Newest ATI PN Comprehensive Predictor® Exit Exam
(2023–2026 Edition with NGN) PDF
Question 1: Management of Care (Prioritization)
A nurse in a long-term care facility is receiving a change-of-shift report for four clients.
Which of the following clients should the nurse assess first?
A) A client who has chronic obstructive pulmonary disease (COPD) and an
of 90%.
B) A client who has diabetes mellitus and reports feeling shaky and lightheaded.
C) A client who has heart failure and an oral temperature of 37.5°C (99.5°F).
D) A client who has a hip fracture and reports a pain level of 7 on a scale of 0 to 10.
Answer: B
Explanation: Using the Survival Priority Framework, the client reporting
shakiness and lightheadedness is showing classic signs of hypoglycemia. This is an
acute, life-threatening condition that requires immediate glucose monitoring and
intervention. Option A is an expected finding for a COPD patient; Option C is a low-
grade fever that is not the highest priority; Option D requires pain management but is
not as life-threatening as a potential hypoglycemic shock.
Question 2: Safety and Infection Control
A nurse is preparing to care for a client who has a prescription for Contact
Precautions. Which of the following actions should the nurse take?
A) Wear an N95 respirator when working within 3 feet of the client.
B) Keep the door to the client's room closed at all times to maintain negative airflow.
C) Dedicated equipment, such as a stethoscope and blood pressure cuff, should remain
in the room.
D) Remove the gown after leaving the client's room and entering the hallway.
Answer: C
, Explanation: For Contact Precautions (used for MRSA, VRE, or C. diff), the
nurse should use dedicated equipment to prevent cross-contamination between
clients. Options A and B refer to Airborne Precautions. Option D is incorrect because
PPE should be removed before exiting the room to prevent carrying pathogens into
common areas.
Question 3: Pharmacology (Medication Safety)
A nurse is preparing to administer regular insulin and NPH insulin in the same syringe
to a client who has diabetes mellitus. Which of the following actions should the nurse
take first?
A) Inject air into the vial of NPH insulin.
B) Withdraw the regular insulin into the syringe.
C) Invert the NPH vial to mix the suspension.
D) Check the client's most recent blood glucose level.
Answer: D
Explanation: According to the Nursing Process, assessment is always the first
step. The nurse must check the blood glucose level to ensure the dose is safe and
appropriate for the client's current status. While injecting air into the NPH (Option A) is
the first physical step of the mixing process (Clear before Cloudy), it should not be done
until the nurse has confirmed the clinical need for the medication.
Question 4: Reduction of Risk Potential (Laboratory Values)
A nurse is reviewing the laboratory results for a client who is receiving furosemide for
heart failure. Which of the following results should the nurse report to the provider?
A) Sodium 138 mEq/L
B) Potassium 2.8 mEq/L
C) Creatinine 1.0 mg/dL
D) BUN 18 mg/dL
Answer: B
Explanation: Furosemide is a loop diuretic that causes the excretion of potassium.
A potassium level of 2.8 mEq/L indicates hypokalemia (normal range is 3.5 to 5.0
, mEq/L), which can lead to life-threatening cardiac dysrhythmias. The other values
(Options A, C, and D) are within the expected reference ranges.
Question 5: NGN Bowtie Item (Clinical Judgment)
A client is admitted with a diagnosis of dehydration and is receiving IV fluids. The
nurse notes the client has developed crackles in the lungs, distended neck veins, and
a bounding pulse.
The nurse should identify that the client is experiencing [ ] and should [ ].
A) Hypovolemia; Increase the IV flow rate.
B) Pulmonary Embolism; Place the client in a supine position.
C) Fluid Volume Excess; Slow the IV infusion rate.
D) Pneumonia; Administer a prescribed antibiotic.
Answer: C
Explanation: Crackles, neck vein distention (JVD), and a bounding pulse are
classic signs of Fluid Volume Excess (hypervolemia). The immediate priority action is
to slow or stop the IV infusion to prevent further fluid overload and potential
pulmonary edema. Increasing the rate (Option A) would worsen the condition.
Question 6: Pharmacology (Adverse Effects)
A nurse is providing teaching to a client who has a new prescription
for spironolactone for the treatment of hypertension. Which of the following statements
by the client indicates an understanding of the teaching?
