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ATI RN COMPREHENSIVE # #
ATI RN Comprehensive Predictor 2026 Exit Exam: Full 180-
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Question NGN Simulation with Rationales # # # #
ATI RN COMPREHENSIVE PREDICTOR 2026 – FULL 180-QUESTION SIMULATED EXAM
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INTRODUCTION
Welcome to this comprehensive simulated ATI RN Comprehensive Predictor Exit Exam.
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This resource is designed to mirror the structure, content, and difficulty level of the
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actual ATI examination that nursing students take as a final assessment of readiness for
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the NCLEX-RN.
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About This Exam # #
Component Details
Total
180
Questions
Format Traditional Multiple Choice + NGN (Next Generation NCLEX) Case Studies
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NGN
6 full case studies with bow-tie, matrix, drag-and-drop, and highlight questions
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Components
Time
180 minutes (1 minute per question)
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Allocation
Management of Care, Safety & Infection Control, Health Promotion, Psychosocial
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Content Areas # Integrity, Basic Care & Comfort, Pharmacological Therapies, Reduction of Risk
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Potential, Physiological Adaptation # #
Purpose Predicts NCLEX-RN pass probability and identifies final remediation needs
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How to Use This Exam
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1. Simulate Real Testing Conditions: Set aside 180 minutes in a quiet environment.
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No books, notes, or electronic devices other than a timer.
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ATI RN COMPREHENSIVE # #
2. Answer All Questions: Mark your answers on a separate sheet or document.
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3. Review Rationales: After completing each section, review the rationales for both
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correct and incorrect answers to understand the clinical reasoning.
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4. Track Your Performance: Use the answer key to calculate your percentage score.
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A score of 70% or higher indicates strong NCLEX readiness.
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5. Focus on Weak Areas: Identify content areas where you scored below 70% and
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prioritize remediation. #
EXAM START #
SECTION 1: MANAGEMENT OF CARE (Questions 1-36)
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This section tests your knowledge of delegation, prioritization, client advocacy,
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legal/ethical issues, case management, and healthcare systems.
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Question 1 #
A charge nurse is assigning clients on a medical-surgical unit. Which client should be
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assigned to a licensed practical nurse (LPN)?
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A) A client with a new tracheostomy requiring initial tracheostomy care teaching
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B) A client with stable diabetes mellitus requiring morning insulin administration
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C) A client with chest tubes and continuous bubbling in the water seal chamber
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D) A client with a head injury and Glasgow Coma Scale score of 9
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Answer: B #
Rationale: The LPN can safely administer medications to stable clients. Option A
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requires RN-level teaching. Option C requires RN assessment of an air leak. Option D
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requires RN-level neurological assessment.
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Question 2 #
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ATI RN COMPREHENSIVE # #
A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
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client's spouse demands that the transfusion be given. What is the nurse's priority
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action?
A) Administer the transfusion as the spouse requests
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B) Notify the healthcare provider of the client's refusal
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C) Contact the hospital ethics committee
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D) Ask the client to reconsider for the family's sake
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Answer: B #
Rationale: The nurse must respect the client's autonomy and right to refuse treatment.
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The healthcare provider should be notified so alternative treatments can be considered.
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The client's decision takes precedence over family wishes.
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Question 3 #
A nurse is preparing to discharge a client who speaks a language different from the
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nurse. No interpreter is immediately available. Which action is appropriate?
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A) Use the client's adult child as an interpreter
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B) Provide written discharge instructions in the client's language
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C) Delay discharge until a certified medical interpreter is available
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D) Use a translation app on a personal smartphone
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Answer: C #
Rationale: Delaying discharge until a qualified medical interpreter is available ensures
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accurate communication and safe discharge. Family members may not provide accurate
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medical interpretation. Written instructions may not be understood if the client is
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illiterate. Translation apps may not be HIPAA-compliant.
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Question 4 #
A nurse manager is reviewing informed consent with new staff. Which statement by a
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staff member indicates understanding?
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A) "The nurse is responsible for explaining the procedure to the client."
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B) "A witness signature confirms the client gave voluntary consent."
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ATI RN COMPREHENSIVE# #
C) "Informed consent is only required for surgical procedures."
