PRACTICE PROCTORED-STYLE ASSESSMENT
PN Comprehensive Predictor Practice Exam
Answer Key With Full Rationales
180 Original Exit-Exam-Style Items Aligned With the NCLEX-PN Test Plan and the ATI PN
Comprehensive Predictor Content Areas
Total items 180
Traditional multiple choice (single best answer) 106
Select all that apply (SATA) 29
Next Generation NCLEX (NGN)-style items 45
• Unfolding case studies (6 items each) 5 cases / 30 items
• Stand-alone bowtie, matrix, cloze, trend, and ordered-response items 15
MC, SATA, matrix/grid, drop-down cloze, highlight,
Item formats used
bowtie, trend, ordered response
Content areas covered
Fundamentals (39), Leadership and Management (30), Adult Medical-Surgical (29), Nursing Care of Children (24),
Maternal-Newborn (23), Mental Health (18), Pharmacology (17)
Original practice items written for exam preparation. Not affiliated with, endorsed by, or reproduced from ATI Nursing Education or NCSBN.
Always follow current facility policy, state scope of practice, and provider prescriptions.
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
How to Use This Answer Key
• Take the exam first under timed conditions, then score it with the Quick Answer Key that follows.
• Strict scoring (recommended, similar to most proctored practice exams): award 1 point only when the entire response is
correct — every correct SATA option and no incorrect ones, every matrix row, every drop-down, and all five bowtie
selections.
• Partial-credit scoring (similar to NGN polytomous scoring): for SATA, highlight, and multiple-response items, add 1 point
for each correct selection and subtract 1 for each incorrect selection (minimum 0); for matrix and cloze items, award 1
point per correct row or drop-down; for bowtie items, award 1 point per correct selection (maximum 5).
• Target: aim for at least 75% to 80% under strict scoring before your proctored exam. Use the blueprint to find weak
content areas, then reread the full rationales and Exam Pearls for every item you missed or guessed on.
• Each rationale explains the underlying concept, why the correct answer is correct, and why every other option is wrong
— study the wrong options as carefully as the right ones, because they represent the most common distractors on
proctored exams.
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 2 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
Quick Answer Key
# Format Correct answer Topic
1 Multiple Choice A Nursing Care of Children — Digoxin
Administration in Infants
2 Multiple Choice D Fundamentals — Pulse Oximetry Accuracy
3 Select All That Apply A, B, E Adult Medical-Surgical — Celiac Disease
(Gluten-Free Diet)
4 Multiple Choice C Mental Health — Crisis Care After Sexual
Assault
5 Multiple Choice A Fundamentals — Hearing Aid Care
6 Multiple Choice A Adult Medical-Surgical — Recognizing a
Critical Laboratory Value
7 Multiple Choice B Fundamentals — Hazardous Drug Spill
8 Multiple Choice A Leadership and Management — Social
Media and Confidentiality
9 Multiple Choice B Fundamentals — Ambulating With a Walker
10 Multiple Choice A Leadership and Management — Clarifying a
Prescription
11 Multiple Choice C Fundamentals — Administering a Cleansing
Enema
12 Select All That Apply A, B, C, E Adult Medical-Surgical — MRI Safety
Screening
13 NGN Ordered Response D→B→A→C Fundamentals — Fire Safety (RACE)
(Drag and Drop)
14 Multiple Choice A Mental Health — Nutrition in Acute Mania
15 Multiple Choice A Fundamentals — Radiation Emergency
(Contaminated Victim)
16 Select All That Apply A, C, D, E, G Nursing Care of Children — Cystic Fibrosis
Nutrition and Enzymes
17 Multiple Choice D Fundamentals — Bladder Training for Urge
Incontinence
18 Multiple Choice B Pharmacology — Weight-Based Enoxaparin
Dose
19 Multiple Choice D Leadership and Management — SBAR
Communication
20 Multiple Choice B Fundamentals — Calculating Fluid Intake
21 Multiple Choice B Leadership and Management —
Confidentiality and Telephone Inquiries
22 Multiple Choice D Mental Health — Anorexia Nervosa and
Refeeding Syndrome
23 Multiple Choice C Leadership and Management — Electronic
Health Record Security
24 NGN Trend • Multiple B Nursing Care of Children — Bronchiolitis
Choice (Trend)
25 Select All That Apply A, B, C Pharmacology — Disulfiram Therapy
26 Case 1 • NGN Highlight Segments 1, 2, 3, 4, 5, 7 Maternal-Newborn — Preeclampsia With
Severe Features (NGN Case)
27 Case 1 • NGN Matrix / Grid Row 1: Central nervous system; Row 2: Central nervous Maternal-Newborn — Preeclampsia With
system; Row 3: Liver; Row 4: Liver; Row 5: Kidneys; Row 6: Severe Features (NGN Case)
Kidneys; Row 7: Hematologic system; Row 8: Central nervous
system
28 Case 1 • NGN Drop-Down (1) eclampsia (seizures); (2) cerebral vasospasm and edema; Maternal-Newborn — Preeclampsia With
Cloze (3) placental abruption Severe Features (NGN Case)
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 3 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
29 Case 1 • NGN Select All That A, B, C, D, E Maternal-Newborn — Preeclampsia With
Apply Severe Features (NGN Case)
30 Case 1 • NGN Multiple C Maternal-Newborn — Magnesium Sulfate
Choice Toxicity (NGN Case)
31 Case 1 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Ineffective; Row 4: Maternal-Newborn — Preeclampsia With
Effective; Row 5: Ineffective; Row 6: Effective; Row 7: Severe Features (NGN Case)
Ineffective
32 Multiple Choice C Leadership and Management — Informed
Consent With an Interpreter
