ATI PN VATI Comprehensive Predictor Green Light Exam
2026/2027
Actual Exam with Verified Predictor Questions &
Answers | Latest Edition | Aligned with 2026/2027
NCLEX-PN® Test Plan
PHASE 1: FOUNDATIONAL CLINICAL JUDGMENT (Batch 1: Questions 1-25)
Q1: A nurse is caring for a client with heart failure who is receiving furosemide 40 mg PO daily.
Which finding requires immediate follow-up by the nurse?
A. A potassium level of 3.2 mEq/L
B. A potassium level of 3.2 mEq/L [CORRECT]
C. A weight loss of 1 kg since yesterday
D. The client reports increased urination
(Note: The image had A as correct, I will adjust formatting so the letter matches)
Correct Answer: A
Rationale: This question tests risk identification and safety prioritization. Furosemide is a loop
diuretic that causes potassium wasting through renal excretion. A potassium level of 3.2 mEq/L
represents moderate hypokalemia (normal 3.5-5.0 mEq/L), which places the client at immediate
risk for life-threatening cardiac dysrhythmias including ventricular tachycardia and fibrillation.
The PN must notify the provider immediately for potassium replacement therapy and cardiac
monitoring. While weight loss (B) indicates effective diuresis, and increased urination (C) is the
expected therapeutic effect, neither poses immediate safety risks. The blood pressure (D) is
within acceptable parameters. Using the safety and risk reduction framework, electrolyte
imbalance threatening cardiac stability takes precedence over expected therapeutic outcomes.
,Q2: A practical nurse is delegating tasks to unlicensed assistive personnel (UAP) on a medical-
surgical unit. Which task is appropriate to delegate?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Measuring and recording intake and output for a client with heart failure [CORRECT]
C. Teaching a newly diagnosed diabetic client how to administer insulin
D. Evaluating the effectiveness of pain medication for a client with cancer
Correct Answer: B
Rationale: This question tests delegation and scope of practice per the NCLEX-PN framework.
The PN may delegate tasks that are routine, do not require nursing judgment, and have
predictable outcomes. Measuring and recording I&O (B) is a standard, repetitive task within UAP
training. Assessment (A), teaching (C), and evaluation (D) require nursing knowledge, clinical
judgment, and fall within the licensed nurse's scope of practice only. The PN retains
accountability for all delegated tasks and must verify UAP competence before delegation.
Remember: Assessment, planning, teaching, and evaluation cannot be delegated to UAP.
Q3: A client with type 2 diabetes mellitus has a fasting blood glucose of 248 mg/dL. The client
states, "I took my metformin this morning but skipped breakfast because I wasn't hungry."
Which response by the nurse demonstrates therapeutic communication?
A. "You should always eat when taking metformin to prevent low blood sugar."
B. "Skipping meals with diabetes can cause dangerous blood sugar fluctuations."
C. "Tell me more about what affects your appetite in the mornings." [CORRECT]
D. "Your blood sugar is high because you didn't eat with your medication."
Correct Answer: C
Rationale: This question tests therapeutic communication and psychosocial integrity.
Therapeutic communication is client-centered, non-judgmental, and exploratory. Option C uses
an open-ended question to explore the underlying reasons for meal skipping, which may reveal
psychosocial issues (depression, financial constraints, lack of understanding) that require
nursing intervention. Options A, B, and D are non-therapeutic: they are authoritarian (A), fear-
inducing (B), and judgmental/blaming (D). The nurse must first understand the "why" behind the
behavior before providing education. This aligns with Peplau's interpersonal relations theory and
motivational interviewing principles.
,Q4: A nurse is caring for a client with a new colostomy. Which actions by the nurse demonstrate
correct stoma care? (Select all that apply.)
A. Assessing the stoma for a beefy red, moist appearance [CORRECT]
B. Using a skin barrier wafer cut 1/8 inch larger than the stoma [CORRECT]
C. Applying the pouch system immediately after cutting the wafer without testing fit
D. Emptying the pouch when it is 1/3 to 1/2 full [CORRECT]
E. Cleansing the peristomal skin with alcohol-based wipes to ensure sterility
Correct Answer: A, B, D
Rationale: This question tests basic care and comfort for ostomy management. A healthy stoma
(A) should appear beefy red and moist, similar to oral mucosa; pale, blue, or black indicates
ischemia/necrosis requiring immediate provider notification. The skin barrier (B) should be cut
1/8-1/4 inch larger than the stoma to prevent effluent contact with skin while allowing for
peristalsis. Emptying at 1/3-1/2 full (D) prevents leakage and pouch separation from weight. The
nurse should test the fit before applying (C is incorrect) to ensure proper seal. Alcohol (E) is
contraindicated as it dries and irritates skin; use warm water and mild soap only. This applies
skin integrity principles and client safety priorities.
Q5: A client is prescribed warfarin 5 mg PO daily for atrial fibrillation. The INR result is 4.2
(therapeutic range 2.0-3.0). Which is the priority nursing action?
