VATI GREENLIGHT PREDICTOR VERSION B
NEWEST VERSION 2026/2027 ACTUAL EXAM
Complete 300 Questions and Correct Detailed Answers | A+
Aligned with the 2026-2027 VATI Greenlight Predictor Version B Examination Blueprint and NCLEX-RN Test Plan
Total Questions: 300 | Cognitive Distribution: 30% Recall, 50% Application, 20% Analysis | Format: 80%
Scenario-Based, 20% Direct Recall
Blocks: 4 NCLEX-RN Client Need Categories | Question Styles: Prioritization, Delegation, Dosage Calculation, Lab
Interpretation, Clinical Judgment
BLOCK 1 - MANAGEMENT OF CARE, SAFETY & LEGAL
Section 1A: Management of Care
Advocacy, Delegation, Prioritization, Case Management, & Continuity of Care
Q1: The RN is caring for four clients. Which client should the nurse assess FIRST?
A. A client 2 hours post-cardiac catheterization with stable vital signs
B. A client who is postoperative day 1 from a hip replacement reporting calf pain [CORRECT]
C. A client receiving IV antibiotics for pneumonia with a temperature of 99.8 F
D. A client with chronic kidney disease scheduled for hemodialysis this afternoon
Correct Answer: B
Rationale: Calf pain in a postoperative client suggests deep vein thrombosis (DVT), which can progress to pulmonary
embolism—a life-threatening complication. Using the ABC framework and unstable-vs-stable prioritization, potential
DVT takes priority. The other clients are stable or have expected findings. Test-taking strategy: when multiple stable
clients and one potentially unstable client appear, assess the potentially unstable client first.
Q2: Which client assignment is most appropriate for the LPN/LVN on a medical-surgical unit?
A. A client receiving a continuous heparin infusion requiring hourly aPTT monitoring
B. A client 12 hours post-open heart surgery with chest tubes and a mediastinal drain
C. A client 3 days post-mastectomy receiving oral analgesics and oral antibiotics [CORRECT]
D. A client admitted 2 hours ago with acute GI bleeding and a continuous IV infusion of pantoprazole
Correct Answer: C
Rationale: The LPN/LVN scope includes caring for stable clients with predictable outcomes. The client 3 days
post-mastectomy on oral medications with an established recovery trajectory fits this profile. Titrated heparin,
immediate post-cardiac surgery, and acute GI bleeding require RN-level assessment and complex interventions.
Test-taking strategy: LPN assignments favor stable, post-acute phase clients with routine care needs.
300 Questions & Detailed Answers | NCLEX-RN Readiness Aligned
,VATI Greenlight Predictor Version B | 2026/2027 Actual Exam | A+ Page 2
Q3: Which task is appropriate for the RN to delegate to a UAP?
A. Measuring intake and output on a client with a Foley catheter [CORRECT]
B. Reinforcing teaching about a newly prescribed diabetic medication
C. Assessing a stage 2 pressure injury for signs of infection
D. Explaining the purpose of an upcoming colonoscopy to a client
Correct Answer: A
Rationale: Measuring intake and output is a routine, protocol-driven task within the UAP scope. Teaching, assessment,
and explanation require nursing judgment and are non-delegable. The 5 rights of delegation confirm: right task, right
circumstance, right person, right direction/communication, right supervision. Test-taking strategy: UAP may perform
ADLs, ambulation, vital signs on stable clients, and I&O;—never teaching, assessment, or judgment-based activities.
Q4: A client scheduled for an elective cholecystectomy refuses to sign the consent form after the surgeon has
explained the procedure. What is the most appropriate action by the nurse?
A. Explain the risks again to ensure the client understands the procedure
B. Notify the surgeon so the surgeon can speak with the client before surgery [CORRECT]
C. Document the refusal and proceed with preoperative preparation
D. Ask a family member to convince the client to sign the consent
Correct Answer: B
Rationale: Informed consent requires the provider (surgeon) to explain risks, benefits, and alternatives. If the client
refuses after explanation, the nurse must notify the surgeon. The nurse's role is to witness the signature and verify
understanding, not to obtain consent or persuade. Forcing or coercing a family member violates autonomy. Test-taking
strategy: when consent is questioned or refused, the answer is always to notify the provider.
