ATI PN Comprehensive Predictor 2026/2027 | ATI PN
Comprehensive Predictor Proctored Exam Study Guide
& NCLEX-PN Readiness Review | ATI Practical
Nursing Comprehensive Predictor Practice Questions,
Answers & Detailed Rationales | ATI PN Predictor
Exam Prep, Clinical Judgment, NGN, Practical Nursing
Fundamentals, Pharmacology, Adult Medical-Surgical
Nursing, Maternal-Newborn Nursing, Pediatric
Nursing, Mental Health Nursing, Community Health,
Nursing Leadership, Prioritization, Delegation, Patient
Safety, Care Coordination & Comprehensive Practical
Nursing Case-Based Practice
Question 1: A nurse is caring for a client who is postoperative day 1 following
abdominal surgery. Which of the following findings should the nurse report to
the provider immediately?
A. Heart rate 88/min
B. Respiratory rate 28/min
C. Temperature 37.2°C (99.0°F)
D. Blood pressure 118/76 mm Hg
CORRECT ANSWER: B. Respiratory rate 28/min
Rationale: Tachypnea (respiratory rate greater than 20/min) following abdominal
surgery may indicate atelectasis, pneumonia, or pulmonary embolism. This finding
requires immediate intervention because it suggests a potential respiratory complication
that could compromise oxygenation. The other vital signs are within acceptable
parameters for a postoperative client.
Question 2: A nurse is caring for a client with chronic heart failure who reports
increased shortness of breath and swelling in the ankles. Which intervention
should the nurse prioritize?
A. Encourage increased fluid intake
B. Administer prescribed diuretic
C. Provide a high-sodium snack
D. Increase the room temperature
CORRECT ANSWER: B. Administer prescribed diuretic
Rationale: The client's symptoms indicate fluid overload. Administering a diuretic
directly addresses the cause by reducing preload and pulmonary congestion, which
improves oxygenation. Encouraging fluid intake and providing a high-sodium snack
would worsen the condition.
,Question 3: 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
CORRECT ANSWER: B. Check blood glucose level
Rationale: Hypoglycemia can mimic stroke symptoms such as slurred speech, weakness,
and confusion. The nurse must quickly rule out low blood sugar before proceeding with
a stroke workup. Administering aspirin before ruling out hemorrhagic stroke could cause
harm.
Question 4: 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
CORRECT ANSWER: C. Instill normal saline and suction
Rationale: Thick secretions obstructing the tracheostomy tube require immediate
suctioning to maintain airway patency. Instilling normal saline can help loosen
secretions. Airway maintenance is always the priority. Calling respiratory therapy delays
intervention.
Question 5: 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
CORRECT ANSWER: C. A client with a new diagnosis of diabetes needing
insulin instruction
Rationale: Initial client education requires complex assessment and evaluation of
learning, which falls under the RN scope of practice. PNs can reinforce teaching but
cannot perform initial patient teaching. The other tasks are stable and within PN scope.
Question 6: A PN is caring for four clients. Which client should the PN assess
FIRST?
A. Post-op day 2 client requesting pain medication for a 4/10 pain
B. Client with COPD with a new onset of confusion and BP 88/50
,C. Client with diabetes requesting a PRN snack due to hunger
D. Client with a fractured tibia asking for help to the bathroom
CORRECT ANSWER: B. Client with COPD with a new onset of confusion and
BP 88/50
Rationale: New onset confusion combined with hypotension is a classic sign of shock
(sepsis, hemorrhage, or dehydration). This represents a change in neurological status
and hemodynamic instability, which is the priority. The other clients have stable, non-
urgent needs.
Question 7: A client with a new diagnosis of Type 1 Diabetes Mellitus presents
with polydipsia, polyuria, and polyphagia. Which condition do these
manifestations indicate?
A. Hypoglycemia
B. Hyperglycemia
C. Diabetic ketoacidosis
D. Insulin shock
CORRECT ANSWER: B. Hyperglycemia
Rationale: Hyperglycemia typically presents with the three Ps: polyuria, polydipsia, and
polyphagia. Polyuria occurs due to osmotic diuresis, polydipsia results from dehydration,
and polyphagia occurs because cells cannot utilize glucose. Hypoglycemia presents with
diaphoresis and shakiness.
Question 8: A nurse is teaching a client about a new prescription for
Alendronate for osteoporosis. Which instruction is most important?
A. Remain upright for 30 minutes after taking the dose
B. Take the medication with a full glass of milk
C. Take the medication right before bedtime
D. Exercise immediately after taking the pill
CORRECT ANSWER: A. Remain upright for 30 minutes after taking the dose
Rationale: Alendronate can cause severe esophageal irritation and ulceration.
