ATI RN Comprehensive Predictor 2026 – NGN-
Style Exam Questions with Answers and Detailed
Rationales Top Rated Latest Version
ATI RN Comprehensive Predictor 2026–style NGN practice exam with:
• ✅ Next Generation NCLEX (NGN) formats
• ✅ Clinical Judgment case studies
• ✅ Multiple-choice questions
• ✅ Select-all-that-apply (SATA)
• ✅ Matrix/Grid questions
• ✅ Bow-tie questions
• ✅ Trend questions
• ✅ Prioritization & delegation
• ✅ Correct answers
• ✅ Detailed rationales explaining why each option is right or wrong
I will create it as a practice exam (not an actual ATI secure exam) covering major RN
domains: Fundamentals, Adult Medical-Surgical, Pharmacology, Mental Health, Pediatrics,
Maternal-Newborn, Leadership, Safety, and Critical Care. Similar NGN-style practice materials
Question 1 — NGN Case Study (Clinical Judgment)
A nurse is caring for a 68-year-old client admitted with pneumonia.
Assessment findings:
• Temperature: 39.1°C (102.4°F)
• Heart rate: 118/min
• Respiratory rate: 32/min
• Blood pressure: 88/54 mm Hg
• Oxygen saturation: 86% on room air
• Confusion noted
• Urine output: 20 mL/hr
Question:
Which finding requires the nurse’s priority action?
,A. Fever of 39.1°C
B. Confusion
C. Oxygen saturation of 86%
D. Urine output of 20 mL/hr
Correct Answer:
✅ C. Oxygen saturation of 86%
Rationale:
The client is showing signs of sepsis with possible septic shock. The immediate priority is
airway and breathing. An oxygen saturation of 86% indicates significant hypoxemia requiring
rapid intervention.
• A: Fever is expected with infection but is not the immediate threat.
• B: Confusion may indicate worsening sepsis but follows oxygenation concerns.
• D: Low urine output suggests poor perfusion but is secondary to airway/breathing.
NCLEX Priority Concept: ABCs — Airway, Breathing, Circulation.
Question 2 — NGN Bow-Tie Item
A client receiving morphine after surgery develops:
• Respiratory rate: 8/min
• Oxygen saturation: 89%
• Difficult to arouse
• Pinpoint pupils
Select the correct options:
Condition:
A. Opioid toxicity
B. Stroke
C. Hypoglycemia
D. Pulmonary embolism
Actions:
1. Administer naloxone
2. Increase opioid dose
, 3. Apply oxygen
4. Place client supine and leave alone
Expected Outcomes:
A. Respiratory rate improves
B. Increased sedation
C. Improved oxygen saturation
D. Decreased level of consciousness
Correct Answer:
Condition:
✅ Opioid toxicity
Actions:
✅ Administer naloxone
✅ Apply oxygen
Expected Outcomes:
✅ Respiratory rate improves
✅ Improved oxygen saturation
Rationale:
Morphine overdose causes CNS depression, respiratory depression, and pinpoint pupils.
Naloxone reverses opioid effects. Oxygen supports ventilation while the medication takes effect.
Question 3 — Pharmacology
A nurse is teaching a client taking warfarin. Which statement indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will use aspirin for headaches."
C. "I will have my INR checked regularly."
D. "I can stop the medication when I feel better."
Correct Answer:
✅ C. "I will have my INR checked regularly."
Rationale:
, Warfarin requires monitoring of INR to evaluate therapeutic anticoagulation.
• Green leafy vegetables contain vitamin K and can interfere with therapy.
• Aspirin increases bleeding risk.
• Warfarin should not be stopped without provider direction.
Question 4 — SATA
A nurse is caring for a client with heart failure. Which findings should the nurse report?
Select all that apply.
A. Weight gain of 2 kg (4.4 lb) in 2 days
B. Bilateral crackles
C. Increased appetite
D. New onset confusion
E. Decreased ankle swelling
Correct Answers:
✅A
✅B
✅D
Rationale:
Rapid weight gain indicates fluid retention. Crackles indicate pulmonary congestion. Confusion
may indicate decreased cardiac output.
• Increased appetite is not concerning.
• Decreased swelling indicates improvement.
Question 5 — Maternal-Newborn
A postpartum client has heavy vaginal bleeding 2 hours after delivery. The uterus is boggy.
What should the nurse do first?