33 Multiple Choice A Pharmacology — Transdermal Nitroglycerin
34 Select All That Apply A, D Leadership and Management — Delegation
in Long-Term Care
35 NGN Bowtie Condition: C1 (Lithium toxicity); Actions: A1, A3; Monitor: P1, Pharmacology — Lithium Toxicity
P2
36 Multiple Choice C Mental Health — Prioritization on a Mental
Health Unit
37 Select All That Apply A, C, D Leadership and Management — Client
Assignment to the PN
38 Multiple Choice C Fundamentals — Transferring a Client With
Hemiplegia
39 Select All That Apply A, B, E, F Nursing Care of Children — Care After
Tonsillectomy
40 Multiple Choice C Maternal-Newborn — Estimated Date of
Birth (Naegele's Rule)
41 Multiple Choice A Nursing Care of Children — Hypertrophic
Pyloric Stenosis
42 Select All That Apply A, B, D Adult Medical-Surgical — Colonoscopy
Preparation
43 Multiple Choice C Mental Health — Defense Mechanisms
44 Multiple Choice C Fundamentals — Restraint Alternatives and
Side Rails
45 Select All That Apply A, C, D Leadership and Management — Legal
Principles of Documentation
46 Multiple Choice B Maternal-Newborn — Gravidity and Parity
(GTPAL)
47 Multiple Choice C Fundamentals — Religious Beliefs and
Refusal of Blood
48 Multiple Choice B Leadership and Management — Supervising
Assistive Personnel
49 Multiple Choice A Fundamentals — Electrical Safety
50 NGN Ordered Response B→D→A→C→E Nursing Care of Children — Relieving
(Drag and Drop) Foreign-Body Airway Obstruction in an Infant
51 Multiple Choice D Maternal-Newborn — Rho(D) Immune
Globulin
52 Multiple Choice B Fundamentals — Signs of Approaching Death
53 Multiple Choice D Nursing Care of Children — Toddler Nutrition
and Iron Deficiency
54 Multiple Choice B Leadership and Management — Client's
Right to Refuse Medication
55 Multiple Choice D Fundamentals — Capillary Blood Glucose
Monitoring
56 NGN Matrix / Grid Row 1: Autonomy; Row 2: Fidelity; Row 3: Justice; Row 4: Leadership and Management — Ethical
Veracity; Row 5: Autonomy; Row 6: Justice; Row 7: Fidelity Principles
57 Case 2 • NGN Highlight Segments 1, 2, 4, 5, 7, 8 Adult Medical-Surgical — Postoperative
Delirium (NGN Case)
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 4 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
58 Case 2 • NGN Matrix / Grid Row 1: Delirium; Row 2: Delirium; Row 3: Dementia; Row 4: Adult Medical-Surgical — Delirium vs.
Delirium; Row 5: Both; Row 6: Dementia; Row 7: Delirium; Dementia (NGN Case)
Row 8: Dementia
59 Case 2 • NGN Drop-Down (1) delirium; (2) hypoxemia, fever, and dark, cloudy urine; (3) Adult Medical-Surgical — Postoperative
Cloze the anticholinergic effects of diphenhydramine Delirium (NGN Case)
60 Case 2 • NGN Select All That A, C Adult Medical-Surgical — Postoperative
Apply Delirium (NGN Case)
61 Case 2 • NGN Multiple A Adult Medical-Surgical — Postoperative
Choice Delirium (NGN Case)
62 Case 2 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Effective; Row 4: Adult Medical-Surgical — Postoperative
Effective; Row 5: Ineffective; Row 6: Ineffective; Row 7: Delirium (NGN Case)
Effective
63 Multiple Choice D Nursing Care of Children — Kawasaki Disease
64 Multiple Choice C Maternal-Newborn — Umbilical Cord
Prolapse
65 Multiple Choice A Leadership and Management — Referral to a
Social Worker or Case Manager
66 Multiple Choice B Adult Medical-Surgical — Heat Stroke
67 NGN Drop-Down Cloze (1) late decelerations; (2) uteroplacental insufficiency; (3) Maternal-Newborn — Fetal Heart Rate
discontinue the oxytocin infusion; (4) reposition the client to a Decelerations
lateral position and administer an IV fluid bolus as prescribed
68 Select All That Apply A, C, D, E, G Pharmacology — Long-Term Corticosteroid
Therapy
69 Select All That Apply A, B, C, D Fundamentals — Home Safety for Older
Adults
70 Select All That Apply A, B, E Pharmacology — Medications That Must Not
Be Crushed
71 Multiple Choice A Fundamentals — Oral Care for an
Unconscious Client
72 Multiple Choice D Maternal-Newborn — Prioritization on the
Postpartum Unit
73 Select All That Apply A, C, E Nursing Care of Children — Safe Infant Sleep
74 NGN Highlight Segments 2, 4, 5, 7, 9 Adult Medical-Surgical — Postoperative
Complications
75 Select All That Apply A, B, D, F Fundamentals — Surgical Asepsis (Sterile
Field)
76 Multiple Choice D Adult Medical-Surgical — Heparin-Induced
Thrombocytopenia
77 Multiple Choice D Fundamentals — Preventing Footdrop
78 Multiple Choice C Pharmacology — Gravity IV Drip Rate
Calculation
79 Multiple Choice A Leadership and Management —
Interprofessional Referrals
80 Multiple Choice C Pharmacology — Heparin Infusion Rate
Calculation
81 Multiple Choice C Adult Medical-Surgical — Care After a
Percutaneous Liver Biopsy
82 Multiple Choice B Leadership and Management —
Truth-Telling and Client Advocacy
83 Select All That Apply A, B, C Maternal-Newborn — Adequacy of
Breastfeeding
84 Multiple Choice A Fundamentals — Collecting a Urine
Specimen From an Indwelling Catheter
85 Multiple Choice B Leadership and Management — Mandatory
Reporting of Elder Abuse
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 5 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
86 Multiple Choice B Mental Health — Panic Attack
87 Multiple Choice B Leadership and Management — Medication
Errors
88 Case 3 • NGN Highlight Segments 1, 2, 3, 4, 5, 6, 9 Nursing Care of Children — Dehydration
(NGN Case)
89 Case 3 • NGN Matrix / Grid Row 1: Dehydration (fluid volume deficit); Row 2: Dehydration Nursing Care of Children — Dehydration
