warfarin increases bleeding risk, so using an electric razor minimizes the risk of cuts and
subsequent bleeding. Clients should maintain a consistent intake of vitamin K-rich foods (not
increase or decrease dramatically). Aspirin should be avoided due to increased bleeding risk, and
clients should not stop warfarin without provider guidance, as this could lead to clot formation.
Q7. A nurse is assessing a client who is receiving furosemide for heart failure. Which laboratory value
should the nurse monitor most closely?
A. Sodium
B. Potassium
C. Chloride
D. Magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss through increased
urinary excretion. Hypokalemia is a major risk and can lead to dangerous cardiac dysrhythmias.
While sodium, chloride, and magnesium can also be affected, potassium is the most critical
electrolyte to monitor due to its direct effect on cardiac function.
Q8. A client with diabetic ketoacidosis (DKA) is admitted to the unit. Which assessment finding is
expected?
A. Shallow, slow respirations
B. Kussmaul respirations
C. Bradycardia
D. Hypertension
Correct Answer: B
Rationale: Kussmaul respirations are deep, rapid, labored breaths that occur as the body attempts
to blow off excess carbon dioxide to compensate for metabolic acidosis. This is a classic finding in
DKA. Other expected findings include fruity breath, hyperglycemia, dehydration, tachycardia, and
hypotension. Shallow respirations and bradycardia are not characteristic of DKA.
Q9. A postpartum client is experiencing heavy vaginal bleeding. The nurse assesses a firm fundus.
What is the nurse's priority action?
pg. 3
, A. Massage the fundus vigorously
B. Notify the healthcare provider immediately
C. Administer oxytocin as prescribed
D. Encourage the client to void
Correct Answer: B
Rationale: A firm fundus indicates that uterine atony is not the cause of the bleeding. Heavy
bleeding with a firm uterus suggests another source such as a cervical or vaginal laceration, retained
placental fragments, or a hematoma. This requires immediate medical evaluation and intervention.
Massaging the fundus would be appropriate for a boggy uterus, and administering oxytocin is used
for uterine atony, not lacerations.
Q10. A client is admitted with a suspected pulmonary embolism. Which assessment finding requires
immediate intervention?
A. Pleuritic chest pain
B. Sudden onset of shortness of breath and tachycardia
C. Low-grade fever
D. Cough producing small amounts of blood-tinged sputum
Correct Answer: B
Rationale: Sudden dyspnea, tachycardia, and hypoxia are classic signs of a pulmonary embolism
causing acute respiratory compromise. This is a medical emergency requiring immediate oxygen
administration, anticoagulation, and possibly thrombolytic therapy. While pleuritic chest pain and
hemoptysis can occur with PE, the sudden onset of respiratory distress is the most critical finding
requiring immediate action.
Q11. A nurse is caring for a client with a nasogastric (NG) tube connected to low intermittent
suction. The client reports nausea. What is the nurse's first action?
A. Increase the suction pressure
B. Irrigate the NG tube with normal saline
C. Check the patency of the NG tube
D. Administer an antiemetic as prescribed
Correct Answer: C
Rationale: Nausea in a client with an NG tube often indicates that the tube is blocked, kinked, or
displaced, preventing effective gastric decompression. The nurse should first check the patency of
the tube by aspirating for gastric contents or irrigating with normal saline. Increasing suction
pressure or administering an antiemetic without first ensuring tube patency would not address the
underlying issue.
Q12. A client is receiving a blood transfusion. Ten minutes after the start of the transfusion, the
client develops fever, chills, and flank pain. What is the nurse's priority action?
pg. 4
Exam 2026 with NGN Package | 180 Real Exam
Questions & Answers | Comprehensive Study
Guide and Practice Test
ATI RN Comprehensive Predictor 2026 Exit Proctored Exam with NGN Package
180 Real Exam Questions & Answers | Comprehensive Study Guide and Practice Test
Q1. A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess
first?
A. A client with a chronic obstructive pulmonary disease who reports a headache
B. A client two days postoperative who reports calf pain and new-onset shortness of breath
C. A client with diabetes mellitus who is requesting a snack
D. A client with a leg cast who reports mild itching under the cast
Correct Answer: B
Rationale: Calf pain in a postoperative client, combined with sudden shortness of breath, is highly
suggestive of a deep vein thrombosis that has embolized to the lungs, forming a pulmonary
embolism. This is a life-threatening emergency requiring immediate assessment and intervention.
The other clients have non-urgent concerns. The COPD client's headache may warrant follow-up for
possible carbon dioxide retention, but it is not the priority when a suspected PE is present.
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate for
the nurse to delegate?
A. Teaching a client about a new insulin regimen
B. Ambulating a stable client to the bathroom
C. Assessing a client's surgical wound for signs of infection
D. Administering a PRN pain medication
Correct Answer: B
Rationale: Ambulating a stable client is a routine, non-invasive task with a predictable outcome,
which falls within the scope of UAP practice. Client teaching, wound assessment, and medication
administration all require the clinical judgment and licensure of a registered nurse. Delegation
decisions must always consider the stability of the client, the complexity of the task, and the scope
of practice of the delegatee.
Q3. A nurse is receiving report on four clients. Which client requires immediate intervention?
pg. 1
,A. A client with pneumonia who has a temperature of 101.2°F (38.4°C)
B. A client four hours postoperative following a cholecystectomy who reports 7/10 incisional pain
C. A client with a chest tube for a pneumothorax who has new-onset crepitus around the insertion
site
D. A client with chronic kidney disease whose latest creatinine is 2.4 mg/dL
Correct Answer: C
Rationale: New-onset crepitus (subcutaneous emphysema) around a chest tube insertion site
indicates a leak in the chest tube system or worsening pneumothorax, which requires immediate
intervention to prevent respiratory compromise. The other findings are concerning but do not
represent immediate life-threatening emergencies. The postoperative client's pain should be
addressed but is not the priority over a potentially compromised airway.
