1
Virtual ATI Green Light Comprehensive Predictor
Actual Exam 2026/2027 | Verified Practice Test Bank
with Detailed Answers & Rationales | NCLEX
Readiness Assessment | A+ Graded
SECTION 1: MANAGEMENT OF CARE (Questions 1-25)
Q1: The charge nurse is making assignments for the medical-surgical unit. Which client should
be assigned to the most experienced registered nurse (RN)?
A. A 45-year-old with diabetes requiring a fasting blood glucose test and insulin administration
before breakfast
B. A 62-year-old 2 days post-operative following a total knee replacement requiring pain
management and physical therapy assistance
C. A 58-year-old with new-onset atrial fibrillation who just started an amiodarone IV infusion
and requires continuous cardiac monitoring [CORRECT]
D. A 72-year-old with pneumonia receiving IV antibiotics every 8 hours with stable vital signs
Rationale: The client with new-onset atrial fibrillation on amiodarone IV requires close
monitoring for dysrhythmias, hypotension, and adverse effects of the medication, necessitating
the clinical judgment of the most experienced RN. The other clients have stable, predictable care
needs that could be safely assigned to less experienced staff.
Q2: A nurse manager is reviewing incident reports. Which situation requires immediate follow-
up with the staff nurse?
A. An LPN administered a scheduled oral antibiotic 30 minutes late
B. An RN failed to document the client's pain assessment in the electronic record
C. An RN administered insulin without verifying the blood glucose level first [CORRECT]
D. A nursing assistant repositioned a client without assistance
Rationale: Administering insulin without verifying blood glucose is a serious medication error
that could result in hypoglycemia or hyperglycemia. This requires immediate coaching and
,2
possible disciplinary action. The other options represent documentation issues or minor delays
that, while needing correction, do not pose immediate patient safety risks.
Q3: Which task is appropriate for the RN to delegate to an unlicensed assistive personnel
(UAP)?
A. Administering a scheduled subcutaneous heparin injection
B. Measuring and recording intake and output for a client with heart failure [CORRECT]
C. Teaching a client how to use an incentive spirometer post-operatively
D. Assessing a post-operative client's surgical incision for signs of infection
Rationale: Measuring and recording I&O is within the UAP's scope of practice as it is a routine,
predictable task that does not require nursing judgment or assessment skills. Medication
administration, patient education, and wound assessment require licensed nursing knowledge and
cannot be delegated to UAPs.
Q4: A client is being discharged home with a new diagnosis of heart failure. Which statement by
the client indicates understanding of the discharge teaching?
A. "I should weigh myself daily and call my doctor if I gain 3 pounds in one day or 5 pounds in a
week" [CORRECT]
B. "I can eat as much salt as I want as long as I take my diuretic"
C. "I should stop taking my medication if I start feeling better"
D. "It's okay to drink 3-4 liters of fluid daily to stay hydrated"
Rationale: Daily weights are critical for monitoring fluid status in heart failure; a 2-3 pound gain
in 24 hours or 5 pounds in a week indicates fluid retention requiring medical evaluation. The
other statements demonstrate dangerous misconceptions about sodium restriction, medication
adherence, and fluid limitation in heart failure management.
Q5: The nurse is caring for four clients. Which client should the nurse assess first?
A. A client with a blood pressure of 148/92 mmHg
B. A client reporting chest pain rated 8/10 [CORRECT]
C. A client requesting a PRN laxative
,3
D. A client whose IV infusion is 30 minutes behind schedule
Rationale: Chest pain rated 8/10 indicates potential myocardial ischemia or infarction, requiring
immediate assessment and intervention to prevent cardiac damage. While elevated BP and
delayed medications need attention, they do not represent immediate life threats compared to
acute chest pain.
Q6: [Prioritization/Delegation] The charge nurse on a busy medical-surgical unit must delegate
tasks. Which assignment is most appropriate for the licensed practical nurse (LPN)?
A. Developing a plan of care for a newly admitted client with complex needs
B. Administering oral medications to a group of stable clients [CORRECT]
C. Performing the initial assessment on a client transferred from the ICU
D. Analyzing arterial blood gas results for a client with respiratory distress
Rationale: Administering oral medications to stable clients is within the LPN scope of practice.
Developing care plans, initial assessments, and analyzing diagnostic data require RN-level
critical thinking and judgment, making these inappropriate for LPN delegation.
Q7: A nurse is caring for a client who refuses a blood transfusion based on religious beliefs, even
though the transfusion is medically necessary. What is the nurse's priority action?
