Study ATI PN Comprehensive Predictor 2026
Exit Exam Complete 180 NGN-Style Practice
Questions & Rationales already graded A+
This comprehensive practice exam is designed to help you achieve a Level 3 score on the ATI PN
Comprehensive Predictor 2026 Exit Exam. All questions are formatted in the Next Generation
NCLEX (NGN) style, featuring multiple-choice, select-all-that-apply, and clinical judgment case
scenarios with detailed rationales for every answer.
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
Rationale: Informed consent for incapacitated clients must be obtained from the healthcare
surrogate or legal guardian. The surrogate must understand the risks and benefits .
, QUESTION 7
During a mass casualty event, the nurse's priority action is to:
A) Prepare the emergency department for incoming clients
B) Determine medical needs of incoming clients (triage)
C) Discharge stable clients
D) Call in additional staff
Correct Answer: B
Rationale: Triage requires assessing and categorizing clients based on medical needs to allocate
resources effectively. This is the priority action during a mass casualty event .
QUESTION 8
A nurse discovers a fire in a client's room. What is the first action?
A) Activate the fire alarm
B) Use the fire extinguisher
C) Remove the client from the room
D) Close all doors on the unit
Correct Answer: C
Rationale: RACE protocol: Rescue, Alarm, Contain, Extinguish. Client safety (rescue) is the
priority action .
QUESTION 9
A client refuses a prescribed medication. What should the PN do first?
A) Give the medication anyway
B) Document refusal and notify the RN/provider
C) Hide the medication in food
D) Call family to convince the client
Correct Answer: B
Rationale: Respect client autonomy. Document refusal, notify RN/provider, and explore reasons
for refusal .
Exit Exam Complete 180 NGN-Style Practice
Questions & Rationales already graded A+
This comprehensive practice exam is designed to help you achieve a Level 3 score on the ATI PN
Comprehensive Predictor 2026 Exit Exam. All questions are formatted in the Next Generation
NCLEX (NGN) style, featuring multiple-choice, select-all-that-apply, and clinical judgment case
scenarios with detailed rationales for every answer.
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
Rationale: Informed consent for incapacitated clients must be obtained from the healthcare
surrogate or legal guardian. The surrogate must understand the risks and benefits .
, QUESTION 7
During a mass casualty event, the nurse's priority action is to:
A) Prepare the emergency department for incoming clients
B) Determine medical needs of incoming clients (triage)
C) Discharge stable clients
D) Call in additional staff
Correct Answer: B
Rationale: Triage requires assessing and categorizing clients based on medical needs to allocate
resources effectively. This is the priority action during a mass casualty event .
QUESTION 8
A nurse discovers a fire in a client's room. What is the first action?
A) Activate the fire alarm
B) Use the fire extinguisher
C) Remove the client from the room
D) Close all doors on the unit
Correct Answer: C
Rationale: RACE protocol: Rescue, Alarm, Contain, Extinguish. Client safety (rescue) is the
priority action .
QUESTION 9
A client refuses a prescribed medication. What should the PN do first?
A) Give the medication anyway
B) Document refusal and notify the RN/provider
C) Hide the medication in food
D) Call family to convince the client
Correct Answer: B
Rationale: Respect client autonomy. Document refusal, notify RN/provider, and explore reasons
for refusal .
