1|Page
PN ATI COMPREHENSIVE PREDICTOR
EXIT EXAM 2026 | QUESTIONS 1–100
AND ANSWERS UPDATED 2026/2027 |
DETAILED RATIONALES | EXAM-LEVEL
PRACTICE
Independent practice question bank for nursing students preparing for a PN ATI Comprehensive
Predictor or practical nursing exit examination. These are original practice questions, not official
ATI exam questions, and no passing score can be guaranteed.
Introduction
The PN ATI Comprehensive Predictor Exit Exam is designed to assess a practical nursing
student's readiness to progress toward graduation and entry-level nursing practice. Preparation
typically involves integrating knowledge from adult medical-surgical nursing, pharmacology,
maternal-newborn care, pediatric nursing, mental health, fundamentals of nursing, leadership,
safety, and infection prevention.
This practice question bank is intended for practical nursing students who want to strengthen
clinical judgment, improve prioritization, and identify knowledge gaps before an exit
examination. The questions emphasize challenging clinical scenarios, including changes in
patient condition, medication safety, delegation, therapeutic communication, and recognition of
complications.
Each question contains four answer options, one best answer, and a detailed rationale explaining
the clinical reasoning behind the correct choice and why the alternatives are less appropriate. The
content follows common practical nursing competency areas rather than claiming to reproduce a
proprietary ATI examination blueprint. Students should use the questions alongside their course
materials, current nursing guidelines, and official ATI review resources. For the best results,
answer each question before reading its rationale, record missed concepts, and revisit those
topics until you can explain the reasoning independently.
Content area overview
The following table organizes the major competency areas commonly covered in practical
nursing comprehensive exit preparation. The weights are illustrative study-planning allocations,
not official ATI percentages.
Suggested
Content area Questions Key topics
weight
,2|Page
Adult medical-surgical Cardiovascular, respiratory, renal,
1–20 20%
nursing endocrine, neurological disorders
Medication administration, adverse
Pharmacology 21–32 12%
effects, calculations, monitoring
Infection control, assessment, procedures,
Fundamentals and safety 33–44 12%
patient safety
Labor, postpartum complications,
Maternal-newborn nursing 45–54 10%
newborn care
Growth, respiratory emergencies,
Pediatric nursing 55–64 10%
dehydration, pediatric safety
Crisis intervention, therapeutic
Mental health nursing 65–74 10%
communication, psychiatric disorders
Leadership and Delegation, prioritization, documentation,
75–82 8%
coordination ethical practice
Clinical judgment and Deterioration, shock, emergency
83–92 10%
emergency care interventions, complications
Nutrition, elimination, and Fluid balance, nutrition, ostomies,
93–100 8%
wound care pressure injuries
QUESTIONS 1–100
Select the single best answer for each question. Follow your nursing program's scope-of-practice
rules and applicable clinical protocols.
Adult medical-surgical nursing
Q1: A practical nurse is caring for a client admitted with heart failure who suddenly develops
severe dyspnea, pink frothy sputum, and bilateral crackles. Which action is the priority?
A) Encourage the client to drink warm fluids.
B) Activate emergency assistance, position the client upright, and promptly report the
deterioration.
C) Place the client flat and elevate the legs.
D) Reassess the client after completing the medication round.
Rationale: B is correct because the findings suggest acute pulmonary edema, a potentially life-
threatening complication requiring immediate escalation, respiratory support, and prompt
treatment. A may worsen fluid overload. C can increase pulmonary congestion and respiratory
distress. D dangerously delays intervention.
,3|Page
Q2: A client with diabetes mellitus becomes diaphoretic and confused. The bedside glucose is 48
mg/dL (2.7 mmol/L). The client is conscious and can swallow safely. What should the nurse do
first?
A) Administer the scheduled insulin.
B) Give approximately 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes.
C) Provide a high-fat meal and reassess in one hour.
D) Encourage the client to walk to improve circulation.
Rationale: B is correct because a conscious client with hypoglycemia who can swallow safely
should receive rapid-acting carbohydrate, followed by reassessment and repeat treatment if
necessary. A can worsen hypoglycemia. C delays glucose absorption and reassessment. D
increases metabolic demand and may worsen the condition.
Q3: A client admitted with a suspected stroke develops sudden difficulty speaking and weakness
of the right arm. The symptoms began 25 minutes ago. What is the priority action?
A) Give oral aspirin immediately.
B) Offer water to determine whether swallowing is intact.
C) Activate the stroke response and establish the time the client was last known well.
D) Allow the client to sleep while the symptoms are monitored.
Rationale: C is correct because stroke treatment is time-sensitive, and the last-known-well time
helps determine eligibility for emergency interventions. A should not be given before appropriate
evaluation and exclusion of intracranial hemorrhage. B risks aspiration before a swallowing
assessment. D delays urgent neurological evaluation.
