ATI PN Comprehensive Predictor Exit
NGN ACTUAL EXAM 2026/2027: 100%
Verified Questions & Correct Answers
Question 1 (Matrix/NGN):
A 72-year-old client is 6 hours post–right total-hip replacement. The LPN is reviewing the
electronic medication administration record (eMAR) and the provider’s post-op orders.
For each order below, identify whether the LPN may independently initiate, must first validate
with the RN, or must first contact the provider.
TableCopy
LPN may Must first Must first
Order independently validate with contact
initiate RN provider
1. Advance diet from clear liquids to
☑ ☐ ☐
general as tolerated.
2. Morphine 2 mg IV q4h PRN pain,
☐ ☑ ☐
hold if respiratory rate < 10.
3. Enoxaparin 40 mg subcut daily ×
☐ ☐ ☑
14 days, first dose now.
Correct Answer:
1. LPN may independently initiate
2. Must first validate with RN
3. Must first contact provider
Rationale: LPN scope allows diet advancement per protocol; IV opioid titration requires RN
validation; first-dose anticoagulant post-op requires provider confirmation of current labs and
bleeding risk.
,Question 2:
The LPN is assisting the RN to develop a plan of care for a client with chronic kidney disease
(CKD) stage 4. Which nursing activity is most appropriate for the LPN to independently
implement?
A. Adjust the heparin infusion rate per protocol
B. Teach the client about phosphate binder compliance
C. Delegate morning hygiene to assistive personnel
D. Interpret the morning arterial blood gas results
Correct Answer: C
Rationale: LPNs may delegate and supervise hygiene tasks; teaching, titrating infusions, and
interpreting ABGs exceed LPN scope.
Question 3 (Highlight/NGN):
A 5-year-old with asthma is receiving albuterol 2.5 mg nebulizer q4h. During the treatment the
child reports tingling fingers and the pulse oximeter reads 98%.
Highlight the finding in the scenario that requires **immediate RN notification.
Correct Answer: tingling fingers
Rationale: Tinging fingers suggests respiratory alkalosis from hyperventilation, requiring RN
assessment for possible nebulizer discontinuation or oxygen adjustment.
Question 4:
The LPN is preparing to administer digoxin 0.25 mg PO to an 82-year-old client with heart
failure. Prior to administration the LPN should:
A. Check the last potassium level and notify the RN if < 3.5 mEq/L
B. Hold the dose if apical pulse < 60 bpm
C. Administer the dose with an antacid to decrease GI upset
D. Crush the tablet and mix in applesauce to enhance absorption
,Correct Answer: B
Rationale: LPN holds digoxin for apical pulse < 60 bpm per protocol; checking labs is an RN
responsibility; antacids and crushing alter absorption.
Question 5 (Cloze/Drop-Down NGN):
A 68-year-old post–MI client has a new prescription for metoprolol 50 mg PO BID. The
pharmacy supplies 100 mg unscored tablets. The client’s last blood pressure was 104/66 mm
Hg and heart rate 54 bpm.
The LPN should first ____ (action) and then ____ (action).
Drop-Down 1:
● administer the 100 mg tablet
● contact the pharmacist
● hold the dose and notify the RN
Drop-Down 2:
● document teaching
● recheck vitals in 30 minutes
● clarify the prescription with the provider
Correct Answer:
hold the dose and notify the RN
clarify the prescription with the provider
Rationale: Bradycardia and hypotension are contraindications; unscored tablet cannot be split
for 50 mg dose; RN must contact provider.
Question 6:
The LPN is caring for four clients. Which client should the LPN see first?
A. Client with pneumonia on day 2 of antibiotics, temperature 37.2 °C
B. Client with type 2 diabetes scheduled for 0730 regular insulin, breakfast tray on table
C. Client with peripheral IV infiltrate rated 2+ edema but no pain
, D. Client with new colostomy requesting discharge teaching before 0900 transport
Correct Answer: C
Rationale: IV infiltrate can progress to tissue damage; LPN intervenes immediately by
discontinuing IV and notifying RN.
Question 7 (Matrix/NGN):
A 34-week-pregnant client arrives to triage with bright red bleeding and abdominal tenderness.
The LPN is asked to ready the room.
For each potential intervention, identify if the LPN may perform, assist, or not perform.
TableCopy
LPN may LPN may LPN may not
Intervention
perform assist perform
Start 18-gauge IV line with lactated
☐ ☑ ☐
Ringer’s.
Apply continuous fetal monitor. ☑ ☐ ☐
Perform cervical check. ☐ ☐ ☑
Correct Answer:
IV line: assist
Fetal monitor: perform
Cervical check: not perform
Rationale: LPN initiates external fetal monitoring; IV initiation requires RN but LPN may
assist; cervical assessment is RN/provider scope.
