ATI PN Comprehensive Predictor 2026 Exit Exam
180 NGN-Style Practice Questions with ANSWERs &
Rationales
SECTION 1: MANAGEMENT OF CARE & PRIORITIZATION (Questions 1-25)
NGN CASE SCENARIO 1 (Questions 1-3)
A practical nurse (PN) is caring for a client in a long-term care facility. During the 0700 assessment, the
PN notes:
Unresponsive to verbal stimuli
Respirations: 8/min and shallow
Pulse: 42 bpm and weak
Oxygen saturation: 84% on room air
History: Advanced dementia and DNR/AND orders
QUESTION 1
Which action should the PN take FIRST?
A) Administer oxygen via non-rebreather mask
B) Call the client's family to inform them of the change
,C) Reposition the client to facilitate airway clearance
D) Place the client in a supine position with a pillow under the head
Correct ANSWER: C
Rationale: In an unresponsive client with shallow respirations, the priority is airway patency (ABC
framework). The PN must first open the airway and clear secretions. Repositioning (side-lying) helps
drain secretions and prevents aspiration. Oxygen is ineffective without a patent airway. DNR/AND status
means no CPR or intubation, but supportive care (repositioning, suctioning) is still provided .
QUESTION 2
Following airway clearance, what is the next appropriate action?
A) Document the findings in the client's chart
B) Notify the family of the change in status
C) Notify the provider of the client's status
D) Administer oxygen at 2 L/min via nasal cannula
Correct ANSWER: C
Rationale: After implementing the initial intervention (airway clearance), the PN should notify the
provider of the client's status. DNR/AND orders do not mean "do not treat"; they mean no CPR or
intubation. The PN must still provide supportive care and notify the provider of significant changes .
QUESTION 3
The client's family arrives and asks about the DNR/AND status. Which statement by the PN is
appropriate?
A) "The DNR means we cannot do anything to help your loved one."
,B) "The DNR/AND status means we will not perform CPR or intubate, but we will provide comfort care."
C) "I can't discuss that with you; you need to speak with the doctor."
D) "The DNR order is irreversible once signed."
Correct ANSWER: B
Rationale: The nurse should clearly explain that DNR/AND means no CPR or intubation, but the client
will continue to receive comfort measures and supportive care. This provides accurate information while
being therapeutic and reassuring .
QUESTION 4
A PN is caring for four clients at the start of the shift. Which client should be assessed FIRST?
A) Client with diabetes requesting pain medication for neuropathy
B) Client with COPD who has a new cough producing green sputum
C) Client post-op day 1 with new-onset confusion and BP 88/50
D) Client with a fractured tibia requesting help to the bathroom
Correct ANSWER: C
Rationale: New confusion combined with hypotension suggests possible sepsis, hemorrhage, or shock—
unstable priority indicators. Airway and circulation concerns precede stable complaints. The client with
altered mental status and hemodynamic instability requires immediate assessment and intervention .
QUESTION 5
Which client can be assigned to a PN (LPN/LVN) under RN supervision?
A) Client newly diagnosed with unstable angina on a titratable heparin drip
, B) Client with stable congestive heart failure receiving daily furosemide
C) Client requiring blood transfusion for symptomatic anemia
D) Client with chest tube and continuous bubbling in water seal chamber
Correct ANSWER: B
Rationale: Stable CHF on routine diuretic medication is within PN scope of practice. Titratable drips,
blood transfusions, and chest tube troubleshooting typically require RN scope due to the complexity and
potential for rapid changes in client status .
QUESTION 6
A charge nurse is assigning staff for the shift. Which client should be assigned to an RN rather than a PN?
A) A client with stable CHF receiving daily Lasix
B) A client requiring a blood transfusion for symptomatic anemia
C) A client with a new diagnosis of diabetes needing insulin instruction
D) A client with a PEG tube requiring intermittent feedings
Correct ANSWER: C
Rationale: Initial client education falls under RN scope as it requires complex assessment and evaluation
of learning. PNs can reinforce teaching but cannot perform initial patient teaching .
QUESTION 7
A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate to delegate?