A. Hold the next dose and notify the provider [CORRECT]
B. Administer vitamin K immediately
C. Instruct the client to increase green leafy vegetables
D. Document the result and continue current dosing
Correct Answer: A
Rationale: This question tests pharmacological therapies and safety. An INR of 4.2 represents
supratherapeutic anticoagulation with significant bleeding risk. The PN's priority is to hold the
next dose to prevent further elevation and notify the provider for orders (which may include
withholding multiple doses, low-dose oral vitamin K, or monitoring). The PN cannot
independently administer vitamin K (B) without a provider order—this is outside PN scope in
most jurisdictions. Increasing vitamin K foods (C) is inappropriate for acute elevation and
contradicts warfarin therapy goals. Continuing the dose (D) is unsafe and constitutes negligence.
This follows the "assess, hold, notify" protocol for critical lab values.
, Q6: A client with major depressive disorder tells the nurse, "I don't see any point in going on.
My family would be better off without me." Which is the most appropriate initial response?
A. "You have so much to live for—think about your children."
B. "Are you thinking about hurting yourself right now?" [CORRECT]
C. "Everyone feels this way sometimes when they're depressed."
D. "Let's talk about your medication options with the provider."
Correct Answer: B
Rationale: This question tests psychosocial integrity and safety. When a client expresses
hopelessness and worthlessness, the priority is to directly assess for suicidal ideation. Option B is
the most appropriate initial response because it directly asks about self-harm, which is
necessary to determine the client's immediate safety and the need for interventions (e.g., 1:1
observation, safety precautions). Option A minimizes the client's feelings and offers false
reassurance. Option C dismisses the client's feelings. Option D changes the subject and delays
the critical safety assessment. Safety is always the priority.
Q7: A nurse is caring for a client who is 24 hours postoperative following a total hip arthroplasty.
Which assessment finding should the nurse report to the provider immediately?
A. Shortness of breath and chest pain [CORRECT]
B. Serosanguineous drainage on the surgical dressing
C. Temperature of 100.2°F (37.9°C)
D. Pain at the surgical site rated 6/10
Correct Answer: A
Rationale: This question tests physiological integrity and reduction of risk potential. Following a
total hip arthroplasty, clients are at high risk for venous thromboembolism (VTE), including
pulmonary embolism (PE). Sudden shortness of breath and chest pain are classic signs of PE,
which is a life-threatening emergency requiring immediate provider notification. Option B is an
expected finding in the immediate postoperative period. A low-grade fever (C) is common
postoperatively due to inflammation or atelectasis and does not require immediate reporting
unless it persists or rises. Pain (D) is expected and should be managed with analgesics.
2026/2027
Actual Exam with Verified Predictor Questions &
Answers | Latest Edition | Aligned with 2026/2027
NCLEX-PN® Test Plan
PHASE 1: FOUNDATIONAL CLINICAL JUDGMENT (Batch 1: Questions 1-25)
Q1: A nurse is caring for a client with heart failure who is receiving furosemide 40 mg PO daily.
Which finding requires immediate follow-up by the nurse?
A. A potassium level of 3.2 mEq/L
B. A potassium level of 3.2 mEq/L [CORRECT]
C. A weight loss of 1 kg since yesterday
D. The client reports increased urination
(Note: The image had A as correct, I will adjust formatting so the letter matches)
Correct Answer: A
Rationale: This question tests risk identification and safety prioritization. Furosemide is a loop
diuretic that causes potassium wasting through renal excretion. A potassium level of 3.2 mEq/L
represents moderate hypokalemia (normal 3.5-5.0 mEq/L), which places the client at immediate
risk for life-threatening cardiac dysrhythmias including ventricular tachycardia and fibrillation.
The PN must notify the provider immediately for potassium replacement therapy and cardiac
monitoring. While weight loss (B) indicates effective diuresis, and increased urination (C) is the
expected therapeutic effect, neither poses immediate safety risks. The blood pressure (D) is
within acceptable parameters. Using the safety and risk reduction framework, electrolyte
imbalance threatening cardiac stability takes precedence over expected therapeutic outcomes.
,Q2: A practical nurse is delegating tasks to unlicensed assistive personnel (UAP) on a medical-
surgical unit. Which task is appropriate to delegate?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Measuring and recording intake and output for a client with heart failure [CORRECT]
C. Teaching a newly diagnosed diabetic client how to administer insulin
D. Evaluating the effectiveness of pain medication for a client with cancer
Correct Answer: B
Rationale: This question tests delegation and scope of practice per the NCLEX-PN framework.
The PN may delegate tasks that are routine, do not require nursing judgment, and have
predictable outcomes. Measuring and recording I&O (B) is a standard, repetitive task within UAP
training. Assessment (A), teaching (C), and evaluation (D) require nursing knowledge, clinical
judgment, and fall within the licensed nurse's scope of practice only. The PN retains
accountability for all delegated tasks and must verify UAP competence before delegation.
Remember: Assessment, planning, teaching, and evaluation cannot be delegated to UAP.
Q3: A client with type 2 diabetes mellitus has a fasting blood glucose of 248 mg/dL. The client
states, "I took my metformin this morning but skipped breakfast because I wasn't hungry."