Question 8:
NGN ACTUAL EXAM 2026/2027: 100%
Verified Questions & Correct Answers
Question 1 (Matrix/NGN):
A 72-year-old client is 6 hours post–right total-hip replacement. The LPN is reviewing the
electronic medication administration record (eMAR) and the provider’s post-op orders.
For each order below, identify whether the LPN may independently initiate, must first validate
with the RN, or must first contact the provider.
TableCopy
LPN may Must first Must first
Order independently validate with contact
initiate RN provider
1. Advance diet from clear liquids to
☑ ☐ ☐
general as tolerated.
2. Morphine 2 mg IV q4h PRN pain,
☐ ☑ ☐
hold if respiratory rate < 10.
3. Enoxaparin 40 mg subcut daily ×
☐ ☐ ☑
14 days, first dose now.
Correct Answer:
1. LPN may independently initiate
2. Must first validate with RN
3. Must first contact provider
Rationale: LPN scope allows diet advancement per protocol; IV opioid titration requires RN
validation; first-dose anticoagulant post-op requires provider confirmation of current labs and
bleeding risk.
,Question 2:
The LPN is assisting the RN to develop a plan of care for a client with chronic kidney disease
(CKD) stage 4. Which nursing activity is most appropriate for the LPN to independently
implement?
A. Adjust the heparin infusion rate per protocol
B. Teach the client about phosphate binder compliance
C. Delegate morning hygiene to assistive personnel
D. Interpret the morning arterial blood gas results
Correct Answer: C
Rationale: LPNs may delegate and supervise hygiene tasks; teaching, titrating infusions, and
interpreting ABGs exceed LPN scope.
Question 3 (Highlight/NGN):
A 5-year-old with asthma is receiving albuterol 2.5 mg nebulizer q4h. During the treatment the
child reports tingling fingers and the pulse oximeter reads 98%.
Highlight the finding in the scenario that requires **immediate RN notification.
Correct Answer: tingling fingers
Rationale: Tinging fingers suggests respiratory alkalosis from hyperventilation, requiring RN
assessment for possible nebulizer discontinuation or oxygen adjustment.
Question 4:
The LPN is preparing to administer digoxin 0.25 mg PO to an 82-year-old client with heart
failure. Prior to administration the LPN should:
A. Check the last potassium level and notify the RN if < 3.5 mEq/L
B. Hold the dose if apical pulse < 60 bpm
C. Administer the dose with an antacid to decrease GI upset
D. Crush the tablet and mix in applesauce to enhance absorption
,Correct Answer: B
Rationale: LPN holds digoxin for apical pulse < 60 bpm per protocol; checking labs is an RN
responsibility; antacids and crushing alter absorption.
Question 5 (Cloze/Drop-Down NGN):
A 68-year-old post–MI client has a new prescription for metoprolol 50 mg PO BID. The
pharmacy supplies 100 mg unscored tablets. The client’s last blood pressure was 104/66 mm
Hg and heart rate 54 bpm.
The LPN should first ____ (action) and then ____ (action).
Drop-Down 1:
● administer the 100 mg tablet
● contact the pharmacist
● hold the dose and notify the RN
Drop-Down 2:
● document teaching
● recheck vitals in 30 minutes
● clarify the prescription with the provider
Correct Answer:
hold the dose and notify the RN
clarify the prescription with the provider
Rationale: Bradycardia and hypotension are contraindications; unscored tablet cannot be split
for 50 mg dose; RN must contact provider.
Question 6:
The LPN is caring for four clients. Which client should the LPN see first?
A. Client with pneumonia on day 2 of antibiotics, temperature 37.2 °C
B. Client with type 2 diabetes scheduled for 0730 regular insulin, breakfast tray on table
C. Client with peripheral IV infiltrate rated 2+ edema but no pain
, D. Client with new colostomy requesting discharge teaching before 0900 transport
Correct Answer: C
Rationale: IV infiltrate can progress to tissue damage; LPN intervenes immediately by
discontinuing IV and notifying RN.
Question 7 (Matrix/NGN):
A 34-week-pregnant client arrives to triage with bright red bleeding and abdominal tenderness.
The LPN is asked to ready the room.
For each potential intervention, identify if the LPN may perform, assist, or not perform.
TableCopy
LPN may LPN may LPN may not
Intervention
perform assist perform
Start 18-gauge IV line with lactated
☐ ☑ ☐
Ringer’s.
Apply continuous fetal monitor. ☑ ☐ ☐
Perform cervical check. ☐ ☐ ☑
Correct Answer:
IV line: assist
Fetal monitor: perform
Cervical check: not perform
Rationale: LPN initiates external fetal monitoring; IV initiation requires RN but LPN may
assist; cervical assessment is RN/provider scope.
Question 8:
