ATI PN COMPREHENSIVE PREDICTOR
2026/2027 | ATI PN PROCTORED EXAM
STUDY GUIDE & NCLEX-PN READINESS
REVIEW WITH PRACTICE QUESTIONS
ATI PN COMPREHENSIVE PREDICTOR 2026/2027
ATI PN PROCTORED EXAM STUDY GUIDE & NCLEX-PN READINESS REVIEW
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice questions designed to simulate
the ATI PN exam and NCLEX-PN readiness assessment with emphasis on critical
thinking, clinical judgment, and real-world nursing scenarios
• Features include multiple-choice questions with detailed rationales covering all
major nursing domains including fundamentals, pharmacology, medical-surgical
nursing, psychiatric nursing, pediatrics, maternity, and leadership—study
systematically through each section to identify knowledge gaps and reinforce
learning
QUESTION 1: A licensed practical nurse (LPN) is reviewing a client's
medication list and notes the client is taking both metformin and glipizide.
Which of the following is the primary concern with this combination?
A) The medications will interact and increase the risk of hypoglycemia
B) Metformin will reduce the absorption of glipizide in the gastrointestinal tract
C) Glipizide will cause the client to develop lactic acidosis
D) The combination is contraindicated in all clients with type 2 diabetes
E) Metformin should be held when glipizide is administered
✓ CORRECT ANSWER: A) The medications will interact and increase the risk of
hypoglycemia
,RATIONALE: Metformin and glipizide are commonly used together in type 2
diabetes management because they have complementary mechanisms of action.
However, when used together, there is an increased risk of hypoglycemia because
glipizide stimulates insulin release while metformin improves insulin sensitivity. The
nurse should monitor the client for signs of hypoglycemia including tremors,
diaphoresis, confusion, and tachycardia. While hypoglycemia is a concern with this
combination, it is a manageable side effect and the medications are not
contraindicated. Metformin does not significantly reduce glipizide absorption, and
glipizide does not cause lactic acidosis—lactic acidosis is a rare side effect
associated with metformin use.
QUESTION 2: A client presents to the emergency department with acute
angle-closure glaucoma. Which of the following interventions should the LPN
anticipate?
A) Application of warm compresses to the affected eye
B) Instillation of mydriatic eye drops
C) Immediate administration of osmotic diuretics
D) Patching both eyes for 24 hours
E) Administration of topical corticosteroids only
✓ CORRECT ANSWER: C) Immediate administration of osmotic diuretics
RATIONALE: Acute angle-closure glaucoma is an ophthalmic emergency that
requires immediate intervention to lower intraocular pressure. Osmotic diuretics
such as IV mannitol or oral glycerol are used to decrease aqueous humor
production by creating an osmotic gradient. These medications rapidly reduce
intraocular pressure and can prevent permanent vision loss. Mydriatic drops are
contraindicated in acute angle-closure glaucoma as they worsen the condition by
pushing the lens-iris diaphragm forward, further blocking aqueous humor outflow.
Warm compresses would increase intraocular pressure. Patching both eyes is
unnecessary. While corticosteroids may be used as adjunctive therapy, they are not
the primary intervention.
,QUESTION 3: An LPN is caring for a client with severe burns covering 40% of
the body. During the acute phase, which fluid replacement therapy is most
appropriate?
A) Hypotonic saline solution at a rate determined by urinary output
B) Hypertonic saline solution using the Parkland formula calculation
C) Isotonic crystalloid solution using the Parkland formula calculation
D) Dextrose in water to maintain hydration and provide calories
E) Albumin infusion as the primary fluid replacement
✓ CORRECT ANSWER: C) Isotonic crystalloid solution using the Parkland
formula calculation
RATIONALE: The Parkland formula is the gold standard for burn fluid resuscitation
and uses isotonic crystalloid solutions such as normal saline or lactated Ringer's
solution. The formula calculates 4 mL × body weight in kilograms × percentage of
body surface area burned, with half administered in the first 8 hours and the
remainder over the next 16 hours. The goal is to maintain urinary output of 0.5
mL/kg/hour for adults. Hypertonic saline is not the standard of care and can cause
hypernatremia. Hypotonic solutions are contraindicated as they do not adequately
restore intravascular volume and can cause cerebral edema. Dextrose in water is
hypotonic and provides minimal caloric support. Albumin is used in severe burns
but not as the primary initial fluid replacement.
