Level 3 Attempt ATI PN Comprehensive Predictor Exit Exam 2023–2026
with NGN – 800 Questions and Fully Detailed Answers
This comprehensive exam preparation resource is designed for practical nursing students
preparing to take the ATI PN Comprehensive Predictor Exit Exam. It contains NGN-style and
traditional questions covering all major content areas: Management of Care, Safety and
Infection Control, Health Promotion and Maintenance, Psychosocial Integrity, Basic Care and
Comfort, Pharmacological Therapies, Reduction of Risk Potential, and Physiological
Adaptation.
SECTION 1: MANAGEMENT OF CARE (Questions 1–100)
Question 1: 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
Correct Answer: C — New-onset confusion combined with hypotension suggests possible
sepsis, hemorrhage, or shock—unstable priority indicators. Airway and circulation concerns
precede stable complaints. The client with altered mental status and hemodynamic instability
requires immediate assessment and intervention.
Question 2: Which client can be assigned to a PN (LPN/LVN) under RN supervision? A) Client
newly diagnosed with unstable angina on a titratable heparin drip B) Client with stable
congestive heart failure receiving daily furosemide C) Client requiring blood transfusion for
symptomatic anemia D) Client with chest tube and continuous bubbling in water seal chamber
Correct Answer: B — Stable CHF on routine diuretic is within PN scope. Titratable drips, blood
transfusions, and chest tube troubleshooting are typically RN scope. The PN can administer
stable medications and perform routine monitoring.
Question 3: A charge nurse is assigning staff for the shift. Which client should be assigned to an
RN rather than a PN? 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
,Correct Answer: C — Initial client education falls under RN scope as it requires complex
assessment and evaluation of learning. PNs can reinforce teaching but cannot perform initial
patient teaching.
Question 4: A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate
to delegate? A) Administering an enema B) Inserting an indwelling urinary catheter C)
Measuring a client's vital signs D) Teaching a client how to use an incentive spirometer
Correct Answer: C — Measuring vital signs is within the AP's scope of practice. The nurse
cannot delegate tasks requiring nursing judgment, sterile technique (catheter insertion), or
client education. APs can perform routine, stable tasks.
Question 5: A nurse on a medical-surgical unit has received change-of-shift report and will care
for four clients. Which of the following client needs should the nurse assign to an assistive
personnel (AP)? A) Feeding a client who was admitted 24 hours ago with aspiration pneumonia
B) Reinforcing teaching with a client who is learning to walk with a quad cane C) Reapplying a
condom catheter for a client who has urinary incontinence D) Applying a sterile dressing to a
pressure ulcer
Correct Answer: C — Reapplying a condom catheter is a non-invasive task within the AP's
scope. Options A, B, and D require nursing judgment or sterile technique.
Question 6: An RN is making assignments for client care to an LPN at the beginning of the shift.
Which of the following assignments should the LPN question? A) Assisting a client who is 24
hours postoperative to use an incentive spirometer B) Collecting a clean-catch urine specimen
from a client who was admitted on the previous shift C) Providing nasopharyngeal suctioning for
a client who has pneumonia D) Replacing the cartridge and tubing on a PCA pump
Correct Answer: D — The RN is responsible for the PCA pump. Tasks involving complex
medication administration and pump programming should not be delegated to LPNs. Options A,
B, and C are within LPN scope for stable clients.
Question 7: A practical nurse is preparing to apply restraints to a client. Which of the following
is an appropriate action? A) Apply restraints for 4 hours without reassessment B) Tie restraints
to the bed frame C) Ensure two fingers can fit between the restraint and the client's skin D)
Remove restraints every 4 hours for range of motion
Correct Answer: C — Restraints should be applied so that two fingers can fit between the
restraint and the client's skin to prevent circulation impairment. Restraints must be reassessed
frequently, tied to the bed frame (not side rails), and removed for range of motion at least every
2 hours.
,Question 8: A nurse is caring for a client who has a nasogastric (NG) tube. Which finding
indicates correct tube placement? A) The client is able to speak B) Aspiration yields gastric
contents with a pH of 5 C) Bowel sounds are audible D) The tube is taped to the client's nose
Correct Answer: B — A gastric pH of 5 or less indicates gastric placement. The client's ability to
speak suggests the tube is in the trachea, not the stomach. Bowel sounds and tube taping do
not confirm placement.