Q5: A 78-year-old client with advanced dementia has no advance directive but has a daughter holding durable
power of attorney for health care. The client develops a treatable pneumonia. What should the nurse do
FIRST?
A. Administer the prescribed antibiotics as ordered [CORRECT]
B. Ask the daughter to make decisions regarding treatment
C. Notify the health care provider of the lack of advance directive
D. Withhold antibiotics until an ethics consult is obtained
Correct Answer: A
Rationale: Pneumonia is a treatable condition, and the standard of care is to provide prescribed treatment. The durable
POA becomes relevant for decisions about withholding/withdrawing life-sustaining treatment, not for routine
prescribed care. Withholding antibiotics would constitute neglect. The provider and POA should be involved for
end-of-life decisions. Test-taking strategy: distinguish between routine treatment (administer as ordered) and end-of-life
decisions (involve POA/ethics).
Q6: The nurse receives a telephone order from a provider for morphine 4 mg IV for a postoperative client.
What should the nurse do?
A. Administer the medication and document the order as received
B. Repeat the order back to the provider, confirm, then administer and document [CORRECT]
C. Ask the provider to come to the unit to write the order before administering
D. Refuse to accept a telephone order and request the provider send it via fax
Correct Answer: B
Rationale: Telephone orders require the nurse to use the 'read-back' verification process to confirm accuracy with the
provider before administration. This prevents medication errors. After verification and administration, the order must be
documented with the provider's name, time, and 'read back and verified.' Test-taking strategy: read-back verification is
always required for telephone orders; refusing or delaying pain management is inappropriate.
300 Questions & Detailed Answers | NCLEX-RN Readiness Aligned
,VATI Greenlight Predictor Version B | 2026/2027 Actual Exam | A+ Page 3
Q7: Which client should the nurse identify as the HIGHEST priority during shift report?
A. A client 4 hours post-cardiac catheterization with stable vital signs
B. A client with COPD whose SpO2 dropped from 94% to 88% over the last hour [CORRECT]
C. A client with type 1 diabetes scheduled for a fasting blood glucose
D. A client receiving IV antibiotics for cellulitis with no complaints
Correct Answer: B
Rationale: A 6% drop in SpO2 to 88% in a COPD client indicates acute respiratory compromise requiring immediate
assessment and intervention. Using ABC and the unstable-vs-stable framework, the client with declining respiratory
status is the highest priority. The post-cath client is stable, the diabetic's fasting glucose is routine, and the antibiotic
client is stable. Test-taking strategy: a changing/declining value trumps a static stable value.
Q8: The nurse discovers that a colleague appears impaired during the shift. What is the most appropriate
action?
A. Confront the colleague privately and offer to cover their assignment
B. Report the observation to the nursing supervisor immediately [CORRECT]
C. Document the concern in the colleague's personnel file
D. Wait until the end of shift to discuss concerns with the colleague
Correct Answer: B
Rationale: Patient safety is the priority; an impaired nurse poses a direct threat to clients. The nurse must report
immediately to the supervisor, who can remove the nurse from client care and initiate appropriate evaluation. Private
confrontation delays client protection; documenting in personnel files is not within the nurse's role; waiting until end of
shift compromises client safety. Test-taking strategy: when patient safety is at risk, escalate immediately through the
chain of command.
Q9: A client diagnosed with terminal cancer tells the nurse, 'I don't want any more treatment. Let me die
peacefully.' What is the best response?
A. 'You should discuss this decision with your family before stopping treatment.'
B. 'I'll notify your health care provider so we can discuss your wishes and options.' [CORRECT]
C. 'Don't give up hope; new treatments are being developed all the time.'
D. 'Are you sure? Your family would be devastated to lose you.'
Correct Answer: B
Rationale: The client has the right to refuse treatment (autonomy), and the nurse must advocate by communicating this
to the provider. Options A and D introduce guilt and undermine autonomy; option C gives false hope. The therapeutic
response acknowledges the client's right and activates the care team. Test-taking strategy: respect client autonomy,
advocate for the client, and engage the provider for treatment decisions.