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D) "A family member can sign consent for any adult client."
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Answer: B #
Rationale: The witness signature confirms the client signed voluntarily and appeared
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competent. The provider (not nurse) explains the procedure. Consent is required for
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invasive procedures, not just surgery. Family can only sign if the client is incapacitated
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with appropriate legal documentation.
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Question 5 #
A nurse is delegating tasks to assistive personnel (AP). Which task is appropriate for the
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AP to perform?
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A) Assess a client's surgical incision for signs of infection
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B) Measure intake and output for a client with heart failure
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C) Evaluate the effectiveness of pain medication
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D) Teach a client how to use an incentive spirometer
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Answer: B #
Rationale: Measuring intake and output is within the AP's scope of practice. Assessment
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(A), evaluation (C), and teaching (D) require nursing judgment and are outside AP scope.
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Question 6 #
A nurse is caring for a client who has a living will. The client's condition has deteriorated,
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and the family wants aggressive treatment. What should the nurse do?
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A) Follow the family's wishes to avoid conflict
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B) Initiate aggressive treatment as requested
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C) Review the living will with the family and honor the client's wishes
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D) Contact risk management for legal guidance
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Answer: C #
Rationale: The living will documents the client's wishes and must be honored. The nurse
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should review it with the family and advocate for client autonomy. The provider may
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need to clarify, but client wishes take precedence over family preferences.
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ATI RN COMPREHENSIVE # #
ATI RN Comprehensive Predictor 2026 Exit Exam: Full 180-
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Question NGN Simulation with Rationales # # # #
ATI RN COMPREHENSIVE PREDICTOR 2026 – FULL 180-QUESTION SIMULATED EXAM
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INTRODUCTION
Welcome to this comprehensive simulated ATI RN Comprehensive Predictor Exit Exam.
# # # # # # # # # #
This resource is designed to mirror the structure, content, and difficulty level of the
# # # # # # # # # # # # #
actual ATI examination that nursing students take as a final assessment of readiness for
# # # # # # # # # # # # #
the NCLEX-RN.
#
About This Exam # #
Component Details
Total
180
Questions
Format Traditional Multiple Choice + NGN (Next Generation NCLEX) Case Studies
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NGN
6 full case studies with bow-tie, matrix, drag-and-drop, and highlight questions
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Components
Time
180 minutes (1 minute per question)
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Allocation
Management of Care, Safety & Infection Control, Health Promotion, Psychosocial
# # # # # # # # #
Content Areas # Integrity, Basic Care & Comfort, Pharmacological Therapies, Reduction of Risk
# # # # # # # # #
Potential, Physiological Adaptation # #
Purpose Predicts NCLEX-RN pass probability and identifies final remediation needs
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How to Use This Exam
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1. Simulate Real Testing Conditions: Set aside 180 minutes in a quiet environment.
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No books, notes, or electronic devices other than a timer.
# # # # # # # # #
,#
ATI RN COMPREHENSIVE # #
2. Answer All Questions: Mark your answers on a separate sheet or document.
# # # # # # # # # # # #
3. Review Rationales: After completing each section, review the rationales for both
# # # # # # # # # # #
correct and incorrect answers to understand the clinical reasoning.
# # # # # # # #
4. Track Your Performance: Use the answer key to calculate your percentage score.
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A score of 70% or higher indicates strong NCLEX readiness.
# # # # # # # # #
5. Focus on Weak Areas: Identify content areas where you scored below 70% and
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prioritize remediation. #
EXAM START #
SECTION 1: MANAGEMENT OF CARE (Questions 1-36)
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This section tests your knowledge of delegation, prioritization, client advocacy,
# # # # # # # # #
legal/ethical issues, case management, and healthcare systems.
# # # # # #
Question 1 #
A charge nurse is assigning clients on a medical-surgical unit. Which client should be
# # # # # # # # # # # # #
assigned to a licensed practical nurse (LPN)?
