ATI PN Comprehensive Predictor Exit Exam – 2026/2027
NGN Final Version
Complete Answer Key and Verified Questions
Effective Date: April 1, 2026 – March 31, 2029
Aligned with: 2026 NCLEX-PN® Test Plan & NCSBN Clinical Judgment Measurement
Model (NCJMM)
SECTION 1: TRADITIONAL MULTIPLE-CHOICE & SELECT-ALL-THAT-APPLY
(100 items)
Q1: A practical nurse is caring for a client with a serum potassium level of 5.8 mEq/L.
Which finding requires immediate intervention?
A. Client reports mild fatigue
B. Tall, peaked T waves on cardiac monitor [CORRECT]
C. Blood pressure 138/84 mmHg
D. Client denies muscle weakness
Correct Answer: B
Rationale: B is correct. [CORRECT] A potassium level of 5.8 mEq/L indicates
hyperkalemia. Tall, peaked T waves are the earliest electrocardiographic sign of
hyperkalemia and indicate cardiac irritability, which can progress to life-threatening
arrhythmias. This requires immediate intervention, including cardiac monitoring and
potential treatment with calcium gluconate, insulin/glucose, or sodium polystyrene
,sulfonate. Fatigue (A) and hypertension (C) are nonspecific. Denial of weakness (D)
does not rule out progressive neuromuscular complications.
Q2: A practical nurse is delegating tasks to unlicensed assistive personnel (UAP) on a
medical-surgical unit. Which task is appropriate to delegate?
A. Obtain vital signs on a stable postoperative client [CORRECT]
B. Administer oral medications to a newly admitted client
C. Assess wound healing in a client with diabetes
D. Teach a client about insulin self-administration
Correct Answer: A
Rationale: A is correct. [CORRECT] The PN scope of practice includes delegation to UAP
of tasks that are routine, do not require nursing judgment, and pose minimal risk to
stable clients. Obtaining vital signs on a stable client meets these criteria. Medication
administration (B), assessment requiring clinical judgment (C), and client education (D)
are within the scope of licensed nursing practice and cannot be delegated to UAP. The
PN remains accountable for delegated tasks.
Q3: A client with heart failure is prescribed furosemide 40 mg orally daily. Which
instruction should the practical nurse provide?
A. Take the medication at bedtime to avoid nocturia
B. Weigh yourself daily at the same time and report weight gain of 3 pounds in one day
[CORRECT]
C. Restrict fluid intake to 500 mL per day
,D. Stop taking the medication if you feel dizzy
Correct Answer: B
Rationale: B is correct. [CORRECT] Daily weights are the most sensitive indicator of fluid
retention in heart failure. A weight gain of 2-3 pounds in 24 hours or 5 pounds in one
week indicates fluid accumulation and requires healthcare provider notification.
Furosemide should be taken in the morning (A) to prevent nocturia. Fluid restriction (C)
is prescribed individually; 500 mL is excessively restrictive without specific orders.
Dizziness (D) may indicate hypotension but the medication should not be stopped
without consulting the provider.
Q4: A practical nurse is caring for a client with a nasogastric (NG) tube connected to
low intermittent suction. Which action by the nurse requires immediate correction?
A. Checking tube placement by aspirating gastric contents
B. Irrigating the NG tube with 30 mL sterile water using a piston syringe [CORRECT]
C. Securing the tube to the client's gown to prevent tension
D. Monitoring intake and output every 8 hours
Correct Answer: B
Rationale: B is correct. [CORRECT] NG tubes connected to suction should be irrigated
with normal saline, not sterile water. Water is hypotonic and can cause electrolyte
imbalances if absorbed. Additionally, irrigation should use the instillation/aspiration
method with a piston syringe, not forceful instillation. Checking placement (A), securing
to prevent tension (C), and monitoring I&O (D) are all appropriate interventions.
, Q5: Select all that apply. A practical nurse is caring for a client with chronic obstructive
pulmonary disease (COPD) who is receiving oxygen therapy. Which actions by the nurse
are appropriate? (Select all that apply.)
A. Set the oxygen flow rate to maintain SpO2 between 88-92% [CORRECT]
B. Encourage pursed-lip breathing techniques [CORRECT]
C. Position the client in high Fowler's position [CORRECT]
D. Monitor for signs of CO2 retention (somnolence, confusion) [CORRECT]
E. Increase oxygen flow rate to 6 L/min via nasal cannula to relieve dyspnea
Correct Answers: A, B, C, D
Rationale: A, B, C, D are correct. [CORRECT] Clients with COPD have chronic hypercapnia
and rely on hypoxic drive for breathing. Oxygen should be titrated to maintain SpO2
88-92% (A) to prevent CO2 narcosis. Pursed-lip breathing (B) prolongs exhalation and
prevents airway collapse. High Fowler's position (C) maximizes lung expansion.
Monitoring for CO2 retention (D) is essential. High-flow oxygen (E) is dangerous for
COPD clients as it can suppress the hypoxic drive and cause respiratory arrest.
Q6: A practical nurse is preparing to administer heparin 5,000 units subcutaneously.
Which action demonstrates correct technique?