Q10: A client is being discharged after a total hip replacement. Which discharge instruction is the PRIORITY
to reinforce?
A. Use a raised toilet seat for the next 6 to 8 weeks
B. Notify the provider for fever, increased hip pain, or drainage from incision [CORRECT]
C. Perform hip flexion exercises three times daily
D. Continue taking the prescribed stool softener daily
Correct Answer: B
Rationale: Recognizing and reporting signs of complications (infection, dislocation, DVT) is the priority because early
intervention prevents severe outcomes. While all instructions are important, recognition of complications addresses the
highest risk to client safety. Hip flexion beyond 90° is actually contraindicated post-THR. Test-taking strategy: priority
discharge teaching focuses on what the client must report immediately—safety comes before comfort measures.
300 Questions & Detailed Answers | NCLEX-RN Readiness Aligned
, VATI Greenlight Predictor Version B | 2026/2027 Actual Exam | A+ Page 4
Q11: The nurse is preparing to administer prescribed morphine to a client. The client states, 'I don't want to
take anything that could make me addicted.' What should the nurse do FIRST?
A. Administer the medication anyway because it has been ordered
B. Educate the client about the difference between dependence and addiction [CORRECT]
C. Withhold the medication and document the client's refusal
D. Notify the provider to change the medication order
Correct Answer: B
Rationale: A client has the right to refuse medication, but the nurse should first provide education to support informed
decision-making. Many clients confuse physical dependence with addiction; education empowers the client to make an
informed choice. If the client still refuses after education, the nurse respects the refusal, documents, and notifies the
provider. Test-taking strategy: when a client refuses treatment, first provide education to support informed consent.
Q12: The nurse notices a UAP preparing to ambulate a client who is on fall precautions and is currently dizzy.
What is the most appropriate action?
A. Allow the UAP to ambulate the client with a gait belt
B. Reassign the UAP to a different client and ambulate the client with the RN [CORRECT]
C. Have the UAP ambulate the client with two assistants
D. Tell the UAP to ambulate the client only if a family member is present
Correct Answer: B
Rationale: An actively dizzy client on fall precautions requires nursing assessment before ambulation, which is beyond
UAP scope. The nurse must either ambulate the client personally or assign another RN if available. Allowing a UAP to
ambulate an unstable client violates the five rights of delegation. Test-taking strategy: if the client's status changes or is
unstable, nursing judgment is required—return the task to the licensed nurse.
Q13: A client asks the nurse for information about another client on the unit who is a neighbor. What is the
best response?
A. 'I can only confirm whether the client is on the unit but cannot share other information.' [CORRECT]
B. 'The client is doing well; I'll let them know you stopped by.'
C. 'I'll have to ask the client if they want me to share that information.'
D. 'You should ask the client directly when you visit.'
Correct Answer: A
Rationale: HIPAA protects all client health information, including whether the client is in the facility. The nurse should
not confirm presence without the client's permission and should not share any clinical information. Test-taking strategy:
HIPAA requires explicit client permission to release any information, including presence in the facility.
Q14: A 16-year-old client requests that her pregnancy test results not be shared with her parents. What is the
most appropriate action by the nurse?
A. Inform the client that parents must be told because she is a minor
B. Honor the client's request according to state laws regarding minor confidentiality [CORRECT]
C. Notify the parents without informing the client
D. Ask the provider to convince the client to inform her parents
Correct Answer: B
Rationale: Most states have laws allowing minors to consent to reproductive health services and protecting the
confidentiality of those services. The nurse must be familiar with state-specific laws and facility policy. Test-taking
strategy: minors have rights regarding reproductive health, mental health, and substance abuse services that may not
require parental notification—know your state's laws.