Question 9: A practical nurse is reinforcing teaching with a client who has a new prescription for
metformin. Which statement by the client indicates understanding? A) "I will take this
medication with my morning meal." B) "I should expect to gain weight while on this
medication." C) "This medication may cause my urine to turn orange." D) "I will stop taking this
medication if my blood sugar is normal."
Correct Answer: A — Metformin should be taken with meals to reduce GI upset. It is weight-
neutral or may cause mild weight loss. Orange urine is seen with rifampin, not metformin.
Never stop diabetes medications without provider guidance.
Question 10: A 72-year-old client is admitted with confusion, fever, and flank pain. Urinalysis
shows leukocyte esterase and nitrites positive. Which 3 findings would the PN expect to report
to the RN immediately? (Select 3) A) Temperature 101.2°F (38.4°C) B) Blood pressure 88/52 mm
Hg C) Heart rate 112 bpm D) Urine output 40 mL/hr E) Blood glucose 110 mg/dL F) Oxygen
saturation 94% on room air
Correct Answer: A, B, C — Fever, hypotension, and tachycardia suggest possible urosepsis.
Urine output 40 mL/hr is adequate (normal >30 mL/hr). Glucose and O2 sat are within normal
limits.
Question 11: A nurse is assessing a client's vital signs. The client's blood pressure is 158/94 mm
Hg. Which of the following actions should the nurse take first? A) Administer an
antihypertensive medication B) Retake the blood pressure in the same arm after 2 minutes C)
Notify the provider immediately D) Document the finding and continue the assessment
Correct Answer: B — When a single blood pressure reading is elevated, the nurse should first
verify the reading by retaking the measurement after allowing the client to rest for 1 to 2
minutes. This helps rule out factors such as anxiety, incorrect cuff size, or improper positioning.
Question 12: A client is on fall precautions. Which of the following interventions should the
nurse implement? (Select all that apply.) A) Keep the bed in the lowest position B) Raise all four
side rails C) Place a fall risk bracelet on the client D) Ensure the call light is within reach
, Correct Answer: A, C, D — Keeping the bed in the lowest position reduces injury risk. A fall risk
bracelet alerts staff. Call light within reach enables the client to request assistance. Raising all
four side rails is considered a restraint and can increase fall risk.
Question 13: A nurse is preparing to administer a medication via the Z-track method. Which of
the following is the correct technique? A) Pull the skin laterally before injection and release
after withdrawing the needle B) Massage the site vigorously after injection C) Inject the
medication at a 45-degree angle D) Aspirate for 10 seconds before injecting
Correct Answer: A — The Z-track method involves pulling the skin and subcutaneous tissue
laterally before inserting the needle, holding the skin in place during injection, and waiting 10
seconds before withdrawing. The skin is then released, creating a zigzag path that seals the
medication within the muscle.
Question 14: A nurse is caring for a client who has a stage 3 pressure injury. Which of the
following findings should the nurse expect? A) Intact skin with non-blanchable redness B) Full-
thickness skin loss with visible subcutaneous fat C) Full-thickness tissue loss with exposed bone
or muscle D) Partial-thickness skin loss with a pink wound bed
Correct Answer: B — A stage 3 pressure injury involves full-thickness skin loss with visible
subcutaneous fat. Stage 1 is intact skin with non-blanchable redness. Stage 4 involves exposed
bone, muscle, or tendon. Stage 2 is partial-thickness skin loss.
Question 15: A client with dementia is becoming increasingly agitated and trying to pull out an
IV line. Place in order the PN's actions (1 = first, 4 = last): ___ Apply soft wrist restraints ___
Offer a stuffed animal or blanket ___ Redirect to a different activity ___ Notify RN and
document behaviors
Correct Answer: 1 – Redirect to a different activity, 2 – Offer a stuffed animal or blanket, 3 –
Notify RN and document behaviors, 4 – Apply soft wrist restraints — Least restrictive
interventions should always be attempted first. Redirection and comfort measures precede
restraint use. Restraints require a provider order and are a last resort.
