VATI Greenlight Predictor Version A - 2026/27 Newest Version
Actual Exam Complete Questions and Correct Detailed Answers | A+
NCLEX-RN Readiness | Virtual ATI Greenlight Predictor v.A | 300 Verified Questions
Total Questions 300 (single best answer)
Cognitive Level Recall 30% | Application 50% | Analysis 20%
Question Format 80% scenario-based | 20% direct recall
Blocks 4 (Management/Care + Health Promo + Pharm/Parenteral + Risk/Adaptation)
Standard VATI Greenlight Predictor v.A - 2026/27 NCLEX-RN
BLOCK 1 - Management of Care, Safety & Legal (Q1 - Q75)
Section 1A: Management of Care (Q1-Q20)
Advocacy, Delegation, Prioritization, Case Management, & Continuity of Care
Q1: A nurse on a medical-surgical unit is caring for four clients. Using the ABC priority-setting framework, which
client should the nurse assess FIRST? [Prioritization]
A. A client with a blood pressure of 150/90 mm Hg reporting a headache
B. A client with chronic COPD reporting increased dyspnea and an oxygen saturation of 88% on room air
[CORRECT]
C. A client with type 2 diabetes requesting a snack before bedtime
D. A client post-op day 1 reporting incisional pain rated 6/10
Correct Answer: B
Rationale: The ABC framework prioritizes Airway, Breathing, and Circulation. A COPD client with dyspnea and SpO2 88% has
respiratory compromise (Breathing) requiring immediate intervention. The hypertensive client (option A) is stable. The diabetic
client (option C) and post-op client (option D) are non-urgent. VATI strategy: when "FIRST" appears, apply ABCs; respiratory
distress always wins.
Q2: A charge nurse is delegating tasks to a UAP (unlicensed assistive personnel). Which task is APPROPRIATE to
delegate to the UAP? [Delegation]
A. Administering oral acetaminophen to a stable client
B. Teaching a newly diagnosed diabetic client about foot care
C. Measuring vital signs and recording intake/output on stable clients [CORRECT]
D. Performing the initial head-to-toe admission assessment
Correct Answer: C
Rationale: The UAP scope includes ADLs, vital signs on stable clients, intake/output, ambulation, and reporting changes to the
RN. Medication administration (option A), teaching (option B), and assessment (option D) are RN-only responsibilities per the 5
Rights of Delegation (right task, circumstance, person, direction, supervision). VATI strategy: UAP = "ADLs + vitals stable
clients"; RN retains assessment, teaching, meds.
Q3: A nurse is assigning care for the shift. Which client should be assigned to the LPN/LVN? [Delegation]
A. A client admitted 2 hours ago with acute GI bleeding and an IV infusion running
B. A client on a heparin infusion for pulmonary embolism requiring hourly aPTT checks
C. A client with a stage 3 sacral pressure injury requiring wound care and stable vitals [CORRECT]
D. A newly admitted client with chest pain undergoing diagnostic workup
Correct Answer: C
Rationale: The LPN/LVN scope includes caring for stable clients with predictable outcomes: basic wound care, oral medications
(per state law), catheterization, and reinforcement of teaching. Unstable clients (options A, B, D), IV titrated medications
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(heparin), and complex assessments require an RN. VATI strategy: LPN = stable, predictable; RN = unstable, complex, IV
titrated, initial assessment.
Q4: A nurse receives an order from a provider that appears to be outside the standard of care. Which action should
the nurse take FIRST? [Advocacy]
A. Refuse to carry out the order and document the refusal.
B. Implement the order and document the concern.
C. Clarify the order with the provider, document the conversation, and follow the chain of command if needed.
[CORRECT]
D. Notify the charge nurse and let them handle the situation.
Correct Answer: C
Rationale: The nurse's role as client advocate requires clarification of questionable orders. The first step is to communicate
directly with the provider; if unresolved, follow the chain of command (charge nurse, supervisor, ethics committee). Document
the conversation. Refusal without clarification (option A) is premature. VATI strategy: clarify → document → escalate; never
implement an unsafe order without clarification.
Q5: A nurse is caring for four clients. Using Maslow's hierarchy of needs, which client should the nurse prioritize?