# # # # # #
A) A client with a new tracheostomy requiring initial tracheostomy care teaching
# # # # # # # # # # #
B) A client with stable diabetes mellitus requiring morning insulin administration
# # # # # # # # # #
C) A client with chest tubes and continuous bubbling in the water seal chamber
# # # # # # # # # # # # #
D) A client with a head injury and Glasgow Coma Scale score of 9
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Answer: B #
Rationale: The LPN can safely administer medications to stable clients. Option A
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requires RN-level teaching. Option C requires RN assessment of an air leak. Option D
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requires RN-level neurological assessment.
# # #
Question 2 #
,#
ATI RN COMPREHENSIVE # #
A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
# # # # # # # # # # # # # # # #
client's spouse demands that the transfusion be given. What is the nurse's priority
# # # # # # # # # # # #
action?
A) Administer the transfusion as the spouse requests
# # # # # # #
B) Notify the healthcare provider of the client's refusal
# # # # # # # #
C) Contact the hospital ethics committee
# # # # #
D) Ask the client to reconsider for the family's sake
# # # # # # # # #
Answer: B #
Rationale: The nurse must respect the client's autonomy and right to refuse treatment.
# # # # # # # # # # # #
The healthcare provider should be notified so alternative treatments can be considered.
# # # # # # # # # # #
The client's decision takes precedence over family wishes.
# # # # # # #
Question 3 #
A nurse is preparing to discharge a client who speaks a language different from the
# # # # # # # # # # # # # #
nurse. No interpreter is immediately available. Which action is appropriate?
# # # # # # # # #
A) Use the client's adult child as an interpreter
# # # # # # # #
B) Provide written discharge instructions in the client's language
# # # # # # # #
C) Delay discharge until a certified medical interpreter is available
# # # # # # # # #
D) Use a translation app on a personal smartphone
# # # # # # # #
Answer: C #
Rationale: Delaying discharge until a qualified medical interpreter is available ensures
# # # # # # # # # #
accurate communication and safe discharge. Family members may not provide accurate
# # # # # # # # # #
medical interpretation. Written instructions may not be understood if the client is
# # # # # # # # # # #
illiterate. Translation apps may not be HIPAA-compliant.
# # # # # #
Question 4 #
A nurse manager is reviewing informed consent with new staff. Which statement by a
# # # # # # # # # # # # #
staff member indicates understanding?
# # #
A) "The nurse is responsible for explaining the procedure to the client."
# # # # # # # # # # #
B) "A witness signature confirms the client gave voluntary consent."
# # # # # # # # #
,#
ATI RN COMPREHENSIVE# #
C) "Informed consent is only required for surgical procedures."
# # # # # # # #
D) "A family member can sign consent for any adult client."
# # # # # # # # # #
Answer: B #
Rationale: The witness signature confirms the client signed voluntarily and appeared
# # # # # # # # # #
competent. The provider (not nurse) explains the procedure. Consent is required for
# # # # # # # # # # #
invasive procedures, not just surgery. Family can only sign if the client is incapacitated
# # # # # # # # # # # # #
with appropriate legal documentation.
# # #
Question 5 #
A nurse is delegating tasks to assistive personnel (AP). Which task is appropriate for the
# # # # # # # # # # # # # #
AP to perform?
# #
A) Assess a client's surgical incision for signs of infection
# # # # # # # # #
B) Measure intake and output for a client with heart failure
# # # # # # # # # #
C) Evaluate the effectiveness of pain medication
# # # # # #
D) Teach a client how to use an incentive spirometer
# # # # # # # # #
Answer: B #
Rationale: Measuring intake and output is within the AP's scope of practice. Assessment
# # # # # # # # # # # #
(A), evaluation (C), and teaching (D) require nursing judgment and are outside AP scope.
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Question 6 #
A nurse is caring for a client who has a living will. The client's condition has deteriorated,
# # # # # # # # # # # # # # # #
and the family wants aggressive treatment. What should the nurse do?
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A) Follow the family's wishes to avoid conflict
# # # # # # #
B) Initiate aggressive treatment as requested
# # # # #
C) Review the living will with the family and honor the client's wishes
# # # # # # # # # # # #
D) Contact risk management for legal guidance
# # # # # #
Answer: C #
Rationale: The living will documents the client's wishes and must be honored. The nurse
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should review it with the family and advocate for client autonomy. The provider may
# # # # # # # # # # # # #
need to clarify, but client wishes take precedence over family preferences.
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