ATI RN Comprehensive Predictor 2026
Exit CMS Proctored Exam
ATI RN Comprehensive Predictor 2026 Exit CMS Proctored Exam
SECTION 1: MANAGEMENT OF CARE (Q1–Q18)
Q1. A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess
first?
A. A client who is 2 days postoperative reporting pain at 6/10
B. A client with COPD whose oxygen saturation is 88% on room air
C. A client awaiting discharge teaching about wound care
D. A client with stable diabetes requesting a snack
Correct Answer: B
Rationale: Airway and oxygenation take priority according to the ABC framework. An oxygen
saturation of 88% indicates hypoxemia and potential respiratory compromise. Pain management,
discharge teaching, and dietary requests are important but non-urgent compared to respiratory
distress.
Q2. A competent adult client refuses a blood transfusion for religious reasons. Which action should
the nurse take?
A. Administer the transfusion if the hemoglobin is critically low
B. Verify the client understands the risks, document the refusal, and notify the provider
C. Ask the family to override the client's decision
D. Document the refusal and take no further action
Correct Answer: B
Rationale: Competent adults have the right to autonomy and to refuse any treatment. The nurse
must ensure informed refusal by verifying the client understands the risks, document the refusal,
and notify the provider. The nurse cannot administer treatment against the client's wishes, and
family members cannot override the decision of a competent adult.
Q3. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A. Assessing a client's postoperative pain level
B. Ambulating a stable client who has been cleared by physical therapy
C. Administering a tube feeding through a nasogastric tube
D. Evaluating the effectiveness of a client's incentive spirometry use
pg. 1
,Correct Answer: B
Rationale: UAPs may perform routine, non-assessment tasks such as ambulating stable clients.
Assessment, tube feedings, and evaluation of interventions require licensed nursing staff because
they involve clinical judgment and professional accountability.
Q4. A nurse discovers that a colleague has documented assessment findings that were not actually
performed. What is the nurse's legal and ethical responsibility?
A. Confront the colleague privately and ask them to correct the documentation
B. Report the incident to the nurse manager or supervisor
C. Document the correct findings in the nurse's own notes
D. Ignore the incident to avoid workplace conflict
Correct Answer: B
Rationale: Falsifying medical records is a serious legal and ethical violation. The nurse has a duty to
report impaired or unsafe practice to a supervisor. Confrontation may not resolve the issue,
documenting in one's own notes does not address the violation, and ignoring the incident places
clients at risk.
Q5. A nurse is caring for a client who has a living will. The family disagrees with the document's
provisions. What action should the nurse take?
A. Follow the family's wishes since they are the client's surrogate decision-makers
B. Follow the client's documented wishes regarding life-sustaining treatment
C. Ask the provider to make the final decision
D. Ignore the living will if the family objects
Correct Answer: B
Rationale: A living will is a legal document that specifies the client's wishes regarding life-sustaining
treatment. The nurse must follow the client's documented wishes. Family disagreement does not
override a valid living will, and the provider cannot supersede the client's legal directive.
Q6. A nurse is preparing to administer medication to a client. Which action is most important for
preventing medication errors?
A. Verify the client's identity using two identifiers
B. Ask the client to state their name only
C. Check the medication once at the nursing station
D. Administer the medication quickly to save time
Correct Answer: A
Rationale: Using two client identifiers (such as name and date of birth) is a standard safety practice
to prevent medication errors. Asking only for the client's name is insufficient, checking medication
only once is inadequate, and rushing administration increases error risk.
pg. 2
, Q7. A nurse is receiving a change-of-shift report. Which client should the nurse assess first?
A. A client with cirrhosis whose blood pressure has dropped from 120/80 to 90/60 mmHg over the
past hour
B. A client with newly diagnosed diabetes requiring diet teaching
C. A client with pneumonia being discharged this afternoon
D. A client with a fractured femur in balanced skeletal traction
Correct Answer: A
Rationale: A significant drop in blood pressure in a client with cirrhosis may indicate hypovolemic
shock from variceal bleeding, requiring immediate assessment and intervention. The other clients
are stable or have predictable needs that can be addressed after the unstable client.
Q8. A nurse observes a coworker diverting narcotic pain medication for personal use. What is the
nurse's priority action?
A. Confront the coworker directly
B. Document the observation in the client's medical record
C. Report the behavior to the nurse manager or supervisor immediately
D. Call the local police
Correct Answer: C
Rationale: The nurse has a legal and ethical duty to report impaired practice to a supervisor.
Confrontation may lead to conflict and does not ensure client safety. The observation should not be
documented in the client's chart. Law enforcement is not the first step in the chain of reporting.
Q9. A nurse is triaging clients after a mass casualty event. Using disaster triage principles, which
client should receive care first?
A. A client with a tension pneumothorax
B. A client with an open femur fracture
C. A client with a sprained ankle
D. A client with a minor laceration
Correct Answer: A
Rationale: Under disaster triage, life-threatening but survivable injuries receive the highest priority.
A tension pneumothorax is immediately life-threatening and requires rapid intervention. The open
femur fracture is also critical, but hemorrhage control is typically prioritized in mass casualty triage.
The sprained ankle and minor laceration are non-urgent.