300 Questions & Detailed Answers | NCLEX-RN Readiness Aligned
NEWEST VERSION 2026/2027 ACTUAL EXAM
Complete 300 Questions and Correct Detailed Answers | A+
Aligned with the 2026-2027 VATI Greenlight Predictor Version B Examination Blueprint and NCLEX-RN Test Plan
Total Questions: 300 | Cognitive Distribution: 30% Recall, 50% Application, 20% Analysis | Format: 80%
Scenario-Based, 20% Direct Recall
Blocks: 4 NCLEX-RN Client Need Categories | Question Styles: Prioritization, Delegation, Dosage Calculation, Lab
Interpretation, Clinical Judgment
BLOCK 1 - MANAGEMENT OF CARE, SAFETY & LEGAL
Section 1A: Management of Care
Advocacy, Delegation, Prioritization, Case Management, & Continuity of Care
Q1: The RN is caring for four clients. Which client should the nurse assess FIRST?
A. A client 2 hours post-cardiac catheterization with stable vital signs
B. A client who is postoperative day 1 from a hip replacement reporting calf pain [CORRECT]
C. A client receiving IV antibiotics for pneumonia with a temperature of 99.8 F
D. A client with chronic kidney disease scheduled for hemodialysis this afternoon
Correct Answer: B
Rationale: Calf pain in a postoperative client suggests deep vein thrombosis (DVT), which can progress to pulmonary
embolism—a life-threatening complication. Using the ABC framework and unstable-vs-stable prioritization, potential
DVT takes priority. The other clients are stable or have expected findings. Test-taking strategy: when multiple stable
clients and one potentially unstable client appear, assess the potentially unstable client first.
Q2: Which client assignment is most appropriate for the LPN/LVN on a medical-surgical unit?
A. A client receiving a continuous heparin infusion requiring hourly aPTT monitoring
B. A client 12 hours post-open heart surgery with chest tubes and a mediastinal drain
C. A client 3 days post-mastectomy receiving oral analgesics and oral antibiotics [CORRECT]
D. A client admitted 2 hours ago with acute GI bleeding and a continuous IV infusion of pantoprazole
Correct Answer: C
Rationale: The LPN/LVN scope includes caring for stable clients with predictable outcomes. The client 3 days
post-mastectomy on oral medications with an established recovery trajectory fits this profile. Titrated heparin,
immediate post-cardiac surgery, and acute GI bleeding require RN-level assessment and complex interventions.
Test-taking strategy: LPN assignments favor stable, post-acute phase clients with routine care needs.
300 Questions & Detailed Answers | NCLEX-RN Readiness Aligned
,VATI Greenlight Predictor Version B | 2026/2027 Actual Exam | A+ Page 2
Q3: Which task is appropriate for the RN to delegate to a UAP?
A. Measuring intake and output on a client with a Foley catheter [CORRECT]
B. Reinforcing teaching about a newly prescribed diabetic medication
C. Assessing a stage 2 pressure injury for signs of infection
D. Explaining the purpose of an upcoming colonoscopy to a client
Correct Answer: A
Rationale: Measuring intake and output is a routine, protocol-driven task within the UAP scope. Teaching, assessment,
and explanation require nursing judgment and are non-delegable. The 5 rights of delegation confirm: right task, right
circumstance, right person, right direction/communication, right supervision. Test-taking strategy: UAP may perform
ADLs, ambulation, vital signs on stable clients, and I&O;—never teaching, assessment, or judgment-based activities.
Q4: A client scheduled for an elective cholecystectomy refuses to sign the consent form after the surgeon has
explained the procedure. What is the most appropriate action by the nurse?
A. Explain the risks again to ensure the client understands the procedure
B. Notify the surgeon so the surgeon can speak with the client before surgery [CORRECT]
C. Document the refusal and proceed with preoperative preparation
D. Ask a family member to convince the client to sign the consent
Correct Answer: B
Rationale: Informed consent requires the provider (surgeon) to explain risks, benefits, and alternatives. If the client
refuses after explanation, the nurse must notify the surgeon. The nurse's role is to witness the signature and verify
understanding, not to obtain consent or persuade. Forcing or coercing a family member violates autonomy. Test-taking
strategy: when consent is questioned or refused, the answer is always to notify the provider.