Question 16: A nurse is caring for a client who has a vented NG tube set to low intermittent
suction and has vomited. Which of the following actions should the nurse perform first? A)
Irrigate the NG tube with sterile water B) Turn off the suction and notify the provider C) Position
the client on the left side D) Check the tube for patency
Correct Answer: B — If a client with an NG tube set to suction vomits, the nurse should first
turn off the suction to prevent aspiration and then notify the provider. Positioning and patency
checks follow after ensuring immediate safety.
with NGN – 800 Questions and Fully Detailed Answers
This comprehensive exam preparation resource is designed for practical nursing students
preparing to take the ATI PN Comprehensive Predictor Exit Exam. It contains NGN-style and
traditional questions covering all major content areas: Management of Care, Safety and
Infection Control, Health Promotion and Maintenance, Psychosocial Integrity, Basic Care and
Comfort, Pharmacological Therapies, Reduction of Risk Potential, and Physiological
Adaptation.
SECTION 1: MANAGEMENT OF CARE (Questions 1–100)
Question 1: 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
Correct Answer: C — New-onset confusion combined with hypotension suggests possible
sepsis, hemorrhage, or shock—unstable priority indicators. Airway and circulation concerns
precede stable complaints. The client with altered mental status and hemodynamic instability
requires immediate assessment and intervention.
Question 2: Which client can be assigned to a PN (LPN/LVN) under RN supervision? A) Client
newly diagnosed with unstable angina on a titratable heparin drip B) Client with stable
congestive heart failure receiving daily furosemide C) Client requiring blood transfusion for
symptomatic anemia D) Client with chest tube and continuous bubbling in water seal chamber
Correct Answer: B — Stable CHF on routine diuretic is within PN scope. Titratable drips, blood
transfusions, and chest tube troubleshooting are typically RN scope. The PN can administer
stable medications and perform routine monitoring.
Question 3: A charge nurse is assigning staff for the shift. Which client should be assigned to an
RN rather than a PN? 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
,Correct Answer: C — Initial client education falls under RN scope as it requires complex
assessment and evaluation of learning. PNs can reinforce teaching but cannot perform initial
patient teaching.
Question 4: A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate
to delegate? A) Administering an enema B) Inserting an indwelling urinary catheter C)
Measuring a client's vital signs D) Teaching a client how to use an incentive spirometer
Correct Answer: C — Measuring vital signs is within the AP's scope of practice. The nurse
cannot delegate tasks requiring nursing judgment, sterile technique (catheter insertion), or
client education. APs can perform routine, stable tasks.
Question 5: A nurse on a medical-surgical unit has received change-of-shift report and will care
for four clients. Which of the following client needs should the nurse assign to an assistive
personnel (AP)? A) Feeding a client who was admitted 24 hours ago with aspiration pneumonia
B) Reinforcing teaching with a client who is learning to walk with a quad cane C) Reapplying a
condom catheter for a client who has urinary incontinence D) Applying a sterile dressing to a
pressure ulcer
Correct Answer: C — Reapplying a condom catheter is a non-invasive task within the AP's
scope. Options A, B, and D require nursing judgment or sterile technique.
Question 6: An RN is making assignments for client care to an LPN at the beginning of the shift.
Which of the following assignments should the LPN question? A) Assisting a client who is 24
hours postoperative to use an incentive spirometer B) Collecting a clean-catch urine specimen
from a client who was admitted on the previous shift C) Providing nasopharyngeal suctioning for
a client who has pneumonia D) Replacing the cartridge and tubing on a PCA pump
Correct Answer: D — The RN is responsible for the PCA pump. Tasks involving complex
medication administration and pump programming should not be delegated to LPNs. Options A,
B, and C are within LPN scope for stable clients.
Question 7: A practical nurse is preparing to apply restraints to a client. Which of the following
is an appropriate action? A) Apply restraints for 4 hours without reassessment B) Tie restraints
to the bed frame C) Ensure two fingers can fit between the restraint and the client's skin D)
Remove restraints every 4 hours for range of motion
Correct Answer: C — Restraints should be applied so that two fingers can fit between the
restraint and the client's skin to prevent circulation impairment. Restraints must be reassessed
frequently, tied to the bed frame (not side rails), and removed for range of motion at least every
2 hours.
,Question 8: A nurse is caring for a client who has a nasogastric (NG) tube. Which finding
indicates correct tube placement? A) The client is able to speak B) Aspiration yields gastric
contents with a pH of 5 C) Bowel sounds are audible D) The tube is taped to the client's nose
Correct Answer: B — A gastric pH of 5 or less indicates gastric placement. The client's ability to
speak suggests the tube is in the trachea, not the stomach. Bowel sounds and tube taping do
not confirm placement.