QUESTION 4: A client with chronic kidney disease stage 4 has a potassium
level of 5.8 mEq/L. Which of the following medications should the LPN expect
to administer?
A) Spironolactone to promote sodium retention
B) Calcium polystyrene sulfonate to promote potassium excretion
C) Insulin with dextrose to shift potassium into cells
, D) Both B and C are correct
E) ACE inhibitor to improve kidney function
✓ CORRECT ANSWER: D) Both B and C are correct
RATIONALE: In hyperkalemia, multiple interventions may be used depending on the
severity and electrocardiographic changes. Calcium polystyrene sulfonate
(Kayexalate) removes potassium from the body through the gastrointestinal tract.
Insulin with dextrose shifts potassium intracellularly through increased glucose
metabolism, providing temporary relief while potassium is removed from the body.
Both interventions are appropriate and may be used together. Spironolactone is a
potassium-sparing diuretic and would worsen hyperkalemia. ACE inhibitors can
increase potassium levels and should be used cautiously or avoided in stage 4 CKD
with hyperkalemia.
QUESTION 5: An LPN is educating a client newly diagnosed with type 1
diabetes about insulin administration. Which statement by the client
indicates a need for further education?
A) "I will store my current insulin vial at room temperature and replace it every 28
days"
B) "I will store unopened insulin vials in the refrigerator until I need to use them"
C) "I will inject insulin at a 90-degree angle to ensure it reaches the subcutaneous
tissue"
D) "I will rotate injection sites systematically to prevent lipodystrophy"
E) "I will use a new needle for each injection to prevent infection"
✓ CORRECT ANSWER: C) "I will inject insulin at a 90-degree angle to ensure it
reaches the subcutaneous tissue"
RATIONALE: While insulin is typically injected at a 90-degree angle, this statement is
not necessarily incorrect, but it is overly rigid. Insulin injection angles can vary
based on client body composition. For clients with minimal subcutaneous tissue, a
45-degree angle may be appropriate to prevent intramuscular injection. The other
2026/2027 | ATI PN PROCTORED EXAM
STUDY GUIDE & NCLEX-PN READINESS
REVIEW WITH PRACTICE QUESTIONS
ATI PN COMPREHENSIVE PREDICTOR 2026/2027
ATI PN PROCTORED EXAM STUDY GUIDE & NCLEX-PN READINESS REVIEW
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice questions designed to simulate
the ATI PN exam and NCLEX-PN readiness assessment with emphasis on critical
thinking, clinical judgment, and real-world nursing scenarios
• Features include multiple-choice questions with detailed rationales covering all
major nursing domains including fundamentals, pharmacology, medical-surgical
nursing, psychiatric nursing, pediatrics, maternity, and leadership—study
systematically through each section to identify knowledge gaps and reinforce
learning
QUESTION 1: A licensed practical nurse (LPN) is reviewing a client's
medication list and notes the client is taking both metformin and glipizide.
Which of the following is the primary concern with this combination?
A) The medications will interact and increase the risk of hypoglycemia
B) Metformin will reduce the absorption of glipizide in the gastrointestinal tract
C) Glipizide will cause the client to develop lactic acidosis
D) The combination is contraindicated in all clients with type 2 diabetes
E) Metformin should be held when glipizide is administered
✓ CORRECT ANSWER: A) The medications will interact and increase the risk of
hypoglycemia
,RATIONALE: Metformin and glipizide are commonly used together in type 2
diabetes management because they have complementary mechanisms of action.
However, when used together, there is an increased risk of hypoglycemia because
glipizide stimulates insulin release while metformin improves insulin sensitivity. The
nurse should monitor the client for signs of hypoglycemia including tremors,
diaphoresis, confusion, and tachycardia. While hypoglycemia is a concern with this
combination, it is a manageable side effect and the medications are not
contraindicated. Metformin does not significantly reduce glipizide absorption, and
glipizide does not cause lactic acidosis—lactic acidosis is a rare side effect
associated with metformin use.
QUESTION 2: A client presents to the emergency department with acute
angle-closure glaucoma. Which of the following interventions should the LPN
anticipate?
