ATI PN COMPREHENSIVE PREDICTOR EXIT EXAM NGN
PRACTICE QUESTIONS 2026-2027 – LATEST UPDATE NURSING
STUDY GUIDE
TABLE OF CONTENTS
• Management of Care & Prioritization
• Safety, Infection Control & Risk Reduction
• Pharmacology & Medication Administration
• Adult Medical-Surgical Nursing
• Maternal-Newborn Nursing
• Pediatric Nursing
• Mental Health Nursing
• Health Promotion & Maintenance
• Physiological Adaptation & Emergency Care
• Clinical Judgment, Delegation & Professional Practice
INTRODUCTION
This comprehensive ATI PN Comprehensive Predictor Exit Exam practice set is
designed for practical nursing students preparing for high-level predictor and
licensure-style
assessments. It emphasizes clinical judgment, prioritization, safety, pharmacology,
physiological adaptation, maternal-newborn care, pediatrics, mental health, and
professional nursing practice. Questions require application, interpretation, analysis,
and decision-making rather than simple memorization. It is particularly useful for PN
students approaching program completion, predictor examinations, and NCLEX-PN
preparation. Expect realistic, challenging scenarios modeled around NGN-style clinical
reasoning. This resource contains 100+ questions and answers with rationale. Purchase
and instantly get a downloadable and editable PDF for convenient study, review, and
practice.
QUESTIONS 1–30
Question 1
A practical nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client with heart failure who has gained 1 kg (2.2 lb) since yesterday
B. A client with pneumonia whose oxygen saturation decreased from 95% to 89% on 2
L/min oxygen
,C. A client with diabetes who has a premeal blood glucose of 68 mg/dL
D. A client 24 hours after abdominal surgery reporting incisional pain rated 7/10
Correct Answer: B.
Rationale: The acute decline in oxygenation indicates potential respiratory deterioration
and takes priority according to airway and breathing priorities. The other findings require
intervention but are not as immediately life-threatening.
Question 2
A client receiving digoxin reports nausea and blurred vision. The apical pulse is 54/min.
Which action should the practical nurse take?
A. Administer the medication with food
B. Recheck the blood pressure after administration
C. Withhold digoxin and notify the provider
D. Administer the prescribed potassium supplement and then give digoxin
Correct Answer: C.
Rationale: Bradycardia, nausea, and visual disturbances are concerning for digoxin
toxicity. The medication should be withheld and the provider notified for further
evaluation.
Question 3
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by
nasal cannula. The client becomes increasingly somnolent and difficult to arouse. Which
finding requires the most immediate intervention?
A. Respiratory rate of 10/min
B. Barrel-shaped chest
C. Productive cough with thick sputum
D. Oxygen saturation of 92%
Correct Answer: A.
Rationale: A respiratory rate of 10/min with increasing somnolence suggests
hypoventilation and possible respiratory failure. The nurse must immediately assess
airway and ventilation and escalate care.
Question 4
,A practical nurse is reinforcing teaching for a client prescribed warfarin. Which
statement indicates a need for further teaching?
A. “I will report unusual bruising.”
B. “I will keep my intake of vitamin K-containing foods consistent.”
C. “I can take aspirin whenever I develop a headache.”
D. “I will have my coagulation tests performed as scheduled.”
Correct Answer: C.
Rationale: Aspirin can increase bleeding risk when combined with warfarin and should
not be taken unless specifically prescribed or approved by the provider.
Question 5
A postoperative client suddenly develops dyspnea, pleuritic chest pain, tachycardia, and
anxiety. Which complication should the practical nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Fluid overload
Correct Answer: B.
Rationale: Sudden dyspnea, pleuritic chest pain, tachycardia, and anxiety are classic
warning findings of pulmonary embolism. This is an emergency requiring immediate
intervention.
Question 6
A client with diabetes mellitus is awake, confused, diaphoretic, and has a blood glucose
level of 52 mg/dL. Which intervention should the nurse perform first?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Obtain a urine specimen for ketones
D. Encourage the client to ambulate
Correct Answer: B.
Rationale: An alert client with symptomatic hypoglycemia should receive
approximately 15 g of rapid-acting carbohydrate, followed by reassessment of glucose
according to
protocol.
, Question 7
A client with a traumatic head injury has a Glasgow Coma Scale score that decreases
from 14 to 10. Which action is the priority?
A. Reorient the client
B. Offer oral fluids
C. Notify the provider or activate emergency response according to facility protocol
D. Place the client in a dark room
Correct Answer: C.
Rationale: A significant decline in level of consciousness can indicate increasing
intracranial pressure or neurological deterioration and requires immediate escalation.
Question 8
A practical nurse is caring for a client with suspected Clostridioides difficile infection.
Which infection-control measure is most appropriate?
A. Use alcohol-based hand sanitizer after removing gloves
B. Place the client on airborne precautions
C. Wash hands with soap and water after contact with the client
D. Assign the client to a positive-pressure room
Correct Answer: C.
Rationale: C. difficile spores are not reliably removed by alcohol-based hand
sanitizer. Soap-and-water hand hygiene and appropriate contact precautions are
required.
Question 9
A client receiving a blood transfusion develops chills, fever, low back pain, and
hypotension. What should the nurse do first?
A. Slow the transfusion
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Flush the blood tubing with dextrose solution
Correct Answer: B.
Rationale: These findings may indicate an acute hemolytic transfusion reaction. The first
action is to stop the transfusion and maintain IV access with appropriate compatible fluid
using new tubing according to protocol.
