ATI PN Fundamentals Predictor Exam - Form A (2026/2027) Practical Nursing Education
ATI PN Fundamentals Predictor Exam
Form A - Questions and Answers
Latest Edition | Practical Nursing (PN) Proficiency Standards
Total Questions: 75 | Cognitive Mix: 25% Recall | 55% Application | 20% Analysis | Time: 110 minutes
Instructions: Select the ONE best answer for each question. Each question is designed around ATI PN Fundamentals
priority-setting frameworks including the Nursing Process (ADPIE), Maslow's Hierarchy of Needs, ABC
(Airway-Breathing-Circulation), Safety & Infection Control, and Least Restrictive Interventions. Rationales follow each question
and reference current ATI Testing proficiency expectations for the 2026-2027 cycle.
Section 1: Safe, Effective Care Environment (Q1 - Q20)
Management of Care, Legal/Ethical Issues, Delegation, Safety & Infection Control
Q1. A 74-year-old client is scheduled for a total hip replacement. The surgeon
explains the procedure, risks, and alternatives, then asks the practical nurse (PN)
to witness the client's signature on the consent form. The client says, "I'm not
really sure what they're going to do, but I'll sign it." Which action by the PN is most
appropriate?
A. Witness the signature because the surgeon already explained the procedure
B. Explain the surgical procedure to the client in simple terms
C. Notify the surgeon that the client does not fully understand the procedure [CORRECT]
D. Document that the client signed the consent willingly
Correct Answer: C
Rationale: Informed consent requires the client to demonstrate full understanding of the
procedure, risks, benefits, and alternatives before signing. The PN's role as a witness is to verify
the signature, NOT to confirm understanding. When a client verbalizes uncertainty, the PN must
notify the provider so consent can be re-obtained. Signing anyway (A), explaining the procedure (B
- outside PN scope), or simply documenting (D) all violate the legal and ethical principle of
informed consent.
Q2. A client with terminal cancer has a signed advance directive indicating no
cardiopulmonary resuscitation (DNR). When the client becomes unresponsive and
a family member begs the PN to "do something," what is the priority action?
A. Begin chest compressions because the family is requesting intervention
B. Call a code and let the code team decide whether to resuscitate
C. Honor the DNR order and provide comfort measures only [CORRECT]
D. Ask the healthcare provider to revoke the advance directive
Correct Answer: C
Rationale: Advance directives are legal documents that must be honored per the Patient
Self-Determination Act. The PN must respect the client's autonomous decision documented in the
DNR, even when family members request otherwise. Beginning compressions (A) violates the
directive, calling a code (B) creates unnecessary chaos, and requesting revocation (D) disregards
the client's expressed wishes. Comfort measures and emotional support for the family are the
priority nursing actions.
Page 1 | 75 Questions Total
,ATI PN Fundamentals Predictor Exam - Form A (2026/2027) Practical Nursing Education
Q3. A PN is caring for a client and is approached by a neighbor who asks, "How is
my friend Mrs. Lopez doing?" Which response by the PN best complies with HIPAA
regulations?
A. "She is improving and should be discharged soon."
B. "I cannot confirm or deny whether Mrs. Lopez is a patient here." [CORRECT]
C. "You should ask her directly when she is well enough."
D. "I can only share information if you are on her approved contact list."
Correct Answer: B
Rationale: HIPAA's Privacy Rule prohibits disclosing any protected health information (PHI)
without the client's written authorization, including confirmation that a person is receiving care.
Option B is the only response that fully complies - it neither confirms nor denies the client's
presence. Option A directly violates HIPAA, option C implies the client is hospitalized, and option D
still implicitly confirms the client is a patient. The safest response is a neutral non-confirmation.
Q4. A PN notices multiple bruises of varying ages on a 5-year-old child during a
clinic visit, along with inconsistent parental explanations. Which action is legally
required of the PN?
