Recommended ATI PN Comprehensive Predictor
2026 Exit Exam 180 NGN-Style Practice Questions
with Verified Answers & Rationales
Exam Type: ATI PN Comprehensive Predictor – Exit Exam
Format: NGN-Style Questions & Case Scenarios
Target Score: Level 3
Content Areas: Fundamentals, Pharmacology, Med-Surg, Maternal-Newborn, Pediatrics,
Mental Health, Management of Care
SECTION 1: MANAGEMENT OF CARE & PRIORITIZATION
(Questions 1-25)
QUESTION 1
A practical nurse (PN) is caring for a client in a long-term care facility. During the 0700
assessment, the PN notes:
• Unresponsive to verbal stimuli
• Respirations: 8/min and shallow
• Pulse: 42 bpm and weak
• Oxygen saturation: 84% on room air
• History: Advanced dementia and DNR/AND orders
Which action should the PN take first?
,A) Administer oxygen via non-rebreather mask
B) Call the client's family to inform them of the change
C) Reposition the client to facilitate airway clearance
D) Place the client in a supine position with a pillow under the head
Correct Answer: C
Rationale: In an unresponsive client with shallow respirations, the priority is airway
patency (ABC framework). The PN must first open the airway and clear secretions.
Repositioning (side-lying) helps drain secretions and prevents aspiration. Oxygen is
ineffective without a patent airway. DNR/AND status means no CPR or intubation, but
supportive care (repositioning, suctioning) is still provided.
QUESTION 2
A nurse is reinforcing teaching about advance directives. Which statement by the client
indicates understanding?
A) "Once I sign, I cannot change my advance directives."
B) "My family can override my decisions if they disagree."
C) "Advance directives only apply if I am unable to make decisions."
D) "I must have a lawyer present to create advance directives."
Correct Answer: C
Rationale: Advance directives provide guidance when the client cannot communicate
their wishes. Clients can change directives at any time as long as they are competent.
Family cannot override them. A lawyer is not required.
,QUESTION 3
A charge nurse is making assignments on a medical-surgical unit. Which client should
be assigned to the LPN/LVN?
A) Client 1 hour post-cardiac catheterization with bleeding at insertion site
B) Client with stable diabetes mellitus requiring insulin administration and routine
wound care
C) Client newly admitted with stroke and altered mental status
D) Client receiving IV heparin with PTT of 98 seconds
Correct Answer: B
Rationale: LPNs/LVNs can administer insulin and perform stable wound care for
predictable clients. Options A, C, and D require RN-level assessment: active bleeding
requires immediate intervention, neurological changes need expert evaluation, and
critical lab monitoring demands RN judgment.
QUESTION 4
The nurse has received change-of-shift report and is delegating tasks to the assistive
personnel (AP). Which task is appropriate to delegate?
A) Feeding a client admitted 24 hours ago with aspiration pneumonia
B) Reinforcing teaching with a client learning to use a quad cane
C) Reapplying a condom catheter for a client with urinary incontinence
D) Applying a sterile dressing to a pressure ulcer
Correct Answer: C
Rationale: APs can perform routine care for stable clients, including condom catheter
reapplication. Feeding a client with aspiration precautions requires skilled observation.
, Reinforcing teaching requires licensed nursing judgment. Sterile dressings require
aseptic technique and assessment skills.
QUESTION 5
A nurse is caring for four clients after receiving change-of-shift report. Which client
should the nurse assess first?
A) A client who is 2 days post-stroke and receiving enteral feedings
B) A client with COPD who reports increased shortness of breath
C) A client scheduled for discharge teaching in 1 hour
D) A client requesting pain medication for a headache
Correct Answer: B
Rationale: The ABC framework prioritizes airway and breathing. Increased shortness of
breath in a COPD client indicates potential respiratory compromise, requiring immediate
assessment.