A. Notify the provider
B. Massage the fundus
Style Exam Questions with Answers and Detailed
Rationales Top Rated Latest Version
ATI RN Comprehensive Predictor 2026–style NGN practice exam with:
• ✅ Next Generation NCLEX (NGN) formats
• ✅ Clinical Judgment case studies
• ✅ Multiple-choice questions
• ✅ Select-all-that-apply (SATA)
• ✅ Matrix/Grid questions
• ✅ Bow-tie questions
• ✅ Trend questions
• ✅ Prioritization & delegation
• ✅ Correct answers
• ✅ Detailed rationales explaining why each option is right or wrong
I will create it as a practice exam (not an actual ATI secure exam) covering major RN
domains: Fundamentals, Adult Medical-Surgical, Pharmacology, Mental Health, Pediatrics,
Maternal-Newborn, Leadership, Safety, and Critical Care. Similar NGN-style practice materials
Question 1 — NGN Case Study (Clinical Judgment)
A nurse is caring for a 68-year-old client admitted with pneumonia.
Assessment findings:
• Temperature: 39.1°C (102.4°F)
• Heart rate: 118/min
• Respiratory rate: 32/min
• Blood pressure: 88/54 mm Hg
• Oxygen saturation: 86% on room air
• Confusion noted
• Urine output: 20 mL/hr
Question:
Which finding requires the nurse’s priority action?
,A. Fever of 39.1°C
B. Confusion
C. Oxygen saturation of 86%
D. Urine output of 20 mL/hr
Correct Answer:
✅ C. Oxygen saturation of 86%
Rationale:
The client is showing signs of sepsis with possible septic shock. The immediate priority is
airway and breathing. An oxygen saturation of 86% indicates significant hypoxemia requiring
rapid intervention.
• A: Fever is expected with infection but is not the immediate threat.
• B: Confusion may indicate worsening sepsis but follows oxygenation concerns.
• D: Low urine output suggests poor perfusion but is secondary to airway/breathing.
NCLEX Priority Concept: ABCs — Airway, Breathing, Circulation.
Question 2 — NGN Bow-Tie Item
A client receiving morphine after surgery develops:
• Respiratory rate: 8/min
• Oxygen saturation: 89%
• Difficult to arouse
• Pinpoint pupils
Select the correct options:
Condition:
A. Opioid toxicity
B. Stroke
C. Hypoglycemia
D. Pulmonary embolism
Actions:
1. Administer naloxone
2. Increase opioid dose
, 3. Apply oxygen
4. Place client supine and leave alone
Expected Outcomes:
A. Respiratory rate improves
B. Increased sedation
C. Improved oxygen saturation
D. Decreased level of consciousness
Correct Answer:
Condition:
✅ Opioid toxicity
Actions:
✅ Administer naloxone
✅ Apply oxygen
Expected Outcomes:
✅ Respiratory rate improves
✅ Improved oxygen saturation
Rationale:
Morphine overdose causes CNS depression, respiratory depression, and pinpoint pupils.
Naloxone reverses opioid effects. Oxygen supports ventilation while the medication takes effect.
Question 3 — Pharmacology
A nurse is teaching a client taking warfarin. Which statement indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will use aspirin for headaches."
C. "I will have my INR checked regularly."
D. "I can stop the medication when I feel better."
Correct Answer:
✅ C. "I will have my INR checked regularly."
Rationale:
, Warfarin requires monitoring of INR to evaluate therapeutic anticoagulation.
• Green leafy vegetables contain vitamin K and can interfere with therapy.
• Aspirin increases bleeding risk.
• Warfarin should not be stopped without provider direction.
Question 4 — SATA
A nurse is caring for a client with heart failure. Which findings should the nurse report?
Select all that apply.
A. Weight gain of 2 kg (4.4 lb) in 2 days
B. Bilateral crackles
C. Increased appetite
D. New onset confusion
E. Decreased ankle swelling
Correct Answers:
✅A
✅B
✅D
Rationale:
Rapid weight gain indicates fluid retention. Crackles indicate pulmonary congestion. Confusion
may indicate decreased cardiac output.
• Increased appetite is not concerning.
• Decreased swelling indicates improvement.
Question 5 — Maternal-Newborn
A postpartum client has heavy vaginal bleeding 2 hours after delivery. The uterus is boggy.
What should the nurse do first?
A. Notify the provider
B. Massage the fundus
