ATI PN Comprehensive Exit Actual
Exam 2026/2027 | Verified Questions
Assessment Technologies Institute (ATI) | Verified Q&A |
Practical Nursing Students and Candidates
180 Official Examination Questions | 144 Correct Selections Required (80% Passing Score)
This comprehensive examination set comprises exactly 180 original questions designed to
reinforce official ATI PN Comprehensive Predictor objectives for actual exam readiness and
clinical proficiency, adhering strictly to the standard comprehensive ATI PN Comprehensive
Predictor actual exam blueprint. The examination covers five primary domains: Medical-
Surgical Nursing; Maternal-Newborn Nursing; Pediatric Nursing; Mental Health Nursing; and
Leadership, Management, and Professional Nursing Concepts (incorporating Next Generation
NCLEX (NGN) clinical judgment scenarios). In accordance with official Assessment
Technologies Institute (ATI) practical nursing curriculum benchmarks, candidates must execute
180 questions and achieve a minimum of 144 correct selections to attain the required 80%
passing score. Each item in this verified collection addresses distinct medical-surgical
interventions, obstetric and pediatric care standards, mental health therapeutic modalities, and
leadership/NGN clinical judgment competencies to ensure thorough mastery of professional
practical nursing standards in 2026/2027.
Domain: Medical-Surgical Nursing
1. A patient with acute decompensated heart failure presents with severe dyspnea,
bilateral crackles on pulmonary auscultation, and 3+ pitting pedal edema. Which
immediate practical nursing intervention takes priority?
A. Place the patient in a supine position with lower extremities elevated 45 degrees
B. Position the patient in high-Fowler's position, administer supplemental oxygen as
prescribed, initiate prescribed intravenous furosemide, and monitor urinary output and
serum potassium levels
C. Encourage the patient to consume 2,000 mL of oral fluids to flush renal tubules
D. Administer sublingual atropine to increase myocardial contractility
Correct Answer: B
Rationale: In acute decompensated heart failure with pulmonary edema, positioning the
patient in high-Fowler's position reduces venous return (preload) and improves
diaphragmatic excursion. Intravenous loop diuretics (furosemide) eliminate excess
intravascular fluid, requiring strict monitoring of urinary output and potassium levels due
to hypokalemia risk.
ATI PN Comprehensive Exit Actual Exam 2026/2027 | Verified Questions
,2. A patient with stable coronary artery disease reports acute substernal chest
pressure radiating to the left jaw. What is the correct protocol for administering
prescribed sublingual nitroglycerin?
A. Administer one tablet every 15 minutes for up to five doses without checking vital signs
B. Administer one sublingual tablet, check blood pressure, and repeat every 5 minutes for a
maximum of three doses if pain persists and systolic blood pressure remains above 90 mm
Hg; activate emergency medical services if pain is unrelieved after the initial dose
C. Have the patient chew and swallow three tablets simultaneously with a full glass of water
D. Instruct the patient to walk rapidly around the room to accelerate mucosal drug
absorption
Correct Answer: B
Rationale: Sublingual nitroglycerin vasodilates coronary and peripheral arteries.
Evidence-based nursing care mandates administering one tablet sublingually every 5
minutes up to three doses, monitoring systolic blood pressure before each dose
(withholding if <90 mm Hg), and activating emergency medical services if chest pain is
unrelieved 5 minutes after the first dose.
3. An adult patient is admitted with crushing substernal chest pain and an
electrocardiogram (ECG) showing ST-segment elevation in leads V2 through V4.
Which combination of immediate interventions is indicated for an acute anterior
wall STEMI?
A. Administer oral digoxin, restrict oxygen, and schedule an exercise tolerance assessment
for the following morning
B. Administer supplemental oxygen if oxygen saturation is below 94 percent, chewable
aspirin (162 to 325 mg), sublingual nitroglycerin, and intravenous morphine as prescribed,
and prepare the patient for immediate cardiac catheterization
C. Administer intramuscular epinephrine and encourage deep breathing exercises in bed
D. Provide a high-protein meal and administer subcutaneous heparin every 12 hours
Correct Answer: B
Rationale: ST-elevation myocardial infarction (STEMI) indicates acute coronary artery
occlusion. Immediate care includes chewable aspirin (to inhibit platelet aggregation),
nitroglycerin (to vasodilate coronary vessels), morphine (to relieve refractory pain and
decrease preload), oxygen if hypoxic, and rapid preparation for emergent percutaneous
coronary intervention (PCI).