Q5: A 78-year-old client with advanced dementia has no advance directive but has a daughter holding durable
power of attorney for health care. The client develops a treatable pneumonia. What should the nurse do
FIRST?
A. Administer the prescribed antibiotics as ordered [CORRECT]
B. Ask the daughter to make decisions regarding treatment
C. Notify the health care provider of the lack of advance directive
D. Withhold antibiotics until an ethics consult is obtained
Correct Answer: A
Rationale: Pneumonia is a treatable condition, and the standard of care is to provide prescribed treatment. The durable
POA becomes relevant for decisions about withholding/withdrawing life-sustaining treatment, not for routine
prescribed care. Withholding antibiotics would constitute neglect. The provider and POA should be involved for
end-of-life decisions. Test-taking strategy: distinguish between routine treatment (administer as ordered) and end-of-life
decisions (involve POA/ethics).
Q6: The nurse receives a telephone order from a provider for morphine 4 mg IV for a postoperative client.
What should the nurse do?
A. Administer the medication and document the order as received
B. Repeat the order back to the provider, confirm, then administer and document [CORRECT]
C. Ask the provider to come to the unit to write the order before administering
D. Refuse to accept a telephone order and request the provider send it via fax
Correct Answer: B
Rationale: Telephone orders require the nurse to use the 'read-back' verification process to confirm accuracy with the
provider before administration. This prevents medication errors. After verification and administration, the order must be
documented with the provider's name, time, and 'read back and verified.' Test-taking strategy: read-back verification is
always required for telephone orders; refusing or delaying pain management is inappropriate.
300 Questions & Detailed Answers | NCLEX-RN Readiness Aligned
,VATI Greenlight Predictor Version B | 2026/2027 Actual Exam | A+ Page 3
Q7: Which client should the nurse identify as the HIGHEST priority during shift report?
A. A client 4 hours post-cardiac catheterization with stable vital signs
B. A client with COPD whose SpO2 dropped from 94% to 88% over the last hour [CORRECT]
C. A client with type 1 diabetes scheduled for a fasting blood glucose
D. A client receiving IV antibiotics for cellulitis with no complaints
Correct Answer: B
Rationale: A 6% drop in SpO2 to 88% in a COPD client indicates acute respiratory compromise requiring immediate
assessment and intervention. Using ABC and the unstable-vs-stable framework, the client with declining respiratory
status is the highest priority. The post-cath client is stable, the diabetic's fasting glucose is routine, and the antibiotic
client is stable. Test-taking strategy: a changing/declining value trumps a static stable value.
Q8: The nurse discovers that a colleague appears impaired during the shift. What is the most appropriate
action?
A. Confront the colleague privately and offer to cover their assignment
B. Report the observation to the nursing supervisor immediately [CORRECT]
C. Document the concern in the colleague's personnel file
D. Wait until the end of shift to discuss concerns with the colleague
Correct Answer: B
Rationale: Patient safety is the priority; an impaired nurse poses a direct threat to clients. The nurse must report
immediately to the supervisor, who can remove the nurse from client care and initiate appropriate evaluation. Private
confrontation delays client protection; documenting in personnel files is not within the nurse's role; waiting until end of
shift compromises client safety. Test-taking strategy: when patient safety is at risk, escalate immediately through the
chain of command.
Q9: A client diagnosed with terminal cancer tells the nurse, 'I don't want any more treatment. Let me die
peacefully.' What is the best response?
A. 'You should discuss this decision with your family before stopping treatment.'
B. 'I'll notify your health care provider so we can discuss your wishes and options.' [CORRECT]
C. 'Don't give up hope; new treatments are being developed all the time.'
D. 'Are you sure? Your family would be devastated to lose you.'
Correct Answer: B
Rationale: The client has the right to refuse treatment (autonomy), and the nurse must advocate by communicating this
to the provider. Options A and D introduce guilt and undermine autonomy; option C gives false hope. The therapeutic
response acknowledges the client's right and activates the care team. Test-taking strategy: respect client autonomy,
advocate for the client, and engage the provider for treatment decisions.