(fluid volume deficit); Row 3: Metabolic acidosis; Row 4: (NGN Case)
Metabolic acidosis; Row 5: Hypokalemia; Row 6: Dehydration
(fluid volume deficit); Row 7: Dehydration (fluid volume
deficit); Row 8: Hypokalemia
90 Case 3 • NGN Drop-Down (1) moderate dehydration, with a weight loss of about 9%; (2) Nursing Care of Children — Dehydration
Cloze risk for hypovolemic shock; (3) tachycardia, delayed capillary (NGN Case)
refill, listlessness, and decreased urine output indicate
reduced tissue perfusion
91 Case 3 • NGN Select All That A, C Nursing Care of Children — Dehydration
Apply (NGN Case)
92 Case 3 • NGN Multiple B Nursing Care of Children — IV Potassium
Choice Safety (NGN Case)
93 Case 3 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Effective; Row 4: Nursing Care of Children — Dehydration
Effective; Row 5: Effective; Row 6: Ineffective; Row 7: (NGN Case)
Ineffective
94 Multiple Choice C Pharmacology — Clozapine and Severe
Neutropenia
95 NGN Trend • Multiple B Maternal-Newborn — Postpartum
Choice Hematoma (Trend)
96 Multiple Choice A Leadership and Management — Impaired
Coworker
97 Select All That Apply A, C, D Pharmacology — Serotonin Syndrome
98 Multiple Choice A Adult Medical-Surgical — Recombinant
Zoster Vaccine
99 Multiple Choice D Pharmacology — Antithyroid Medication
(Methimazole)
100 NGN Bowtie Condition: C1 (Placental abruption); Actions: A1, A3; Monitor: Maternal-Newborn — Placental Abruption
P1, P2
101 Multiple Choice C Mental Health — Responding to Auditory
Hallucinations
102 Multiple Choice C Adult Medical-Surgical — High-Quality CPR
103 Multiple Choice D Leadership and Management — Referral for
a Swallowing Evaluation
104 Multiple Choice C Adult Medical-Surgical — Nicotine
Replacement Therapy
105 Select All That Apply A, B, D Fundamentals — Seizure Precautions
106 NGN Matrix / Grid Row 1: Trust vs. mistrust; Row 2: Autonomy vs. shame and Nursing Care of Children — Psychosocial
doubt; Row 3: Initiative vs. guilt; Row 4: Industry vs. Development (Erikson)
inferiority; Row 5: Initiative vs. guilt; Row 6: Industry vs.
inferiority; Row 7: Trust vs. mistrust
107 Select All That Apply B, C, E, F Fundamentals — Nontherapeutic
Communication
108 Multiple Choice B Nursing Care of Children — Immunization
Contraindications
109 Multiple Choice B Fundamentals — Assisting a Client Who Has
Low Vision at Meals
110 NGN Matrix / Grid Row 1: Minor (green); Row 2: Expectant or deceased (black); Leadership and Management —
Row 3: Immediate (red); Row 4: Delayed (yellow); Row 5: Mass-Casualty Triage (START)
Immediate (red); Row 6: Immediate (red); Row 7: Delayed
(yellow)
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 6 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
111 Multiple Choice D Nursing Care of Children — Developmental
Milestones
112 Multiple Choice C Fundamentals — Therapeutic
Communication (New Diagnosis)
113 Multiple Choice C Maternal-Newborn — Perinatal Loss and
Grief
114 Multiple Choice D Fundamentals — Wasting a Controlled
Substance
115 Multiple Choice C Pharmacology — Warfarin and Dietary
Vitamin K
116 Multiple Choice A Fundamentals — Handling Soiled Linen
117 NGN Matrix / Grid Row 1: Expected finding; Row 2: Expected finding; Row 3: Maternal-Newborn — Postpartum
Requires follow-up; Row 4: Requires follow-up; Row 5: Physiologic Changes
Expected finding; Row 6: Requires follow-up; Row 7: Expected
finding; Row 8: Requires follow-up
118 Select All That Apply A, B, C, G Mental Health — Suicide Precautions
119 Case 4 • NGN Highlight Segments 1, 2, 3, 4, 5, 8, 9 Mental Health — Alcohol Withdrawal (NGN
Case)
120 Case 4 • NGN Matrix / Grid Row 1: Alcohol withdrawal; Row 2: Both; Row 3: Alcohol Mental Health — Alcohol Withdrawal and
withdrawal; Row 4: Wernicke encephalopathy; Row 5: Wernicke Encephalopathy (NGN Case)
Wernicke encephalopathy; Row 6: Alcohol withdrawal; Row 7:
Wernicke encephalopathy; Row 8: Both
121 Case 4 • NGN Drop-Down (1) delirium tremens; (2) 48 to 96 hours; (3) a previous Mental Health — Alcohol Withdrawal (NGN
Cloze withdrawal seizure Case)
122 Case 4 • NGN Select All That A, B, C, D Mental Health — Alcohol Withdrawal (NGN
Apply Case)
123 Case 4 • NGN Multiple B Mental Health — Alcohol Withdrawal (NGN
Choice Case)
124 Case 4 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Effective; Row 4: Mental Health — Alcohol Withdrawal (NGN
Ineffective; Row 5: Effective; Row 6: Ineffective; Row 7: Case)
Effective
125 Select All That Apply A, B, D Fundamentals — Home Oxygen Safety
126 Multiple Choice D Pharmacology — Methylphenidate for ADHD
127 Multiple Choice D Leadership and Management — Telephone
Prescriptions
128 Multiple Choice D Fundamentals — Client Identification
129 Multiple Choice B Adult Medical-Surgical — Postoperative
Urinary Retention
130 Select All That Apply A, C, D, F Fundamentals — Sodium-Restricted Diet
131 Select All That Apply A, B, D, E, F Leadership and Management — Medication
Reconciliation
132 Multiple Choice A Fundamentals — Intimate Partner Violence
Screening
133 Multiple Choice D Adult Medical-Surgical — Hypertension and
the DASH Eating Plan
134 Select All That Apply A, C, E Maternal-Newborn — Prenatal Nutrition and
Food Safety
135 Multiple Choice C Fundamentals — Client Found on the Floor
136 Multiple Choice D Mental Health — Suicide Risk Assessment
137 Multiple Choice A Fundamentals — Cold Application for an
Acute Injury
138 Select All That Apply A, C, D Nursing Care of Children — Lead Poisoning
Prevention