A. Confront the parents about the suspicious injuries
B. Document the findings and report to Child Protective Services (CPS) [CORRECT]
C. Wait until the next visit to see if injuries recur
D. Discuss the concern with the provider before reporting
Correct Answer: B
Rationale: All nurses are mandated reporters of suspected child abuse. The legal obligation to
report is immediate when suspicion arises - it does not require provider approval or definitive
proof. Documenting objective findings and notifying CPS (B) is mandatory. Confronting parents (A)
may endanger the child further, waiting (C) delays protection, and discussing with the provider
first (D) delays the mandatory report. Mandated reporter laws protect the nurse from liability
when reporting in good faith.
Q5. Which of the following tasks is most appropriate for the PN to delegate to an
unlicensed assistive personnel (UAP)?
A. Teaching a client about a newly prescribed colostomy
B. Measuring intake and output for a stable postoperative client [CORRECT]
C. Assessing a client's surgical incision for signs of infection
D. Administering oral pain medication to a client with chronic pain
Correct Answer: B
Rationale: Delegation follows the Five Rights: right task, right circumstance, right person, right
communication, and right supervision. UAPs may perform routine, non-complex tasks such as
measuring intake and output for stable clients. Teaching (A) requires nursing judgment and is
outside UAP scope, assessment (C) is a licensed nursing function, and medication administration
(D) requires licensure. The PN remains accountable for verifying the UAP's competence and
supervising the delegated task.
Q6. An RN delegates care of four clients to a PN. Which client should the PN
recognize as requiring the most frequent assessment and is best assigned to the
PN rather than a UAP?
Page 2 | 75 Questions Total
, ATI PN Fundamentals Predictor Exam - Form A (2026/2027) Practical Nursing Education
A. A stable client 3 days post-colostomy requiring assistance with ambulation
B. A client with a new tracheostomy requiring suctioning every 2 hours [CORRECT]
C. A client with a chronic pressure injury requiring daily dressing change
D. A stable client requiring vital signs every 4 hours
Correct Answer: B
Rationale: The PN scope includes caring for clients with predictable needs who require skilled
nursing care but are stable. A new tracheostomy with frequent suctioning requires ongoing
assessment of airway patency, oxygenation, and secretions - appropriate for the PN's skill level. A
stable postoperative client (A) and chronic wound care (C) can be managed by the PN but require
less acute monitoring. Routine vital signs (D) can be delegated to a UAP. The five rights of
delegation guide assignment decisions.
Q7. A client requires an IV push medication. The PN should identify that
administering IV push medications is within whose scope of practice in most
states?
A. The PN, after completing a competency checklist
B. The registered nurse (RN) with IV certification [CORRECT]
C. The UAP under direct supervision of a licensed nurse
D. Any licensed nurse who has completed pharmacology training
Correct Answer: B
Rationale: IV push medication administration is generally outside the PN scope of practice in most
states; it is an RN function requiring specialized training. PNs may monitor IV infusions, perform
site care, and discontinue peripheral IVs per facility policy, but IV push medications involve rapid
assessment and potential for immediate complications. UAPs (C) cannot administer any
medications. Generic pharmacology training (D) does not expand scope of practice. Always verify
with the state Nurse Practice Act.
Q8. A PN is preparing to perform tracheostomy suctioning on a client. Which
personal protective equipment (PPE) should the PN don before beginning the
procedure?
A. Gloves only, because the procedure is quick
B. Gloves, mask, and eye protection (goggles or face shield) [CORRECT]
C. Gloves and a surgical mask only
D. Full sterile gown, gloves, and surgical mask
Correct Answer: B
Rationale: Standard precautions require gloves, mask, and eye protection whenever there is risk
of splashing of body fluids, blood, or secretions. Tracheostomy suctioning generates aerosolized
secretions and is a high-splash-risk procedure. Gloves alone (A) leave mucous membranes exposed.
A surgical mask without eye protection (C) does not protect conjunctival mucosa. Full sterile gown
(D) is not required for suctioning a chronic tracheostomy unless strict sterile technique is
specifically indicated.
Q9. A client is admitted with suspected Clostridioides difficile (C. diff) infection.
Which transmission-based precautions should the PN implement?