Q10: A client is being discharged after a total hip replacement. Which discharge instruction is the PRIORITY
to reinforce?
A. Use a raised toilet seat for the next 6 to 8 weeks
B. Notify the provider for fever, increased hip pain, or drainage from incision [CORRECT]
C. Perform hip flexion exercises three times daily
D. Continue taking the prescribed stool softener daily
Correct Answer: B
Rationale: Recognizing and reporting signs of complications (infection, dislocation, DVT) is the priority because early
intervention prevents severe outcomes. While all instructions are important, recognition of complications addresses the
highest risk to client safety. Hip flexion beyond 90° is actually contraindicated post-THR. Test-taking strategy: priority
discharge teaching focuses on what the client must report immediately—safety comes before comfort measures.
300 Questions & Detailed Answers | NCLEX-RN Readiness Aligned
, VATI Greenlight Predictor Version B | 2026/2027 Actual Exam | A+ Page 4
Q11: The nurse is preparing to administer prescribed morphine to a client. The client states, 'I don't want to
take anything that could make me addicted.' What should the nurse do FIRST?
A. Administer the medication anyway because it has been ordered
B. Educate the client about the difference between dependence and addiction [CORRECT]
C. Withhold the medication and document the client's refusal
D. Notify the provider to change the medication order
Correct Answer: B
Rationale: A client has the right to refuse medication, but the nurse should first provide education to support informed
decision-making. Many clients confuse physical dependence with addiction; education empowers the client to make an
informed choice. If the client still refuses after education, the nurse respects the refusal, documents, and notifies the
provider. Test-taking strategy: when a client refuses treatment, first provide education to support informed consent.
Q12: The nurse notices a UAP preparing to ambulate a client who is on fall precautions and is currently dizzy.
What is the most appropriate action?
A. Allow the UAP to ambulate the client with a gait belt
B. Reassign the UAP to a different client and ambulate the client with the RN [CORRECT]
C. Have the UAP ambulate the client with two assistants
D. Tell the UAP to ambulate the client only if a family member is present
Correct Answer: B
Rationale: An actively dizzy client on fall precautions requires nursing assessment before ambulation, which is beyond
UAP scope. The nurse must either ambulate the client personally or assign another RN if available. Allowing a UAP to
ambulate an unstable client violates the five rights of delegation. Test-taking strategy: if the client's status changes or is
unstable, nursing judgment is required—return the task to the licensed nurse.
Q13: A client asks the nurse for information about another client on the unit who is a neighbor. What is the
best response?
A. 'I can only confirm whether the client is on the unit but cannot share other information.' [CORRECT]
B. 'The client is doing well; I'll let them know you stopped by.'
C. 'I'll have to ask the client if they want me to share that information.'
D. 'You should ask the client directly when you visit.'
Correct Answer: A
Rationale: HIPAA protects all client health information, including whether the client is in the facility. The nurse should
not confirm presence without the client's permission and should not share any clinical information. Test-taking strategy:
HIPAA requires explicit client permission to release any information, including presence in the facility.
Q14: A 16-year-old client requests that her pregnancy test results not be shared with her parents. What is the
most appropriate action by the nurse?
A. Inform the client that parents must be told because she is a minor
B. Honor the client's request according to state laws regarding minor confidentiality [CORRECT]
C. Notify the parents without informing the client
D. Ask the provider to convince the client to inform her parents
Correct Answer: B
Rationale: Most states have laws allowing minors to consent to reproductive health services and protecting the
confidentiality of those services. The nurse must be familiar with state-specific laws and facility policy. Test-taking
strategy: minors have rights regarding reproductive health, mental health, and substance abuse services that may not
require parental notification—know your state's laws.
300 Questions & Detailed Answers | NCLEX-RN Readiness Aligned