139 Select All That Apply A, B, C, F Leadership and Management — Leaving
Against Medical Advice
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 7 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
140 Multiple Choice B Fundamentals — Needlestick Injury
141 Multiple Choice C Adult Medical-Surgical — Tension
Pneumothorax
142 Multiple Choice B Leadership and Management — Advance
Directives and POLST
143 Multiple Choice D Fundamentals — Promoting Sleep in Older
Adults
144 Multiple Choice C Adult Medical-Surgical — Colorectal Cancer
Screening
145 Multiple Choice A Fundamentals — Managing Dyspnea at the
End of Life
146 Multiple Choice B Maternal-Newborn — Uterotonic
Medications for Postpartum Hemorrhage
147 NGN Matrix / Grid Row 1: Acute dystonia; Row 2: Akathisia; Row 3: Pharmacology — Extrapyramidal Effects of
Pseudoparkinsonism; Row 4: Tardive dyskinesia; Row 5: Acute Antipsychotics
dystonia; Row 6: Tardive dyskinesia; Row 7: Akathisia; Row 8:
Pseudoparkinsonism
148 Multiple Choice C Fundamentals — Error-Prone Abbreviations
and Dose Notation
149 Multiple Choice A Leadership and Management — Room
Assignment and Cohorting
150 Case 5 • NGN Highlight Segments 1, 2, 3, 4, 5, 9 Adult Medical-Surgical — Upper
Gastrointestinal Bleeding (NGN Case)
151 Case 5 • NGN Matrix / Grid Row 1: Risk factor for upper GI bleeding; Row 2: Risk factor for Adult Medical-Surgical — Upper
upper GI bleeding; Row 3: Sign of upper GI bleeding; Row 4: Gastrointestinal Bleeding (NGN Case)
Sign of upper GI bleeding; Row 5: Sign of hypovolemia from
blood loss; Row 6: Sign of hypovolemia from blood loss; Row
7: Risk factor for upper GI bleeding; Row 8: Sign of upper GI
bleeding
152 Case 5 • NGN Drop-Down (1) hypovolemic shock; (2) orthostatic hypotension, Adult Medical-Surgical — Upper
Cloze tachycardia, and cool, clammy skin; (3) a peptic ulcer related Gastrointestinal Bleeding (NGN Case)
to NSAID and aspirin use
153 Case 5 • NGN Select All That A, B, C Adult Medical-Surgical — Upper
Apply Gastrointestinal Bleeding (NGN Case)
154 Case 5 • NGN Multiple C Adult Medical-Surgical —
Choice Transfusion-Associated Circulatory Overload
(NGN Case)
155 Case 5 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Effective; Row 4: Adult Medical-Surgical — Upper
Ineffective; Row 5: Effective; Row 6: Ineffective; Row 7: Gastrointestinal Bleeding (NGN Case)
Effective
156 Multiple Choice D Fundamentals — Bioterrorism (Anthrax
Exposure)
157 Select All That Apply A, B, D Mental Health — De-escalation of Agitated
Behavior
158 Select All That Apply A, C, E, F Pharmacology — MAOIs and
Tyramine-Restricted Diet
159 Multiple Choice D Fundamentals — Safe Client Handling
160 Multiple Choice C Leadership and Management — Delegation
Instructions to Assistive Personnel
161 NGN Bowtie Condition: C1 (Acute epiglottitis); Actions: A1, A3; Monitor: P1, Nursing Care of Children — Epiglottitis
P2
162 Multiple Choice D Fundamentals — Universal Protocol
(Preventing Wrong-Site Surgery)
163 Multiple Choice B Pharmacology — Ophthalmic Medication
Administration
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 8 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
164 Multiple Choice B Leadership and Management — Quality
Improvement (Fall Prevention)
165 Multiple Choice A Mental Health — Responding to Persecutory
Delusions
166 Multiple Choice D Leadership and Management — Negligence
and Intentional Torts
167 Multiple Choice B Nursing Care of Children — Prioritization on
the Pediatric Unit
168 Multiple Choice A Leadership and Management —
Prioritization (Actual vs. Potential Problems)
169 Multiple Choice B Maternal-Newborn — Apgar Score
170 Multiple Choice D Pharmacology — Aminoglycoside Ototoxicity
and Drug Levels
171 Multiple Choice A Adult Medical-Surgical — Interpreting
Hemoglobin A1c
172 Multiple Choice C Maternal-Newborn — Postpartum
Hemorrhage From Uterine Atony
173 Multiple Choice B Nursing Care of Children — Pediatric Oral
Dosage Calculation
174 Select All That Apply A, B, C, D, G Leadership and Management — Hand-Off for
Transfer to Another Facility
175 Select All That Apply A, B, D, E Maternal-Newborn — Danger Signs in
Pregnancy
176 Multiple Choice B Nursing Care of Children — Croup and
Racemic Epinephrine
177 Multiple Choice A Maternal-Newborn — Nonstress Test
Interpretation
178 Multiple Choice B Adult Medical-Surgical — Incentive
Spirometry
179 NGN Highlight Segments 1, 3, 5, 6, 8 Nursing Care of Children — Recognizing Child
Maltreatment
180 Multiple Choice A Mental Health — Rights of Clients Admitted
Involuntarily
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 9 of 207
PN Comprehensive Predictor Practice Exam
Answer Key With Full Rationales
180 Original Exit-Exam-Style Items Aligned With the NCLEX-PN Test Plan and the ATI PN
Comprehensive Predictor Content Areas
Total items 180
Traditional multiple choice (single best answer) 106
Select all that apply (SATA) 29
Next Generation NCLEX (NGN)-style items 45
• Unfolding case studies (6 items each) 5 cases / 30 items
• Stand-alone bowtie, matrix, cloze, trend, and ordered-response items 15
MC, SATA, matrix/grid, drop-down cloze, highlight,
Item formats used
bowtie, trend, ordered response
Content areas covered
Fundamentals (39), Leadership and Management (30), Adult Medical-Surgical (29), Nursing Care of Children (24),
Maternal-Newborn (23), Mental Health (18), Pharmacology (17)
Original practice items written for exam preparation. Not affiliated with, endorsed by, or reproduced from ATI Nursing Education or NCSBN.