A. Airborne precautions with negative-pressure room
B. Droplet precautions with surgical mask within 3 feet
Page 3 | 75 Questions Total
ATI PN Fundamentals Predictor Exam
Form A - Questions and Answers
Latest Edition | Practical Nursing (PN) Proficiency Standards
Total Questions: 75 | Cognitive Mix: 25% Recall | 55% Application | 20% Analysis | Time: 110 minutes
Instructions: Select the ONE best answer for each question. Each question is designed around ATI PN Fundamentals
priority-setting frameworks including the Nursing Process (ADPIE), Maslow's Hierarchy of Needs, ABC
(Airway-Breathing-Circulation), Safety & Infection Control, and Least Restrictive Interventions. Rationales follow each question
and reference current ATI Testing proficiency expectations for the 2026-2027 cycle.
Section 1: Safe, Effective Care Environment (Q1 - Q20)
Management of Care, Legal/Ethical Issues, Delegation, Safety & Infection Control
Q1. A 74-year-old client is scheduled for a total hip replacement. The surgeon
explains the procedure, risks, and alternatives, then asks the practical nurse (PN)
to witness the client's signature on the consent form. The client says, "I'm not
really sure what they're going to do, but I'll sign it." Which action by the PN is most
appropriate?
A. Witness the signature because the surgeon already explained the procedure
B. Explain the surgical procedure to the client in simple terms
C. Notify the surgeon that the client does not fully understand the procedure [CORRECT]
D. Document that the client signed the consent willingly
Correct Answer: C
Rationale: Informed consent requires the client to demonstrate full understanding of the
procedure, risks, benefits, and alternatives before signing. The PN's role as a witness is to verify
the signature, NOT to confirm understanding. When a client verbalizes uncertainty, the PN must
notify the provider so consent can be re-obtained. Signing anyway (A), explaining the procedure (B
- outside PN scope), or simply documenting (D) all violate the legal and ethical principle of
informed consent.
Q2. A client with terminal cancer has a signed advance directive indicating no
cardiopulmonary resuscitation (DNR). When the client becomes unresponsive and
a family member begs the PN to "do something," what is the priority action?
A. Begin chest compressions because the family is requesting intervention
B. Call a code and let the code team decide whether to resuscitate
C. Honor the DNR order and provide comfort measures only [CORRECT]
D. Ask the healthcare provider to revoke the advance directive
Correct Answer: C
Rationale: Advance directives are legal documents that must be honored per the Patient
Self-Determination Act. The PN must respect the client's autonomous decision documented in the
DNR, even when family members request otherwise. Beginning compressions (A) violates the
directive, calling a code (B) creates unnecessary chaos, and requesting revocation (D) disregards
the client's expressed wishes. Comfort measures and emotional support for the family are the
priority nursing actions.
Page 1 | 75 Questions Total
,ATI PN Fundamentals Predictor Exam - Form A (2026/2027) Practical Nursing Education
Q3. A PN is caring for a client and is approached by a neighbor who asks, "How is
my friend Mrs. Lopez doing?" Which response by the PN best complies with HIPAA
regulations?
A. "She is improving and should be discharged soon."
B. "I cannot confirm or deny whether Mrs. Lopez is a patient here." [CORRECT]
C. "You should ask her directly when she is well enough."
D. "I can only share information if you are on her approved contact list."
Correct Answer: B
Rationale: HIPAA's Privacy Rule prohibits disclosing any protected health information (PHI)
without the client's written authorization, including confirmation that a person is receiving care.
Option B is the only response that fully complies - it neither confirms nor denies the client's
presence. Option A directly violates HIPAA, option C implies the client is hospitalized, and option D
still implicitly confirms the client is a patient. The safest response is a neutral non-confirmation.
Q4. A PN notices multiple bruises of varying ages on a 5-year-old child during a
clinic visit, along with inconsistent parental explanations. Which action is legally
required of the PN?