Question 9: A practical nurse is reinforcing teaching with a client who has a new prescription for
metformin. Which statement by the client indicates understanding? A) "I will take this
medication with my morning meal." B) "I should expect to gain weight while on this
medication." C) "This medication may cause my urine to turn orange." D) "I will stop taking this
medication if my blood sugar is normal."
Correct Answer: A — Metformin should be taken with meals to reduce GI upset. It is weight-
neutral or may cause mild weight loss. Orange urine is seen with rifampin, not metformin.
Never stop diabetes medications without provider guidance.
Question 10: A 72-year-old client is admitted with confusion, fever, and flank pain. Urinalysis
shows leukocyte esterase and nitrites positive. Which 3 findings would the PN expect to report
to the RN immediately? (Select 3) A) Temperature 101.2°F (38.4°C) B) Blood pressure 88/52 mm
Hg C) Heart rate 112 bpm D) Urine output 40 mL/hr E) Blood glucose 110 mg/dL F) Oxygen
saturation 94% on room air
Correct Answer: A, B, C — Fever, hypotension, and tachycardia suggest possible urosepsis.
Urine output 40 mL/hr is adequate (normal >30 mL/hr). Glucose and O2 sat are within normal
limits.
Question 11: A nurse is assessing a client's vital signs. The client's blood pressure is 158/94 mm
Hg. Which of the following actions should the nurse take first? A) Administer an
antihypertensive medication B) Retake the blood pressure in the same arm after 2 minutes C)
Notify the provider immediately D) Document the finding and continue the assessment
Correct Answer: B — When a single blood pressure reading is elevated, the nurse should first
verify the reading by retaking the measurement after allowing the client to rest for 1 to 2
minutes. This helps rule out factors such as anxiety, incorrect cuff size, or improper positioning.
Question 12: A client is on fall precautions. Which of the following interventions should the
nurse implement? (Select all that apply.) A) Keep the bed in the lowest position B) Raise all four
side rails C) Place a fall risk bracelet on the client D) Ensure the call light is within reach
, Correct Answer: A, C, D — Keeping the bed in the lowest position reduces injury risk. A fall risk
bracelet alerts staff. Call light within reach enables the client to request assistance. Raising all
four side rails is considered a restraint and can increase fall risk.
Question 13: A nurse is preparing to administer a medication via the Z-track method. Which of
the following is the correct technique? A) Pull the skin laterally before injection and release
after withdrawing the needle B) Massage the site vigorously after injection C) Inject the
medication at a 45-degree angle D) Aspirate for 10 seconds before injecting
Correct Answer: A — The Z-track method involves pulling the skin and subcutaneous tissue
laterally before inserting the needle, holding the skin in place during injection, and waiting 10
seconds before withdrawing. The skin is then released, creating a zigzag path that seals the
medication within the muscle.
Question 14: A nurse is caring for a client who has a stage 3 pressure injury. Which of the
following findings should the nurse expect? A) Intact skin with non-blanchable redness B) Full-
thickness skin loss with visible subcutaneous fat C) Full-thickness tissue loss with exposed bone
or muscle D) Partial-thickness skin loss with a pink wound bed
Correct Answer: B — A stage 3 pressure injury involves full-thickness skin loss with visible
subcutaneous fat. Stage 1 is intact skin with non-blanchable redness. Stage 4 involves exposed
bone, muscle, or tendon. Stage 2 is partial-thickness skin loss.
Question 15: A client with dementia is becoming increasingly agitated and trying to pull out an
IV line. Place in order the PN's actions (1 = first, 4 = last): ___ Apply soft wrist restraints ___
Offer a stuffed animal or blanket ___ Redirect to a different activity ___ Notify RN and
document behaviors
Correct Answer: 1 – Redirect to a different activity, 2 – Offer a stuffed animal or blanket, 3 –
Notify RN and document behaviors, 4 – Apply soft wrist restraints — Least restrictive
interventions should always be attempted first. Redirection and comfort measures precede
restraint use. Restraints require a provider order and are a last resort.
Question 16: A nurse is caring for a client who has a vented NG tube set to low intermittent
suction and has vomited. Which of the following actions should the nurse perform first? A)
Irrigate the NG tube with sterile water B) Turn off the suction and notify the provider C) Position
the client on the left side D) Check the tube for patency
Correct Answer: B — If a client with an NG tube set to suction vomits, the nurse should first
turn off the suction to prevent aspiration and then notify the provider. Positioning and patency
checks follow after ensuring immediate safety.