4. A patient arrives in the emergency department with a blood pressure of 226/138
mm Hg, severe headache, blurred vision, and chest discomfort. How should the
nurse differentiate a hypertensive emergency from a hypertensive urgency?
A. Hypertensive emergency occurs only in patients over age 70, whereas urgency occurs in
younger adults
B. Hypertensive emergency involves acute, progressive target organ damage (such as
encephalopathy, myocardial ischemia, or acute kidney injury) requiring controlled
intravenous antihypertensive titration; hypertensive urgency lacks target organ damage and
is treated with oral medications
C. Hypertensive emergency requires immediate lowering of systolic blood pressure to 110
mm Hg within 5 minutes
ATI PN Comprehensive Exit Actual Exam 2026/2027 | Verified Questions
, D. Hypertensive urgency involves intracranial hemorrhage, whereas emergency is
asymptomatic
Correct Answer: B
Rationale: Hypertensive emergency is defined by acute elevation of blood pressure
accompanied by progressive target organ damage (cerebral, cardiac, renal, or vascular),
requiring controlled IV antihypertensive titration in an intensive care setting.
Hypertensive urgency involves marked blood pressure elevation without acute target
organ damage, managed with oral medications.
5. A patient with peripheral arterial disease (PAD) reports calf pain when walking
that resolves with rest (intermittent claudication), and has an Ankle-Brachial
Index (ABI) of 0.68. Which nursing teaching instruction is appropriate?
A. Elevate the lower extremities above heart level continuously while sleeping
B. Keep lower extremities in a neutral or dependent position to promote arterial blood flow,
participate in a structured walking program, inspect feet daily, and avoid applying direct
thermal heating pads to the legs
C. Wear knee-high elastic compression stockings with 30 to 40 mm Hg of pressure
D. Apply ice packs to the calves when claudication pain occurs
Correct Answer: B
Rationale: In peripheral arterial disease (PAD), arterial perfusion to lower extremities is
impaired. Keeping legs in a neutral or dependent position enhances gravitational arterial
blood flow; elevation above the heart worsens ischemia. Thermal heating pads are strictly
avoided due to peripheral sensory neuropathy and burn risk.
6. A patient recovering from orthopedic surgery suddenly exhibits acute dyspnea,
pleuritic chest pain, tachycardia (heart rate 118 beats/min), and an oxygen
saturation of 87 percent on room air. What is the nurse's immediate action?
A. Instruct the patient to perform pursed-lip breathing and ambulate in the hallway
B. Elevate the head of the bed, apply supplemental oxygen via face mask immediately, notify
the healthcare provider, and prepare to administer prescribed parenteral anticoagulation for
a suspected pulmonary embolism
C. Place the patient in Trendelenburg position and perform chest physiotherapy
D. Administer oral acetaminophen and encourage coughing
Correct Answer: B
Rationale: Sudden dyspnea, pleuritic chest pain, tachycardia, and hypoxemia in a
postoperative patient strongly indicate pulmonary embolism (PE). Immediate nursing
priorities are elevating the head of the bed, initiating supplemental oxygen to correct
hypoxemia, notifying the provider, and preparing for anticoagulant therapy (IV heparin
or subcutaneous LMWH).
7. An adult patient experiencing an acute asthma exacerbation has audible
wheezing, intercostal retractions, and a peak expiratory flow rate of 45 percent of
personal best. Which inhaled medication should the nurse administer first?
A. Fluticasone propionate dry powder inhaler
B. Albuterol sulfate short-acting beta-2 agonist (SABA) via nebulizer or metered-dose
inhaler with spacer
ATI PN Comprehensive Exit Actual Exam 2026/2027 | Verified Questions
, C. Salmeterol long-acting beta-2 agonist (LABA)
D. Cromolyn sodium mast cell stabilizer
Correct Answer: B
Rationale: In an acute asthma exacerbation, immediate bronchodilation is required to
reverse bronchospasm and airflow obstruction. Albuterol is a rapid-acting short-acting
beta-2 agonist (SABA) that serves as first-line rescue therapy. Inhaled corticosteroids
(fluticasone) and LABAs (salmeterol) are long-term controllers and ineffective for acute
relief.
8. A patient with severe Chronic Obstructive Pulmonary Disease (COPD) and
chronic hypercapnia is admitted with an acute respiratory infection. What is the
correct oxygen administration principle for this patient?