PRACTICE QUESTIONS 2026-2027 – LATEST UPDATE NURSING
STUDY GUIDE
TABLE OF CONTENTS
• Management of Care & Prioritization
• Safety, Infection Control & Risk Reduction
• Pharmacology & Medication Administration
• Adult Medical-Surgical Nursing
• Maternal-Newborn Nursing
• Pediatric Nursing
• Mental Health Nursing
• Health Promotion & Maintenance
• Physiological Adaptation & Emergency Care
• Clinical Judgment, Delegation & Professional Practice
INTRODUCTION
This comprehensive ATI PN Comprehensive Predictor Exit Exam practice set is
designed for practical nursing students preparing for high-level predictor and
licensure-style
assessments. It emphasizes clinical judgment, prioritization, safety, pharmacology,
physiological adaptation, maternal-newborn care, pediatrics, mental health, and
professional nursing practice. Questions require application, interpretation, analysis,
and decision-making rather than simple memorization. It is particularly useful for PN
students approaching program completion, predictor examinations, and NCLEX-PN
preparation. Expect realistic, challenging scenarios modeled around NGN-style clinical
reasoning. This resource contains 100+ questions and answers with rationale. Purchase
and instantly get a downloadable and editable PDF for convenient study, review, and
practice.
QUESTIONS 1–30
Question 1
A practical nurse is caring for four clients on a medical-surgical unit. Which client
should the nurse assess first?
A. A client with heart failure who has gained 1 kg (2.2 lb) since yesterday
B. A client with pneumonia whose oxygen saturation decreased from 95% to 89% on 2
L/min oxygen
,C. A client with diabetes who has a premeal blood glucose of 68 mg/dL
D. A client 24 hours after abdominal surgery reporting incisional pain rated 7/10
Correct Answer: B.
Rationale: The acute decline in oxygenation indicates potential respiratory deterioration
and takes priority according to airway and breathing priorities. The other findings require
intervention but are not as immediately life-threatening.
Question 2
A client receiving digoxin reports nausea and blurred vision. The apical pulse is 54/min.
Which action should the practical nurse take?
A. Administer the medication with food
B. Recheck the blood pressure after administration
C. Withhold digoxin and notify the provider
D. Administer the prescribed potassium supplement and then give digoxin
Correct Answer: C.
Rationale: Bradycardia, nausea, and visual disturbances are concerning for digoxin
toxicity. The medication should be withheld and the provider notified for further
evaluation.
Question 3
A client with chronic obstructive pulmonary disease is receiving oxygen at 2 L/min by
nasal cannula. The client becomes increasingly somnolent and difficult to arouse. Which
finding requires the most immediate intervention?
A. Respiratory rate of 10/min
B. Barrel-shaped chest
C. Productive cough with thick sputum
D. Oxygen saturation of 92%
Correct Answer: A.
Rationale: A respiratory rate of 10/min with increasing somnolence suggests
hypoventilation and possible respiratory failure. The nurse must immediately assess
airway and ventilation and escalate care.
Question 4
,A practical nurse is reinforcing teaching for a client prescribed warfarin. Which
statement indicates a need for further teaching?
A. “I will report unusual bruising.”
B. “I will keep my intake of vitamin K-containing foods consistent.”
C. “I can take aspirin whenever I develop a headache.”
D. “I will have my coagulation tests performed as scheduled.”
Correct Answer: C.
Rationale: Aspirin can increase bleeding risk when combined with warfarin and should
not be taken unless specifically prescribed or approved by the provider.
Question 5
A postoperative client suddenly develops dyspnea, pleuritic chest pain, tachycardia, and
anxiety. Which complication should the practical nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Pneumonia
D. Fluid overload
Correct Answer: B.
Rationale: Sudden dyspnea, pleuritic chest pain, tachycardia, and anxiety are classic
warning findings of pulmonary embolism. This is an emergency requiring immediate
intervention.
Question 6
A client with diabetes mellitus is awake, confused, diaphoretic, and has a blood glucose
level of 52 mg/dL. Which intervention should the nurse perform first?
A. Administer regular insulin
B. Give 15 g of rapid-acting carbohydrate
C. Obtain a urine specimen for ketones
D. Encourage the client to ambulate
Correct Answer: B.
Rationale: An alert client with symptomatic hypoglycemia should receive
approximately 15 g of rapid-acting carbohydrate, followed by reassessment of glucose
according to
protocol.
, Question 7
A client with a traumatic head injury has a Glasgow Coma Scale score that decreases
from 14 to 10. Which action is the priority?
A. Reorient the client
B. Offer oral fluids
C. Notify the provider or activate emergency response according to facility protocol
D. Place the client in a dark room
Correct Answer: C.
Rationale: A significant decline in level of consciousness can indicate increasing
intracranial pressure or neurological deterioration and requires immediate escalation.
Question 8
A practical nurse is caring for a client with suspected Clostridioides difficile infection.
Which infection-control measure is most appropriate?
A. Use alcohol-based hand sanitizer after removing gloves
B. Place the client on airborne precautions
C. Wash hands with soap and water after contact with the client
D. Assign the client to a positive-pressure room
Correct Answer: C.
Rationale: C. difficile spores are not reliably removed by alcohol-based hand
sanitizer. Soap-and-water hand hygiene and appropriate contact precautions are
required.
Question 9
A client receiving a blood transfusion develops chills, fever, low back pain, and
hypotension. What should the nurse do first?
A. Slow the transfusion
B. Stop the transfusion immediately
C. Administer acetaminophen
D. Flush the blood tubing with dextrose solution
Correct Answer: B.
Rationale: These findings may indicate an acute hemolytic transfusion reaction. The first
action is to stop the transfusion and maintain IV access with appropriate compatible fluid
using new tubing according to protocol.
