NEWEST VERSION
Actual Exam — Complete 180 Questions & Correct Answers
ALREADY GRADED A+
Aligned with the 2026–2027 NCLEX-RN Test Plan and the official ATI
Comprehensive Predictor format. Eight content domains, integrated clinical
judgment, prioritization frameworks (ABC, Maslow, Safety, Least Restrictive),
dosage calculation embedded in clinical scenarios, delegation/supervision at
entry-level RN practice, and detailed ATI-focused rationales with NCLEX-RN
alignment.
Cognitive Level Distribution
Recall (Knowledge) 25%
Application 55%
Analysis 20%
# Section Q Range Count
1 Management of Care Q1–Q22 22
2 Safety and Infection Control Q23–Q40 18
3 Health Promotion and Maintenance Q41–Q58 18
4 Psychosocial Integrity Q59–Q76 18
5 Basic Care and Comfort Q77–Q94 18
6 Pharmacological and Parenteral Therapies Q95–Q116 22
,ATI Comprehensive Predictor 2026/2027 — 180-Question Exam Graded A+ | NCLEX-RN Readiness
7 Reduction of Risk Potential Q117–Q140 24
8 Physiological Adaptation Q141–Q180 40
TOTAL Q1–Q180 180
Z.ai Nursing Education Page 2
,ATI Comprehensive Predictor 2026/2027 — 180-Question Exam Graded A+ | NCLEX-RN Readiness
SECTION 1 — MANAGEMENT OF CARE (Advocacy, Delegation, Case
Management, Continuity of Care, Legal/Ethical)
Q1: A registered nurse (RN) on a medical-surgical unit is assigned four clients. Which client should the RN
assess FIRST?
A. A client who is 2 days postoperative with a temperature of 100.4°F (38°C)
B. A client with chronic heart failure reporting dyspnea after walking to the bathroom [CORRECT]
C. A client receiving IV antibiotics who is scheduled for the next dose in 30 minutes
D. A client with type 2 diabetes mellitus awaiting discharge teaching
Correct Answer: B
Rationale:
Using the ABC (Airway-Breathing-Circulation) prioritization framework, dyspnea in a heart failure client signals possible
acute decompensation or pulmonary edema and must be assessed first. The postoperative low-grade fever, scheduled
antibiotic, and discharge teaching are important but not immediately life-threatening. ATI Predictor questions reward
selecting the unstable airway/breathing client before stable or routine needs.
Q2: An RN is delegating care to an unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A. Teaching a client newly diagnosed with diabetes how to inject insulin
B. Assessing a surgical incision for signs of infection
C. Ambulating a stable client who is 2 days postoperative from an appendectomy [CORRECT]
D. Evaluating the effectiveness of a newly administered analgesic
Correct Answer: C
Rationale:
Tasks requiring nursing judgment (teaching, assessing, evaluating) cannot be delegated to UAPs. Ambulating a stable
postoperative client is a routine, noninvasive task within the UAP scope. The Five Rights of Delegation (right task, right
circumstance, right person, right direction, right supervision) guide this decision. ATI emphasizes that the RN retains
accountability for assessment and evaluation even when care is delegated.
Q3: A client with terminal cancer refuses a blood transfusion that the provider has prescribed, citing religious
beliefs. Which action should the nurse take FIRST?
A. Administer the transfusion because it is prescribed
B. Notify the provider and document the client's refusal [CORRECT]
C. Call the hospital's ethics committee immediately
D. Explain that the transfusion is necessary to live
Correct Answer: B
Rationale:
Autonomy is a core ethical principle; a competent adult has the right to refuse treatment even when life-sustaining. The
nurse's first action is to notify the provider of the refusal so alternative options can be discussed and to document the
refusal in the medical record. Coercing treatment violates informed consent and autonomy. Ethics committees are
reserved for unresolved conflicts, not the initial refusal.
Z.ai Nursing Education Page 3
, ATI Comprehensive Predictor 2026/2027 — 180-Question Exam Graded A+ | NCLEX-RN Readiness
Q4: A nurse manager is reviewing staff assignments for the shift. Which assignment by the charge nurse
demonstrates an understanding of delegation principles?
A. Assigning a newly licensed RN to care for an unstable client receiving a heparin drip
B. Assigning a UAP to measure and record intake and output for four clients [CORRECT]
C. Assigning a licensed practical nurse (LPN) to administer the first dose of IV potassium
D. Assigning a float nurse from labor and delivery to a critical care client
Correct Answer: B
Rationale:
Measuring intake and output is a routine, standard task appropriate for a UAP and aligns with the Five Rights of
Delegation. Newly licensed RNs should not care for unstable clients requiring high-acuity interventions. Initial doses of
high-alert IV medications require an RN. Float nurses should be assigned to clients within their area of competency to
avoid safety risks.
Q5: A client is scheduled for discharge following a total hip arthroplasty. The client tells the nurse, "I live
alone and don't know how I'll manage." Which action by the nurse BEST demonstrates advocacy?
A. Reassure the client that everything will be fine once home
B. Consult the case manager to arrange home health services and equipment [CORRECT]
C. Tell the client to ask a family member to move in temporarily
D. Document the statement and continue with discharge preparations
Correct Answer: B
Rationale:
Advocacy involves actively supporting the client's needs and coordinating resources. Engaging the case manager to
arrange home health services, durable medical equipment, and community resources directly addresses the client's safety
and continuity of care. Empty reassurance, suggesting informal caregiver arrangements, or simple documentation does not
resolve the identified discharge risk.
Q6: A nurse witnesses a colleague make a medication error but fail to report it. Which action should the nurse
take FIRST?
A. Notify the charge nurse immediately [CORRECT]
B. File an incident report on behalf of the colleague
C. Confront the colleague privately and demand they report it
D. Wait to see if the colleague self-reports at the end of the shift
Correct Answer: A
Rationale:
Patient safety supersedes personal loyalty; the nurse has a professional obligation to escalate unreported errors to the
charge nurse so the client can be assessed and the event documented. Filing an incident report on someone's behalf
without their knowledge is inappropriate, and delaying action puts the client at risk for unrecognized adverse effects. ATI
Predictor rationales emphasize the chain-of-command for safety violations.
Z.ai Nursing Education Page 4