A) "I will increase my intake of bananas and orange juice."
B) "I will use a salt substitute to season my food."
C) "I will report any new onset of breast tenderness or enlargement."
D) "I will take this medication right before I go to bed."
Answer: C
Explanation: Spironolactone is a potassium-sparing diuretic that can
cause gynecomastia (breast tissue growth) or breast tenderness due to its hormonal
effects. Options A and B are incorrect because increasing potassium or using salt
, substitutes (which often contain potassium) increases the risk of life-
threatening hyperkalemia. Option D is incorrect because diuretics should be taken in
the morning to prevent nocturia (waking up at night to urinate).
Question 7: Pediatrics (Growth and Development)
A nurse is performing a physical assessment on a 12-month-old infant. Which of the
following findings should the nurse report to the provider?
A) The infant’s birth weight has tripled.
B) The infant’s anterior fontanel is closed.
C) The infant is unable to sit steadily without support.
D) The infant has six erupted teeth.
Answer: C
Explanation: According to developmental milestones, an infant should be able to
sit steadily without support by 8 months of age. Inability to do so at 12 months indicates
a potential developmental delay. Tripling birth weight (Option A) and having six teeth
(Option D) are expected findings at 1 year. The anterior fontanel (Option B) typically
closes between 12 and 18 months, so closure at 12 months is within the normal range.
Question 8: Maternal-Newborn (Postpartum Care)
A nurse is assessing a client who is 2 hr postpartum. Which of the following findings is
the priority for the nurse to report to the provider?
A) A fundus that is firm and located at the level of the umbilicus.
B) A small amount of lochia rubra on the perineal pad.
C) A client report of feeling a "gush of blood" when standing up.
D) A fundus that is deviated to the right and above the umbilicus.
Answer: D
Explanation: A fundus that is deviated to the right and high usually indicates
a distended bladder. A full bladder prevents the uterus from contracting effectively,
which significantly increases the risk of postpartum hemorrhage. The nurse should
first assist the client to void. Options A and B are normal findings. Option C is a
common occurrence due to pooling of blood in the vagina while lying down.
(2023–2026 Edition with NGN) PDF
Question 1: Management of Care (Prioritization)
A nurse in a long-term care facility is receiving a change-of-shift report for four clients.
Which of the following clients should the nurse assess first?
A) A client who has chronic obstructive pulmonary disease (COPD) and an
of 90%.
B) A client who has diabetes mellitus and reports feeling shaky and lightheaded.
C) A client who has heart failure and an oral temperature of 37.5°C (99.5°F).
D) A client who has a hip fracture and reports a pain level of 7 on a scale of 0 to 10.
Answer: B
Explanation: Using the Survival Priority Framework, the client reporting
shakiness and lightheadedness is showing classic signs of hypoglycemia. This is an
acute, life-threatening condition that requires immediate glucose monitoring and
intervention. Option A is an expected finding for a COPD patient; Option C is a low-
grade fever that is not the highest priority; Option D requires pain management but is
not as life-threatening as a potential hypoglycemic shock.
Question 2: Safety and Infection Control
A nurse is preparing to care for a client who has a prescription for Contact
Precautions. Which of the following actions should the nurse take?
A) Wear an N95 respirator when working within 3 feet of the client.
B) Keep the door to the client's room closed at all times to maintain negative airflow.
C) Dedicated equipment, such as a stethoscope and blood pressure cuff, should remain
in the room.
D) Remove the gown after leaving the client's room and entering the hallway.
Answer: C
, Explanation: For Contact Precautions (used for MRSA, VRE, or C. diff), the
nurse should use dedicated equipment to prevent cross-contamination between
clients. Options A and B refer to Airborne Precautions. Option D is incorrect because
PPE should be removed before exiting the room to prevent carrying pathogens into
common areas.
Question 3: Pharmacology (Medication Safety)
A nurse is preparing to administer regular insulin and NPH insulin in the same syringe
to a client who has diabetes mellitus. Which of the following actions should the nurse
take first?
A) Inject air into the vial of NPH insulin.
B) Withdraw the regular insulin into the syringe.
C) Invert the NPH vial to mix the suspension.
