Latest ATI PN Comprehensive Predictor
2026 Exit Exam Containing NGN and All
180 Questions and Answers
Section 1: Management of Care (Questions 1–18)
1. A PN is caring for four clients on a medical-surgical unit. Which client should the PN assess
first?
A) A client with diabetes who has a blood glucose of 68 mg/dL and is diaphoretic
B) A client with pneumonia whose oxygen saturation decreased from 95% to 89% on 2 L/min
C) A client 24 hours after abdominal surgery reporting incisional pain rated 7/10
D) A client with heart failure who has gained 1 kg since yesterday
Correct Answer: B
Rationale: The client with acute oxygen desaturation is experiencing respiratory
deterioration, which is an immediate airway and breathing priority. While the hypoglycemic
client (A) also requires prompt intervention, the client with declining oxygenation is at risk for
respiratory failure and should be assessed first. Pain (C) and weight gain (D) are important but
not immediately life-threatening.
2. A PN is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate
for the PN to delegate?
A) Performing a sterile dressing change on a surgical wound
B) Assessing a client's lung sounds for crackles
C) Measuring and recording a client's intake and output
D) Teaching a client how to self-administer insulin
Correct Answer: C
Rationale: Measuring and recording intake and output is a standard, unchanging task within
the UAP scope of practice. Sterile dressing changes (A), assessments (B), and initial teaching (D)
all require professional nursing judgment and cannot be delegated to UAP.
,3. A client is admitted with active pulmonary tuberculosis. Which precautions should the PN
implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Correct Answer: C
Rationale: Tuberculosis is spread via airborne droplet nuclei and requires airborne
precautions, including a negative pressure room and an N95 respirator. Contact and droplet
precautions alone are insufficient to prevent transmission.
4. A client refuses a scheduled enema. Which action by the PN demonstrates respect for client
autonomy?
A) Explain the risks of not completing the procedure
B) Document the refusal and notify the RN
C) Ask the family to encourage the client
D) Reschedule the enema for later in the shift without informing the client
Correct Answer: B
Rationale: Competent adults have the right to refuse treatment. The PN must document the
refusal and communicate to the RN. Explaining risks (A) may be appropriate for informed
refusal, but the priority action is documenting and reporting the refusal.
5. A PN is reviewing advance directives with a newly admitted client. Which statement by the
client indicates understanding?
A) "Advance directives only apply if I am in the hospital."
B) "I can change my advance directives at any time as long as I am mentally competent."
C) "My family can override my advance directives if they all agree."
D) "Once signed, advance directives cannot be changed."
Correct Answer: B
, Rationale: Advance directives can be updated or revoked at any time as long as the client is
mentally competent. They apply across all healthcare settings, cannot be overridden by family,
and are not permanent documents.
6. A PN is caring for a client who has a new cast on the right arm. Which task should the PN
delegate to the UAP?
A) Assessing capillary refill in the affected hand
B) Teaching the client how to keep the cast dry
C) Assisting the client with ambulation to the bathroom
D) Evaluating the client's pain level using the 0–10 scale
Correct Answer: C
Rationale: Assisting with ambulation is a standard, stable task within the UAP scope.
Assessment (A), teaching (B), and evaluation (D) require professional nursing judgment and
cannot be delegated.
7. A client with dementia has an order for bilateral soft wrist restraints. Which action is
required by the PN?
A) Secure the restraint ties to the side rails
B) Apply the restraint snugly against the skin
C) Obtain a written prescription for the restraint application
D) Observe the client every 60 minutes after application
Correct Answer: C
Rationale: Restraints require a physician's written order specifying duration and reason. Ties
must never be secured to side rails (A). The restraint should allow two fingers of width (B).
Observations must be made every 15–30 minutes, not hourly (D).
8. A PN is assigned to care for a client who is scheduled for surgery. The client asks the PN to
explain the surgical procedure. Which action should the PN take?
A) Explain the procedure in detail
B) Notify the RN or provider, as this is part of informed consent
, C) Give the client a pamphlet and tell them to read it
D) Tell the client it is not important to know
Correct Answer: B
Rationale: Obtaining informed consent and explaining surgical procedures is the
responsibility of the healthcare provider. The PN should alert the RN or provider so the client
receives accurate information.
9. A PN is making assignments. Which client should be assigned to the most experienced RN?
A) A client with pneumonia requiring IV antibiotics every 6 hours
B) A client with a fractured hip who is 1 day post-operative
C) A client with end-stage renal disease exhibiting confusion and twitching
D) A client with a new diagnosis of hypertension requiring dietary teaching
Correct Answer: C
Rationale: Confusion and twitching in ESRD indicate severe uremia or electrolyte
imbalances that can rapidly progress to seizures or cardiac arrest. This client requires complex
assessment by the most experienced RN.
10. A client's family member asks to review the medical record. The client is intubated and
sedated. What is the PN's best response?
A) Allow the family member to read the chart at the bedside
B) Explain that only the client can access the record
C) Provide a verbal summary of the client's condition and explain the process for record access
D) Inform the family that they cannot have any information
Correct Answer: C
Rationale: Under HIPAA, the client has the right to access their medical record. If
incapacitated, the designated healthcare proxy or legal representative may request access. The
PN should provide a verbal summary and explain the proper process for accessing records.
11. A PN receives a telephone order for "Morphine sulfate 4 mg IV push every 2 hours PRN for
severe pain." Which action should the PN take FIRST?