Always follow current facility policy, state scope of practice, and provider prescriptions.
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
How to Use This Answer Key
• Take the exam first under timed conditions, then score it with the Quick Answer Key that follows.
• Strict scoring (recommended, similar to most proctored practice exams): award 1 point only when the entire response is
correct — every correct SATA option and no incorrect ones, every matrix row, every drop-down, and all five bowtie
selections.
• Partial-credit scoring (similar to NGN polytomous scoring): for SATA, highlight, and multiple-response items, add 1 point
for each correct selection and subtract 1 for each incorrect selection (minimum 0); for matrix and cloze items, award 1
point per correct row or drop-down; for bowtie items, award 1 point per correct selection (maximum 5).
• Target: aim for at least 75% to 80% under strict scoring before your proctored exam. Use the blueprint to find weak
content areas, then reread the full rationales and Exam Pearls for every item you missed or guessed on.
• Each rationale explains the underlying concept, why the correct answer is correct, and why every other option is wrong
— study the wrong options as carefully as the right ones, because they represent the most common distractors on
proctored exams.
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 2 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
Quick Answer Key
# Format Correct answer Topic
1 Multiple Choice A Nursing Care of Children — Digoxin
Administration in Infants
2 Multiple Choice D Fundamentals — Pulse Oximetry Accuracy
3 Select All That Apply A, B, E Adult Medical-Surgical — Celiac Disease
(Gluten-Free Diet)
4 Multiple Choice C Mental Health — Crisis Care After Sexual
Assault
5 Multiple Choice A Fundamentals — Hearing Aid Care
6 Multiple Choice A Adult Medical-Surgical — Recognizing a
Critical Laboratory Value
7 Multiple Choice B Fundamentals — Hazardous Drug Spill
8 Multiple Choice A Leadership and Management — Social
Media and Confidentiality
9 Multiple Choice B Fundamentals — Ambulating With a Walker
10 Multiple Choice A Leadership and Management — Clarifying a
Prescription
11 Multiple Choice C Fundamentals — Administering a Cleansing
Enema
12 Select All That Apply A, B, C, E Adult Medical-Surgical — MRI Safety
Screening
13 NGN Ordered Response D→B→A→C Fundamentals — Fire Safety (RACE)
(Drag and Drop)
14 Multiple Choice A Mental Health — Nutrition in Acute Mania
15 Multiple Choice A Fundamentals — Radiation Emergency
(Contaminated Victim)
16 Select All That Apply A, C, D, E, G Nursing Care of Children — Cystic Fibrosis
Nutrition and Enzymes
17 Multiple Choice D Fundamentals — Bladder Training for Urge
Incontinence
18 Multiple Choice B Pharmacology — Weight-Based Enoxaparin
Dose
19 Multiple Choice D Leadership and Management — SBAR
Communication
20 Multiple Choice B Fundamentals — Calculating Fluid Intake
21 Multiple Choice B Leadership and Management —
Confidentiality and Telephone Inquiries
22 Multiple Choice D Mental Health — Anorexia Nervosa and
Refeeding Syndrome
23 Multiple Choice C Leadership and Management — Electronic
Health Record Security
24 NGN Trend • Multiple B Nursing Care of Children — Bronchiolitis
Choice (Trend)
25 Select All That Apply A, B, C Pharmacology — Disulfiram Therapy
26 Case 1 • NGN Highlight Segments 1, 2, 3, 4, 5, 7 Maternal-Newborn — Preeclampsia With
Severe Features (NGN Case)
27 Case 1 • NGN Matrix / Grid Row 1: Central nervous system; Row 2: Central nervous Maternal-Newborn — Preeclampsia With
system; Row 3: Liver; Row 4: Liver; Row 5: Kidneys; Row 6: Severe Features (NGN Case)
Kidneys; Row 7: Hematologic system; Row 8: Central nervous
system
28 Case 1 • NGN Drop-Down (1) eclampsia (seizures); (2) cerebral vasospasm and edema; Maternal-Newborn — Preeclampsia With
Cloze (3) placental abruption Severe Features (NGN Case)
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 3 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
29 Case 1 • NGN Select All That A, B, C, D, E Maternal-Newborn — Preeclampsia With
Apply Severe Features (NGN Case)
30 Case 1 • NGN Multiple C Maternal-Newborn — Magnesium Sulfate
Choice Toxicity (NGN Case)
31 Case 1 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Ineffective; Row 4: Maternal-Newborn — Preeclampsia With
Effective; Row 5: Ineffective; Row 6: Effective; Row 7: Severe Features (NGN Case)
Ineffective
32 Multiple Choice C Leadership and Management — Informed
Consent With an Interpreter
33 Multiple Choice A Pharmacology — Transdermal Nitroglycerin
34 Select All That Apply A, D Leadership and Management — Delegation
in Long-Term Care
35 NGN Bowtie Condition: C1 (Lithium toxicity); Actions: A1, A3; Monitor: P1, Pharmacology — Lithium Toxicity
P2
36 Multiple Choice C Mental Health — Prioritization on a Mental
Health Unit
37 Select All That Apply A, C, D Leadership and Management — Client
Assignment to the PN
38 Multiple Choice C Fundamentals — Transferring a Client With
Hemiplegia
