ATI NURSING • PN COMPREHENSIVE PREDICTOR
E X I T E X A M 2 0 2 6 • L E V E L 3 P R O F I C I E N C Y T A R G E T
ATI PN
Comprehensive Predictor 2026
Exit Exam — Comprehensive Practice & Review
Level 3 • 125 Questions with Detailed Rationales • NCLEX-PN Preparation
2026 EDITION
5 Content Sections • 125 Practice Questions • 25-Question Exit Exam Simulation
HOW TO USE THIS GUIDE
• Five content sections cover all NCLEX-PN areas: Fundamentals, Pharmacology, Med-Surg, Maternal/Newborn &
Peds, Mental Health/Leadership/Nutrition.
• 125 NCLEX-style questions with detailed rationales reinforce every key concept.
• Each rationale explains the clinical reasoning and nursing priorities.
• Appendices include ATI proficiency levels, NCLEX-PN content weights, lab values, vital signs, and immunization
schedule.
• Aim for Level 3 (proficient) — ATI recommends 75%+ for Comprehensive Predictor.
, ATI PN Comprehensive Predictor 2026 | Level 3 — Comprehensive Practice & Review
Section 1: Fundamentals of Nursing — Practice Questions
These 20 NCLEX-style questions cover nursing fundamentals: nursing process, prioritization,
delegation, safety, infection control, and ethical/legal aspects. Apply the cognitive skills of clinical
judgment as you work through each question.
Q1. A nurse is caring for four patients. Which patient should the nurse assess FIRST?
A. Patient requesting pain medication for chronic back pain
B. Patient with new onset shortness of breath and wheezing
C. Patient scheduled for discharge teaching
D. Patient asking for water
Correct Answer: B
Rationale: Using the ABC prioritization framework, the patient with new onset shortness of breath
and wheezing has a BREATHING problem — this is the highest priority. Breathing problems can
rapidly become life-threatening. The other patients have needs that are important but not immediately
life-threatening: chronic pain (not acute), discharge teaching (planned), and a request for water
(physiological but not emergent). Always address ABC problems first, then other physiological
needs, then psychosocial needs (Maslow's hierarchy).
Q2. A PN is caring for a patient with a Stage 2 pressure injury. Which task can the PN appropriately
delegate to the unlicensed assistive personnel (UAP)?
A. Assess the wound for signs of infection
B. Perform dressing change using sterile technique
C. Reposition the patient every 2 hours and document position
D. Determine the appropriate wound care protocol
Correct Answer: C
Rationale: Using the Five Rights of Delegation, the PN can delegate repositioning (ADL-related task
within UAP scope, stable patient, routine task). UAP CANNOT: assess wounds (requires nursing
judgment), perform sterile procedures (outside UAP scope), or develop care plans (requires nursing
judgment). The PN (or RN) must perform assessment, sterile dressing changes, and develop the care
plan. Delegation requires clear communication, appropriate patient stability, and tasks within
delegate's scope. The PN retains accountability for delegation decisions and must supervise/evaluate
the UAP's performance.
ATI PN Comprehensive Predictor 2026 Study Guide | Page 1
, ATI PN Comprehensive Predictor 2026 | Level 3 — Comprehensive Practice & Review
Q3. A patient is admitted with C. difficile infection. Which type of precautions should the nurse
implement?
A. Airborne precautions (N95 respirator, negative pressure room)
B. Droplet precautions (surgical mask, private room)
C. Contact precautions (gown and gloves; soap and water for hand hygiene — alcohol-
based rub does NOT kill C. diff spores)
D. Standard precautions only
Correct Answer: C
Rationale: C. difficile requires CONTACT PRECAUTIONS (gown and gloves for all patient
contact, private room or cohort, dedicated equipment). CRITICALLY: hand hygiene must use SOAP
AND WATER, not alcohol-based hand rub — alcohol does not kill C. diff spores. C. diff spores are
highly resistant and can survive on surfaces for months. Use bleach-based disinfectants for
environmental cleaning. Symptoms: watery diarrhea (≥3 stools/24 hr), abdominal cramping, fever,
leukocytosis. Treatment: metronidazole or oral vancomycin, stop offending antibiotic if possible.
Patients can shed spores for weeks after symptoms resolve.
Q4. A nurse enters a patient's room and finds the patient unresponsive with no pulse. The nurse
should FIRST:
A. Call for help/activate emergency response, then begin CPR
B. Run to the nurses' station to call a code
C. Begin chest compressions immediately
D. Go get the crash cart
Correct Answer: A
Rationale: If you find an unresponsive patient, FIRST ensure the scene is safe, then check for
responsiveness and breathing. If no pulse/breathing, CALL FOR HELP/ACTIVATE EMERGENCY
RESPONSE (call a code, use call light to summon help, send someone for AED/crash cart). Then
begin CPR starting with chest compressions (CAB — Compressions, Airway, Breathing for adults).
