ATI PN Comprehensive Predictor Exit
Exam Study Guide (2026) | 400
Highlightable NGN Questions with
Explanatory Rationales
Pass your dehydration, adult medical-surgical
stabilization, and fundamental infection control. 2026
PN ATI Comprehensive Predictor Exit Exam on the
first attempt with this high-yield, 400-question
practice package engineered specifically for the
latest Next Generation NCLEX (NGN) curriculum.
Every multiple-choice question and case concept
features an immediate correct answer and an in-
depth clinical rationale enclosed in clean brackets,
making the entire document completely digital-
highlighter friendly. This premium guide provides
broad, comprehensive coverage across essential
exam domains, including pharmacology safety,
maternal-newborn care, pediatric
, 1.A practical nurse (PN) is collecting data from an older adult client who has been
taking furosemide daily for heart failure. Which of the following findings should the
PN report to the charge nurse immediately?
A) Serum potassium level of 4.2 mEq/L
B) Urinary output of 150 mL over the past 4 hours
C) New onset of muscle weakness and irregular pulse
D) Weight gain of 0.5 kg (1.1 lb) in the past week
Answer: C) New onset of muscle weakness and irregular pulse
Rationale: Muscle weakness and an irregular pulse are critical clinical cues indicating
hypokalemia, which is a life-threatening adverse effect of loop diuretics like furosemide.
Although a potassium level of 4.2 mEq/L falls within the normal reference range, actual
physical symptoms of an electrolyte imbalance take absolute priority under safety
frameworks.
2. A practical nurse is reinforcing teaching with a client who has type 1 diabetes mellitus
about self-management. Which of the following instructions regarding insulin glargine
should the PN include?
A) Mix insulin glargine in the same syringe with regular insulin to decrease injections.
B) Administer insulin glargine twice daily at breakfast and bedtime.
C) Draw up insulin glargine only after verifying that it has a cloudy appearance.
D) Do not mix insulin glargine with any other insulin in the same syringe.
Answer: D) Do not mix insulin glargine with any other insulin in the same syringe.
Rationale: Insulin glargine is a long-acting, peakless insulin that has a clear
appearance. It must never be mixed in the same syringe with any other type of insulin
because altering its pH will change its absorption characteristics, destroying its long-
acting profile and compromising blood glucose control.
3. A PN is assigned to care for a group of clients on a medical-surgical unit. Which of the
following tasks should the PN delegate to an experienced Unlicensed Assistive
Personnel (UAP)?
A) Reinforcing dietary restrictions to a client diagnosed with chronic renal failure.
B) Obtaining a clean-catch urine specimen from a client who has a suspected UTI.
C) Monitoring the swallowing capability of a client recovering from a recent CVA.
D) Evaluating a client's response to an administered oral analgesic.
Answer: B) Obtaining a clean-catch urine specimen from a client who has a
suspected UTI.
Rationale: Obtaining a clean-catch urine specimen is a standard, non-invasive task that
does not require clinical assessment or judgment, making it appropriate to delegate to a
UAP. Teaching, assessing, and evaluating are core nursing responsibilities that cannot
be delegated.
,4. A client who is at 32 weeks of gestation presents to the clinic. The client is Rh-negative
and has an Rh-positive partner. Which of the following information should the PN
recognize as correct regarding Rho(D) immune globulin administration?
A) The client should receive Rho(D) immune globulin only if she exhibits signs of
miscarriage.
B) Rho(D) immune globulin is routinely administered at 28 weeks of gestation and within
72 hours after delivery if the newborn is Rh-positive.
C) The medication is administered directly to the newborn immediately following birth.
D) Rho(D) immune globulin is required only during the client's very first pregnancy.
Answer: B) Rho(D) immune globulin is routinely administered at 28 weeks of
gestation and within 72 hours after delivery if the newborn is Rh-positive.
Rationale: Rho(D) immune globulin is given prophylactically to Rh-negative mothers at
28 weeks of gestation and again within 72 hours after birth if the infant is Rh-positive.
This passive immunization prevents maternal antibody sensitization against Rh-positive
fetal blood cells.