A) Application of warm compresses to the affected eye
B) Instillation of mydriatic eye drops
C) Immediate administration of osmotic diuretics
D) Patching both eyes for 24 hours
E) Administration of topical corticosteroids only
✓ CORRECT ANSWER: C) Immediate administration of osmotic diuretics
RATIONALE: Acute angle-closure glaucoma is an ophthalmic emergency that
requires immediate intervention to lower intraocular pressure. Osmotic diuretics
such as IV mannitol or oral glycerol are used to decrease aqueous humor
production by creating an osmotic gradient. These medications rapidly reduce
intraocular pressure and can prevent permanent vision loss. Mydriatic drops are
contraindicated in acute angle-closure glaucoma as they worsen the condition by
pushing the lens-iris diaphragm forward, further blocking aqueous humor outflow.
Warm compresses would increase intraocular pressure. Patching both eyes is
unnecessary. While corticosteroids may be used as adjunctive therapy, they are not
the primary intervention.
,QUESTION 3: An LPN is caring for a client with severe burns covering 40% of
the body. During the acute phase, which fluid replacement therapy is most
appropriate?
A) Hypotonic saline solution at a rate determined by urinary output
B) Hypertonic saline solution using the Parkland formula calculation
C) Isotonic crystalloid solution using the Parkland formula calculation
D) Dextrose in water to maintain hydration and provide calories
E) Albumin infusion as the primary fluid replacement
✓ CORRECT ANSWER: C) Isotonic crystalloid solution using the Parkland
formula calculation
RATIONALE: The Parkland formula is the gold standard for burn fluid resuscitation
and uses isotonic crystalloid solutions such as normal saline or lactated Ringer's
solution. The formula calculates 4 mL × body weight in kilograms × percentage of
body surface area burned, with half administered in the first 8 hours and the
remainder over the next 16 hours. The goal is to maintain urinary output of 0.5
mL/kg/hour for adults. Hypertonic saline is not the standard of care and can cause
hypernatremia. Hypotonic solutions are contraindicated as they do not adequately
restore intravascular volume and can cause cerebral edema. Dextrose in water is
hypotonic and provides minimal caloric support. Albumin is used in severe burns
but not as the primary initial fluid replacement.
QUESTION 4: A client with chronic kidney disease stage 4 has a potassium
level of 5.8 mEq/L. Which of the following medications should the LPN expect
to administer?
A) Spironolactone to promote sodium retention
B) Calcium polystyrene sulfonate to promote potassium excretion
C) Insulin with dextrose to shift potassium into cells
, D) Both B and C are correct
E) ACE inhibitor to improve kidney function
✓ CORRECT ANSWER: D) Both B and C are correct
RATIONALE: In hyperkalemia, multiple interventions may be used depending on the
severity and electrocardiographic changes. Calcium polystyrene sulfonate
(Kayexalate) removes potassium from the body through the gastrointestinal tract.
Insulin with dextrose shifts potassium intracellularly through increased glucose
metabolism, providing temporary relief while potassium is removed from the body.
Both interventions are appropriate and may be used together. Spironolactone is a
potassium-sparing diuretic and would worsen hyperkalemia. ACE inhibitors can
increase potassium levels and should be used cautiously or avoided in stage 4 CKD
with hyperkalemia.
QUESTION 5: An LPN is educating a client newly diagnosed with type 1
diabetes about insulin administration. Which statement by the client
indicates a need for further education?
A) "I will store my current insulin vial at room temperature and replace it every 28
days"
B) "I will store unopened insulin vials in the refrigerator until I need to use them"
C) "I will inject insulin at a 90-degree angle to ensure it reaches the subcutaneous
tissue"
D) "I will rotate injection sites systematically to prevent lipodystrophy"
E) "I will use a new needle for each injection to prevent infection"
✓ CORRECT ANSWER: C) "I will inject insulin at a 90-degree angle to ensure it
reaches the subcutaneous tissue"
RATIONALE: While insulin is typically injected at a 90-degree angle, this statement is
not necessarily incorrect, but it is overly rigid. Insulin injection angles can vary
based on client body composition. For clients with minimal subcutaneous tissue, a
45-degree angle may be appropriate to prevent intramuscular injection. The other
