1
ATI RN Comprehensive Predictor 2026 Exit Exam Study
Guide and Practice Test mixed screenshoots .
Advanced Nursing Practice and Next Generation NCLEX (NGN) Readiness
Examination: 100 High-Acuity Multiple-Choice Questions Covering Clinical
Judgment, Prioritization, Pharmacology, Complex Medical-Surgical Conditions,
Maternal-Newborn Care, Pediatrics, Psychiatric Nursing, Community Health, and
Leadership/Management with Detailed Rationales for NCLEX-RN Success
1. A 68-year-old client with a history of hypertension and type 2 diabetes is
admitted with acute shortness of breath and productive cough with pink, frothy
sputum. Vital signs: BP 168/94 mm Hg, HR 112/min, RR 32/min, SpO₂ 88% on
room air, temperature 37.2°C (99°F). Lung auscultation reveals coarse crackles
throughout all fields. The nurse places the client on 4 L/min oxygen via nasal
cannula. Which finding would indicate improvement in the client's condition?
A. SpO₂ increases to 92% and respiratory rate decreases to 24/min
B. Blood pressure decreases to 142/86 mm Hg and heart rate increases to 118/min
C. Crackles become more pronounced and sputum production increases
D. Client reports feeling more fatigued and requests to rest
Correct Answer: A
Rationale: Improvement in SpO₂ and respiratory rate (A) indicates the
intervention is effective and oxygenation is improving. Increasing heart rate
with BP decrease (B) suggests deterioration. Worsening crackles (C) and
increased fatigue (D) indicate failure of the intervention and possible
deterioration.
, 2
2. A 45-year-old client presents to the emergency department with severe
abdominal pain, nausea, and vomiting for 3 days. The client has a history of
alcohol use disorder. Vital signs: BP 98/62 mm Hg, HR 118/min, RR 22/min,
temperature 37.8°C (100°F). Laboratory findings: serum amylase 600 U/L, lipase
1,200 U/L, glucose 180 mg/dL, calcium 7.8 mg/dL, WBC 16,000/mm³. Which action
should the nurse implement first?
A. Administer IV fluids at 150 mL/hr
B. Administer prescribed morphine for pain
C. Insert a nasogastric tube
D. Obtain a blood culture
Correct Answer: A
, 3
Rationale: The client is showing signs of hypovolemia (hypotension,
tachycardia) due to third-spacing from acute pancreatitis. IV fluid
resuscitation (A) is the priority to restore hemodynamic stability. Pain
management (B), NG tube insertion (C), and blood cultures (D) are important
but secondary to fluid resuscitation.
3. A 72-year-old client with dementia is admitted from a long-term care facility
with a urinary tract infection. The client is confused and has pulled out the IV line
twice. Vital signs are stable. Which intervention is most appropriate to ensure
client safety while maintaining dignity?
A. Apply bilateral soft wrist restraints to prevent IV removal
B. Place the client in a room near the nurses' station for closer monitoring
, 4
C. Administer a PRN sedative medication to reduce agitation
D. Use a mitt restraint on the hand with the IV to prevent access
Correct Answer: B
Rationale: Placing the client near the nurses' station (B) allows for increased
observation without restricting the client. Restraints (A, D) should only be
used as a last resort. Sedation (C) should not be used solely for behavioral
management.
4. A nurse is performing a focused assessment on a client 2 hours after a right
total knee arthroplasty. The client reports pain at the surgical site rated as 7 on a
ATI RN Comprehensive Predictor 2026 Exit Exam Study
Guide and Practice Test mixed screenshoots .
Advanced Nursing Practice and Next Generation NCLEX (NGN) Readiness
Examination: 100 High-Acuity Multiple-Choice Questions Covering Clinical
Judgment, Prioritization, Pharmacology, Complex Medical-Surgical Conditions,
Maternal-Newborn Care, Pediatrics, Psychiatric Nursing, Community Health, and
Leadership/Management with Detailed Rationales for NCLEX-RN Success
1. A 68-year-old client with a history of hypertension and type 2 diabetes is
admitted with acute shortness of breath and productive cough with pink, frothy
sputum. Vital signs: BP 168/94 mm Hg, HR 112/min, RR 32/min, SpO₂ 88% on
room air, temperature 37.2°C (99°F). Lung auscultation reveals coarse crackles
throughout all fields. The nurse places the client on 4 L/min oxygen via nasal
cannula. Which finding would indicate improvement in the client's condition?
A. SpO₂ increases to 92% and respiratory rate decreases to 24/min
B. Blood pressure decreases to 142/86 mm Hg and heart rate increases to 118/min
C. Crackles become more pronounced and sputum production increases
D. Client reports feeling more fatigued and requests to rest
Correct Answer: A
Rationale: Improvement in SpO₂ and respiratory rate (A) indicates the
intervention is effective and oxygenation is improving. Increasing heart rate
with BP decrease (B) suggests deterioration. Worsening crackles (C) and
increased fatigue (D) indicate failure of the intervention and possible
deterioration.
, 2
2. A 45-year-old client presents to the emergency department with severe
abdominal pain, nausea, and vomiting for 3 days. The client has a history of
alcohol use disorder. Vital signs: BP 98/62 mm Hg, HR 118/min, RR 22/min,
temperature 37.8°C (100°F). Laboratory findings: serum amylase 600 U/L, lipase
1,200 U/L, glucose 180 mg/dL, calcium 7.8 mg/dL, WBC 16,000/mm³. Which action
should the nurse implement first?
A. Administer IV fluids at 150 mL/hr
B. Administer prescribed morphine for pain
C. Insert a nasogastric tube
D. Obtain a blood culture
Correct Answer: A
, 3
Rationale: The client is showing signs of hypovolemia (hypotension,
tachycardia) due to third-spacing from acute pancreatitis. IV fluid
resuscitation (A) is the priority to restore hemodynamic stability. Pain
management (B), NG tube insertion (C), and blood cultures (D) are important
but secondary to fluid resuscitation.
3. A 72-year-old client with dementia is admitted from a long-term care facility
with a urinary tract infection. The client is confused and has pulled out the IV line
twice. Vital signs are stable. Which intervention is most appropriate to ensure
client safety while maintaining dignity?
A. Apply bilateral soft wrist restraints to prevent IV removal
B. Place the client in a room near the nurses' station for closer monitoring
, 4
C. Administer a PRN sedative medication to reduce agitation
D. Use a mitt restraint on the hand with the IV to prevent access
Correct Answer: B
Rationale: Placing the client near the nurses' station (B) allows for increased
observation without restricting the client. Restraints (A, D) should only be
used as a last resort. Sedation (C) should not be used solely for behavioral
management.
4. A nurse is performing a focused assessment on a client 2 hours after a right
total knee arthroplasty. The client reports pain at the surgical site rated as 7 on a
