ATI COMPREHENSIVE PREDICTOR
2026/2027 PRACTICE EXAM
DETAILED ANSWER KEY
ALL 150 QUESTIONS
100% Correct Answers With Detailed Rationales | NGN-Style Items Included
Aligned with 2026-2027 ATI Blueprint and NCLEX-RN Test Plan
,Section 1: Management of Care (Q1-Q25)
Q1: A charge nurse is making client assignments for the shift. Which client should the nurse assign to the LPN?
A. A client newly diagnosed with diabetes mellitus who needs discharge teaching about insulin administration
B. A client who is 2 hours postoperative following a bowel resection with a nasogastric tube
C. A client with chronic heart failure who has stable vital signs and needs assistance with ADLs **[CORRECT]**
D. A client admitted with chest pain who needs a comprehensive nursing assessment
Correct Answer: C
Rationale: LPNs can provide care for stable clients with predictable outcomes. The client with chronic heart failure who has stable vital
signs and needs assistance with activities of daily living (ADLs) is the most appropriate assignment for the LPN. Newly diagnosed
clients requiring complex teaching (RN), postoperative clients requiring ongoing assessment (RN), and clients needing comprehensive
admission assessments (RN) require the broader scope of the registered nurse. This aligns with the 5 rights of delegation: right task,
right circumstance, right person, right direction/communication, and right supervision/feedback.
Q2: A nurse is caring for a client who has a DNR order. The client's family member requests that the nurse perform CPR if
the client's heart stops. What is the nurse's best action?
A. Perform CPR because the family member's request overrides the DNR
B. Follow the DNR order and explain the legal validity of the client's directive to the family **[CORRECT]**
C. Call the hospital administrator for immediate guidance
D. Ask the family member to leave the room
Correct Answer: B
Rationale: A valid DNR order is a legal document that reflects the client's autonomous decision about end-of-life care. The nurse must
honor the DNR order and should not perform CPR. The nurse should explain to the family that the DNR order was the client's own
directive and is legally binding. The family member's wishes do not override the competent client's documented advance directive. ATI
prioritization frameworks place legal and ethical obligations as foundational to nursing practice.
Q3: A nurse is caring for four clients. Which client should the nurse assess first?
A. A client scheduled for a computed tomography (CT) scan in 2 hours
B. A client with a blood pressure of 102/60 mmHg who reports feeling dizzy when standing **[CORRECT]**
C. A client with a nasogastric tube who needs a medication administered through the tube
D. A client who is 1 day postoperative and has not yet ambulated
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework and the safety-first approach, the client with dizziness
and borderline low blood pressure is at risk for falls and potential injury. This client requires immediate assessment and intervention.
The client for the CT scan has a non-urgent scheduled test, the NG tube medication can be given after the unstable client is assessed,
and postoperative ambulation, while important, is not immediately life-threatening. ATI teaches using Maslow's hierarchy and safety
as the top priority for prioritization decisions.
Q4: A nurse is providing preoperative teaching to a client who will undergo surgery the next morning. The client states,
"I do not really understand what the surgeon is going to do." What is the nurse's best response?
A. Tell the client that the surgeon will explain everything before the procedure
B. Contact the surgeon to return and clarify the procedure, and verify informed consent was obtained **[CORRECT]**
C. Explain the surgical procedure in detail using medical terminology
D. Document that the client refused the preoperative teaching
Correct Answer: B
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and alternatives. If the client does not
understand the planned surgery, informed consent has not been adequately obtained. The nurse should contact the surgeon to return
and clarify the procedure. The nurse's role as a patient advocate includes ensuring the client has adequate information to make an
informed decision. It is the surgeon's responsibility to obtain informed consent, but the nurse witnesses it and verifies the client's
understanding.
,Q5: A nurse manager is planning the shift assignment. Which task is appropriate to delegate to an unlicensed assistive
personnel (UAP)?
A. Performing an admission assessment on a newly admitted client
B. Measuring and recording vital signs on a stable postoperative client **[CORRECT]**
C. Evaluating the effectiveness of a pain medication
D. Developing a nursing care plan for a client with a new diagnosis
Correct Answer: B
Rationale: UAPs can perform tasks that do not require nursing judgment, such as measuring and recording vital signs on stable clients.