D) Check the client's most recent blood glucose level.
Answer: D
Explanation: According to the Nursing Process, assessment is always the first
step. The nurse must check the blood glucose level to ensure the dose is safe and
appropriate for the client's current status. While injecting air into the NPH (Option A) is
the first physical step of the mixing process (Clear before Cloudy), it should not be done
until the nurse has confirmed the clinical need for the medication.
Question 4: Reduction of Risk Potential (Laboratory Values)
A nurse is reviewing the laboratory results for a client who is receiving furosemide for
heart failure. Which of the following results should the nurse report to the provider?
A) Sodium 138 mEq/L
B) Potassium 2.8 mEq/L
C) Creatinine 1.0 mg/dL
D) BUN 18 mg/dL
Answer: B
Explanation: Furosemide is a loop diuretic that causes the excretion of potassium.
A potassium level of 2.8 mEq/L indicates hypokalemia (normal range is 3.5 to 5.0
, mEq/L), which can lead to life-threatening cardiac dysrhythmias. The other values
(Options A, C, and D) are within the expected reference ranges.
Question 5: NGN Bowtie Item (Clinical Judgment)
A client is admitted with a diagnosis of dehydration and is receiving IV fluids. The
nurse notes the client has developed crackles in the lungs, distended neck veins, and
a bounding pulse.
The nurse should identify that the client is experiencing [ ] and should [ ].
A) Hypovolemia; Increase the IV flow rate.
B) Pulmonary Embolism; Place the client in a supine position.
C) Fluid Volume Excess; Slow the IV infusion rate.
D) Pneumonia; Administer a prescribed antibiotic.
Answer: C
Explanation: Crackles, neck vein distention (JVD), and a bounding pulse are
classic signs of Fluid Volume Excess (hypervolemia). The immediate priority action is
to slow or stop the IV infusion to prevent further fluid overload and potential
pulmonary edema. Increasing the rate (Option A) would worsen the condition.
Question 6: Pharmacology (Adverse Effects)
A nurse is providing teaching to a client who has a new prescription
for spironolactone for the treatment of hypertension. Which of the following statements
by the client indicates an understanding of the teaching?
A) "I will increase my intake of bananas and orange juice."
B) "I will use a salt substitute to season my food."
C) "I will report any new onset of breast tenderness or enlargement."
D) "I will take this medication right before I go to bed."
Answer: C
Explanation: Spironolactone is a potassium-sparing diuretic that can
cause gynecomastia (breast tissue growth) or breast tenderness due to its hormonal
effects. Options A and B are incorrect because increasing potassium or using salt
, substitutes (which often contain potassium) increases the risk of life-
threatening hyperkalemia. Option D is incorrect because diuretics should be taken in
the morning to prevent nocturia (waking up at night to urinate).
Question 7: Pediatrics (Growth and Development)
A nurse is performing a physical assessment on a 12-month-old infant. Which of the
following findings should the nurse report to the provider?
A) The infant’s birth weight has tripled.
B) The infant’s anterior fontanel is closed.
C) The infant is unable to sit steadily without support.
D) The infant has six erupted teeth.
Answer: C
Explanation: According to developmental milestones, an infant should be able to
sit steadily without support by 8 months of age. Inability to do so at 12 months indicates
a potential developmental delay. Tripling birth weight (Option A) and having six teeth
(Option D) are expected findings at 1 year. The anterior fontanel (Option B) typically
closes between 12 and 18 months, so closure at 12 months is within the normal range.
Question 8: Maternal-Newborn (Postpartum Care)
A nurse is assessing a client who is 2 hr postpartum. Which of the following findings is
the priority for the nurse to report to the provider?
A) A fundus that is firm and located at the level of the umbilicus.
B) A small amount of lochia rubra on the perineal pad.
C) A client report of feeling a "gush of blood" when standing up.
D) A fundus that is deviated to the right and above the umbilicus.
Answer: D
Explanation: A fundus that is deviated to the right and high usually indicates
a distended bladder. A full bladder prevents the uterus from contracting effectively,
which significantly increases the risk of postpartum hemorrhage. The nurse should
first assist the client to void. Options A and B are normal findings. Option C is a
common occurrence due to pooling of blood in the vagina while lying down.