A. Obtain a court order to administer the transfusion against the client's wishes
B. Honor the client's autonomy and inform the healthcare provider immediately [CORRECT]
C. Convince the client to accept the transfusion by explaining the consequences
D. Administer the transfusion anyway to save the client's life
Rationale: Clients have the right to refuse treatment based on religious or personal beliefs. The
nurse must respect autonomy while ensuring the provider is informed to discuss alternatives and
document the informed refusal. Forcing treatment violates ethical and legal standards.
Q8: Which action by the nurse demonstrates appropriate use of information technology to ensure
continuity of care?
A. Documenting vital signs in the electronic health record at the end of the shift
B. Using barcode medication administration to verify client identity and medication
[CORRECT]
, 4
C. Sharing a client's information with a colleague in the cafeteria
D. Delaying documentation until all assessments are complete
Rationale: Barcode medication administration (BCMA) is an evidence-based technology that
reduces medication errors by verifying the right client, medication, dose, route, and time. Real-
time documentation and maintaining confidentiality are essential IT practices in nursing.
Q9: The nurse is advocating for a client who is not receiving adequate pain management. What
is the nurse's first step?
A. Contact the state board of nursing to report the provider
B. Document the client's pain scores and ineffective interventions
C. Contact the healthcare provider to discuss the client's pain management [CORRECT]
D. Tell the client to request a different physician
Rationale: The nurse's role as patient advocate includes communicating with the healthcare
provider to address inadequate pain management. This collaborative approach allows for care
plan modification before escalating concerns through formal channels.
Q10: A client with a do-not-resuscitate (DNR) order begins to show signs of respiratory failure.
What is the appropriate nursing action?
A. Initiate CPR immediately
B. Call a code blue and begin resuscitation
C. Provide comfort measures and notify the provider and family [CORRECT]
D. Transfer the client to the ICU for aggressive treatment
Rationale: A valid DNR order indicates the client's wish to forgo resuscitation. The nurse must
honor this advance directive while providing palliative care, ensuring comfort, and
communicating with the family and provider about the client's changing condition.
Q11: [Prioritization] The nurse receives report on four clients. Which client requires immediate
intervention?
A. A client with a potassium level of 4.2 mEq/L
B. A client with a heart rate of 52 bpm and dizziness [CORRECT]
Virtual ATI Green Light Comprehensive Predictor
Actual Exam 2026/2027 | Verified Practice Test Bank
with Detailed Answers & Rationales | NCLEX
Readiness Assessment | A+ Graded
SECTION 1: MANAGEMENT OF CARE (Questions 1-25)
Q1: The charge nurse is making assignments for the medical-surgical unit. Which client should
be assigned to the most experienced registered nurse (RN)?
A. A 45-year-old with diabetes requiring a fasting blood glucose test and insulin administration
before breakfast
B. A 62-year-old 2 days post-operative following a total knee replacement requiring pain
management and physical therapy assistance
C. A 58-year-old with new-onset atrial fibrillation who just started an amiodarone IV infusion
and requires continuous cardiac monitoring [CORRECT]
D. A 72-year-old with pneumonia receiving IV antibiotics every 8 hours with stable vital signs
Rationale: The client with new-onset atrial fibrillation on amiodarone IV requires close
monitoring for dysrhythmias, hypotension, and adverse effects of the medication, necessitating
the clinical judgment of the most experienced RN. The other clients have stable, predictable care
needs that could be safely assigned to less experienced staff.
Q2: A nurse manager is reviewing incident reports. Which situation requires immediate follow-
up with the staff nurse?
A. An LPN administered a scheduled oral antibiotic 30 minutes late
B. An RN failed to document the client's pain assessment in the electronic record
C. An RN administered insulin without verifying the blood glucose level first [CORRECT]
D. A nursing assistant repositioned a client without assistance
Rationale: Administering insulin without verifying blood glucose is a serious medication error
that could result in hypoglycemia or hyperglycemia. This requires immediate coaching and
,2
possible disciplinary action. The other options represent documentation issues or minor delays
that, while needing correction, do not pose immediate patient safety risks.
Q3: Which task is appropriate for the RN to delegate to an unlicensed assistive personnel
(UAP)?
A. Administering a scheduled subcutaneous heparin injection
B. Measuring and recording intake and output for a client with heart failure [CORRECT]
C. Teaching a client how to use an incentive spirometer post-operatively
D. Assessing a post-operative client's surgical incision for signs of infection
Rationale: Measuring and recording I&O is within the UAP's scope of practice as it is a routine,
predictable task that does not require nursing judgment or assessment skills. Medication
administration, patient education, and wound assessment require licensed nursing knowledge and
cannot be delegated to UAPs.
