2025/2026 – ATI PN Comprehensive
Predictor Exit Exam with NGN: Master
Test Bank with Questions and Exam
Answers (A, B, C)
1. A PN is caring for four clients at the start of the shift. Which client should the
PN assess FIRST?
A) A client with diabetes requesting pain medication for neuropathy
B) A client with COPD who has a new cough producing green sputum
C) A client who is post-operative day 1 with new-onset confusion and blood
pressure 88/50
D) A client with a fractured tibia requesting assistance to the bathroom
Correct Answer: C
Rationale: New-onset confusion combined with hypotension suggests
possible sepsis, hemorrhage, or shock—this is an unstable, life-threatening
condition requiring immediate assessment and intervention. The ABC framework
(Airway, Breathing, Circulation) prioritizes this client. Option A is a chronic
condition with stable pain. Option B, while concerning, does not indicate
immediate instability compared to option C. Option D is a stable, routine request.
2. A charge nurse is assigning clients to staff. Which client should be assigned to
an RN rather than a PN?
A) A client with stable congestive heart failure receiving daily furosemide
B) A client requiring a blood transfusion for symptomatic anemia
C) A client with a new diagnosis of diabetes needing initial insulin instruction
D) A client with a PEG tube requiring intermittent feedings
Correct Answer: C
, Rationale: Initial client education and complex assessment of learning needs
fall within the RN scope of practice. PNs can reinforce teaching but cannot
perform initial instruction for a new diagnosis. Option B requires RN-level
monitoring for transfusion reactions. Options A and D are stable, routine tasks
appropriate for the PN. Blood transfusions require close assessment that is
typically RN responsibility.
3. A PN is delegating tasks to assistive personnel (AP). Which task is appropriate
to delegate?
A) Assessing a client's capillary refill
B) Teaching a client how to keep a cast dry
C) Assisting a client with ambulation to the bathroom
D) Evaluating a client's pain level
Correct Answer: C
Rationale: Assisting with ambulation is a standard, stable task within the AP
scope of practice. Assessment (A, D), teaching (B), and evaluation require
professional nursing judgment and cannot be delegated to AP. The PN retains
responsibility for assessment, planning, and evaluation.
4. A client is placed on airborne precautions for active tuberculosis. Which
action is required?
A) Place the client in a room with positive pressure
B) Wear a surgical mask when entering the room
C) Place the client in a negative pressure room
D) Keep the door open for ventilation
Correct Answer: C
Rationale: Tuberculosis is transmitted via airborne droplet nuclei that remain
suspended in the air. Airborne precautions require a negative pressure room (air
flows into the room, not out) and an N95 respirator for healthcare providers.
Positive pressure (A) is for protective environments. A surgical mask (B) is
,insufficient for TB. The door must remain closed (D) to maintain negative
pressure.
5. A client with dementia has an order for bilateral soft wrist restraints. Which
action by the PN is correct?
A) Secure the restraint ties to the side rails
B) Apply the restraint snugly against the skin
C) Obtain a written prescription for the restraint application
D) Observe the client every 60 minutes after application
Correct Answer: C
Rationale: Restraints require a written prescription specifying the reason,
type, and duration. Ties must never be secured to side rails (A) because they can
cause injury when rails are lowered. Restraints should allow two fingers of space
(B) to prevent circulation impairment. Clients in restraints must be observed
every 15–30 minutes (D), not hourly.
6. The nurse has received change-of-shift report and is delegating tasks to
assistive personnel (AP). Which task is appropriate to delegate?
A) Feeding a client admitted 24 hours ago with aspiration pneumonia
B) Reinforcing teaching with a client learning to use a quad cane
C) Reapplying a condom catheter for a client with urinary incontinence
D) Applying a sterile dressing to a pressure ulcer
Correct Answer: C
Rationale: APs can perform routine care for stable clients, including condom
catheter reapplication. Feeding a client with aspiration precautions (A) requires
skilled observation and monitoring. Reinforcing teaching (B) requires licensed
nursing judgment. Sterile dressings (D) require aseptic technique and assessment
skills within the PN scope.
, 7. A PN is caring for a client who is 6 hours post-operative following a total hip
arthroplasty with a patient-controlled analgesia (PCA) pump. The PN finds the
client unresponsive, respiratory rate 6/min, and oxygen saturation 82%. What is
the PN's PRIORITY action?
A) Administer naloxone per standing protocol
B) Apply oxygen at 4 L/min via nasal cannula
C) Attempt to arouse the client and encourage deep breathing
D) Notify the provider immediately
Correct Answer: A
Rationale: The client is exhibiting opioid-induced respiratory depression
(unresponsiveness, bradypnea, hypoxia). Naloxone is the opioid antagonist that
reverses respiratory depression and should be administered immediately per
standing protocol. Applying oxygen (B) is supportive but does not reverse the
opioid effect. Attempting to arouse (C) is insufficient for severe depression.