5. A practical nurse is assisting with the care of a client who has chest trauma following a
motor vehicle crash. The client's vital signs are: HR 102/min, RR 24/min, BP 98/60 mm
Hg, and SpO₂ 91% on 2L of oxygen via nasal cannula. Which of the following actions
should the PN prioritize?
A) Administering a prescribed IV fluid bolus to stabilize the blood pressure.
B) Ensuring a patent airway and preparing for increased oxygen delivery.
C) Administering prescribed opioid analgesics to manage chest wall pain.
D) Reviewing the client's initial arterial blood gas results from the lab.
Answer: B) Ensuring a patent airway and preparing for increased oxygen delivery.
Rationale: Using the airway, breathing, circulation (ABC) priority framework, managing
the client's compromised respiratory status (RR 24, SpO₂ 91%) takes immediate
precedence over pain control or laboratory reviews to prevent respiratory failure.
6. A practical nurse is checking a client for structural safety and orthostatic hypotension.
Which of the following environmental safety actions should the PN implement for a
client at high risk for falls?
A) Place the client in a private room at the far end of the hallway to reduce noise.
B) Ensure the client's bed is maintained in the lowest position with standard fall
precautions active.
C) Instruct the client to change positions rapidly to minimize dizzy spells.
D) Request that security personnel apply soft wrist restraints during sleeping hours.
Answer: B) Ensure the client's bed is maintained in the lowest position with
standard fall precautions active.
Rationale: Standard fall precautions include keeping the bed in its lowest position,
keeping the call light within reach, and encouraging slow position changes. Placing a
high-risk client far from the nursing station or applying unauthorized restraints increases
safety hazards.
7. A practical nurse is reinforcing teaching with a client who is prescribed a low-protein and
low-potassium diet. The PN should recognize that this dietary restriction is indicated for
, which of the following conditions?
A) Diabetic ketoacidosis (DKA)
B) Chronic renal failure
C) Acute hypovolemic shock
D) Severe malabsorption syndrome
Answer: B) Chronic renal failure
Rationale: Clients with chronic renal failure experience a decreased ability to excrete
nitrogenous wastes and potassium. Restricting dietary protein and potassium prevents
the dangerous accumulation of blood urea nitrogen (BUN) and hyperkalemia.
8. A PN is preparing to perform wound care for a client who has a surgical incision. Which
of the following actions demonstrates proper infection control principles?
A) Clean the wound from the outer periphery toward the center using a circular motion.
B) Clean the wound from the least contaminated area to the most contaminated area.
C) Re-use the same gauze sponge for multiple strokes across the incision line.
D) Dry the wound using a fan or by blowing directly on the exposed tissue.
Answer: B) Clean the wound from the least contaminated area to the most
contaminated area.
Rationale: Wound cleaning must always progress from clean to dirty (least
contaminated to most contaminated area). This prevents introducing micro-organisms
from the surrounding skin into the healing surgical incision line.
9. A practical nurse is reviewing the lab results of a client who has chronic pancreatitis.
Which of the following findings should the PN expect when checking the client's stool
characteristics?
A) Dark, tarry stools containing occult blood.
B) Pale, fatty, foul-smelling stools.
C) Small, hard, pellet-like stools.
D) Bright red, mucus-covered stools.
Answer: B) Pale, fatty, foul-smelling stools.
Rationale: Chronic pancreatitis leads to a deficiency in pancreatic enzymes, causing
malabsorption of fats (steatorrhea). This results in stools that are characteristically pale,
fatty, bulky, and foul-smelling. Dark, tarry stools indicate upper gastrointestinal bleeding.
10. A nurse is preparing to administer an intramuscular injection to an infant. Which of the
following muscles should the nurse select as the preferred site for administration?
A) Deltoid
B) Dorsogluteal
C) Ventrogluteal
D) Vastus lateralis
Answer: D) Vastus lateralis
Rationale: The vastus lateralis muscle, located on the anterolateral aspect of the thigh,
is the preferred and safest site for intramuscular injections in infants. This muscle is the
most developed at birth and avoids the risk of damaging the sciatic nerve.