Q4. A nurse is triaging clients following a mass casualty event. Using disaster triage principles, which
client should receive care first?
A. A client with a tension pneumothorax
B. A client with an open femur fracture and active bleeding
C. A client with a sprained ankle
D. A client with a minor laceration
Correct Answer: B
Rationale: Under disaster triage systems, clients are categorized based on the likelihood of survival
with immediate intervention. A client with an open femur fracture and active bleeding has a life-
threatening but survivable injury that requires rapid hemorrhage control and stabilization, placing
them in the immediate (red) category. While a tension pneumothorax is also critical, in mass
casualty triage, the client with the survivable injury who will deteriorate without rapid intervention
is prioritized. The sprained ankle and minor laceration are non-urgent (green).
Q5. A nurse is preparing to administer medications to a client with a new prescription for warfarin.
Which laboratory value should the nurse monitor to evaluate therapeutic effectiveness?
A. Platelet count
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Hemoglobin and hematocrit
Correct Answer: B
Rationale: Warfarin is an anticoagulant that inhibits vitamin K-dependent clotting factors,
prolonging the prothrombin time (PT). The INR is a standardized measure of PT used specifically to
monitor warfarin therapy, with a typical therapeutic range of 2.0–3.0 for most indications. Platelet
count assesses for thrombocytopenia, aPTT monitors heparin therapy, and hemoglobin/hematocrit
assess for bleeding or anemia but do not directly measure warfarin's therapeutic effect.
pg. 2
,Q6. A nurse is teaching a client who has a new prescription for warfarin. Which statement by the
client indicates understanding of the teaching?
A. "I will increase my intake of leafy green vegetables to improve my diet."
B. "I will use an electric razor to shave instead of a disposable razor."
C. "I will take aspirin for headaches instead of acetaminophen."
D. "I will stop taking the medication if I notice any bruising."
Correct Answer: B
Rationale: Warfarin increases bleeding risk, so using an electric razor minimizes the risk of cuts and
subsequent bleeding. Clients should maintain a consistent intake of vitamin K-rich foods (not
increase or decrease dramatically). Aspirin should be avoided due to increased bleeding risk, and
clients should not stop warfarin without provider guidance, as this could lead to clot formation.
Q7. A nurse is assessing a client who is receiving furosemide for heart failure. Which laboratory value
should the nurse monitor most closely?
A. Sodium
B. Potassium
C. Chloride
D. Magnesium
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes significant potassium loss through increased
urinary excretion. Hypokalemia is a major risk and can lead to dangerous cardiac dysrhythmias.
While sodium, chloride, and magnesium can also be affected, potassium is the most critical
electrolyte to monitor due to its direct effect on cardiac function.
Q8. A client with diabetic ketoacidosis (DKA) is admitted to the unit. Which assessment finding is
expected?
A. Shallow, slow respirations
B. Kussmaul respirations
C. Bradycardia
D. Hypertension
Correct Answer: B
Rationale: Kussmaul respirations are deep, rapid, labored breaths that occur as the body attempts
to blow off excess carbon dioxide to compensate for metabolic acidosis. This is a classic finding in
DKA. Other expected findings include fruity breath, hyperglycemia, dehydration, tachycardia, and
hypotension. Shallow respirations and bradycardia are not characteristic of DKA.
Q9. A postpartum client is experiencing heavy vaginal bleeding. The nurse assesses a firm fundus.
What is the nurse's priority action?
pg. 3
, A. Massage the fundus vigorously
B. Notify the healthcare provider immediately
C. Administer oxytocin as prescribed
D. Encourage the client to void
Correct Answer: B
Rationale: A firm fundus indicates that uterine atony is not the cause of the bleeding. Heavy
bleeding with a firm uterus suggests another source such as a cervical or vaginal laceration, retained
placental fragments, or a hematoma. This requires immediate medical evaluation and intervention.
Massaging the fundus would be appropriate for a boggy uterus, and administering oxytocin is used
for uterine atony, not lacerations.
Q10. A client is admitted with a suspected pulmonary embolism. Which assessment finding requires
immediate intervention?
A. Pleuritic chest pain
B. Sudden onset of shortness of breath and tachycardia
C. Low-grade fever
D. Cough producing small amounts of blood-tinged sputum
Correct Answer: B
Rationale: Sudden dyspnea, tachycardia, and hypoxia are classic signs of a pulmonary embolism
causing acute respiratory compromise. This is a medical emergency requiring immediate oxygen
administration, anticoagulation, and possibly thrombolytic therapy. While pleuritic chest pain and
hemoptysis can occur with PE, the sudden onset of respiratory distress is the most critical finding
requiring immediate action.
Q11. A nurse is caring for a client with a nasogastric (NG) tube connected to low intermittent
suction. The client reports nausea. What is the nurse's first action?
A. Increase the suction pressure
B. Irrigate the NG tube with normal saline
C. Check the patency of the NG tube
D. Administer an antiemetic as prescribed
Correct Answer: C
Rationale: Nausea in a client with an NG tube often indicates that the tube is blocked, kinked, or
displaced, preventing effective gastric decompression. The nurse should first check the patency of
the tube by aspirating for gastric contents or irrigating with normal saline. Increasing suction
pressure or administering an antiemetic without first ensuring tube patency would not address the
underlying issue.
Q12. A client is receiving a blood transfusion. Ten minutes after the start of the transfusion, the
client develops fever, chills, and flank pain. What is the nurse's priority action?
pg. 4