QUESTION 6
A client in a coma is scheduled for surgery. The nurse should:
A) Obtain verbal consent from the client
B) Determine if the healthcare surrogate is aware of risks/benefits
C) Have two nurses witness consent
D) Proceed without consent as it is an emergency
Correct Answer: B
2026 Exit Exam 180 NGN-Style Practice Questions
with Verified Answers & Rationales
Exam Type: ATI PN Comprehensive Predictor – Exit Exam
Format: NGN-Style Questions & Case Scenarios
Target Score: Level 3
Content Areas: Fundamentals, Pharmacology, Med-Surg, Maternal-Newborn, Pediatrics,
Mental Health, Management of Care
SECTION 1: MANAGEMENT OF CARE & PRIORITIZATION
(Questions 1-25)
QUESTION 1
A practical nurse (PN) is caring for a client in a long-term care facility. During the 0700
assessment, the PN notes:
• Unresponsive to verbal stimuli
• Respirations: 8/min and shallow
• Pulse: 42 bpm and weak
• Oxygen saturation: 84% on room air
• History: Advanced dementia and DNR/AND orders
Which action should the PN take first?
,A) Administer oxygen via non-rebreather mask
B) Call the client's family to inform them of the change
C) Reposition the client to facilitate airway clearance
D) Place the client in a supine position with a pillow under the head
Correct Answer: C
Rationale: In an unresponsive client with shallow respirations, the priority is airway
patency (ABC framework). The PN must first open the airway and clear secretions.
Repositioning (side-lying) helps drain secretions and prevents aspiration. Oxygen is
ineffective without a patent airway. DNR/AND status means no CPR or intubation, but
supportive care (repositioning, suctioning) is still provided.
QUESTION 2
A nurse is reinforcing teaching about advance directives. Which statement by the client
indicates understanding?
A) "Once I sign, I cannot change my advance directives."
B) "My family can override my decisions if they disagree."
C) "Advance directives only apply if I am unable to make decisions."
D) "I must have a lawyer present to create advance directives."
Correct Answer: C
Rationale: Advance directives provide guidance when the client cannot communicate
their wishes. Clients can change directives at any time as long as they are competent.
Family cannot override them. A lawyer is not required.
,QUESTION 3
A charge nurse is making assignments on a medical-surgical unit. Which client should
be assigned to the LPN/LVN?
A) Client 1 hour post-cardiac catheterization with bleeding at insertion site
B) Client with stable diabetes mellitus requiring insulin administration and routine
wound care
C) Client newly admitted with stroke and altered mental status
D) Client receiving IV heparin with PTT of 98 seconds
Correct Answer: B
Rationale: LPNs/LVNs can administer insulin and perform stable wound care for
predictable clients. Options A, C, and D require RN-level assessment: active bleeding
requires immediate intervention, neurological changes need expert evaluation, and
critical lab monitoring demands RN judgment.
QUESTION 4
The nurse has received change-of-shift report and is delegating tasks to the assistive
personnel (AP). Which task is appropriate to delegate?
A) Feeding a client admitted 24 hours ago with aspiration pneumonia
B) Reinforcing teaching with a client learning to use a quad cane
C) Reapplying a condom catheter for a client with urinary incontinence
D) Applying a sterile dressing to a pressure ulcer
Correct Answer: C
Rationale: APs can perform routine care for stable clients, including condom catheter
reapplication. Feeding a client with aspiration precautions requires skilled observation.
, Reinforcing teaching requires licensed nursing judgment. Sterile dressings require
aseptic technique and assessment skills.
QUESTION 5
A nurse is caring for four clients after receiving change-of-shift report. Which client
should the nurse assess first?
A) A client who is 2 days post-stroke and receiving enteral feedings
B) A client with COPD who reports increased shortness of breath
C) A client scheduled for discharge teaching in 1 hour
D) A client requesting pain medication for a headache
Correct Answer: B
Rationale: The ABC framework prioritizes airway and breathing. Increased shortness of
breath in a COPD client indicates potential respiratory compromise, requiring immediate
assessment.
QUESTION 6
A client in a coma is scheduled for surgery. The nurse should:
A) Obtain verbal consent from the client
B) Determine if the healthcare surrogate is aware of risks/benefits
C) Have two nurses witness consent
D) Proceed without consent as it is an emergency
Correct Answer: B