Q4: A client with chronic kidney disease has a potassium level of 6.4 mEq/L and reports muscle
weakness. The ECG shows peaked T waves. What should the nurse prioritize?
A) Encourage potassium-rich foods.
B) Administer a prescribed potassium supplement.
C) Notify the emergency response team or provider immediately and prepare for urgent
treatment.
D) Recheck the potassium level at the next routine blood draw.
, 4|Page
Rationale: C is correct because severe hyperkalemia with ECG changes can cause fatal
dysrhythmias and requires immediate treatment. A and B increase potassium exposure. D delays
management of a potentially lethal electrolyte disturbance.
Q5: A client with COPD receiving oxygen becomes increasingly drowsy and difficult to arouse.
Respiratory rate is 8/min. What is the best nursing response?
A) Remove all oxygen immediately and leave the client undisturbed.
B) Encourage the client to breathe into a paper bag.
C) Obtain emergency assistance, assess airway and ventilation, and provide oxygen and
ventilatory support as indicated.
D) Document that drowsiness is expected in COPD.
Rationale: C is correct because reduced consciousness and bradypnea indicate potentially life-
threatening ventilatory failure. A risks worsening hypoxemia. B is unsafe and inappropriate for
suspected respiratory failure. D dismisses an emergency. Oxygen should be titrated according to
clinical needs and prescribed targets, not withheld reflexively.
Q6: A client with diabetic ketoacidosis has a glucose level of 520 mg/dL, dehydration, and deep,
rapid respirations. Which intervention is generally initiated first under the emergency protocol?
A) Administer long-acting insulin subcutaneously.
B) Begin prescribed isotonic intravenous fluid replacement and monitor circulation.
C) Restrict fluids until glucose falls below 250 mg/dL.
D) Give oral potassium without checking laboratory results.
Rationale: B is correct because restoring circulating volume is a foundational early intervention
in diabetic ketoacidosis. A does not address severe dehydration and is not a substitute for the
prescribed IV insulin protocol. C worsens volume depletion. D risks dangerous potassium
abnormalities. Potassium must be assessed and managed alongside insulin therapy.
Q7: A client with a suspected myocardial infarction reports crushing chest pain radiating to the
jaw. The client is pale and diaphoretic. What should the nurse do first?
A) Encourage the client to walk to reduce anxiety.
B) Give food to prevent fasting-related weakness.
C) Activate the emergency response, assess vital signs, and facilitate immediate ECG evaluation.
PN ATI COMPREHENSIVE PREDICTOR
EXIT EXAM 2026 | QUESTIONS 1–100
AND ANSWERS UPDATED 2026/2027 |
DETAILED RATIONALES | EXAM-LEVEL
PRACTICE
Independent practice question bank for nursing students preparing for a PN ATI Comprehensive
Predictor or practical nursing exit examination. These are original practice questions, not official
ATI exam questions, and no passing score can be guaranteed.
Introduction
The PN ATI Comprehensive Predictor Exit Exam is designed to assess a practical nursing
student's readiness to progress toward graduation and entry-level nursing practice. Preparation
typically involves integrating knowledge from adult medical-surgical nursing, pharmacology,
maternal-newborn care, pediatric nursing, mental health, fundamentals of nursing, leadership,
safety, and infection prevention.
This practice question bank is intended for practical nursing students who want to strengthen
clinical judgment, improve prioritization, and identify knowledge gaps before an exit
examination. The questions emphasize challenging clinical scenarios, including changes in
patient condition, medication safety, delegation, therapeutic communication, and recognition of
complications.
Each question contains four answer options, one best answer, and a detailed rationale explaining
the clinical reasoning behind the correct choice and why the alternatives are less appropriate. The
content follows common practical nursing competency areas rather than claiming to reproduce a
proprietary ATI examination blueprint. Students should use the questions alongside their course
materials, current nursing guidelines, and official ATI review resources. For the best results,
answer each question before reading its rationale, record missed concepts, and revisit those
topics until you can explain the reasoning independently.
Content area overview
The following table organizes the major competency areas commonly covered in practical
nursing comprehensive exit preparation. The weights are illustrative study-planning allocations,
not official ATI percentages.
Suggested
Content area Questions Key topics
weight
,2|Page
Adult medical-surgical Cardiovascular, respiratory, renal,
1–20 20%
nursing endocrine, neurological disorders
Medication administration, adverse
Pharmacology 21–32 12%
effects, calculations, monitoring
Infection control, assessment, procedures,
Fundamentals and safety 33–44 12%
patient safety
Labor, postpartum complications,
Maternal-newborn nursing 45–54 10%
newborn care
Growth, respiratory emergencies,
Pediatric nursing 55–64 10%
dehydration, pediatric safety
Crisis intervention, therapeutic
Mental health nursing 65–74 10%
communication, psychiatric disorders
Leadership and Delegation, prioritization, documentation,
75–82 8%
coordination ethical practice
Clinical judgment and Deterioration, shock, emergency
83–92 10%
emergency care interventions, complications
Nutrition, elimination, and Fluid balance, nutrition, ostomies,
93–100 8%
wound care pressure injuries
QUESTIONS 1–100
Select the single best answer for each question. Follow your nursing program's scope-of-practice
rules and applicable clinical protocols.
