NCLEX Success Starts Here | ATI RN Comprehensive
Predictor 2026 Level 3 | Forms A, B and C | RN
Program Exit Exam | Actual and Retake | 180 NGN
Questions and Answers
Question 1
A charge nurse is making client assignments on a medical-surgical unit. Which client should be
assigned to the most experienced RN?
A. A client with diabetes mellitus requiring insulin administration
B. A client with pneumonia requiring q4h vital signs
C. A client with chest tubes and new onset of respiratory distress
D. A client with a urinary tract infection requiring IV antibiotics
Answer: C
Rationale: The client with chest tubes and respiratory distress is unstable and requires complex
assessment and intervention. This client should be assigned to the most experienced RN. Stable
clients with routine care (A, B, D) can be assigned to LPNs or less experienced RNs under
supervision.
Question 2
A competent adult client refuses a blood transfusion for religious reasons. Which actions should
the nurse take? (Select all that apply.)
A. Verify the client understands risks
B. Document the refusal
C. Administer the transfusion if Hgb is critical
D. Notify the provider
E. Ask the family to override the decision
Answer: A, B, D
Rationale: Competent adults have autonomy and the right to refuse medical treatment. The
nurse ensures informed refusal, documents the decision, and notifies the provider. The nurse
cannot administer against the client's wishes or ask the family to override the client's decision.
,Question 3
Which client should the nurse assess first?
A. Post-op day 2 with pain 6/10
B. COPD client with O₂ sat 88% on room air
C. Client waiting for discharge teaching
D. Stable diabetic requesting a snack
Answer: B
Rationale: Airway and oxygenation take priority (ABCs). The COPD client with an O₂ saturation
of 88% is hypoxic and at risk for respiratory compromise. This is a physiological priority over
pain, teaching, or a snack request.
Question 4
A nurse is caring for a client who is scheduled for surgery. The client asks, "What are the risks of
this procedure?" The nurse notes that the consent form was signed earlier. What should the
nurse do?
A. Explain the risks to the client
B. Tell the client the provider will discuss risks
C. Document that the client has questions
D. Proceed with preoperative preparation
Answer: B
Rationale: The provider is responsible for explaining risks, benefits, and alternatives of a
procedure to obtain informed consent. The nurse should notify the provider that the client has
questions and defer to the provider for discussion.
Question 5
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?
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 client's autonomous decision documented in the living will must be honored.
The nurse should review the living will with the family and advocate for the client's documented
wishes regarding end-of-life care.
Question 6
A charge nurse is teaching newly licensed nurses about critical pathways. Which information
should the nurse include?
A. Critical pathways have an unlimited timeframe for completion
B. Critical pathways decrease healthcare costs
C. Critical pathways eliminate the need for nursing documentation
D. Critical pathways are only used in intensive care units
Answer: B
Rationale: Critical pathways are multidisciplinary care plans with specific timeframes for
completion. They decrease healthcare costs by standardizing care and reducing unnecessary
interventions. Variances are documented when outcomes are not met.
Question 7
A nurse manager is reviewing informed consent with staff. Which statement by a staff member
indicates understanding?
A. "The nurse is responsible for obtaining informed consent"
B. "The provider is responsible for explaining the procedure and obtaining consent"
C. "The client can only sign consent on the day of the procedure"
D. "Family members can always sign consent for the client"
Answer: B
Rationale: The provider is responsible for explaining the risks, benefits, and alternatives of a
procedure and obtaining informed consent. The nurse acts as a witness to the signature but
does not obtain consent.
, Question 8
A nurse is preparing to discharge a client who has a new colostomy. Which action best
demonstrates client readiness for discharge?
A. The client states they understand the information
B. The client demonstrates proper colostomy care technique
C. The client's family member is present for teaching
D. The client has all prescribed medications
Answer: B
Rationale: Demonstrating proper technique is the best indicator of readiness for discharge.
Return demonstration provides objective evidence that the client can perform the necessary
self-care skills, unlike verbal acknowledgment alone.
Question 9
A nurse is caring for a client who has a terminal illness. The family asks about hospice care.
What information should the nurse provide?
A. "Hospice is designed to help cure the underlying disease"
B. "Hospice care focuses on comfort and quality of life, not a cure"
C. "Hospice provides services only in the hospital setting"
D. "Once you start hospice, you cannot ever stop treatment"
Answer: B
Rationale: Hospice is palliative (comfort) care for clients with a life expectancy of 6 months or
less. The focus is on pain management, symptom control, and quality of life, not curative
treatment.
Question 10
A nurse is reviewing the use of restraints with staff. Which statement indicates understanding?