A) Administering an enema
B) Inserting an indwelling urinary catheter
180 NGN-Style Practice Questions with ANSWERs &
Rationales
SECTION 1: MANAGEMENT OF CARE & PRIORITIZATION (Questions 1-25)
NGN CASE SCENARIO 1 (Questions 1-3)
A practical nurse (PN) is caring for a client in a long-term care facility. During the 0700 assessment, the
PN notes:
Unresponsive to verbal stimuli
Respirations: 8/min and shallow
Pulse: 42 bpm and weak
Oxygen saturation: 84% on room air
History: Advanced dementia and DNR/AND orders
QUESTION 1
Which action should the PN take FIRST?
A) Administer oxygen via non-rebreather mask
B) Call the client's family to inform them of the change
,C) Reposition the client to facilitate airway clearance
D) Place the client in a supine position with a pillow under the head
Correct ANSWER: C
Rationale: In an unresponsive client with shallow respirations, the priority is airway patency (ABC
framework). The PN must first open the airway and clear secretions. Repositioning (side-lying) helps
drain secretions and prevents aspiration. Oxygen is ineffective without a patent airway. DNR/AND status
means no CPR or intubation, but supportive care (repositioning, suctioning) is still provided .
QUESTION 2
Following airway clearance, what is the next appropriate action?
A) Document the findings in the client's chart
B) Notify the family of the change in status
C) Notify the provider of the client's status
D) Administer oxygen at 2 L/min via nasal cannula
Correct ANSWER: C
Rationale: After implementing the initial intervention (airway clearance), the PN should notify the
provider of the client's status. DNR/AND orders do not mean "do not treat"; they mean no CPR or
intubation. The PN must still provide supportive care and notify the provider of significant changes .
QUESTION 3
The client's family arrives and asks about the DNR/AND status. Which statement by the PN is
appropriate?
A) "The DNR means we cannot do anything to help your loved one."
,B) "The DNR/AND status means we will not perform CPR or intubate, but we will provide comfort care."
C) "I can't discuss that with you; you need to speak with the doctor."
D) "The DNR order is irreversible once signed."
Correct ANSWER: B
Rationale: The nurse should clearly explain that DNR/AND means no CPR or intubation, but the client
will continue to receive comfort measures and supportive care. This provides accurate information while
being therapeutic and reassuring .
QUESTION 4
A PN is caring for four clients at the start of the shift. Which client should be assessed FIRST?
A) Client with diabetes requesting pain medication for neuropathy
B) Client with COPD who has a new cough producing green sputum
C) Client post-op day 1 with new-onset confusion and BP 88/50
D) Client with a fractured tibia requesting help to the bathroom
Correct ANSWER: C
Rationale: New confusion combined with hypotension suggests possible sepsis, hemorrhage, or shock—
unstable priority indicators. Airway and circulation concerns precede stable complaints. The client with
altered mental status and hemodynamic instability requires immediate assessment and intervention .
QUESTION 5
Which client can be assigned to a PN (LPN/LVN) under RN supervision?
A) Client newly diagnosed with unstable angina on a titratable heparin drip
, B) Client with stable congestive heart failure receiving daily furosemide
C) Client requiring blood transfusion for symptomatic anemia
D) Client with chest tube and continuous bubbling in water seal chamber
Correct ANSWER: B
Rationale: Stable CHF on routine diuretic medication is within PN scope of practice. Titratable drips,
blood transfusions, and chest tube troubleshooting typically require RN scope due to the complexity and
potential for rapid changes in client status .
QUESTION 6
A charge nurse is assigning staff for the shift. Which client should be assigned to an RN rather than a PN?
A) A client with stable CHF receiving daily Lasix
B) A client requiring a blood transfusion for symptomatic anemia
C) A client with a new diagnosis of diabetes needing insulin instruction
D) A client with a PEG tube requiring intermittent feedings
Correct ANSWER: C
Rationale: Initial client education falls under RN scope as it requires complex assessment and evaluation
of learning. PNs can reinforce teaching but cannot perform initial patient teaching .
QUESTION 7
A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate to delegate?
A) Administering an enema
B) Inserting an indwelling urinary catheter