Q10. A nurse is caring for a client who speaks a different language. Which action should the nurse
take to ensure effective communication?
pg. 3
Exit CMS Proctored Exam
ATI RN Comprehensive Predictor 2026 Exit CMS Proctored Exam
SECTION 1: MANAGEMENT OF CARE (Q1–Q18)
Q1. A nurse is caring for four clients on a medical-surgical unit. Which client should the nurse assess
first?
A. A client who is 2 days postoperative reporting pain at 6/10
B. A client with COPD whose oxygen saturation is 88% on room air
C. A client awaiting discharge teaching about wound care
D. A client with stable diabetes requesting a snack
Correct Answer: B
Rationale: Airway and oxygenation take priority according to the ABC framework. An oxygen
saturation of 88% indicates hypoxemia and potential respiratory compromise. Pain management,
discharge teaching, and dietary requests are important but non-urgent compared to respiratory
distress.
Q2. A competent adult client refuses a blood transfusion for religious reasons. Which action should
the nurse take?
A. Administer the transfusion if the hemoglobin is critically low
B. Verify the client understands the risks, document the refusal, and notify the provider
C. Ask the family to override the client's decision
D. Document the refusal and take no further action
Correct Answer: B
Rationale: Competent adults have the right to autonomy and to refuse any treatment. The nurse
must ensure informed refusal by verifying the client understands the risks, document the refusal,
and notify the provider. The nurse cannot administer treatment against the client's wishes, and
family members cannot override the decision of a competent adult.
Q3. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A. Assessing a client's postoperative pain level
B. Ambulating a stable client who has been cleared by physical therapy
C. Administering a tube feeding through a nasogastric tube
D. Evaluating the effectiveness of a client's incentive spirometry use
pg. 1
,Correct Answer: B
Rationale: UAPs may perform routine, non-assessment tasks such as ambulating stable clients.
Assessment, tube feedings, and evaluation of interventions require licensed nursing staff because
they involve clinical judgment and professional accountability.
Q4. A nurse discovers that a colleague has documented assessment findings that were not actually
performed. What is the nurse's legal and ethical responsibility?
A. Confront the colleague privately and ask them to correct the documentation
B. Report the incident to the nurse manager or supervisor
C. Document the correct findings in the nurse's own notes
D. Ignore the incident to avoid workplace conflict
Correct Answer: B
Rationale: Falsifying medical records is a serious legal and ethical violation. The nurse has a duty to
report impaired or unsafe practice to a supervisor. Confrontation may not resolve the issue,
documenting in one's own notes does not address the violation, and ignoring the incident places
clients at risk.
Q5. A nurse is caring for a client who has a living will. The family disagrees with the document's
provisions. What action should the nurse take?
A. Follow the family's wishes since they are the client's surrogate decision-makers
B. Follow the client's documented wishes regarding life-sustaining treatment
C. Ask the provider to make the final decision
D. Ignore the living will if the family objects
Correct Answer: B
Rationale: A living will is a legal document that specifies the client's wishes regarding life-sustaining
treatment. The nurse must follow the client's documented wishes. Family disagreement does not
override a valid living will, and the provider cannot supersede the client's legal directive.
Q6. A nurse is preparing to administer medication to a client. Which action is most important for
preventing medication errors?
A. Verify the client's identity using two identifiers
B. Ask the client to state their name only
C. Check the medication once at the nursing station
D. Administer the medication quickly to save time
Correct Answer: A
Rationale: Using two client identifiers (such as name and date of birth) is a standard safety practice
to prevent medication errors. Asking only for the client's name is insufficient, checking medication
only once is inadequate, and rushing administration increases error risk.
pg. 2
, Q7. A nurse is receiving a change-of-shift report. Which client should the nurse assess first?
A. A client with cirrhosis whose blood pressure has dropped from 120/80 to 90/60 mmHg over the
past hour
B. A client with newly diagnosed diabetes requiring diet teaching
C. A client with pneumonia being discharged this afternoon
D. A client with a fractured femur in balanced skeletal traction
Correct Answer: A
Rationale: A significant drop in blood pressure in a client with cirrhosis may indicate hypovolemic
shock from variceal bleeding, requiring immediate assessment and intervention. The other clients
are stable or have predictable needs that can be addressed after the unstable client.
Q8. A nurse observes a coworker diverting narcotic pain medication for personal use. What is the
nurse's priority action?
A. Confront the coworker directly
B. Document the observation in the client's medical record
C. Report the behavior to the nurse manager or supervisor immediately
D. Call the local police
Correct Answer: C
Rationale: The nurse has a legal and ethical duty to report impaired practice to a supervisor.
Confrontation may lead to conflict and does not ensure client safety. The observation should not be
documented in the client's chart. Law enforcement is not the first step in the chain of reporting.
Q9. A nurse is triaging clients after a mass casualty event. Using disaster triage principles, which
client should receive care first?
A. A client with a tension pneumothorax
B. A client with an open femur fracture
C. A client with a sprained ankle
D. A client with a minor laceration
Correct Answer: A
Rationale: Under disaster triage, life-threatening but survivable injuries receive the highest priority.
A tension pneumothorax is immediately life-threatening and requires rapid intervention. The open
femur fracture is also critical, but hemorrhage control is typically prioritized in mass casualty triage.
The sprained ankle and minor laceration are non-urgent.
Q10. A nurse is caring for a client who speaks a different language. Which action should the nurse
take to ensure effective communication?
pg. 3