Admission assessments, medication evaluation, and care planning all require the clinical judgment and critical thinking of a licensed
nurse (RN or LPN). The 5 rights of delegation guide the nurse to delegate only tasks that are within the delegatee's scope, appropriate
for the client's condition, and do not require nursing assessment or evaluation.
Q6: A client who is competent and terminally ill tells the nurse, "I want to stop all treatment and go home." The client's
family disagrees with the decision. What should the nurse do?
A. Honor the family's wishes and continue treatment
B. Support the client's autonomous decision and facilitate discharge planning **[CORRECT]**
C. Call a meeting with the ethics committee before taking any action
D. Ask the client to reconsider for the sake of the family
Correct Answer: B
Rationale: A competent adult has the right to refuse any treatment, including life-sustaining treatment. The principle of patient
autonomy takes priority over the family's wishes. The nurse should support the client's decision and facilitate appropriate discharge
planning or palliative care referrals. An ethics committee may be consulted if there is genuine ethical distress or ambiguity, but a
competent client's clear decision does not require ethics committee approval. ATI emphasizes patient autonomy and advocacy as core
legal and ethical principles.
Q7: A nurse is reviewing informed consent forms for four clients. For which client should the nurse contact the surgeon?
A. A client who signed the consent form 24 hours ago for an elective procedure
B. A client who received sedation 30 minutes ago and is now signing the consent form **[CORRECT]**
C. A client who had the procedure, risks, and benefits explained by the surgeon and signed the form
D. A client who is 18 years old and is signing for an elective surgery
Correct Answer: B
Rationale: Informed consent must be obtained while the client is alert and competent. A client who has received sedation cannot
provide valid informed consent because their decision-making capacity is impaired. The nurse should contact the surgeon and
document that the consent was not validly obtained. Consent obtained 24 hours in advance is acceptable, consent after proper
explanation by the surgeon is valid, and an 18-year-old can sign their own consent as a legal adult.
Q8: A nurse is caring for a client on an involuntary psychiatric hold. The client requests to leave the hospital. What is the
nurse's best response?
A. Allow the client to leave because all clients have the right to refuse treatment
B. Explain that the client is on a legal hold and cannot leave until evaluated by a provider **[CORRECT]**
C. Restrain the client to prevent elopement
D. Call the police immediately to have the client arrested
Correct Answer: B
Rationale: A client on an involuntary psychiatric hold (typically a 72-hour hold for evaluation) cannot legally leave the facility. The
nurse should explain this to the client calmly and respectfully. The nurse should not allow the client to leave (legal obligation), should
not use restraints without a specific order, and does not need to call the police unless there is an imminent safety threat. The client has
the right to know the reason for the hold and to have legal representation. ATI emphasizes balancing client rights with safety
obligations in psychiatric care.
Q9: A nurse is delegating tasks for the shift. Which statement by the UAP indicates understanding of delegated tasks?
, A. I will teach the client how to use the incentive spirometer.
B. I will remind the client to use the incentive spirometer every hour while awake. **[CORRECT]**
C. I will evaluate how well the client is using the incentive spirometer.
D. I will modify the incentive spirometry plan based on the client's progress.
Correct Answer: B
Rationale: UAPs can remind and encourage clients to perform previously taught activities like incentive spirometry use. Teaching (RN),
evaluating effectiveness (RN), and modifying the plan of care (RN) require nursing judgment and cannot be delegated. The UAP can
reinforce teaching that has already been provided by the nurse. This reflects the delegation principle that only the right task, under the
right circumstances, to the right person, with right communication and right supervision, is delegated.
Q10: A nurse is caring for a client who has just been informed of a cancer diagnosis. The client says, "This cannot be
happening to me. The lab must be wrong." Which response by the nurse is most therapeutic?
A. You are right to question the results; I am sure it is a mistake.
B. It sounds like you are having a hard time believing this news. Would you like to talk about your feelings? **[CORRECT]**
C. You need to accept this diagnosis so we can start treatment right away.
D. I understand how you feel; I had a family member with cancer too.
Correct Answer: B
Rationale: This response uses therapeutic communication techniques: reflection (acknowledging the client's disbelief) and offering to
explore feelings. It validates the client's emotional response without providing false reassurance (A) or demanding immediate
acceptance (C). Sharing personal experiences (D) shifts focus from the client to the nurse. ATI emphasizes therapeutic communication
as a core competency, including reflection, open-ended questions, and allowing the client to express emotions without judgment.