2026 Exit Exam Containing NGN and All
180 Questions and Answers
Section 1: Management of Care (Questions 1–18)
1. A PN is caring for four clients on a medical-surgical unit. Which client should the PN assess
first?
A) A client with diabetes who has a blood glucose of 68 mg/dL and is diaphoretic
B) A client with pneumonia whose oxygen saturation decreased from 95% to 89% on 2 L/min
C) A client 24 hours after abdominal surgery reporting incisional pain rated 7/10
D) A client with heart failure who has gained 1 kg since yesterday
Correct Answer: B
Rationale: The client with acute oxygen desaturation is experiencing respiratory
deterioration, which is an immediate airway and breathing priority. While the hypoglycemic
client (A) also requires prompt intervention, the client with declining oxygenation is at risk for
respiratory failure and should be assessed first. Pain (C) and weight gain (D) are important but
not immediately life-threatening.
2. A PN is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate
for the PN to delegate?
A) Performing a sterile dressing change on a surgical wound
B) Assessing a client's lung sounds for crackles
C) Measuring and recording a client's intake and output
D) Teaching a client how to self-administer insulin
Correct Answer: C
Rationale: Measuring and recording intake and output is a standard, unchanging task within
the UAP scope of practice. Sterile dressing changes (A), assessments (B), and initial teaching (D)
all require professional nursing judgment and cannot be delegated to UAP.
,3. A client is admitted with active pulmonary tuberculosis. Which precautions should the PN
implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions only
Correct Answer: C
Rationale: Tuberculosis is spread via airborne droplet nuclei and requires airborne
precautions, including a negative pressure room and an N95 respirator. Contact and droplet
precautions alone are insufficient to prevent transmission.
4. A client refuses a scheduled enema. Which action by the PN demonstrates respect for client
autonomy?
A) Explain the risks of not completing the procedure
B) Document the refusal and notify the RN
C) Ask the family to encourage the client
D) Reschedule the enema for later in the shift without informing the client
Correct Answer: B
Rationale: Competent adults have the right to refuse treatment. The PN must document the
refusal and communicate to the RN. Explaining risks (A) may be appropriate for informed
refusal, but the priority action is documenting and reporting the refusal.
5. A PN is reviewing advance directives with a newly admitted client. Which statement by the
client indicates understanding?
A) "Advance directives only apply if I am in the hospital."
B) "I can change my advance directives at any time as long as I am mentally competent."
C) "My family can override my advance directives if they all agree."
D) "Once signed, advance directives cannot be changed."
Correct Answer: B
, Rationale: Advance directives can be updated or revoked at any time as long as the client is
mentally competent. They apply across all healthcare settings, cannot be overridden by family,
and are not permanent documents.
6. A PN is caring for a client who has a new cast on the right arm. Which task should the PN
delegate to the UAP?
A) Assessing capillary refill in the affected hand
B) Teaching the client how to keep the cast dry
C) Assisting the client with ambulation to the bathroom
D) Evaluating the client's pain level using the 0–10 scale
Correct Answer: C
Rationale: Assisting with ambulation is a standard, stable task within the UAP scope.
Assessment (A), teaching (B), and evaluation (D) require professional nursing judgment and
cannot be delegated.
7. A client with dementia has an order for bilateral soft wrist restraints. Which action is
required by the PN?
A) Secure the restraint ties to the side rails
B) Apply the restraint snugly against the skin
C) Obtain a written prescription for the restraint application
D) Observe the client every 60 minutes after application
Correct Answer: C
Rationale: Restraints require a physician's written order specifying duration and reason. Ties
must never be secured to side rails (A). The restraint should allow two fingers of width (B).
Observations must be made every 15–30 minutes, not hourly (D).
8. A PN is assigned to care for a client who is scheduled for surgery. The client asks the PN to
explain the surgical procedure. Which action should the PN take?
A) Explain the procedure in detail
B) Notify the RN or provider, as this is part of informed consent
, C) Give the client a pamphlet and tell them to read it
D) Tell the client it is not important to know
Correct Answer: B
Rationale: Obtaining informed consent and explaining surgical procedures is the
responsibility of the healthcare provider. The PN should alert the RN or provider so the client
receives accurate information.
9. A PN is making assignments. Which client should be assigned to the most experienced RN?
A) A client with pneumonia requiring IV antibiotics every 6 hours
B) A client with a fractured hip who is 1 day post-operative
C) A client with end-stage renal disease exhibiting confusion and twitching
D) A client with a new diagnosis of hypertension requiring dietary teaching
Correct Answer: C
Rationale: Confusion and twitching in ESRD indicate severe uremia or electrolyte
imbalances that can rapidly progress to seizures or cardiac arrest. This client requires complex
assessment by the most experienced RN.
10. A client's family member asks to review the medical record. The client is intubated and
sedated. What is the PN's best response?
A) Allow the family member to read the chart at the bedside
B) Explain that only the client can access the record
C) Provide a verbal summary of the client's condition and explain the process for record access
D) Inform the family that they cannot have any information
Correct Answer: C
Rationale: Under HIPAA, the client has the right to access their medical record. If
incapacitated, the designated healthcare proxy or legal representative may request access. The
PN should provide a verbal summary and explain the proper process for accessing records.
11. A PN receives a telephone order for "Morphine sulfate 4 mg IV push every 2 hours PRN for
severe pain." Which action should the PN take FIRST?