Exam Study Guide (2026) | 400
Highlightable NGN Questions with
Explanatory Rationales
Pass your dehydration, adult medical-surgical
stabilization, and fundamental infection control. 2026
PN ATI Comprehensive Predictor Exit Exam on the
first attempt with this high-yield, 400-question
practice package engineered specifically for the
latest Next Generation NCLEX (NGN) curriculum.
Every multiple-choice question and case concept
features an immediate correct answer and an in-
depth clinical rationale enclosed in clean brackets,
making the entire document completely digital-
highlighter friendly. This premium guide provides
broad, comprehensive coverage across essential
exam domains, including pharmacology safety,
maternal-newborn care, pediatric
, 1.A practical nurse (PN) is collecting data from an older adult client who has been
taking furosemide daily for heart failure. Which of the following findings should the
PN report to the charge nurse immediately?
A) Serum potassium level of 4.2 mEq/L
B) Urinary output of 150 mL over the past 4 hours
C) New onset of muscle weakness and irregular pulse
D) Weight gain of 0.5 kg (1.1 lb) in the past week
Answer: C) New onset of muscle weakness and irregular pulse
Rationale: Muscle weakness and an irregular pulse are critical clinical cues indicating
hypokalemia, which is a life-threatening adverse effect of loop diuretics like furosemide.
Although a potassium level of 4.2 mEq/L falls within the normal reference range, actual
physical symptoms of an electrolyte imbalance take absolute priority under safety
frameworks.
2. A practical nurse is reinforcing teaching with a client who has type 1 diabetes mellitus
about self-management. Which of the following instructions regarding insulin glargine
should the PN include?
A) Mix insulin glargine in the same syringe with regular insulin to decrease injections.
B) Administer insulin glargine twice daily at breakfast and bedtime.
C) Draw up insulin glargine only after verifying that it has a cloudy appearance.
D) Do not mix insulin glargine with any other insulin in the same syringe.
Answer: D) Do not mix insulin glargine with any other insulin in the same syringe.
Rationale: Insulin glargine is a long-acting, peakless insulin that has a clear
appearance. It must never be mixed in the same syringe with any other type of insulin
because altering its pH will change its absorption characteristics, destroying its long-
acting profile and compromising blood glucose control.
3. A PN is assigned to care for a group of clients on a medical-surgical unit. Which of the
following tasks should the PN delegate to an experienced Unlicensed Assistive
Personnel (UAP)?
A) Reinforcing dietary restrictions to a client diagnosed with chronic renal failure.
B) Obtaining a clean-catch urine specimen from a client who has a suspected UTI.
C) Monitoring the swallowing capability of a client recovering from a recent CVA.
D) Evaluating a client's response to an administered oral analgesic.
Answer: B) Obtaining a clean-catch urine specimen from a client who has a
suspected UTI.
Rationale: Obtaining a clean-catch urine specimen is a standard, non-invasive task that
does not require clinical assessment or judgment, making it appropriate to delegate to a
UAP. Teaching, assessing, and evaluating are core nursing responsibilities that cannot
be delegated.
,4. A client who is at 32 weeks of gestation presents to the clinic. The client is Rh-negative
and has an Rh-positive partner. Which of the following information should the PN
recognize as correct regarding Rho(D) immune globulin administration?
A) The client should receive Rho(D) immune globulin only if she exhibits signs of
miscarriage.
B) Rho(D) immune globulin is routinely administered at 28 weeks of gestation and within
72 hours after delivery if the newborn is Rh-positive.
C) The medication is administered directly to the newborn immediately following birth.
D) Rho(D) immune globulin is required only during the client's very first pregnancy.
Answer: B) Rho(D) immune globulin is routinely administered at 28 weeks of
gestation and within 72 hours after delivery if the newborn is Rh-positive.
Rationale: Rho(D) immune globulin is given prophylactically to Rh-negative mothers at
28 weeks of gestation and again within 72 hours after birth if the infant is Rh-positive.
This passive immunization prevents maternal antibody sensitization against Rh-positive
fetal blood cells.