Q11: A nurse on a medical-surgical unit is caring for multiple clients. The nurse receives a call from the laboratory
reporting a critical potassium level of 6.8 mEq/L for a client. What should the nurse do first?
A. Document the value in the client's chart and continue routine care
B. Assess the client immediately and notify the healthcare provider **[CORRECT]**
C. Wait for the provider to call back before taking any action
D. Administer potassium-lowering medications without a provider order
Correct Answer: B
Rationale: A potassium level of 6.8 mEq/L is a critical value that can cause life-threatening cardiac arrhythmias. The nurse must
immediately assess the client (check for cardiac symptoms, ECG changes) and notify the healthcare provider. The nurse should not
delay action, continue routine care, or administer medications without an order. Critical lab values require immediate intervention
following the chain of command. ATI prioritization frameworks place life-threatening conditions at the highest priority using the ABC
approach.
Q12: A nurse is reviewing the medical record of a client who has an advance directive. Which action should the nurse
take?
A. File the advance directive in the client's chart and ensure it is accessible to the health care team **[CORRECT]**
B. Ignore the advance directive during emergency situations
C. Question the validity of the advance directive if the family disagrees
D. Make care decisions based on the advance directive without consulting the provider
Correct Answer: A
Rationale: The nurse should ensure the advance directive is filed in the client's medical record and accessible to all healthcare team
members. Advance directives are legal documents that must be honored in both routine and emergency situations (they do not
become invalid during emergencies). The nurse should not question the validity of a properly executed document, nor make
independent care decisions based on the directive. The advance directive guides the healthcare team in providing care consistent with
the client's wishes.
Q13: A charge nurse is assigning clients to a newly licensed RN. Which client should the charge nurse assign to this
nurse?
A. A client with a new tracheostomy who requires frequent suctioning
2026/2027 PRACTICE EXAM
DETAILED ANSWER KEY
ALL 150 QUESTIONS
100% Correct Answers With Detailed Rationales | NGN-Style Items Included
Aligned with 2026-2027 ATI Blueprint and NCLEX-RN Test Plan
,Section 1: Management of Care (Q1-Q25)
Q1: A charge nurse is making client assignments for the shift. Which client should the nurse assign to the LPN?
A. A client newly diagnosed with diabetes mellitus who needs discharge teaching about insulin administration
B. A client who is 2 hours postoperative following a bowel resection with a nasogastric tube
C. A client with chronic heart failure who has stable vital signs and needs assistance with ADLs **[CORRECT]**
D. A client admitted with chest pain who needs a comprehensive nursing assessment
Correct Answer: C
Rationale: LPNs can provide care for stable clients with predictable outcomes. The client with chronic heart failure who has stable vital
signs and needs assistance with activities of daily living (ADLs) is the most appropriate assignment for the LPN. Newly diagnosed
clients requiring complex teaching (RN), postoperative clients requiring ongoing assessment (RN), and clients needing comprehensive
admission assessments (RN) require the broader scope of the registered nurse. This aligns with the 5 rights of delegation: right task,
right circumstance, right person, right direction/communication, and right supervision/feedback.
Q2: A nurse is caring for a client who has a DNR order. The client's family member requests that the nurse perform CPR if
the client's heart stops. What is the nurse's best action?
A. Perform CPR because the family member's request overrides the DNR
B. Follow the DNR order and explain the legal validity of the client's directive to the family **[CORRECT]**
C. Call the hospital administrator for immediate guidance
D. Ask the family member to leave the room
Correct Answer: B
Rationale: A valid DNR order is a legal document that reflects the client's autonomous decision about end-of-life care. The nurse must
honor the DNR order and should not perform CPR. The nurse should explain to the family that the DNR order was the client's own
directive and is legally binding. The family member's wishes do not override the competent client's documented advance directive. ATI
prioritization frameworks place legal and ethical obligations as foundational to nursing practice.
Q3: A nurse is caring for four clients. Which client should the nurse assess first?