39 Select All That Apply A, B, E, F Nursing Care of Children — Care After
Tonsillectomy
40 Multiple Choice C Maternal-Newborn — Estimated Date of
Birth (Naegele's Rule)
41 Multiple Choice A Nursing Care of Children — Hypertrophic
Pyloric Stenosis
42 Select All That Apply A, B, D Adult Medical-Surgical — Colonoscopy
Preparation
43 Multiple Choice C Mental Health — Defense Mechanisms
44 Multiple Choice C Fundamentals — Restraint Alternatives and
Side Rails
45 Select All That Apply A, C, D Leadership and Management — Legal
Principles of Documentation
46 Multiple Choice B Maternal-Newborn — Gravidity and Parity
(GTPAL)
47 Multiple Choice C Fundamentals — Religious Beliefs and
Refusal of Blood
48 Multiple Choice B Leadership and Management — Supervising
Assistive Personnel
49 Multiple Choice A Fundamentals — Electrical Safety
50 NGN Ordered Response B→D→A→C→E Nursing Care of Children — Relieving
(Drag and Drop) Foreign-Body Airway Obstruction in an Infant
51 Multiple Choice D Maternal-Newborn — Rho(D) Immune
Globulin
52 Multiple Choice B Fundamentals — Signs of Approaching Death
53 Multiple Choice D Nursing Care of Children — Toddler Nutrition
and Iron Deficiency
54 Multiple Choice B Leadership and Management — Client's
Right to Refuse Medication
55 Multiple Choice D Fundamentals — Capillary Blood Glucose
Monitoring
56 NGN Matrix / Grid Row 1: Autonomy; Row 2: Fidelity; Row 3: Justice; Row 4: Leadership and Management — Ethical
Veracity; Row 5: Autonomy; Row 6: Justice; Row 7: Fidelity Principles
57 Case 2 • NGN Highlight Segments 1, 2, 4, 5, 7, 8 Adult Medical-Surgical — Postoperative
Delirium (NGN Case)
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 4 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
58 Case 2 • NGN Matrix / Grid Row 1: Delirium; Row 2: Delirium; Row 3: Dementia; Row 4: Adult Medical-Surgical — Delirium vs.
Delirium; Row 5: Both; Row 6: Dementia; Row 7: Delirium; Dementia (NGN Case)
Row 8: Dementia
59 Case 2 • NGN Drop-Down (1) delirium; (2) hypoxemia, fever, and dark, cloudy urine; (3) Adult Medical-Surgical — Postoperative
Cloze the anticholinergic effects of diphenhydramine Delirium (NGN Case)
60 Case 2 • NGN Select All That A, C Adult Medical-Surgical — Postoperative
Apply Delirium (NGN Case)
61 Case 2 • NGN Multiple A Adult Medical-Surgical — Postoperative
Choice Delirium (NGN Case)
62 Case 2 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Effective; Row 4: Adult Medical-Surgical — Postoperative
Effective; Row 5: Ineffective; Row 6: Ineffective; Row 7: Delirium (NGN Case)
Effective
63 Multiple Choice D Nursing Care of Children — Kawasaki Disease
64 Multiple Choice C Maternal-Newborn — Umbilical Cord
Prolapse
65 Multiple Choice A Leadership and Management — Referral to a
Social Worker or Case Manager
66 Multiple Choice B Adult Medical-Surgical — Heat Stroke
67 NGN Drop-Down Cloze (1) late decelerations; (2) uteroplacental insufficiency; (3) Maternal-Newborn — Fetal Heart Rate
discontinue the oxytocin infusion; (4) reposition the client to a Decelerations
lateral position and administer an IV fluid bolus as prescribed
68 Select All That Apply A, C, D, E, G Pharmacology — Long-Term Corticosteroid
Therapy
69 Select All That Apply A, B, C, D Fundamentals — Home Safety for Older
Adults
70 Select All That Apply A, B, E Pharmacology — Medications That Must Not
Be Crushed
71 Multiple Choice A Fundamentals — Oral Care for an
Unconscious Client
72 Multiple Choice D Maternal-Newborn — Prioritization on the
Postpartum Unit
73 Select All That Apply A, C, E Nursing Care of Children — Safe Infant Sleep
74 NGN Highlight Segments 2, 4, 5, 7, 9 Adult Medical-Surgical — Postoperative
Complications
75 Select All That Apply A, B, D, F Fundamentals — Surgical Asepsis (Sterile
Field)
76 Multiple Choice D Adult Medical-Surgical — Heparin-Induced
Thrombocytopenia
77 Multiple Choice D Fundamentals — Preventing Footdrop
78 Multiple Choice C Pharmacology — Gravity IV Drip Rate
Calculation
79 Multiple Choice A Leadership and Management —
Interprofessional Referrals
80 Multiple Choice C Pharmacology — Heparin Infusion Rate
Calculation
81 Multiple Choice C Adult Medical-Surgical — Care After a
Percutaneous Liver Biopsy
82 Multiple Choice B Leadership and Management —
Truth-Telling and Client Advocacy
83 Select All That Apply A, B, C Maternal-Newborn — Adequacy of
Breastfeeding
84 Multiple Choice A Fundamentals — Collecting a Urine
Specimen From an Indwelling Catheter
85 Multiple Choice B Leadership and Management — Mandatory
Reporting of Elder Abuse
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 5 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
86 Multiple Choice B Mental Health — Panic Attack
87 Multiple Choice B Leadership and Management — Medication
Errors
88 Case 3 • NGN Highlight Segments 1, 2, 3, 4, 5, 6, 9 Nursing Care of Children — Dehydration
(NGN Case)
89 Case 3 • NGN Matrix / Grid Row 1: Dehydration (fluid volume deficit); Row 2: Dehydration Nursing Care of Children — Dehydration
(fluid volume deficit); Row 3: Metabolic acidosis; Row 4: (NGN Case)