A. Confront the parents about the suspicious injuries
B. Document the findings and report to Child Protective Services (CPS) [CORRECT]
C. Wait until the next visit to see if injuries recur
D. Discuss the concern with the provider before reporting
Correct Answer: B
Rationale: All nurses are mandated reporters of suspected child abuse. The legal obligation to
report is immediate when suspicion arises - it does not require provider approval or definitive
proof. Documenting objective findings and notifying CPS (B) is mandatory. Confronting parents (A)
may endanger the child further, waiting (C) delays protection, and discussing with the provider
first (D) delays the mandatory report. Mandated reporter laws protect the nurse from liability
when reporting in good faith.
Q5. Which of the following tasks is most appropriate for the PN to delegate to an
unlicensed assistive personnel (UAP)?
A. Teaching a client about a newly prescribed colostomy
B. Measuring intake and output for a stable postoperative client [CORRECT]
C. Assessing a client's surgical incision for signs of infection
D. Administering oral pain medication to a client with chronic pain
Correct Answer: B
Rationale: Delegation follows the Five Rights: right task, right circumstance, right person, right
communication, and right supervision. UAPs may perform routine, non-complex tasks such as
measuring intake and output for stable clients. Teaching (A) requires nursing judgment and is
outside UAP scope, assessment (C) is a licensed nursing function, and medication administration
(D) requires licensure. The PN remains accountable for verifying the UAP's competence and
supervising the delegated task.
Q6. An RN delegates care of four clients to a PN. Which client should the PN
recognize as requiring the most frequent assessment and is best assigned to the
PN rather than a UAP?
Page 2 | 75 Questions Total
, ATI PN Fundamentals Predictor Exam - Form A (2026/2027) Practical Nursing Education
A. A stable client 3 days post-colostomy requiring assistance with ambulation
B. A client with a new tracheostomy requiring suctioning every 2 hours [CORRECT]
C. A client with a chronic pressure injury requiring daily dressing change
D. A stable client requiring vital signs every 4 hours
Correct Answer: B
Rationale: The PN scope includes caring for clients with predictable needs who require skilled
nursing care but are stable. A new tracheostomy with frequent suctioning requires ongoing
assessment of airway patency, oxygenation, and secretions - appropriate for the PN's skill level. A
stable postoperative client (A) and chronic wound care (C) can be managed by the PN but require
less acute monitoring. Routine vital signs (D) can be delegated to a UAP. The five rights of
delegation guide assignment decisions.
Q7. A client requires an IV push medication. The PN should identify that
administering IV push medications is within whose scope of practice in most
states?
A. The PN, after completing a competency checklist
B. The registered nurse (RN) with IV certification [CORRECT]
C. The UAP under direct supervision of a licensed nurse
D. Any licensed nurse who has completed pharmacology training
Correct Answer: B
Rationale: IV push medication administration is generally outside the PN scope of practice in most
states; it is an RN function requiring specialized training. PNs may monitor IV infusions, perform
site care, and discontinue peripheral IVs per facility policy, but IV push medications involve rapid
assessment and potential for immediate complications. UAPs (C) cannot administer any
medications. Generic pharmacology training (D) does not expand scope of practice. Always verify
with the state Nurse Practice Act.
Q8. A PN is preparing to perform tracheostomy suctioning on a client. Which
personal protective equipment (PPE) should the PN don before beginning the
procedure?
A. Gloves only, because the procedure is quick
B. Gloves, mask, and eye protection (goggles or face shield) [CORRECT]
C. Gloves and a surgical mask only
D. Full sterile gown, gloves, and surgical mask
Correct Answer: B
Rationale: Standard precautions require gloves, mask, and eye protection whenever there is risk
of splashing of body fluids, blood, or secretions. Tracheostomy suctioning generates aerosolized
secretions and is a high-splash-risk procedure. Gloves alone (A) leave mucous membranes exposed.
A surgical mask without eye protection (C) does not protect conjunctival mucosa. Full sterile gown
(D) is not required for suctioning a chronic tracheostomy unless strict sterile technique is
specifically indicated.
Q9. A client is admitted with suspected Clostridioides difficile (C. diff) infection.
Which transmission-based precautions should the PN implement?
A. Airborne precautions with negative-pressure room
B. Droplet precautions with surgical mask within 3 feet
Page 3 | 75 Questions Total
