ATI PN Comprehensive Predictor
2026: 150 Practice Questions with
Answers & Rationales
## Section 1: Management of Care & Prioritization (Questions 1-25)
**Q1.** A PN is caring for four clients at the start of the shift. Which
client should be assessed FIRST?
- A) Client with diabetes requesting pain medication for neuropathy
- B) Client with COPD who has a new cough producing green sputum
- C) Client post-op day 1 with new-onset confusion and BP 88/50
- D) Client with a fractured tibia requesting help to the bathroom
**Answer:** C
**Rationale:** New confusion combined with hypotension suggests
possible sepsis, hemorrhage, or shock — this represents hemodynamic
instability and a change in neurological status, which is the priority.
Apply the ABCs and Maslow's hierarchy: unstable findings take
precedence over stable complaints .
,**Q2.** A charge nurse is assigning staff for the shift. Which client
should be assigned to an RN rather than a PN (LPN)?
- A) A client with stable CHF receiving daily Lasix
- B) A client requiring a blood transfusion for symptomatic anemia
- C) A client with a new diagnosis of diabetes needing insulin instruction
- D) A client with a PEG tube requiring intermittent feedings
**Answer:** C
**Rationale:** Client education (specifically initial instruction) falls
under the RN scope as it requires complex assessment and evaluation
of learning. PNs can reinforce teaching but cannot perform initial
patient teaching. Blood transfusions require RN monitoring. Stable
clients on routine medications and PEG feedings are within PN scope .
**Q3.** A client is admitted with suspected stroke. Which action
should the nurse perform FIRST?
- A) Obtain a detailed neurological history
- B) Check blood glucose level
- C) Prepare for CT scan
- D) Administer aspirin
**Answer:** B
,**Rationale:** Hypoglycemia can mimic stroke symptoms (slurred
speech, weakness, confusion). The nurse must quickly rule out low
blood sugar before proceeding with a stroke workup. This is the priority
assessment .
**Q4.** A client with a new tracheostomy has thick, dry secretions and
difficulty breathing. What is the priority action?
- A) Call respiratory therapy
- B) Change the inner cannula
- C) Instill normal saline and suction
- D) Increase oxygen flow rate
**Answer:** C
**Rationale:** Thick secretions obstructing the airway require
immediate removal. Instilling normal saline and suctioning clears the
airway. Oxygen is ineffective if the airway is blocked; changing the
cannula may be necessary after suctioning .
**Q5.** A PN notices a colleague is impaired and smelling of alcohol.
What action is most appropriate?
- A) Ignore it if it's the first time
- B) Confront the colleague privately
, - C) Report to the nurse manager immediately
- D) Ask the colleague to go home
**Answer:** C
**Rationale:** The nurse has a duty to report impaired practice to the
supervisor to ensure patient safety. Confrontation or ignoring does not
address the risk. Reporting to the nurse manager follows the
appropriate chain of command .
**Q6.** 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
**Answer:** B
**Rationale:** Respect client autonomy. The PN should document the
refusal, notify the RN/provider, and explore reasons for refusal.
Coercion or forcing medication violates patient rights .
**Q7.** During a mass casualty event, the nurse's priority action is:
2026: 150 Practice Questions with
Answers & Rationales
## Section 1: Management of Care & Prioritization (Questions 1-25)
**Q1.** A PN is caring for four clients at the start of the shift. Which
client should be assessed FIRST?
- A) Client with diabetes requesting pain medication for neuropathy
- B) Client with COPD who has a new cough producing green sputum
- C) Client post-op day 1 with new-onset confusion and BP 88/50
- D) Client with a fractured tibia requesting help to the bathroom
**Answer:** C
**Rationale:** New confusion combined with hypotension suggests
possible sepsis, hemorrhage, or shock — this represents hemodynamic
instability and a change in neurological status, which is the priority.
Apply the ABCs and Maslow's hierarchy: unstable findings take
precedence over stable complaints .
,**Q2.** A charge nurse is assigning staff for the shift. Which client
should be assigned to an RN rather than a PN (LPN)?
- A) A client with stable CHF receiving daily Lasix
- B) A client requiring a blood transfusion for symptomatic anemia
- C) A client with a new diagnosis of diabetes needing insulin instruction
- D) A client with a PEG tube requiring intermittent feedings
**Answer:** C
**Rationale:** Client education (specifically initial instruction) falls
under the RN scope as it requires complex assessment and evaluation
of learning. PNs can reinforce teaching but cannot perform initial
patient teaching. Blood transfusions require RN monitoring. Stable
clients on routine medications and PEG feedings are within PN scope .
**Q3.** A client is admitted with suspected stroke. Which action
should the nurse perform FIRST?
- A) Obtain a detailed neurological history
- B) Check blood glucose level
- C) Prepare for CT scan
- D) Administer aspirin
**Answer:** B
,**Rationale:** Hypoglycemia can mimic stroke symptoms (slurred
speech, weakness, confusion). The nurse must quickly rule out low
blood sugar before proceeding with a stroke workup. This is the priority
assessment .
**Q4.** A client with a new tracheostomy has thick, dry secretions and
difficulty breathing. What is the priority action?
- A) Call respiratory therapy
- B) Change the inner cannula
- C) Instill normal saline and suction
- D) Increase oxygen flow rate
**Answer:** C
**Rationale:** Thick secretions obstructing the airway require
immediate removal. Instilling normal saline and suctioning clears the
airway. Oxygen is ineffective if the airway is blocked; changing the
cannula may be necessary after suctioning .
**Q5.** A PN notices a colleague is impaired and smelling of alcohol.
What action is most appropriate?
- A) Ignore it if it's the first time
- B) Confront the colleague privately
, - C) Report to the nurse manager immediately
- D) Ask the colleague to go home
**Answer:** C
**Rationale:** The nurse has a duty to report impaired practice to the
supervisor to ensure patient safety. Confrontation or ignoring does not
address the risk. Reporting to the nurse manager follows the
appropriate chain of command .
**Q6.** 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
**Answer:** B
**Rationale:** Respect client autonomy. The PN should document the
refusal, notify the RN/provider, and explore reasons for refusal.
Coercion or forcing medication violates patient rights .
**Q7.** During a mass casualty event, the nurse's priority action is:
