2025/2026 ATI PN Comprehensive
Predictor Exit Exam with NGN
Master Practice Exam Bank (Next Generation NCLEX - NGN Style)
This comprehensive practice exam is designed to simulate the 2025/2026 ATI PN
Comprehensive Predictor Exit Exam. It includes traditional multiple-choice questions (with
options A, B, C) and Next Generation NCLEX (NGN) case studies to evaluate clinical
judgment, prioritization, pharmacology, medical-surgical nursing, maternal-newborn care,
pediatrics, and mental health.
Section 1: Adult Medical-Surgical Nursing
1. A licensed practical nurse (LPN) is caring for a client with heart failure who is
prescribed daily furosemide. Which of the following laboratory values requires
immediate reporting to the provider?
A) Sodium 138 mEq/L
B) Potassium 3.1 mEq/L
C) Creatinine 1.0 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that leads to potassium loss. A potassium level of
3.1 mEq/L is below the normal range (3.5–5.0 mEq/L) and puts the client at high risk for
fatal cardiac dysrhythmias.
2. An LPN is reinforcing discharge teaching for a client with a new prescription for
warfarin following a deep-vein thrombosis (DVT). Which of the following statements
by the client indicates an understanding of the teaching?
A) 'I will increase my daily intake of dark green leafy vegetables like spinach.'
B) 'I should use a soft-bristled toothbrush and an electric razor.'
C) 'I can take aspirin for mild headaches while on this medication.'
Answer: B
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Clients should use soft-
bristled toothbrushes and electric razors to prevent trauma and bleeding. Leafy greens
contain vitamin K, which antagonizes warfarin, and should be kept consistent rather than
increased. Aspirin increases bleeding risk and should be avoided.
3. A nurse is caring for a client who is 4 hours postoperative following a total knee
arthroplasty. Which of the following findings is the nurse's highest priority?
, A) Pain score of 6 on a scale of 0 to 10
B) Absent pedal pulses and cool, pale skin in the affected extremity
C) Serosanguineous drainage on the surgical dressing measuring 4 cm
Answer: B
Rationale: Using the ABC / urgent vs. non-urgent prioritization framework, compromised
tissue perfusion (absent pulses, cool pale skin) indicates acute arterial occlusion or
compartment syndrome, threatening limb survival and requiring immediate intervention.
4. An LPN is collecting data from a client who has chronic obstructive pulmonary
disease (COPD) and is experiencing dyspnea. Which of the following techniques
should the LPN instruct the client to use?
A) Pursed-lip breathing
B) Diaphragmatic breathing while lying flat
C) High-flow oxygen administration at 6 L/min via nasal cannula
Answer: A
Rationale: Pursed-lip breathing helps prolong exhalation, keeps airways open longer, and
prevents airway collapse in clients with COPD, reducing air trapping. Clients with COPD
should avoid high oxygen flow rates that can depress their hypoxic respiratory drive.
5. A nurse is reviewing laboratory results for a client with type 1 diabetes mellitus.
Which of the following findings indicates effective management of the client's
condition over the past 3 months?
A) Fasting blood glucose 150 mg/dL
B) Glycosylated hemoglobin (HbA1c) of 6.5%
C) Random blood glucose 210 mg/dL
Answer: B
Rationale: An HbA1c level of 6.5% is within the target therapeutic goal for most clients with
diabetes (less than 7%), reflecting long-term glycemic control over the preceding 90 days.
Section 2: Pharmacology & Parenteral Therapies
6. An LPN is preparing to administer digoxin to a client with heart failure. Which of
the following actions should the LPN take prior to administration?
A) Check the client's radial pulse for 30 seconds
B) Measure the client's apical pulse for a full minute
C) Verify the client's most recent serum sodium level
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows heart rate. The LPN must measure the
Predictor Exit Exam with NGN
Master Practice Exam Bank (Next Generation NCLEX - NGN Style)
This comprehensive practice exam is designed to simulate the 2025/2026 ATI PN
Comprehensive Predictor Exit Exam. It includes traditional multiple-choice questions (with
options A, B, C) and Next Generation NCLEX (NGN) case studies to evaluate clinical
judgment, prioritization, pharmacology, medical-surgical nursing, maternal-newborn care,
pediatrics, and mental health.
Section 1: Adult Medical-Surgical Nursing
1. A licensed practical nurse (LPN) is caring for a client with heart failure who is
prescribed daily furosemide. Which of the following laboratory values requires
immediate reporting to the provider?
A) Sodium 138 mEq/L
B) Potassium 3.1 mEq/L
C) Creatinine 1.0 mg/dL
Answer: B
Rationale: Furosemide is a loop diuretic that leads to potassium loss. A potassium level of
3.1 mEq/L is below the normal range (3.5–5.0 mEq/L) and puts the client at high risk for
fatal cardiac dysrhythmias.
2. An LPN is reinforcing discharge teaching for a client with a new prescription for
warfarin following a deep-vein thrombosis (DVT). Which of the following statements
by the client indicates an understanding of the teaching?
A) 'I will increase my daily intake of dark green leafy vegetables like spinach.'
B) 'I should use a soft-bristled toothbrush and an electric razor.'
C) 'I can take aspirin for mild headaches while on this medication.'
Answer: B
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Clients should use soft-
bristled toothbrushes and electric razors to prevent trauma and bleeding. Leafy greens
contain vitamin K, which antagonizes warfarin, and should be kept consistent rather than
increased. Aspirin increases bleeding risk and should be avoided.
3. A nurse is caring for a client who is 4 hours postoperative following a total knee
arthroplasty. Which of the following findings is the nurse's highest priority?
, A) Pain score of 6 on a scale of 0 to 10
B) Absent pedal pulses and cool, pale skin in the affected extremity
C) Serosanguineous drainage on the surgical dressing measuring 4 cm
Answer: B
Rationale: Using the ABC / urgent vs. non-urgent prioritization framework, compromised
tissue perfusion (absent pulses, cool pale skin) indicates acute arterial occlusion or
compartment syndrome, threatening limb survival and requiring immediate intervention.
4. An LPN is collecting data from a client who has chronic obstructive pulmonary
disease (COPD) and is experiencing dyspnea. Which of the following techniques
should the LPN instruct the client to use?
A) Pursed-lip breathing
B) Diaphragmatic breathing while lying flat
C) High-flow oxygen administration at 6 L/min via nasal cannula
Answer: A
Rationale: Pursed-lip breathing helps prolong exhalation, keeps airways open longer, and
prevents airway collapse in clients with COPD, reducing air trapping. Clients with COPD
should avoid high oxygen flow rates that can depress their hypoxic respiratory drive.
5. A nurse is reviewing laboratory results for a client with type 1 diabetes mellitus.
Which of the following findings indicates effective management of the client's
condition over the past 3 months?
A) Fasting blood glucose 150 mg/dL
B) Glycosylated hemoglobin (HbA1c) of 6.5%
C) Random blood glucose 210 mg/dL
Answer: B
Rationale: An HbA1c level of 6.5% is within the target therapeutic goal for most clients with
diabetes (less than 7%), reflecting long-term glycemic control over the preceding 90 days.
Section 2: Pharmacology & Parenteral Therapies
6. An LPN is preparing to administer digoxin to a client with heart failure. Which of
the following actions should the LPN take prior to administration?
A) Check the client's radial pulse for 30 seconds
B) Measure the client's apical pulse for a full minute
C) Verify the client's most recent serum sodium level
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows heart rate. The LPN must measure the