[Prioritization]
A. A client who is anxious about an upcoming diagnostic procedure
B. A client with a potassium of 3.0 mEq/L and muscle weakness [CORRECT]
C. A client who requests spiritual counseling for end-of-life decisions
D. A client who asks for information about discharge planning
Correct Answer: B
Rationale: Maslow's hierarchy prioritizes physiological needs over safety, love/belonging, esteem, or self-actualization.
Hypokalemia with muscle weakness is a physiological risk (potential cardiac dysrhythmias). Anxiety, spiritual needs, and
discharge teaching are higher-level needs. VATI strategy: Maslow physiological > psychosocial; ABCs > electrolyte imbalance >
anxiety/teaching.
Q6: A nurse is planning care for a client being discharged to a skilled nursing facility (SNF). Which action best
demonstrates continuity of care? [Case Mgmt]
A. Providing the client with a list of medications
B. Sending a complete transfer summary, medication reconciliation, and care plan to the SNF and conducting a
nurse-to-nurse report [CORRECT]
C. Telling the client to follow up with their PCP
D. Asking the family to transport the medical records
Correct Answer: B
Rationale: Continuity of care requires a structured handoff including the transfer summary, reconciled medication list, plan of
care, and direct nurse-to-nurse communication. This minimizes adverse events and rehospitalization. VATI strategy: continuity =
comprehensive handoff (SBAR) + medication reconciliation + care plan; don't rely on client to convey medical information.
Q7: A nurse is preparing to administer a medication and notes the order reads "Give 2.5 mg PO daily." The
medication is supplied as 5 mg tablets. How many tablets should the nurse administer? [Med Calc]
A. 1 tablet
B. 0.5 tablet (2.5 mg ÷ 5 mg/tablet = 0.5 tablet) [CORRECT]
C. 2 tablets
D. 1.5 tablets
Correct Answer: B
Rationale: Dose calculation: desired dose (2.5 mg) ÷ dose on hand (5 mg/tablet) = 0.5 tablet. Always use the 6 rights (right
client, drug, dose, route, time, documentation) and double-check high-alert medications. VATI strategy: memorize the formula
"want/have × quantity"; for scored tablets, 0.5 is acceptable; do not split unscored tablets.
Q8: A nurse is delegating care to a UAP. Which principle reflects "right supervision" of the 5 Rights of Delegation?
[Delegation]
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A. Assigning the task and not checking back until end of shift
B. Monitoring the UAP's performance, intervening if needed, and ensuring the task was completed and
documented [CORRECT]
C. Delegating only tasks the UAP prefers
D. Allowing the UAP to make changes to the care plan
Correct Answer: B
Rationale: Right supervision requires monitoring, intervention, evaluation, and feedback. The RN retains accountability for
delegated tasks. VATI strategy: delegation is not "dumping"; supervise, intervene, evaluate, and document outcomes.
Q9: A client is admitted with severe respiratory distress. The provider orders immediate intubation, but the client is
alert and refuses. Which action by the nurse is appropriate? [Advocacy]
A. Proceed with intubation since the client cannot refuse life-saving treatment
B. Notify the provider, document the refusal, encourage the client to discuss concerns, and consider ethics
consult [CORRECT]
C. Restrain the client for safety
D. Administer a sedative without consent
Correct Answer: B
Rationale: A competent adult has the right to refuse treatment, even life-saving. The nurse must notify the provider, document
the refusal and client's capacity, explore concerns, and involve ethics/patient representative if needed. Forcing treatment is
battery. VATI strategy: competent adults have autonomy; document refusal and capacity; offer alternatives; ethics consult for
unresolved cases.
Q10: A nurse is caring for a client who is requesting to leave the hospital against medical advice (AMA). Which
action should the nurse take FIRST? [Advocacy]
A. Call security to prevent the client from leaving
B. Notify the provider to discuss risks of leaving; ensure the client signs the AMA form; document the
conversation and client's capacity [CORRECT]
C. Tell the client they cannot leave until discharge orders are written
D. Administer a sedative to calm the client
Correct Answer: B
Rationale: A competent adult may leave AMA. The nurse's role: notify the provider to discuss risks and alternatives, ensure the
client signs an AMA form (documenting informed refusal), arrange follow-up, and document the conversation and assessment of
capacity. Physical restraint is inappropriate. VATI strategy: respect autonomy; document informed refusal; arrange follow-up;
never restrain.