A. Administer 100 percent oxygen via non-rebreather mask continuously to achieve an
oxygen saturation of 99 percent
B. Deliver oxygen via Venturi mask or nasal cannula titrated to achieve a target oxygen
saturation of 88 to 92 percent, avoiding hyperoxia that could worsen hypercapnia
C. Withhold all supplemental oxygen regardless of hypoxemia to protect hypoxic respiratory
drive
D. Administer 50 percent oxygen via aerosol mask only during sleeping hours
Correct Answer: B
Rationale: In patients with severe COPD and chronic hypercapnia, excessive oxygen
administration (hyperoxia) worsens CO2 retention through ventilation-perfusion
mismatching and Haldane effect. Evidence-based COPD guidelines mandate titrating
supplemental oxygen to achieve a safe target saturation of 88% to 92%.
9. A patient is admitted with community-acquired right lower lobe pneumonia,
fever of 102.4 degrees Fahrenheit, and productive cough with purulent sputum.
What is the correct sequence of clinical nursing interventions?
A. Administer prescribed intravenous antibiotics immediately before collecting sputum or
blood specimens
B. Obtain prescribed blood and sputum specimens for culture and sensitivity first, initiate
empiric intravenous antibiotic therapy promptly, encourage fluid intake, and assist with
incentive spirometry every hour while awake
C. Restrict oral fluid intake to 500 mL daily to prevent pulmonary edema
D. Place the patient on strict flat bedrest without turning for 48 hours
Correct Answer: B
Rationale: To identify the causative pathogen accurately, blood and sputum cultures must
be collected before initiating antimicrobial therapy. Once cultures are obtained, empiric
antibiotics must be administered promptly, combined with hydration to thin bronchial
secretions and hourly incentive spirometry to prevent atelectasis.
10. Which airborne infection isolation precautions and nursing monitoring
protocols are mandatory when caring for a hospitalized patient with active
pulmonary tuberculosis (TB)?
A. Place in a positive-pressure room with standard surgical mask for visitors; monitor blood
glucose hourly
ATI PN Comprehensive Exit Actual Exam 2026/2027 | Verified Questions
Exam 2026/2027 | Verified Questions
Assessment Technologies Institute (ATI) | Verified Q&A |
Practical Nursing Students and Candidates
180 Official Examination Questions | 144 Correct Selections Required (80% Passing Score)
This comprehensive examination set comprises exactly 180 original questions designed to
reinforce official ATI PN Comprehensive Predictor objectives for actual exam readiness and
clinical proficiency, adhering strictly to the standard comprehensive ATI PN Comprehensive
Predictor actual exam blueprint. The examination covers five primary domains: Medical-
Surgical Nursing; Maternal-Newborn Nursing; Pediatric Nursing; Mental Health Nursing; and
Leadership, Management, and Professional Nursing Concepts (incorporating Next Generation
NCLEX (NGN) clinical judgment scenarios). In accordance with official Assessment
Technologies Institute (ATI) practical nursing curriculum benchmarks, candidates must execute
180 questions and achieve a minimum of 144 correct selections to attain the required 80%
passing score. Each item in this verified collection addresses distinct medical-surgical
interventions, obstetric and pediatric care standards, mental health therapeutic modalities, and
leadership/NGN clinical judgment competencies to ensure thorough mastery of professional
practical nursing standards in 2026/2027.
Domain: Medical-Surgical Nursing
1. A patient with acute decompensated heart failure presents with severe dyspnea,
bilateral crackles on pulmonary auscultation, and 3+ pitting pedal edema. Which
immediate practical nursing intervention takes priority?
A. Place the patient in a supine position with lower extremities elevated 45 degrees
B. Position the patient in high-Fowler's position, administer supplemental oxygen as
prescribed, initiate prescribed intravenous furosemide, and monitor urinary output and
serum potassium levels
C. Encourage the patient to consume 2,000 mL of oral fluids to flush renal tubules
D. Administer sublingual atropine to increase myocardial contractility
Correct Answer: B
Rationale: In acute decompensated heart failure with pulmonary edema, positioning the
patient in high-Fowler's position reduces venous return (preload) and improves
diaphragmatic excursion. Intravenous loop diuretics (furosemide) eliminate excess
intravascular fluid, requiring strict monitoring of urinary output and potassium levels due
to hypokalemia risk.