Metabolic acidosis; Row 5: Hypokalemia; Row 6: Dehydration
(fluid volume deficit); Row 7: Dehydration (fluid volume
deficit); Row 8: Hypokalemia
90 Case 3 • NGN Drop-Down (1) moderate dehydration, with a weight loss of about 9%; (2) Nursing Care of Children — Dehydration
Cloze risk for hypovolemic shock; (3) tachycardia, delayed capillary (NGN Case)
refill, listlessness, and decreased urine output indicate
reduced tissue perfusion
91 Case 3 • NGN Select All That A, C Nursing Care of Children — Dehydration
Apply (NGN Case)
92 Case 3 • NGN Multiple B Nursing Care of Children — IV Potassium
Choice Safety (NGN Case)
93 Case 3 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Effective; Row 4: Nursing Care of Children — Dehydration
Effective; Row 5: Effective; Row 6: Ineffective; Row 7: (NGN Case)
Ineffective
94 Multiple Choice C Pharmacology — Clozapine and Severe
Neutropenia
95 NGN Trend • Multiple B Maternal-Newborn — Postpartum
Choice Hematoma (Trend)
96 Multiple Choice A Leadership and Management — Impaired
Coworker
97 Select All That Apply A, C, D Pharmacology — Serotonin Syndrome
98 Multiple Choice A Adult Medical-Surgical — Recombinant
Zoster Vaccine
99 Multiple Choice D Pharmacology — Antithyroid Medication
(Methimazole)
100 NGN Bowtie Condition: C1 (Placental abruption); Actions: A1, A3; Monitor: Maternal-Newborn — Placental Abruption
P1, P2
101 Multiple Choice C Mental Health — Responding to Auditory
Hallucinations
102 Multiple Choice C Adult Medical-Surgical — High-Quality CPR
103 Multiple Choice D Leadership and Management — Referral for
a Swallowing Evaluation
104 Multiple Choice C Adult Medical-Surgical — Nicotine
Replacement Therapy
105 Select All That Apply A, B, D Fundamentals — Seizure Precautions
106 NGN Matrix / Grid Row 1: Trust vs. mistrust; Row 2: Autonomy vs. shame and Nursing Care of Children — Psychosocial
doubt; Row 3: Initiative vs. guilt; Row 4: Industry vs. Development (Erikson)
inferiority; Row 5: Initiative vs. guilt; Row 6: Industry vs.
inferiority; Row 7: Trust vs. mistrust
107 Select All That Apply B, C, E, F Fundamentals — Nontherapeutic
Communication
108 Multiple Choice B Nursing Care of Children — Immunization
Contraindications
109 Multiple Choice B Fundamentals — Assisting a Client Who Has
Low Vision at Meals
110 NGN Matrix / Grid Row 1: Minor (green); Row 2: Expectant or deceased (black); Leadership and Management —
Row 3: Immediate (red); Row 4: Delayed (yellow); Row 5: Mass-Casualty Triage (START)
Immediate (red); Row 6: Immediate (red); Row 7: Delayed
(yellow)
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 6 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
111 Multiple Choice D Nursing Care of Children — Developmental
Milestones
112 Multiple Choice C Fundamentals — Therapeutic
Communication (New Diagnosis)
113 Multiple Choice C Maternal-Newborn — Perinatal Loss and
Grief
114 Multiple Choice D Fundamentals — Wasting a Controlled
Substance
115 Multiple Choice C Pharmacology — Warfarin and Dietary
Vitamin K
116 Multiple Choice A Fundamentals — Handling Soiled Linen
117 NGN Matrix / Grid Row 1: Expected finding; Row 2: Expected finding; Row 3: Maternal-Newborn — Postpartum
Requires follow-up; Row 4: Requires follow-up; Row 5: Physiologic Changes
Expected finding; Row 6: Requires follow-up; Row 7: Expected
finding; Row 8: Requires follow-up
118 Select All That Apply A, B, C, G Mental Health — Suicide Precautions
119 Case 4 • NGN Highlight Segments 1, 2, 3, 4, 5, 8, 9 Mental Health — Alcohol Withdrawal (NGN
Case)
120 Case 4 • NGN Matrix / Grid Row 1: Alcohol withdrawal; Row 2: Both; Row 3: Alcohol Mental Health — Alcohol Withdrawal and
withdrawal; Row 4: Wernicke encephalopathy; Row 5: Wernicke Encephalopathy (NGN Case)
Wernicke encephalopathy; Row 6: Alcohol withdrawal; Row 7:
Wernicke encephalopathy; Row 8: Both
121 Case 4 • NGN Drop-Down (1) delirium tremens; (2) 48 to 96 hours; (3) a previous Mental Health — Alcohol Withdrawal (NGN
Cloze withdrawal seizure Case)
122 Case 4 • NGN Select All That A, B, C, D Mental Health — Alcohol Withdrawal (NGN
Apply Case)
123 Case 4 • NGN Multiple B Mental Health — Alcohol Withdrawal (NGN
Choice Case)
124 Case 4 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Effective; Row 4: Mental Health — Alcohol Withdrawal (NGN
Ineffective; Row 5: Effective; Row 6: Ineffective; Row 7: Case)
Effective
125 Select All That Apply A, B, D Fundamentals — Home Oxygen Safety
126 Multiple Choice D Pharmacology — Methylphenidate for ADHD
127 Multiple Choice D Leadership and Management — Telephone
Prescriptions
128 Multiple Choice D Fundamentals — Client Identification
129 Multiple Choice B Adult Medical-Surgical — Postoperative
Urinary Retention
130 Select All That Apply A, C, D, F Fundamentals — Sodium-Restricted Diet
131 Select All That Apply A, B, D, E, F Leadership and Management — Medication
Reconciliation
132 Multiple Choice A Fundamentals — Intimate Partner Violence
Screening
133 Multiple Choice D Adult Medical-Surgical — Hypertension and
the DASH Eating Plan