Remaining upright for at least 30 minutes prevents reflux of the medication into the
esophagus. The medication must be taken on an empty stomach with plain water only.
Question 9: A patient with COPD is receiving oxygen at 2L/min via nasal
cannula. The nurse notes the client is becoming increasingly lethargic. What is
the nurse's first action?
A. Increase the oxygen flow to 4L/min
B. Check the client's oxygen saturation levels
C. Place the client in a high-Fowler's position
D. Perform a neurological assessment and call the provider
CORRECT ANSWER: B. Check the client's oxygen saturation levels
, Rationale: In COPD patients, high levels of oxygen can suppress the respiratory drive,
leading to CO2 retention and narcosis. Lethargy is a critical sign of respiratory failure or
hypercapnia. Assessment of oxygen saturation provides objective data before
intervention.
Question 10: Which task is most appropriate for the nurse to delegate to an
Unlicensed Assistive Personnel (UAP)?
A. Assessing a client's surgical incision
B. Feeding a client who has a high risk of aspiration
C. Teaching a client how to use an incentive spirometer
D. Ambulating a stable post-operative client
CORRECT ANSWER: D. Ambulating a stable post-operative client
Rationale: UAPs can perform tasks that are routine and do not require clinical judgment.
Ambulating a stable client is within their scope of practice. Assessment, feeding high-
risk clients, and patient teaching must be performed by licensed nursing staff.
Question 11: A client is taking Digoxin for atrial fibrillation. Which lab result
should the nurse report to the provider immediately?
A. Sodium 140 mEq/L
B. Digoxin level 0.8 ng/mL
C. Calcium 9.5 mg/dL
D. Potassium 3.1 mEq/L
CORRECT ANSWER: D. Potassium 3.1 mEq/L
Rationale: Hypokalemia (low potassium) significantly increases the risk of Digoxin
toxicity. A potassium level of 3.1 mEq/L is below the normal range of 3.5 to 5.0 mEq/L.
The nurse must report this to prevent life-threatening cardiac dysrhythmias.
Question 12: 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
CORRECT ANSWER: C. Instill normal saline and suction
Rationale: Thick secretions obstructing the tracheostomy tube require immediate
suctioning to maintain airway patency. Instilling normal saline can help loosen
secretions. Airway maintenance is always the priority. Calling respiratory therapy delays
intervention.
Question 13: A nurse is caring for a client who is postoperative day 1 following
abdominal surgery. Which of the following findings should the nurse report to
the provider immediately?
Comprehensive Predictor Proctored Exam Study Guide
& NCLEX-PN Readiness Review | ATI Practical
Nursing Comprehensive Predictor Practice Questions,
Answers & Detailed Rationales | ATI PN Predictor
Exam Prep, Clinical Judgment, NGN, Practical Nursing
Fundamentals, Pharmacology, Adult Medical-Surgical
Nursing, Maternal-Newborn Nursing, Pediatric
Nursing, Mental Health Nursing, Community Health,
Nursing Leadership, Prioritization, Delegation, Patient
Safety, Care Coordination & Comprehensive Practical
Nursing Case-Based Practice
Question 1: A nurse is caring for a client who is postoperative day 1 following
abdominal surgery. Which of the following findings should the nurse report to
the provider immediately?
A. Heart rate 88/min
B. Respiratory rate 28/min
C. Temperature 37.2°C (99.0°F)
D. Blood pressure 118/76 mm Hg
CORRECT ANSWER: B. Respiratory rate 28/min
Rationale: Tachypnea (respiratory rate greater than 20/min) following abdominal
surgery may indicate atelectasis, pneumonia, or pulmonary embolism. This finding
requires immediate intervention because it suggests a potential respiratory complication
that could compromise oxygenation. The other vital signs are within acceptable
parameters for a postoperative client.
Question 2: A nurse is caring for a client with chronic heart failure who reports
increased shortness of breath and swelling in the ankles. Which intervention
should the nurse prioritize?
A. Encourage increased fluid intake
B. Administer prescribed diuretic
C. Provide a high-sodium snack
D. Increase the room temperature
CORRECT ANSWER: B. Administer prescribed diuretic
Rationale: The client's symptoms indicate fluid overload. Administering a diuretic
directly addresses the cause by reducing preload and pulmonary congestion, which
improves oxygenation. Encouraging fluid intake and providing a high-sodium snack
would worsen the condition.
,Question 3: 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
CORRECT ANSWER: B. Check blood glucose level
Rationale: Hypoglycemia can mimic stroke symptoms such as slurred speech, weakness,
and confusion. The nurse must quickly rule out low blood sugar before proceeding with
a stroke workup. Administering aspirin before ruling out hemorrhagic stroke could cause
harm.
