ATI PN Comprehensive Predictor CMS Exit Exam —
Practice Exam 2026
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT — Management of Care (Questions 1-20)
1. A charge nurse on a medical-surgical unit receives report on four clients. Which client should the
nurse assess FIRST?
A. A client with pneumonia who has an oxygen saturation of 92% on 2L nasal cannula
B. A client post-appendectomy 24 hours ago with a temperature of 101.2°F (38.4°C)
C. A client with heart failure who reports sudden onset of severe dyspnea and is sitting upright
D. A client with diabetes who has a blood glucose of 180 mg/dL before lunch
Correct ANSWER: C
Rationale: The client with heart failure reporting sudden severe dyspnea represents an acute change in
respiratory status, indicating potential pulmonary edema—a life-threatening emergency requiring
immediate assessment per the ABCs (Airway, Breathing, Circulation) of prioritization. Option A shows
acceptable oxygenation for a pneumonia client. Option B shows expected post-operative inflammation.
Option D shows mild hyperglycemia that is not immediately dangerous.
2. The PN is assigned to care for a client who has a new cast on the right arm. Which task should the PN
delegate to the unlicensed assistive personnel (UAP)?
A. Assessing the client's capillary refill in the affected hand
B. Teaching the client how to keep the cast dry while showering
C. Assisting the client with ambulation to the bathroom
D. Evaluating the client's pain level using the 0-10 scale
,Correct ANSWER: C
Rationale: Assisting with ambulation is a standard, stable task that falls within the scope of UAP practice.
The PN cannot delegate assessment (A), evaluation (D), or teaching (B) as these require professional
nursing judgment and licensure. Delegation requires ensuring the right task, right circumstance, right
person, right direction, and supervision.
3. A client falls while attempting to ambulate to the bathroom unassisted. Which action should the
nurse take FIRST?
A. Complete an incident report
B. Notify the provider
C. Assess the client for injuries
D. Document the fall in the medical record
Correct ANSWER: C
Rationale: Client safety is always first. Assess for injuries before notifying provider, documenting, or
completing the incident report.
4. A nurse is caring for a client refusing a blood transfusion due to religious beliefs. The nurse respects
the client's decision. Which ethical principle is the nurse demonstrating?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
Correct ANSWER: C
,Rationale: Autonomy respects the client's right to make their own healthcare decisions, even if the
nurse disagrees. Beneficence means doing good, nonmaleficence means avoiding harm, and justice
refers to fairness.
5. An LPN is working under the supervision of an RN. Which task is MOST APPROPRIATE for the LPN to
perform?
A. Developing the initial plan of care for a newly admitted client
B. Administering IV push morphine to a client in acute pain
C. Performing sterile dressing changes on a post-operative wound
D. Providing discharge teaching to a client starting anticoagulant therapy
Correct ANSWER: C
Rationale: LPN scope of practice includes performing sterile procedures such as dressing changes under
RN supervision. Option A (care planning) and Option D (complex teaching) require RN-level judgment.
Option B (IV push medications) typically requires additional certification or RN licensure per state nurse
practice acts.
6. A nurse discovers that a client received the wrong medication 2 hours ago. The client is currently
stable with no adverse effects noted. What is the FIRST action the nurse should take?
A. Document the error in the client's medical record
B. Complete an incident report for the quality improvement department
C. Assess the client thoroughly and notify the healthcare provider
D. Wait to see if any adverse effects develop before reporting
Correct ANSWER: C
Rationale: The nurse should first assess the client and notify the healthcare provider. Client safety is the
priority. Documentation and incident reporting follow after the client is stable.
, 7. A nurse is reinforcing teaching about advance directives. Which statement by the client indicates
understanding?
A. "Once I sign, I cannot change my advance directives."
B. "My family can override my decisions if they disagree."
C. "Advance directives only apply if I am unable to make decisions."
D. "I must have a lawyer present to create advance directives."
Correct ANSWER: C
Rationale: Advance directives provide guidance when the client cannot communicate their wishes.
Clients can change directives at any time, family cannot override, and legal representation is not
required.
8. A nurse on a med-surg unit has received change-of-shift report and will care for 4 clients. Which of
the following clients' needs will the nurse assign to an AP?
A. Feeding a client who was admitted 24 hours ago with aspiration pneumonia
B. Reinforcing teaching with a client who is learning to walk with a quad cane
C. Reapplying a condom catheter for a client who has urinary incontinence
D. Applying a sterile dressing to a pressure ulcer
Correct ANSWER: C
Rationale: Reapplying a condom catheter is within AP scope. Feeding a client with aspiration pneumonia
requires swallow assessment (PN/RN). Teaching requires PN/RN judgment. Sterile dressing changes
require PN/RN skills.
9. A nurse is reinforcing teaching with a client who has a new permanent pacemaker. Which statement
by the client indicates understanding?