134 Select All That Apply A, C, E Maternal-Newborn — Prenatal Nutrition and
Food Safety
135 Multiple Choice C Fundamentals — Client Found on the Floor
136 Multiple Choice D Mental Health — Suicide Risk Assessment
137 Multiple Choice A Fundamentals — Cold Application for an
Acute Injury
138 Select All That Apply A, C, D Nursing Care of Children — Lead Poisoning
Prevention
139 Select All That Apply A, B, C, F Leadership and Management — Leaving
Against Medical Advice
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 7 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
140 Multiple Choice B Fundamentals — Needlestick Injury
141 Multiple Choice C Adult Medical-Surgical — Tension
Pneumothorax
142 Multiple Choice B Leadership and Management — Advance
Directives and POLST
143 Multiple Choice D Fundamentals — Promoting Sleep in Older
Adults
144 Multiple Choice C Adult Medical-Surgical — Colorectal Cancer
Screening
145 Multiple Choice A Fundamentals — Managing Dyspnea at the
End of Life
146 Multiple Choice B Maternal-Newborn — Uterotonic
Medications for Postpartum Hemorrhage
147 NGN Matrix / Grid Row 1: Acute dystonia; Row 2: Akathisia; Row 3: Pharmacology — Extrapyramidal Effects of
Pseudoparkinsonism; Row 4: Tardive dyskinesia; Row 5: Acute Antipsychotics
dystonia; Row 6: Tardive dyskinesia; Row 7: Akathisia; Row 8:
Pseudoparkinsonism
148 Multiple Choice C Fundamentals — Error-Prone Abbreviations
and Dose Notation
149 Multiple Choice A Leadership and Management — Room
Assignment and Cohorting
150 Case 5 • NGN Highlight Segments 1, 2, 3, 4, 5, 9 Adult Medical-Surgical — Upper
Gastrointestinal Bleeding (NGN Case)
151 Case 5 • NGN Matrix / Grid Row 1: Risk factor for upper GI bleeding; Row 2: Risk factor for Adult Medical-Surgical — Upper
upper GI bleeding; Row 3: Sign of upper GI bleeding; Row 4: Gastrointestinal Bleeding (NGN Case)
Sign of upper GI bleeding; Row 5: Sign of hypovolemia from
blood loss; Row 6: Sign of hypovolemia from blood loss; Row
7: Risk factor for upper GI bleeding; Row 8: Sign of upper GI
bleeding
152 Case 5 • NGN Drop-Down (1) hypovolemic shock; (2) orthostatic hypotension, Adult Medical-Surgical — Upper
Cloze tachycardia, and cool, clammy skin; (3) a peptic ulcer related Gastrointestinal Bleeding (NGN Case)
to NSAID and aspirin use
153 Case 5 • NGN Select All That A, B, C Adult Medical-Surgical — Upper
Apply Gastrointestinal Bleeding (NGN Case)
154 Case 5 • NGN Multiple C Adult Medical-Surgical —
Choice Transfusion-Associated Circulatory Overload
(NGN Case)
155 Case 5 • NGN Matrix / Grid Row 1: Effective; Row 2: Effective; Row 3: Effective; Row 4: Adult Medical-Surgical — Upper
Ineffective; Row 5: Effective; Row 6: Ineffective; Row 7: Gastrointestinal Bleeding (NGN Case)
Effective
156 Multiple Choice D Fundamentals — Bioterrorism (Anthrax
Exposure)
157 Select All That Apply A, B, D Mental Health — De-escalation of Agitated
Behavior
158 Select All That Apply A, C, E, F Pharmacology — MAOIs and
Tyramine-Restricted Diet
159 Multiple Choice D Fundamentals — Safe Client Handling
160 Multiple Choice C Leadership and Management — Delegation
Instructions to Assistive Personnel
161 NGN Bowtie Condition: C1 (Acute epiglottitis); Actions: A1, A3; Monitor: P1, Nursing Care of Children — Epiglottitis
P2
162 Multiple Choice D Fundamentals — Universal Protocol
(Preventing Wrong-Site Surgery)
163 Multiple Choice B Pharmacology — Ophthalmic Medication
Administration
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 8 of 207
,PN Comprehensive Predictor Practice Exam Answer Key and Rationales
# Format Correct answer Topic
164 Multiple Choice B Leadership and Management — Quality
Improvement (Fall Prevention)
165 Multiple Choice A Mental Health — Responding to Persecutory
Delusions
166 Multiple Choice D Leadership and Management — Negligence
and Intentional Torts
167 Multiple Choice B Nursing Care of Children — Prioritization on
the Pediatric Unit
168 Multiple Choice A Leadership and Management —
Prioritization (Actual vs. Potential Problems)
169 Multiple Choice B Maternal-Newborn — Apgar Score
170 Multiple Choice D Pharmacology — Aminoglycoside Ototoxicity
and Drug Levels
171 Multiple Choice A Adult Medical-Surgical — Interpreting
Hemoglobin A1c
172 Multiple Choice C Maternal-Newborn — Postpartum
Hemorrhage From Uterine Atony
173 Multiple Choice B Nursing Care of Children — Pediatric Oral
Dosage Calculation
174 Select All That Apply A, B, C, D, G Leadership and Management — Hand-Off for
Transfer to Another Facility
175 Select All That Apply A, B, D, E Maternal-Newborn — Danger Signs in
Pregnancy
176 Multiple Choice B Nursing Care of Children — Croup and
Racemic Epinephrine
177 Multiple Choice A Maternal-Newborn — Nonstress Test
Interpretation
178 Multiple Choice B Adult Medical-Surgical — Incentive
Spirometry
179 NGN Highlight Segments 1, 3, 5, 6, 8 Nursing Care of Children — Recognizing Child
Maltreatment
180 Multiple Choice A Mental Health — Rights of Clients Admitted
Involuntarily
Original practice items — not affiliated with or endorsed by ATI Nursing Education. Page 9 of 207