ATI PN Comprehensive Exit Actual Exam 2026/2027 | Verified Questions
,2. A patient with stable coronary artery disease reports acute substernal chest
pressure radiating to the left jaw. What is the correct protocol for administering
prescribed sublingual nitroglycerin?
A. Administer one tablet every 15 minutes for up to five doses without checking vital signs
B. Administer one sublingual tablet, check blood pressure, and repeat every 5 minutes for a
maximum of three doses if pain persists and systolic blood pressure remains above 90 mm
Hg; activate emergency medical services if pain is unrelieved after the initial dose
C. Have the patient chew and swallow three tablets simultaneously with a full glass of water
D. Instruct the patient to walk rapidly around the room to accelerate mucosal drug
absorption
Correct Answer: B
Rationale: Sublingual nitroglycerin vasodilates coronary and peripheral arteries.
Evidence-based nursing care mandates administering one tablet sublingually every 5
minutes up to three doses, monitoring systolic blood pressure before each dose
(withholding if <90 mm Hg), and activating emergency medical services if chest pain is
unrelieved 5 minutes after the first dose.
3. An adult patient is admitted with crushing substernal chest pain and an
electrocardiogram (ECG) showing ST-segment elevation in leads V2 through V4.
Which combination of immediate interventions is indicated for an acute anterior
wall STEMI?
A. Administer oral digoxin, restrict oxygen, and schedule an exercise tolerance assessment
for the following morning
B. Administer supplemental oxygen if oxygen saturation is below 94 percent, chewable
aspirin (162 to 325 mg), sublingual nitroglycerin, and intravenous morphine as prescribed,
and prepare the patient for immediate cardiac catheterization
C. Administer intramuscular epinephrine and encourage deep breathing exercises in bed
D. Provide a high-protein meal and administer subcutaneous heparin every 12 hours
Correct Answer: B
Rationale: ST-elevation myocardial infarction (STEMI) indicates acute coronary artery
occlusion. Immediate care includes chewable aspirin (to inhibit platelet aggregation),
nitroglycerin (to vasodilate coronary vessels), morphine (to relieve refractory pain and
decrease preload), oxygen if hypoxic, and rapid preparation for emergent percutaneous
coronary intervention (PCI).
4. A patient arrives in the emergency department with a blood pressure of 226/138
mm Hg, severe headache, blurred vision, and chest discomfort. How should the
nurse differentiate a hypertensive emergency from a hypertensive urgency?
A. Hypertensive emergency occurs only in patients over age 70, whereas urgency occurs in
younger adults
B. Hypertensive emergency involves acute, progressive target organ damage (such as
encephalopathy, myocardial ischemia, or acute kidney injury) requiring controlled
intravenous antihypertensive titration; hypertensive urgency lacks target organ damage and
is treated with oral medications
C. Hypertensive emergency requires immediate lowering of systolic blood pressure to 110
mm Hg within 5 minutes
ATI PN Comprehensive Exit Actual Exam 2026/2027 | Verified Questions
, D. Hypertensive urgency involves intracranial hemorrhage, whereas emergency is
asymptomatic
Correct Answer: B
Rationale: Hypertensive emergency is defined by acute elevation of blood pressure
accompanied by progressive target organ damage (cerebral, cardiac, renal, or vascular),
requiring controlled IV antihypertensive titration in an intensive care setting.
Hypertensive urgency involves marked blood pressure elevation without acute target
organ damage, managed with oral medications.
5. A patient with peripheral arterial disease (PAD) reports calf pain when walking
that resolves with rest (intermittent claudication), and has an Ankle-Brachial
Index (ABI) of 0.68. Which nursing teaching instruction is appropriate?
A. Elevate the lower extremities above heart level continuously while sleeping
B. Keep lower extremities in a neutral or dependent position to promote arterial blood flow,
participate in a structured walking program, inspect feet daily, and avoid applying direct
thermal heating pads to the legs
C. Wear knee-high elastic compression stockings with 30 to 40 mm Hg of pressure
D. Apply ice packs to the calves when claudication pain occurs
Correct Answer: B
Rationale: In peripheral arterial disease (PAD), arterial perfusion to lower extremities is
impaired. Keeping legs in a neutral or dependent position enhances gravitational arterial
blood flow; elevation above the heart worsens ischemia. Thermal heating pads are strictly
avoided due to peripheral sensory neuropathy and burn risk.