A. A client scheduled for a computed tomography (CT) scan in 2 hours
B. A client with a blood pressure of 102/60 mmHg who reports feeling dizzy when standing **[CORRECT]**
C. A client with a nasogastric tube who needs a medication administered through the tube
D. A client who is 1 day postoperative and has not yet ambulated
Correct Answer: B
Rationale: Using the ABC (Airway, Breathing, Circulation) priority framework and the safety-first approach, the client with dizziness
and borderline low blood pressure is at risk for falls and potential injury. This client requires immediate assessment and intervention.
The client for the CT scan has a non-urgent scheduled test, the NG tube medication can be given after the unstable client is assessed,
and postoperative ambulation, while important, is not immediately life-threatening. ATI teaches using Maslow's hierarchy and safety
as the top priority for prioritization decisions.
Q4: A nurse is providing preoperative teaching to a client who will undergo surgery the next morning. The client states,
"I do not really understand what the surgeon is going to do." What is the nurse's best response?
A. Tell the client that the surgeon will explain everything before the procedure
B. Contact the surgeon to return and clarify the procedure, and verify informed consent was obtained **[CORRECT]**
C. Explain the surgical procedure in detail using medical terminology
D. Document that the client refused the preoperative teaching
Correct Answer: B
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and alternatives. If the client does not
understand the planned surgery, informed consent has not been adequately obtained. The nurse should contact the surgeon to return
and clarify the procedure. The nurse's role as a patient advocate includes ensuring the client has adequate information to make an
informed decision. It is the surgeon's responsibility to obtain informed consent, but the nurse witnesses it and verifies the client's
understanding.
,Q5: A nurse manager is planning the shift assignment. Which task is appropriate to delegate to an unlicensed assistive
personnel (UAP)?
A. Performing an admission assessment on a newly admitted client
B. Measuring and recording vital signs on a stable postoperative client **[CORRECT]**
C. Evaluating the effectiveness of a pain medication
D. Developing a nursing care plan for a client with a new diagnosis
Correct Answer: B
Rationale: UAPs can perform tasks that do not require nursing judgment, such as measuring and recording vital signs on stable clients.
Admission assessments, medication evaluation, and care planning all require the clinical judgment and critical thinking of a licensed
nurse (RN or LPN). The 5 rights of delegation guide the nurse to delegate only tasks that are within the delegatee's scope, appropriate
for the client's condition, and do not require nursing assessment or evaluation.
Q6: A client who is competent and terminally ill tells the nurse, "I want to stop all treatment and go home." The client's
family disagrees with the decision. What should the nurse do?
A. Honor the family's wishes and continue treatment
B. Support the client's autonomous decision and facilitate discharge planning **[CORRECT]**
C. Call a meeting with the ethics committee before taking any action
D. Ask the client to reconsider for the sake of the family
Correct Answer: B
Rationale: A competent adult has the right to refuse any treatment, including life-sustaining treatment. The principle of patient
autonomy takes priority over the family's wishes. The nurse should support the client's decision and facilitate appropriate discharge
planning or palliative care referrals. An ethics committee may be consulted if there is genuine ethical distress or ambiguity, but a
competent client's clear decision does not require ethics committee approval. ATI emphasizes patient autonomy and advocacy as core
legal and ethical principles.
Q7: A nurse is reviewing informed consent forms for four clients. For which client should the nurse contact the surgeon?
A. A client who signed the consent form 24 hours ago for an elective procedure
B. A client who received sedation 30 minutes ago and is now signing the consent form **[CORRECT]**
C. A client who had the procedure, risks, and benefits explained by the surgeon and signed the form
D. A client who is 18 years old and is signing for an elective surgery
Correct Answer: B
Rationale: Informed consent must be obtained while the client is alert and competent. A client who has received sedation cannot
provide valid informed consent because their decision-making capacity is impaired. The nurse should contact the surgeon and
document that the consent was not validly obtained. Consent obtained 24 hours in advance is acceptable, consent after proper
explanation by the surgeon is valid, and an 18-year-old can sign their own consent as a legal adult.
Q8: A nurse is caring for a client on an involuntary psychiatric hold. The client requests to leave the hospital. What is the
nurse's best response?