A. "I can apply wrist restraints for up to 4 hours without a new prescription"
B. "I will document a verbal order for restraints within 4 hours"
C. "Restraints require a prescription that specifies the type and duration"
D. "I can use restraints as needed for client safety without a prescription"
Answer: C
Predictor 2026 Level 3 | Forms A, B and C | RN
Program Exit Exam | Actual and Retake | 180 NGN
Questions and Answers
Question 1
A charge nurse is making client assignments on a medical-surgical unit. Which client should be
assigned to the most experienced RN?
A. A client with diabetes mellitus requiring insulin administration
B. A client with pneumonia requiring q4h vital signs
C. A client with chest tubes and new onset of respiratory distress
D. A client with a urinary tract infection requiring IV antibiotics
Answer: C
Rationale: The client with chest tubes and respiratory distress is unstable and requires complex
assessment and intervention. This client should be assigned to the most experienced RN. Stable
clients with routine care (A, B, D) can be assigned to LPNs or less experienced RNs under
supervision.
Question 2
A competent adult client refuses a blood transfusion for religious reasons. Which actions should
the nurse take? (Select all that apply.)
A. Verify the client understands risks
B. Document the refusal
C. Administer the transfusion if Hgb is critical
D. Notify the provider
E. Ask the family to override the decision
Answer: A, B, D
Rationale: Competent adults have autonomy and the right to refuse medical treatment. The
nurse ensures informed refusal, documents the decision, and notifies the provider. The nurse
cannot administer against the client's wishes or ask the family to override the client's decision.
,Question 3
Which client should the nurse assess first?
A. Post-op day 2 with pain 6/10
B. COPD client with O₂ sat 88% on room air
C. Client waiting for discharge teaching
D. Stable diabetic requesting a snack
Answer: B
Rationale: Airway and oxygenation take priority (ABCs). The COPD client with an O₂ saturation
of 88% is hypoxic and at risk for respiratory compromise. This is a physiological priority over
pain, teaching, or a snack request.
Question 4
A nurse is caring for a client who is scheduled for surgery. The client asks, "What are the risks of
this procedure?" The nurse notes that the consent form was signed earlier. What should the
nurse do?
A. Explain the risks to the client
B. Tell the client the provider will discuss risks
C. Document that the client has questions
D. Proceed with preoperative preparation
Answer: B
Rationale: The provider is responsible for explaining risks, benefits, and alternatives of a
procedure to obtain informed consent. The nurse should notify the provider that the client has
questions and defer to the provider for discussion.
Question 5
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?
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 client's autonomous decision documented in the living will must be honored.
The nurse should review the living will with the family and advocate for the client's documented
wishes regarding end-of-life care.
Question 6
A charge nurse is teaching newly licensed nurses about critical pathways. Which information
should the nurse include?
A. Critical pathways have an unlimited timeframe for completion
B. Critical pathways decrease healthcare costs
C. Critical pathways eliminate the need for nursing documentation
D. Critical pathways are only used in intensive care units
Answer: B
Rationale: Critical pathways are multidisciplinary care plans with specific timeframes for
completion. They decrease healthcare costs by standardizing care and reducing unnecessary
interventions. Variances are documented when outcomes are not met.
Question 7
A nurse manager is reviewing informed consent with staff. Which statement by a staff member
indicates understanding?
A. "The nurse is responsible for obtaining informed consent"
B. "The provider is responsible for explaining the procedure and obtaining consent"
C. "The client can only sign consent on the day of the procedure"
D. "Family members can always sign consent for the client"
Answer: B
Rationale: The provider is responsible for explaining the risks, benefits, and alternatives of a
procedure and obtaining informed consent. The nurse acts as a witness to the signature but
does not obtain consent.
, Question 8
A nurse is preparing to discharge a client who has a new colostomy. Which action best
demonstrates client readiness for discharge?
A. The client states they understand the information
B. The client demonstrates proper colostomy care technique
C. The client's family member is present for teaching
D. The client has all prescribed medications
Answer: B
Rationale: Demonstrating proper technique is the best indicator of readiness for discharge.
Return demonstration provides objective evidence that the client can perform the necessary
self-care skills, unlike verbal acknowledgment alone.
Question 9
A nurse is caring for a client who has a terminal illness. The family asks about hospice care.
What information should the nurse provide?
A. "Hospice is designed to help cure the underlying disease"
B. "Hospice care focuses on comfort and quality of life, not a cure"
C. "Hospice provides services only in the hospital setting"
D. "Once you start hospice, you cannot ever stop treatment"
Answer: B
Rationale: Hospice is palliative (comfort) care for clients with a life expectancy of 6 months or
less. The focus is on pain management, symptom control, and quality of life, not curative
treatment.
Question 10
A nurse is reviewing the use of restraints with staff. Which statement indicates understanding?
A. "I can apply wrist restraints for up to 4 hours without a new prescription"
B. "I will document a verbal order for restraints within 4 hours"
C. "Restraints require a prescription that specifies the type and duration"
D. "I can use restraints as needed for client safety without a prescription"
Answer: C