6. A patient recovering from orthopedic surgery suddenly exhibits acute dyspnea,
pleuritic chest pain, tachycardia (heart rate 118 beats/min), and an oxygen
saturation of 87 percent on room air. What is the nurse's immediate action?
A. Instruct the patient to perform pursed-lip breathing and ambulate in the hallway
B. Elevate the head of the bed, apply supplemental oxygen via face mask immediately, notify
the healthcare provider, and prepare to administer prescribed parenteral anticoagulation for
a suspected pulmonary embolism
C. Place the patient in Trendelenburg position and perform chest physiotherapy
D. Administer oral acetaminophen and encourage coughing
Correct Answer: B
Rationale: Sudden dyspnea, pleuritic chest pain, tachycardia, and hypoxemia in a
postoperative patient strongly indicate pulmonary embolism (PE). Immediate nursing
priorities are elevating the head of the bed, initiating supplemental oxygen to correct
hypoxemia, notifying the provider, and preparing for anticoagulant therapy (IV heparin
or subcutaneous LMWH).
7. An adult patient experiencing an acute asthma exacerbation has audible
wheezing, intercostal retractions, and a peak expiratory flow rate of 45 percent of
personal best. Which inhaled medication should the nurse administer first?
A. Fluticasone propionate dry powder inhaler
B. Albuterol sulfate short-acting beta-2 agonist (SABA) via nebulizer or metered-dose
inhaler with spacer
ATI PN Comprehensive Exit Actual Exam 2026/2027 | Verified Questions
, C. Salmeterol long-acting beta-2 agonist (LABA)
D. Cromolyn sodium mast cell stabilizer
Correct Answer: B
Rationale: In an acute asthma exacerbation, immediate bronchodilation is required to
reverse bronchospasm and airflow obstruction. Albuterol is a rapid-acting short-acting
beta-2 agonist (SABA) that serves as first-line rescue therapy. Inhaled corticosteroids
(fluticasone) and LABAs (salmeterol) are long-term controllers and ineffective for acute
relief.
8. A patient with severe Chronic Obstructive Pulmonary Disease (COPD) and
chronic hypercapnia is admitted with an acute respiratory infection. What is the
correct oxygen administration principle for this patient?
A. Administer 100 percent oxygen via non-rebreather mask continuously to achieve an
oxygen saturation of 99 percent
B. Deliver oxygen via Venturi mask or nasal cannula titrated to achieve a target oxygen
saturation of 88 to 92 percent, avoiding hyperoxia that could worsen hypercapnia
C. Withhold all supplemental oxygen regardless of hypoxemia to protect hypoxic respiratory
drive
D. Administer 50 percent oxygen via aerosol mask only during sleeping hours
Correct Answer: B
Rationale: In patients with severe COPD and chronic hypercapnia, excessive oxygen
administration (hyperoxia) worsens CO2 retention through ventilation-perfusion
mismatching and Haldane effect. Evidence-based COPD guidelines mandate titrating
supplemental oxygen to achieve a safe target saturation of 88% to 92%.
9. A patient is admitted with community-acquired right lower lobe pneumonia,
fever of 102.4 degrees Fahrenheit, and productive cough with purulent sputum.
What is the correct sequence of clinical nursing interventions?
A. Administer prescribed intravenous antibiotics immediately before collecting sputum or
blood specimens
B. Obtain prescribed blood and sputum specimens for culture and sensitivity first, initiate
empiric intravenous antibiotic therapy promptly, encourage fluid intake, and assist with
incentive spirometry every hour while awake
C. Restrict oral fluid intake to 500 mL daily to prevent pulmonary edema
D. Place the patient on strict flat bedrest without turning for 48 hours
Correct Answer: B
Rationale: To identify the causative pathogen accurately, blood and sputum cultures must
be collected before initiating antimicrobial therapy. Once cultures are obtained, empiric
antibiotics must be administered promptly, combined with hydration to thin bronchial
secretions and hourly incentive spirometry to prevent atelectasis.
10. Which airborne infection isolation precautions and nursing monitoring
protocols are mandatory when caring for a hospitalized patient with active
pulmonary tuberculosis (TB)?
A. Place in a positive-pressure room with standard surgical mask for visitors; monitor blood
glucose hourly
ATI PN Comprehensive Exit Actual Exam 2026/2027 | Verified Questions