Starting CPR without summoning help means no one will bring the AED or additional support. Do
NOT leave the patient alone to call for help if you can summon from the room (call light, shout).
High-quality CPR: compressions at least 2 inches deep, rate 100-120/min, full recoil, minimize
interruptions, ratio 30:2.
ATI PN Comprehensive Predictor 2026 Study Guide | Page 2
, ATI PN Comprehensive Predictor 2026 | Level 3 — Comprehensive Practice & Review
Q5. A patient is scheduled for surgery and asks the nurse to explain the procedure. The nurse's BEST
response is to:
A. Explain the procedure in detail
B. Ask the surgeon to come explain the procedure and answer questions before signing the
consent
C. Have the patient sign the consent and explain after
D. Tell the patient not to worry — the surgeon knows best
Correct Answer: B
Rationale: Informed consent is the PROVIDER'S responsibility (surgeon performing the procedure).
The nurse's role is to: witness the patient's signature, verify patient identity, verify patient
understanding (ask patient to explain in own words), and notify the provider if the patient has
questions or appears to not understand. The nurse does NOT obtain consent or provide detailed
procedural explanation (this is the surgeon's role). If the patient has unanswered questions or doesn't
understand, the nurse must notify the provider BEFORE the consent is signed. Consent cannot be
obtained if the patient is under sedation, confused, or a minor without guardian.
Q6. A patient with tuberculosis is admitted. Which precaution should the nurse implement?
A. Contact precautions with private room
B. Droplet precautions with surgical mask
C. Airborne precautions: private NEGATIVE PRESSURE room, N95 respirator, door
closed
D. Standard precautions only
Correct Answer: C
Rationale: Tuberculosis is transmitted via AIRBORNE droplet nuclei (small enough to remain
suspended in air and travel on air currents). Airborne precautions require: PRIVATE NEGATIVE-
PRESSURE room (air exhausted outside or HEPA-filtered, 6-12 air changes per hour), N95
RESPIRATOR (or higher) for everyone entering the room, door kept CLOSED. Continue
precautions until patient is non-infectious (typically after 2 weeks of effective therapy with three
negative AFB sputum smears). Healthcare workers must be fit-tested for N95 respirators. Gowns and
gloves are not specifically required for airborne precautions but may be used per standard
precautions.
ATI PN Comprehensive Predictor 2026 Study Guide | Page 3
E X I T E X A M 2 0 2 6 • L E V E L 3 P R O F I C I E N C Y T A R G E T
ATI PN
Comprehensive Predictor 2026
Exit Exam — Comprehensive Practice & Review
Level 3 • 125 Questions with Detailed Rationales • NCLEX-PN Preparation
2026 EDITION
5 Content Sections • 125 Practice Questions • 25-Question Exit Exam Simulation
HOW TO USE THIS GUIDE
• Five content sections cover all NCLEX-PN areas: Fundamentals, Pharmacology, Med-Surg, Maternal/Newborn &
Peds, Mental Health/Leadership/Nutrition.
• 125 NCLEX-style questions with detailed rationales reinforce every key concept.
• Each rationale explains the clinical reasoning and nursing priorities.
• Appendices include ATI proficiency levels, NCLEX-PN content weights, lab values, vital signs, and immunization
schedule.
• Aim for Level 3 (proficient) — ATI recommends 75%+ for Comprehensive Predictor.
, ATI PN Comprehensive Predictor 2026 | Level 3 — Comprehensive Practice & Review
Section 1: Fundamentals of Nursing — Practice Questions
These 20 NCLEX-style questions cover nursing fundamentals: nursing process, prioritization,
delegation, safety, infection control, and ethical/legal aspects. Apply the cognitive skills of clinical
judgment as you work through each question.
Q1. A nurse is caring for four patients. Which patient should the nurse assess FIRST?
A. Patient requesting pain medication for chronic back pain
B. Patient with new onset shortness of breath and wheezing
C. Patient scheduled for discharge teaching
D. Patient asking for water
Correct Answer: B
Rationale: Using the ABC prioritization framework, the patient with new onset shortness of breath
and wheezing has a BREATHING problem — this is the highest priority. Breathing problems can
rapidly become life-threatening. The other patients have needs that are important but not immediately
life-threatening: chronic pain (not acute), discharge teaching (planned), and a request for water
(physiological but not emergent). Always address ABC problems first, then other physiological
needs, then psychosocial needs (Maslow's hierarchy).
Q2. A PN is caring for a patient with a Stage 2 pressure injury. Which task can the PN appropriately
delegate to the unlicensed assistive personnel (UAP)?