A. Allow the client to leave because all clients have the right to refuse treatment
B. Explain that the client is on a legal hold and cannot leave until evaluated by a provider **[CORRECT]**
C. Restrain the client to prevent elopement
D. Call the police immediately to have the client arrested
Correct Answer: B
Rationale: A client on an involuntary psychiatric hold (typically a 72-hour hold for evaluation) cannot legally leave the facility. The
nurse should explain this to the client calmly and respectfully. The nurse should not allow the client to leave (legal obligation), should
not use restraints without a specific order, and does not need to call the police unless there is an imminent safety threat. The client has
the right to know the reason for the hold and to have legal representation. ATI emphasizes balancing client rights with safety
obligations in psychiatric care.
Q9: A nurse is delegating tasks for the shift. Which statement by the UAP indicates understanding of delegated tasks?
, A. I will teach the client how to use the incentive spirometer.
B. I will remind the client to use the incentive spirometer every hour while awake. **[CORRECT]**
C. I will evaluate how well the client is using the incentive spirometer.
D. I will modify the incentive spirometry plan based on the client's progress.
Correct Answer: B
Rationale: UAPs can remind and encourage clients to perform previously taught activities like incentive spirometry use. Teaching (RN),
evaluating effectiveness (RN), and modifying the plan of care (RN) require nursing judgment and cannot be delegated. The UAP can
reinforce teaching that has already been provided by the nurse. This reflects the delegation principle that only the right task, under the
right circumstances, to the right person, with right communication and right supervision, is delegated.
Q10: A nurse is caring for a client who has just been informed of a cancer diagnosis. The client says, "This cannot be
happening to me. The lab must be wrong." Which response by the nurse is most therapeutic?
A. You are right to question the results; I am sure it is a mistake.
B. It sounds like you are having a hard time believing this news. Would you like to talk about your feelings? **[CORRECT]**
C. You need to accept this diagnosis so we can start treatment right away.
D. I understand how you feel; I had a family member with cancer too.
Correct Answer: B
Rationale: This response uses therapeutic communication techniques: reflection (acknowledging the client's disbelief) and offering to
explore feelings. It validates the client's emotional response without providing false reassurance (A) or demanding immediate
acceptance (C). Sharing personal experiences (D) shifts focus from the client to the nurse. ATI emphasizes therapeutic communication
as a core competency, including reflection, open-ended questions, and allowing the client to express emotions without judgment.
Q11: A nurse on a medical-surgical unit is caring for multiple clients. The nurse receives a call from the laboratory
reporting a critical potassium level of 6.8 mEq/L for a client. What should the nurse do first?
A. Document the value in the client's chart and continue routine care
B. Assess the client immediately and notify the healthcare provider **[CORRECT]**
C. Wait for the provider to call back before taking any action
D. Administer potassium-lowering medications without a provider order
Correct Answer: B
Rationale: A potassium level of 6.8 mEq/L is a critical value that can cause life-threatening cardiac arrhythmias. The nurse must
immediately assess the client (check for cardiac symptoms, ECG changes) and notify the healthcare provider. The nurse should not
delay action, continue routine care, or administer medications without an order. Critical lab values require immediate intervention
following the chain of command. ATI prioritization frameworks place life-threatening conditions at the highest priority using the ABC
approach.
Q12: A nurse is reviewing the medical record of a client who has an advance directive. Which action should the nurse
take?
A. File the advance directive in the client's chart and ensure it is accessible to the health care team **[CORRECT]**
B. Ignore the advance directive during emergency situations
C. Question the validity of the advance directive if the family disagrees
D. Make care decisions based on the advance directive without consulting the provider
Correct Answer: A
Rationale: The nurse should ensure the advance directive is filed in the client's medical record and accessible to all healthcare team
members. Advance directives are legal documents that must be honored in both routine and emergency situations (they do not
become invalid during emergencies). The nurse should not question the validity of a properly executed document, nor make
independent care decisions based on the directive. The advance directive guides the healthcare team in providing care consistent with
the client's wishes.
Q13: A charge nurse is assigning clients to a newly licensed RN. Which client should the charge nurse assign to this
nurse?
A. A client with a new tracheostomy who requires frequent suctioning