Q11: A nurse receives a verbal order from a provider during an emergency. Which action is required to ensure
proper documentation? [Legal]
A. Implement the order and document only the medication given
B. Repeat the order back to the provider verbatim (read-back), document it, and obtain the provider's signature
within the facility-defined timeframe (typically 24-48 hours) [CORRECT]
C. Refuse to accept verbal orders
D. Wait for the provider to write the order
Correct Answer: B
Rationale: Verbal/telephone orders should be avoided except in emergencies. When necessary, the nurse must read back the
order verbatim, document as a verbal order, and ensure the provider signs within the facility-defined timeframe (usually 24-48
hours). VATI strategy: read-back is mandatory; minimize verbal orders; document and obtain signature within required
timeframe.
Q12: A nurse is caring for a client who is experiencing a code blue. The client's family is at the bedside and wishes to
remain during resuscitation. Which action is appropriate? [Case Mgmt]
A. Ask the family to leave the room for safety and infection control
B. Allow a family member to remain at the bedside, assign a staff member to support them, and explain
procedures [CORRECT]
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C. Call security to remove the family
D. Continue resuscitation without acknowledging the family
Correct Answer: B
Rationale: Evidence-based practice (Pettigan, Kudchadkar, Gordon 2013) supports family presence during resuscitation when
possible, with a designated staff supporter who explains procedures. Benefits: closure, reduced PTSD/anxiety, witness to provider
efforts. Contraindicated if family is disruptive or compromising care. VATI strategy: offer family presence option with staff
support; never force removal unless disrupting care.
Q13: A nurse is preparing to discharge a client with complex medication regimen. Which action best ensures
continuity of care and prevents medication errors at home? [Case Mgmt]
A. Provide a printed list of medications
B. Provide a reconciled medication list (including dose, route, frequency, indication, and prescribing provider),
teach-back verification, and follow-up phone call within 48 hours [CORRECT]
C. Tell the client to call the pharmacy if they have questions
D. Discharge the client with verbal instructions only
Correct Answer: B
Rationale: Best practice for discharge transitions includes reconciled medication list with dose/route/frequency/indication,
teach-back verification of understanding, and follow-up phone call within 48 hours (TRANSITION, Project BOOST, RED
interventions). VATI strategy: written + teach-back + follow-up call; medication reconciliation is essential to prevent adverse
events post-discharge.
Q14: A nurse is caring for four clients and must prioritize care. Which client should the nurse see FIRST?
[Prioritization]
A. A client awaiting discharge teaching
B. A client reporting new-onset chest pain and diaphoresis [CORRECT]
C. A client requesting pain medication for chronic back pain
D. A client scheduled for physical therapy in 2 hours
Correct Answer: B
Rationale: Acute chest pain with diaphoresis suggests possible acute coronary syndrome requiring immediate assessment (ECG,
vitals, oxygen, nitroglycerin per protocol). Discharge teaching (option A), chronic pain (option C), and PT scheduling (option D)
are non-urgent. VATI strategy: "first/next/immediate" → acute over chronic, unstable over stable, ABC first.
Q15: A nurse is caring for a client who requires frequent turning and repositioning. Which task is APPROPRIATE
to delegate to a UAP? [Delegation]
A. Assessing the client's skin integrity after repositioning
B. Turning and repositioning the client every 2 hours per the care plan [CORRECT]
C. Documenting a new pressure injury
D. Developing a plan of care for skin integrity
Correct Answer: B
Rationale: Turning and repositioning is within UAP scope. Assessment (option A), documentation of new findings (option C),
and care planning (option D) are RN responsibilities. The UAP should report changes (e.g., redness, breakdown) to the RN.
VATI strategy: UAP performs routine tasks; RN assesses, plans, evaluates, and documents new findings.
Q16: A nurse case manager is working with a client who is being discharged home with home health services. Which
intervention best reflects case management? [Case Mgmt]
A. Coordinating care across the continuum (hospital, home health, primary care, therapies) to achieve outcomes
within available resources [CORRECT]
B. Visiting the client at home to administer medications
C. Providing direct care to the client in the hospital
D. Managing the client's insurance claims only
Correct Answer: A
Rationale: Case management coordinates care across settings and providers to optimize outcomes, contain costs, and ensure
continuity. It includes assessment, planning, implementation, coordination, monitoring, and evaluation. VATI strategy: case
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