5. A practical nurse is assisting with the care of a client who has chest trauma following a
motor vehicle crash. The client's vital signs are: HR 102/min, RR 24/min, BP 98/60 mm
Hg, and SpO₂ 91% on 2L of oxygen via nasal cannula. Which of the following actions
should the PN prioritize?
A) Administering a prescribed IV fluid bolus to stabilize the blood pressure.
B) Ensuring a patent airway and preparing for increased oxygen delivery.
C) Administering prescribed opioid analgesics to manage chest wall pain.
D) Reviewing the client's initial arterial blood gas results from the lab.
Answer: B) Ensuring a patent airway and preparing for increased oxygen delivery.
Rationale: Using the airway, breathing, circulation (ABC) priority framework, managing
the client's compromised respiratory status (RR 24, SpO₂ 91%) takes immediate
precedence over pain control or laboratory reviews to prevent respiratory failure.
6. A practical nurse is checking a client for structural safety and orthostatic hypotension.
Which of the following environmental safety actions should the PN implement for a
client at high risk for falls?
A) Place the client in a private room at the far end of the hallway to reduce noise.
B) Ensure the client's bed is maintained in the lowest position with standard fall
precautions active.
C) Instruct the client to change positions rapidly to minimize dizzy spells.
D) Request that security personnel apply soft wrist restraints during sleeping hours.
Answer: B) Ensure the client's bed is maintained in the lowest position with
standard fall precautions active.
Rationale: Standard fall precautions include keeping the bed in its lowest position,
keeping the call light within reach, and encouraging slow position changes. Placing a
high-risk client far from the nursing station or applying unauthorized restraints increases
safety hazards.
7. A practical nurse is reinforcing teaching with a client who is prescribed a low-protein and
low-potassium diet. The PN should recognize that this dietary restriction is indicated for
, which of the following conditions?
A) Diabetic ketoacidosis (DKA)
B) Chronic renal failure
C) Acute hypovolemic shock
D) Severe malabsorption syndrome
Answer: B) Chronic renal failure
Rationale: Clients with chronic renal failure experience a decreased ability to excrete
nitrogenous wastes and potassium. Restricting dietary protein and potassium prevents
the dangerous accumulation of blood urea nitrogen (BUN) and hyperkalemia.
8. A PN is preparing to perform wound care for a client who has a surgical incision. Which
of the following actions demonstrates proper infection control principles?
A) Clean the wound from the outer periphery toward the center using a circular motion.
B) Clean the wound from the least contaminated area to the most contaminated area.
C) Re-use the same gauze sponge for multiple strokes across the incision line.
D) Dry the wound using a fan or by blowing directly on the exposed tissue.
Answer: B) Clean the wound from the least contaminated area to the most
contaminated area.
Rationale: Wound cleaning must always progress from clean to dirty (least
contaminated to most contaminated area). This prevents introducing micro-organisms
from the surrounding skin into the healing surgical incision line.
9. A practical nurse is reviewing the lab results of a client who has chronic pancreatitis.
Which of the following findings should the PN expect when checking the client's stool
characteristics?
A) Dark, tarry stools containing occult blood.
B) Pale, fatty, foul-smelling stools.
C) Small, hard, pellet-like stools.
D) Bright red, mucus-covered stools.
Answer: B) Pale, fatty, foul-smelling stools.
Rationale: Chronic pancreatitis leads to a deficiency in pancreatic enzymes, causing
malabsorption of fats (steatorrhea). This results in stools that are characteristically pale,
fatty, bulky, and foul-smelling. Dark, tarry stools indicate upper gastrointestinal bleeding.
10. A nurse is preparing to administer an intramuscular injection to an infant. Which of the
following muscles should the nurse select as the preferred site for administration?
A) Deltoid
B) Dorsogluteal
C) Ventrogluteal
D) Vastus lateralis
Answer: D) Vastus lateralis
Rationale: The vastus lateralis muscle, located on the anterolateral aspect of the thigh,
is the preferred and safest site for intramuscular injections in infants. This muscle is the
most developed at birth and avoids the risk of damaging the sciatic nerve.