Adult medical-surgical nursing
Q1: A practical nurse is caring for a client admitted with heart failure who suddenly develops
severe dyspnea, pink frothy sputum, and bilateral crackles. Which action is the priority?
A) Encourage the client to drink warm fluids.
B) Activate emergency assistance, position the client upright, and promptly report the
deterioration.
C) Place the client flat and elevate the legs.
D) Reassess the client after completing the medication round.
Rationale: B is correct because the findings suggest acute pulmonary edema, a potentially life-
threatening complication requiring immediate escalation, respiratory support, and prompt
treatment. A may worsen fluid overload. C can increase pulmonary congestion and respiratory
distress. D dangerously delays intervention.
,3|Page
Q2: A client with diabetes mellitus becomes diaphoretic and confused. The bedside glucose is 48
mg/dL (2.7 mmol/L). The client is conscious and can swallow safely. What should the nurse do
first?
A) Administer the scheduled insulin.
B) Give approximately 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes.
C) Provide a high-fat meal and reassess in one hour.
D) Encourage the client to walk to improve circulation.
Rationale: B is correct because a conscious client with hypoglycemia who can swallow safely
should receive rapid-acting carbohydrate, followed by reassessment and repeat treatment if
necessary. A can worsen hypoglycemia. C delays glucose absorption and reassessment. D
increases metabolic demand and may worsen the condition.
Q3: A client admitted with a suspected stroke develops sudden difficulty speaking and weakness
of the right arm. The symptoms began 25 minutes ago. What is the priority action?
A) Give oral aspirin immediately.
B) Offer water to determine whether swallowing is intact.
C) Activate the stroke response and establish the time the client was last known well.
D) Allow the client to sleep while the symptoms are monitored.
Rationale: C is correct because stroke treatment is time-sensitive, and the last-known-well time
helps determine eligibility for emergency interventions. A should not be given before appropriate
evaluation and exclusion of intracranial hemorrhage. B risks aspiration before a swallowing
assessment. D delays urgent neurological evaluation.
Q4: A client with chronic kidney disease has a potassium level of 6.4 mEq/L and reports muscle
weakness. The ECG shows peaked T waves. What should the nurse prioritize?
A) Encourage potassium-rich foods.
B) Administer a prescribed potassium supplement.
C) Notify the emergency response team or provider immediately and prepare for urgent
treatment.
D) Recheck the potassium level at the next routine blood draw.
, 4|Page
Rationale: C is correct because severe hyperkalemia with ECG changes can cause fatal
dysrhythmias and requires immediate treatment. A and B increase potassium exposure. D delays
management of a potentially lethal electrolyte disturbance.
Q5: A client with COPD receiving oxygen becomes increasingly drowsy and difficult to arouse.
Respiratory rate is 8/min. What is the best nursing response?
A) Remove all oxygen immediately and leave the client undisturbed.
B) Encourage the client to breathe into a paper bag.
C) Obtain emergency assistance, assess airway and ventilation, and provide oxygen and
ventilatory support as indicated.
D) Document that drowsiness is expected in COPD.
Rationale: C is correct because reduced consciousness and bradypnea indicate potentially life-
threatening ventilatory failure. A risks worsening hypoxemia. B is unsafe and inappropriate for
suspected respiratory failure. D dismisses an emergency. Oxygen should be titrated according to
clinical needs and prescribed targets, not withheld reflexively.
Q6: A client with diabetic ketoacidosis has a glucose level of 520 mg/dL, dehydration, and deep,
rapid respirations. Which intervention is generally initiated first under the emergency protocol?
A) Administer long-acting insulin subcutaneously.
B) Begin prescribed isotonic intravenous fluid replacement and monitor circulation.
C) Restrict fluids until glucose falls below 250 mg/dL.
D) Give oral potassium without checking laboratory results.
Rationale: B is correct because restoring circulating volume is a foundational early intervention
in diabetic ketoacidosis. A does not address severe dehydration and is not a substitute for the
prescribed IV insulin protocol. C worsens volume depletion. D risks dangerous potassium
abnormalities. Potassium must be assessed and managed alongside insulin therapy.
Q7: A client with a suspected myocardial infarction reports crushing chest pain radiating to the
jaw. The client is pale and diaphoretic. What should the nurse do first?
A) Encourage the client to walk to reduce anxiety.
B) Give food to prevent fasting-related weakness.
C) Activate the emergency response, assess vital signs, and facilitate immediate ECG evaluation.