A. Aspirate for blood return before injecting [CORRECT]
B. Massage the injection site after administration
C. Use a 1-inch, 25-gauge needle
D. Inject into the same site each time for consistency
NGN Final Version
Complete Answer Key and Verified Questions
Effective Date: April 1, 2026 – March 31, 2029
Aligned with: 2026 NCLEX-PN® Test Plan & NCSBN Clinical Judgment Measurement
Model (NCJMM)
SECTION 1: TRADITIONAL MULTIPLE-CHOICE & SELECT-ALL-THAT-APPLY
(100 items)
Q1: A practical nurse is caring for a client with a serum potassium level of 5.8 mEq/L.
Which finding requires immediate intervention?
A. Client reports mild fatigue
B. Tall, peaked T waves on cardiac monitor [CORRECT]
C. Blood pressure 138/84 mmHg
D. Client denies muscle weakness
Correct Answer: B
Rationale: B is correct. [CORRECT] A potassium level of 5.8 mEq/L indicates
hyperkalemia. Tall, peaked T waves are the earliest electrocardiographic sign of
hyperkalemia and indicate cardiac irritability, which can progress to life-threatening
arrhythmias. This requires immediate intervention, including cardiac monitoring and
potential treatment with calcium gluconate, insulin/glucose, or sodium polystyrene
,sulfonate. Fatigue (A) and hypertension (C) are nonspecific. Denial of weakness (D)
does not rule out progressive neuromuscular complications.
Q2: A practical nurse is delegating tasks to unlicensed assistive personnel (UAP) on a
medical-surgical unit. Which task is appropriate to delegate?
A. Obtain vital signs on a stable postoperative client [CORRECT]
B. Administer oral medications to a newly admitted client
C. Assess wound healing in a client with diabetes
D. Teach a client about insulin self-administration
Correct Answer: A
Rationale: A is correct. [CORRECT] The PN scope of practice includes delegation to UAP
of tasks that are routine, do not require nursing judgment, and pose minimal risk to
stable clients. Obtaining vital signs on a stable client meets these criteria. Medication
administration (B), assessment requiring clinical judgment (C), and client education (D)
are within the scope of licensed nursing practice and cannot be delegated to UAP. The
PN remains accountable for delegated tasks.
Q3: A client with heart failure is prescribed furosemide 40 mg orally daily. Which
instruction should the practical nurse provide?
A. Take the medication at bedtime to avoid nocturia
B. Weigh yourself daily at the same time and report weight gain of 3 pounds in one day
[CORRECT]
C. Restrict fluid intake to 500 mL per day
,D. Stop taking the medication if you feel dizzy
Correct Answer: B
Rationale: B is correct. [CORRECT] Daily weights are the most sensitive indicator of fluid
retention in heart failure. A weight gain of 2-3 pounds in 24 hours or 5 pounds in one
week indicates fluid accumulation and requires healthcare provider notification.
Furosemide should be taken in the morning (A) to prevent nocturia. Fluid restriction (C)
is prescribed individually; 500 mL is excessively restrictive without specific orders.
Dizziness (D) may indicate hypotension but the medication should not be stopped
without consulting the provider.
Q4: A practical nurse is caring for a client with a nasogastric (NG) tube connected to
low intermittent suction. Which action by the nurse requires immediate correction?
A. Checking tube placement by aspirating gastric contents
B. Irrigating the NG tube with 30 mL sterile water using a piston syringe [CORRECT]
C. Securing the tube to the client's gown to prevent tension
D. Monitoring intake and output every 8 hours
Correct Answer: B
Rationale: B is correct. [CORRECT] NG tubes connected to suction should be irrigated
with normal saline, not sterile water. Water is hypotonic and can cause electrolyte
imbalances if absorbed. Additionally, irrigation should use the instillation/aspiration
method with a piston syringe, not forceful instillation. Checking placement (A), securing
to prevent tension (C), and monitoring I&O (D) are all appropriate interventions.
, Q5: Select all that apply. A practical nurse is caring for a client with chronic obstructive
pulmonary disease (COPD) who is receiving oxygen therapy. Which actions by the nurse
are appropriate? (Select all that apply.)
A. Set the oxygen flow rate to maintain SpO2 between 88-92% [CORRECT]
B. Encourage pursed-lip breathing techniques [CORRECT]
C. Position the client in high Fowler's position [CORRECT]
D. Monitor for signs of CO2 retention (somnolence, confusion) [CORRECT]
E. Increase oxygen flow rate to 6 L/min via nasal cannula to relieve dyspnea
Correct Answers: A, B, C, D
Rationale: A, B, C, D are correct. [CORRECT] Clients with COPD have chronic hypercapnia
and rely on hypoxic drive for breathing. Oxygen should be titrated to maintain SpO2
88-92% (A) to prevent CO2 narcosis. Pursed-lip breathing (B) prolongs exhalation and
prevents airway collapse. High Fowler's position (C) maximizes lung expansion.
Monitoring for CO2 retention (D) is essential. High-flow oxygen (E) is dangerous for
COPD clients as it can suppress the hypoxic drive and cause respiratory arrest.
Q6: A practical nurse is preparing to administer heparin 5,000 units subcutaneously.
Which action demonstrates correct technique?
A. Aspirate for blood return before injecting [CORRECT]
B. Massage the injection site after administration
C. Use a 1-inch, 25-gauge needle
D. Inject into the same site each time for consistency