Practice Exam 2026
SECTION 1: SAFE & EFFECTIVE CARE ENVIRONMENT — Management of Care (Questions 1-20)
1. A charge nurse on a medical-surgical unit receives report on four clients. Which client should the
nurse assess FIRST?
A. A client with pneumonia who has an oxygen saturation of 92% on 2L nasal cannula
B. A client post-appendectomy 24 hours ago with a temperature of 101.2°F (38.4°C)
C. A client with heart failure who reports sudden onset of severe dyspnea and is sitting upright
D. A client with diabetes who has a blood glucose of 180 mg/dL before lunch
Correct ANSWER: C
Rationale: The client with heart failure reporting sudden severe dyspnea represents an acute change in
respiratory status, indicating potential pulmonary edema—a life-threatening emergency requiring
immediate assessment per the ABCs (Airway, Breathing, Circulation) of prioritization. Option A shows
acceptable oxygenation for a pneumonia client. Option B shows expected post-operative inflammation.
Option D shows mild hyperglycemia that is not immediately dangerous.
2. The PN is assigned to care for a client who has a new cast on the right arm. Which task should the PN
delegate to the unlicensed assistive personnel (UAP)?
A. Assessing the client's capillary refill in the affected hand
B. Teaching the client how to keep the cast dry while showering
C. Assisting the client with ambulation to the bathroom
D. Evaluating the client's pain level using the 0-10 scale
,Correct ANSWER: C
Rationale: Assisting with ambulation is a standard, stable task that falls within the scope of UAP practice.
The PN cannot delegate assessment (A), evaluation (D), or teaching (B) as these require professional
nursing judgment and licensure. Delegation requires ensuring the right task, right circumstance, right
person, right direction, and supervision.
3. A client falls while attempting to ambulate to the bathroom unassisted. Which action should the
nurse take FIRST?
A. Complete an incident report
B. Notify the provider
C. Assess the client for injuries
D. Document the fall in the medical record
Correct ANSWER: C
Rationale: Client safety is always first. Assess for injuries before notifying provider, documenting, or
completing the incident report.
4. A nurse is caring for a client refusing a blood transfusion due to religious beliefs. The nurse respects
the client's decision. Which ethical principle is the nurse demonstrating?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Justice
Correct ANSWER: C
,Rationale: Autonomy respects the client's right to make their own healthcare decisions, even if the
nurse disagrees. Beneficence means doing good, nonmaleficence means avoiding harm, and justice
refers to fairness.
5. An LPN is working under the supervision of an RN. Which task is MOST APPROPRIATE for the LPN to
perform?
A. Developing the initial plan of care for a newly admitted client
B. Administering IV push morphine to a client in acute pain
C. Performing sterile dressing changes on a post-operative wound
D. Providing discharge teaching to a client starting anticoagulant therapy
Correct ANSWER: C
Rationale: LPN scope of practice includes performing sterile procedures such as dressing changes under
RN supervision. Option A (care planning) and Option D (complex teaching) require RN-level judgment.
Option B (IV push medications) typically requires additional certification or RN licensure per state nurse
practice acts.
6. A nurse discovers that a client received the wrong medication 2 hours ago. The client is currently
stable with no adverse effects noted. What is the FIRST action the nurse should take?
A. Document the error in the client's medical record
B. Complete an incident report for the quality improvement department
C. Assess the client thoroughly and notify the healthcare provider
D. Wait to see if any adverse effects develop before reporting
Correct ANSWER: C
Rationale: The nurse should first assess the client and notify the healthcare provider. Client safety is the
priority. Documentation and incident reporting follow after the client is stable.
, 7. A nurse is reinforcing teaching about advance directives. Which statement by the client indicates
understanding?
A. "Once I sign, I cannot change my advance directives."
B. "My family can override my decisions if they disagree."
C. "Advance directives only apply if I am unable to make decisions."
D. "I must have a lawyer present to create advance directives."
Correct ANSWER: C
Rationale: Advance directives provide guidance when the client cannot communicate their wishes.
Clients can change directives at any time, family cannot override, and legal representation is not
required.
8. A nurse on a med-surg unit has received change-of-shift report and will care for 4 clients. Which of
the following clients' needs will the nurse assign to an AP?
A. Feeding a client who was admitted 24 hours ago with aspiration pneumonia
B. Reinforcing teaching with a client who is learning to walk with a quad cane
C. Reapplying a condom catheter for a client who has urinary incontinence
D. Applying a sterile dressing to a pressure ulcer
Correct ANSWER: C
Rationale: Reapplying a condom catheter is within AP scope. Feeding a client with aspiration pneumonia
requires swallow assessment (PN/RN). Teaching requires PN/RN judgment. Sterile dressing changes
require PN/RN skills.
9. A nurse is reinforcing teaching with a client who has a new permanent pacemaker. Which statement
by the client indicates understanding?