A. Assess the wound for signs of infection
B. Perform dressing change using sterile technique
C. Reposition the patient every 2 hours and document position
D. Determine the appropriate wound care protocol
Correct Answer: C
Rationale: Using the Five Rights of Delegation, the PN can delegate repositioning (ADL-related task
within UAP scope, stable patient, routine task). UAP CANNOT: assess wounds (requires nursing
judgment), perform sterile procedures (outside UAP scope), or develop care plans (requires nursing
judgment). The PN (or RN) must perform assessment, sterile dressing changes, and develop the care
plan. Delegation requires clear communication, appropriate patient stability, and tasks within
delegate's scope. The PN retains accountability for delegation decisions and must supervise/evaluate
the UAP's performance.
ATI PN Comprehensive Predictor 2026 Study Guide | Page 1
, ATI PN Comprehensive Predictor 2026 | Level 3 — Comprehensive Practice & Review
Q3. A patient is admitted with C. difficile infection. Which type of precautions should the nurse
implement?
A. Airborne precautions (N95 respirator, negative pressure room)
B. Droplet precautions (surgical mask, private room)
C. Contact precautions (gown and gloves; soap and water for hand hygiene — alcohol-
based rub does NOT kill C. diff spores)
D. Standard precautions only
Correct Answer: C
Rationale: C. difficile requires CONTACT PRECAUTIONS (gown and gloves for all patient
contact, private room or cohort, dedicated equipment). CRITICALLY: hand hygiene must use SOAP
AND WATER, not alcohol-based hand rub — alcohol does not kill C. diff spores. C. diff spores are
highly resistant and can survive on surfaces for months. Use bleach-based disinfectants for
environmental cleaning. Symptoms: watery diarrhea (≥3 stools/24 hr), abdominal cramping, fever,
leukocytosis. Treatment: metronidazole or oral vancomycin, stop offending antibiotic if possible.
Patients can shed spores for weeks after symptoms resolve.
Q4. A nurse enters a patient's room and finds the patient unresponsive with no pulse. The nurse
should FIRST:
A. Call for help/activate emergency response, then begin CPR
B. Run to the nurses' station to call a code
C. Begin chest compressions immediately
D. Go get the crash cart
Correct Answer: A
Rationale: If you find an unresponsive patient, FIRST ensure the scene is safe, then check for
responsiveness and breathing. If no pulse/breathing, CALL FOR HELP/ACTIVATE EMERGENCY
RESPONSE (call a code, use call light to summon help, send someone for AED/crash cart). Then
begin CPR starting with chest compressions (CAB — Compressions, Airway, Breathing for adults).
Starting CPR without summoning help means no one will bring the AED or additional support. Do
NOT leave the patient alone to call for help if you can summon from the room (call light, shout).
High-quality CPR: compressions at least 2 inches deep, rate 100-120/min, full recoil, minimize
interruptions, ratio 30:2.
ATI PN Comprehensive Predictor 2026 Study Guide | Page 2
, ATI PN Comprehensive Predictor 2026 | Level 3 — Comprehensive Practice & Review
Q5. A patient is scheduled for surgery and asks the nurse to explain the procedure. The nurse's BEST
response is to:
A. Explain the procedure in detail
B. Ask the surgeon to come explain the procedure and answer questions before signing the
consent
C. Have the patient sign the consent and explain after
D. Tell the patient not to worry — the surgeon knows best
Correct Answer: B
Rationale: Informed consent is the PROVIDER'S responsibility (surgeon performing the procedure).
The nurse's role is to: witness the patient's signature, verify patient identity, verify patient
understanding (ask patient to explain in own words), and notify the provider if the patient has
questions or appears to not understand. The nurse does NOT obtain consent or provide detailed
procedural explanation (this is the surgeon's role). If the patient has unanswered questions or doesn't
understand, the nurse must notify the provider BEFORE the consent is signed. Consent cannot be
obtained if the patient is under sedation, confused, or a minor without guardian.
Q6. A patient with tuberculosis is admitted. Which precaution should the nurse implement?
A. Contact precautions with private room
B. Droplet precautions with surgical mask
C. Airborne precautions: private NEGATIVE PRESSURE room, N95 respirator, door
closed
D. Standard precautions only
Correct Answer: C
Rationale: Tuberculosis is transmitted via AIRBORNE droplet nuclei (small enough to remain
suspended in air and travel on air currents). Airborne precautions require: PRIVATE NEGATIVE-
PRESSURE room (air exhausted outside or HEPA-filtered, 6-12 air changes per hour), N95
RESPIRATOR (or higher) for everyone entering the room, door kept CLOSED. Continue
precautions until patient is non-infectious (typically after 2 weeks of effective therapy with three
negative AFB sputum smears). Healthcare workers must be fit-tested for N95 respirators. Gowns and
gloves are not specifically required for airborne precautions but may be used per standard
precautions.
ATI PN Comprehensive Predictor 2026 Study Guide | Page 3