Question 4: 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
CORRECT ANSWER: C. Instill normal saline and suction
Rationale: Thick secretions obstructing the tracheostomy tube require immediate
suctioning to maintain airway patency. Instilling normal saline can help loosen
secretions. Airway maintenance is always the priority. Calling respiratory therapy delays
intervention.
Question 5: 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
CORRECT ANSWER: C. A client with a new diagnosis of diabetes needing
insulin instruction
Rationale: Initial client education requires complex assessment and evaluation of
learning, which falls under the RN scope of practice. PNs can reinforce teaching but
cannot perform initial patient teaching. The other tasks are stable and within PN scope.
Question 6: A PN is caring for four clients. Which client should the PN assess
FIRST?
A. Post-op day 2 client requesting pain medication for a 4/10 pain
B. Client with COPD with a new onset of confusion and BP 88/50
,C. Client with diabetes requesting a PRN snack due to hunger
D. Client with a fractured tibia asking for help to the bathroom
CORRECT ANSWER: B. Client with COPD with a new onset of confusion and
BP 88/50
Rationale: New onset confusion combined with hypotension is a classic sign of shock
(sepsis, hemorrhage, or dehydration). This represents a change in neurological status
and hemodynamic instability, which is the priority. The other clients have stable, non-
urgent needs.
Question 7: A client with a new diagnosis of Type 1 Diabetes Mellitus presents
with polydipsia, polyuria, and polyphagia. Which condition do these
manifestations indicate?
A. Hypoglycemia
B. Hyperglycemia
C. Diabetic ketoacidosis
D. Insulin shock
CORRECT ANSWER: B. Hyperglycemia
Rationale: Hyperglycemia typically presents with the three Ps: polyuria, polydipsia, and
polyphagia. Polyuria occurs due to osmotic diuresis, polydipsia results from dehydration,
and polyphagia occurs because cells cannot utilize glucose. Hypoglycemia presents with
diaphoresis and shakiness.
Question 8: A nurse is teaching a client about a new prescription for
Alendronate for osteoporosis. Which instruction is most important?
A. Remain upright for 30 minutes after taking the dose
B. Take the medication with a full glass of milk
C. Take the medication right before bedtime
D. Exercise immediately after taking the pill
CORRECT ANSWER: A. Remain upright for 30 minutes after taking the dose
Rationale: Alendronate can cause severe esophageal irritation and ulceration.
Remaining upright for at least 30 minutes prevents reflux of the medication into the
esophagus. The medication must be taken on an empty stomach with plain water only.
Question 9: A patient with COPD is receiving oxygen at 2L/min via nasal
cannula. The nurse notes the client is becoming increasingly lethargic. What is
the nurse's first action?
A. Increase the oxygen flow to 4L/min
B. Check the client's oxygen saturation levels
C. Place the client in a high-Fowler's position
D. Perform a neurological assessment and call the provider
CORRECT ANSWER: B. Check the client's oxygen saturation levels
, Rationale: In COPD patients, high levels of oxygen can suppress the respiratory drive,
leading to CO2 retention and narcosis. Lethargy is a critical sign of respiratory failure or
hypercapnia. Assessment of oxygen saturation provides objective data before
intervention.
Question 10: Which task is most appropriate for the nurse to delegate to an
Unlicensed Assistive Personnel (UAP)?
A. Assessing a client's surgical incision
B. Feeding a client who has a high risk of aspiration
C. Teaching a client how to use an incentive spirometer
D. Ambulating a stable post-operative client
CORRECT ANSWER: D. Ambulating a stable post-operative client
Rationale: UAPs can perform tasks that are routine and do not require clinical judgment.
Ambulating a stable client is within their scope of practice. Assessment, feeding high-
risk clients, and patient teaching must be performed by licensed nursing staff.
Question 11: A client is taking Digoxin for atrial fibrillation. Which lab result
should the nurse report to the provider immediately?
A. Sodium 140 mEq/L
B. Digoxin level 0.8 ng/mL
C. Calcium 9.5 mg/dL
D. Potassium 3.1 mEq/L
CORRECT ANSWER: D. Potassium 3.1 mEq/L
Rationale: Hypokalemia (low potassium) significantly increases the risk of Digoxin
toxicity. A potassium level of 3.1 mEq/L is below the normal range of 3.5 to 5.0 mEq/L.
The nurse must report this to prevent life-threatening cardiac dysrhythmias.
Question 12: 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
CORRECT ANSWER: C. Instill normal saline and suction
Rationale: Thick secretions obstructing the tracheostomy tube require immediate
suctioning to maintain airway patency. Instilling normal saline can help loosen
secretions. Airway maintenance is always the priority. Calling respiratory therapy delays
intervention.
Question 13: A nurse is caring for a client who is postoperative day 1 following
abdominal surgery. Which of the following findings should the nurse report to
the provider immediately?