Q4: A client is being discharged home with a new diagnosis of heart failure. Which statement by
the client indicates understanding of the discharge teaching?
A. "I should weigh myself daily and call my doctor if I gain 3 pounds in one day or 5 pounds in a
week" [CORRECT]
B. "I can eat as much salt as I want as long as I take my diuretic"
C. "I should stop taking my medication if I start feeling better"
D. "It's okay to drink 3-4 liters of fluid daily to stay hydrated"
Rationale: Daily weights are critical for monitoring fluid status in heart failure; a 2-3 pound gain
in 24 hours or 5 pounds in a week indicates fluid retention requiring medical evaluation. The
other statements demonstrate dangerous misconceptions about sodium restriction, medication
adherence, and fluid limitation in heart failure management.
Q5: The nurse is caring for four clients. Which client should the nurse assess first?
A. A client with a blood pressure of 148/92 mmHg
B. A client reporting chest pain rated 8/10 [CORRECT]
C. A client requesting a PRN laxative
,3
D. A client whose IV infusion is 30 minutes behind schedule
Rationale: Chest pain rated 8/10 indicates potential myocardial ischemia or infarction, requiring
immediate assessment and intervention to prevent cardiac damage. While elevated BP and
delayed medications need attention, they do not represent immediate life threats compared to
acute chest pain.
Q6: [Prioritization/Delegation] The charge nurse on a busy medical-surgical unit must delegate
tasks. Which assignment is most appropriate for the licensed practical nurse (LPN)?
A. Developing a plan of care for a newly admitted client with complex needs
B. Administering oral medications to a group of stable clients [CORRECT]
C. Performing the initial assessment on a client transferred from the ICU
D. Analyzing arterial blood gas results for a client with respiratory distress
Rationale: Administering oral medications to stable clients is within the LPN scope of practice.
Developing care plans, initial assessments, and analyzing diagnostic data require RN-level
critical thinking and judgment, making these inappropriate for LPN delegation.
Q7: A nurse is caring for a client who refuses a blood transfusion based on religious beliefs, even
though the transfusion is medically necessary. What is the nurse's priority action?
A. Obtain a court order to administer the transfusion against the client's wishes
B. Honor the client's autonomy and inform the healthcare provider immediately [CORRECT]
C. Convince the client to accept the transfusion by explaining the consequences
D. Administer the transfusion anyway to save the client's life
Rationale: Clients have the right to refuse treatment based on religious or personal beliefs. The
nurse must respect autonomy while ensuring the provider is informed to discuss alternatives and
document the informed refusal. Forcing treatment violates ethical and legal standards.
Q8: Which action by the nurse demonstrates appropriate use of information technology to ensure
continuity of care?
A. Documenting vital signs in the electronic health record at the end of the shift
B. Using barcode medication administration to verify client identity and medication
[CORRECT]
, 4
C. Sharing a client's information with a colleague in the cafeteria
D. Delaying documentation until all assessments are complete
Rationale: Barcode medication administration (BCMA) is an evidence-based technology that
reduces medication errors by verifying the right client, medication, dose, route, and time. Real-
time documentation and maintaining confidentiality are essential IT practices in nursing.
Q9: The nurse is advocating for a client who is not receiving adequate pain management. What
is the nurse's first step?
A. Contact the state board of nursing to report the provider
B. Document the client's pain scores and ineffective interventions
C. Contact the healthcare provider to discuss the client's pain management [CORRECT]
D. Tell the client to request a different physician
Rationale: The nurse's role as patient advocate includes communicating with the healthcare
provider to address inadequate pain management. This collaborative approach allows for care
plan modification before escalating concerns through formal channels.
Q10: A client with a do-not-resuscitate (DNR) order begins to show signs of respiratory failure.
What is the appropriate nursing action?
A. Initiate CPR immediately
B. Call a code blue and begin resuscitation
C. Provide comfort measures and notify the provider and family [CORRECT]
D. Transfer the client to the ICU for aggressive treatment
Rationale: A valid DNR order indicates the client's wish to forgo resuscitation. The nurse must
honor this advance directive while providing palliative care, ensuring comfort, and
communicating with the family and provider about the client's changing condition.
Q11: [Prioritization] The nurse receives report on four clients. Which client requires immediate
intervention?
A. A client with a potassium level of 4.2 mEq/L
B. A client with a heart rate of 52 bpm and dizziness [CORRECT]