Which response by the nurse demonstrates therapeutic communication?
A. "You should always eat when taking metformin to prevent low blood sugar."
B. "Skipping meals with diabetes can cause dangerous blood sugar fluctuations."
C. "Tell me more about what affects your appetite in the mornings." [CORRECT]
D. "Your blood sugar is high because you didn't eat with your medication."
Correct Answer: C
Rationale: This question tests therapeutic communication and psychosocial integrity.
Therapeutic communication is client-centered, non-judgmental, and exploratory. Option C uses
an open-ended question to explore the underlying reasons for meal skipping, which may reveal
psychosocial issues (depression, financial constraints, lack of understanding) that require
nursing intervention. Options A, B, and D are non-therapeutic: they are authoritarian (A), fear-
inducing (B), and judgmental/blaming (D). The nurse must first understand the "why" behind the
behavior before providing education. This aligns with Peplau's interpersonal relations theory and
motivational interviewing principles.
,Q4: A nurse is caring for a client with a new colostomy. Which actions by the nurse demonstrate
correct stoma care? (Select all that apply.)
A. Assessing the stoma for a beefy red, moist appearance [CORRECT]
B. Using a skin barrier wafer cut 1/8 inch larger than the stoma [CORRECT]
C. Applying the pouch system immediately after cutting the wafer without testing fit
D. Emptying the pouch when it is 1/3 to 1/2 full [CORRECT]
E. Cleansing the peristomal skin with alcohol-based wipes to ensure sterility
Correct Answer: A, B, D
Rationale: This question tests basic care and comfort for ostomy management. A healthy stoma
(A) should appear beefy red and moist, similar to oral mucosa; pale, blue, or black indicates
ischemia/necrosis requiring immediate provider notification. The skin barrier (B) should be cut
1/8-1/4 inch larger than the stoma to prevent effluent contact with skin while allowing for
peristalsis. Emptying at 1/3-1/2 full (D) prevents leakage and pouch separation from weight. The
nurse should test the fit before applying (C is incorrect) to ensure proper seal. Alcohol (E) is
contraindicated as it dries and irritates skin; use warm water and mild soap only. This applies
skin integrity principles and client safety priorities.
Q5: A client is prescribed warfarin 5 mg PO daily for atrial fibrillation. The INR result is 4.2
(therapeutic range 2.0-3.0). Which is the priority nursing action?
A. Hold the next dose and notify the provider [CORRECT]
B. Administer vitamin K immediately
C. Instruct the client to increase green leafy vegetables
D. Document the result and continue current dosing
Correct Answer: A
Rationale: This question tests pharmacological therapies and safety. An INR of 4.2 represents
supratherapeutic anticoagulation with significant bleeding risk. The PN's priority is to hold the
next dose to prevent further elevation and notify the provider for orders (which may include
withholding multiple doses, low-dose oral vitamin K, or monitoring). The PN cannot
independently administer vitamin K (B) without a provider order—this is outside PN scope in
most jurisdictions. Increasing vitamin K foods (C) is inappropriate for acute elevation and
contradicts warfarin therapy goals. Continuing the dose (D) is unsafe and constitutes negligence.
This follows the "assess, hold, notify" protocol for critical lab values.
, Q6: A client with major depressive disorder tells the nurse, "I don't see any point in going on.
My family would be better off without me." Which is the most appropriate initial response?
A. "You have so much to live for—think about your children."
B. "Are you thinking about hurting yourself right now?" [CORRECT]
C. "Everyone feels this way sometimes when they're depressed."
D. "Let's talk about your medication options with the provider."
Correct Answer: B
Rationale: This question tests psychosocial integrity and safety. When a client expresses
hopelessness and worthlessness, the priority is to directly assess for suicidal ideation. Option B is
the most appropriate initial response because it directly asks about self-harm, which is
necessary to determine the client's immediate safety and the need for interventions (e.g., 1:1
observation, safety precautions). Option A minimizes the client's feelings and offers false
reassurance. Option C dismisses the client's feelings. Option D changes the subject and delays
the critical safety assessment. Safety is always the priority.
Q7: A nurse is caring for a client who is 24 hours postoperative following a total hip arthroplasty.
Which assessment finding should the nurse report to the provider immediately?
A. Shortness of breath and chest pain [CORRECT]
B. Serosanguineous drainage on the surgical dressing
C. Temperature of 100.2°F (37.9°C)
D. Pain at the surgical site rated 6/10
Correct Answer: A
Rationale: This question tests physiological integrity and reduction of risk potential. Following a
total hip arthroplasty, clients are at high risk for venous thromboembolism (VTE), including
pulmonary embolism (PE). Sudden shortness of breath and chest pain are classic signs of PE,
which is a life-threatening emergency requiring immediate provider notification. Option B is an
expected finding in the immediate postoperative period. A low-grade fever (C) is common
postoperatively due to inflammation or atelectasis and does not require immediate reporting
unless it persists or rises. Pain (D) is expected and should be managed with analgesics.