Notifying the provider (D) is necessary but not the immediate priority when a
standing order exists.
8. A PN is reinforcing teaching about advance directives. Which statement by
the client indicates understanding?
A) "Once I sign, I cannot change my advance directives."
B) "My family can override my decisions if they disagree."
C) "Advance directives only apply if I am unable to make decisions."
D) "I must have a lawyer present to create advance directives."
Correct Answer: C
Rationale: Advance directives provide guidance when the client cannot
communicate their wishes. Clients can change directives at any time as long as
they are competent (A is incorrect). Family cannot override them (B is incorrect).
A lawyer is not required (D is incorrect).
Predictor Exit Exam with NGN: Master
Test Bank with Questions and Exam
Answers (A, B, C)
1. A PN is caring for four clients at the start of the shift. Which client should the
PN assess FIRST?
A) A client with diabetes requesting pain medication for neuropathy
B) A client with COPD who has a new cough producing green sputum
C) A client who is post-operative day 1 with new-onset confusion and blood
pressure 88/50
D) A client with a fractured tibia requesting assistance to the bathroom
Correct Answer: C
Rationale: New-onset confusion combined with hypotension suggests
possible sepsis, hemorrhage, or shock—this is an unstable, life-threatening
condition requiring immediate assessment and intervention. The ABC framework
(Airway, Breathing, Circulation) prioritizes this client. Option A is a chronic
condition with stable pain. Option B, while concerning, does not indicate
immediate instability compared to option C. Option D is a stable, routine request.
2. A charge nurse is assigning clients to staff. Which client should be assigned to
an RN rather than a PN?
A) A client with stable congestive heart failure receiving daily furosemide
B) A client requiring a blood transfusion for symptomatic anemia
C) A client with a new diagnosis of diabetes needing initial insulin instruction
D) A client with a PEG tube requiring intermittent feedings
Correct Answer: C
, Rationale: Initial client education and complex assessment of learning needs
fall within the RN scope of practice. PNs can reinforce teaching but cannot
perform initial instruction for a new diagnosis. Option B requires RN-level
monitoring for transfusion reactions. Options A and D are stable, routine tasks
appropriate for the PN. Blood transfusions require close assessment that is
typically RN responsibility.
3. A PN is delegating tasks to assistive personnel (AP). Which task is appropriate
to delegate?
A) Assessing a client's capillary refill
B) Teaching a client how to keep a cast dry
C) Assisting a client with ambulation to the bathroom
D) Evaluating a client's pain level
Correct Answer: C
Rationale: Assisting with ambulation is a standard, stable task within the AP
scope of practice. Assessment (A, D), teaching (B), and evaluation require
professional nursing judgment and cannot be delegated to AP. The PN retains
responsibility for assessment, planning, and evaluation.
4. A client is placed on airborne precautions for active tuberculosis. Which
action is required?
A) Place the client in a room with positive pressure
B) Wear a surgical mask when entering the room
C) Place the client in a negative pressure room
D) Keep the door open for ventilation
Correct Answer: C
Rationale: Tuberculosis is transmitted via airborne droplet nuclei that remain
suspended in the air. Airborne precautions require a negative pressure room (air
flows into the room, not out) and an N95 respirator for healthcare providers.
Positive pressure (A) is for protective environments. A surgical mask (B) is
,insufficient for TB. The door must remain closed (D) to maintain negative
pressure.
5. A client with dementia has an order for bilateral soft wrist restraints. Which
action by the PN is correct?
A) Secure the restraint ties to the side rails
B) Apply the restraint snugly against the skin
C) Obtain a written prescription for the restraint application
D) Observe the client every 60 minutes after application
Correct Answer: C
Rationale: Restraints require a written prescription specifying the reason,
type, and duration. Ties must never be secured to side rails (A) because they can
cause injury when rails are lowered. Restraints should allow two fingers of space
(B) to prevent circulation impairment. Clients in restraints must be observed
every 15–30 minutes (D), not hourly.
6. The nurse has received change-of-shift report and is delegating tasks to
assistive personnel (AP). Which task is appropriate to delegate?
A) Feeding a client admitted 24 hours ago with aspiration pneumonia
B) Reinforcing teaching with a client learning to use a quad cane
C) Reapplying a condom catheter for a client with urinary incontinence
D) Applying a sterile dressing to a pressure ulcer
Correct Answer: C
Rationale: APs can perform routine care for stable clients, including condom
catheter reapplication. Feeding a client with aspiration precautions (A) requires
skilled observation and monitoring. Reinforcing teaching (B) requires licensed
nursing judgment. Sterile dressings (D) require aseptic technique and assessment
skills within the PN scope.
, 7. A PN is caring for a client who is 6 hours post-operative following a total hip
arthroplasty with a patient-controlled analgesia (PCA) pump. The PN finds the
client unresponsive, respiratory rate 6/min, and oxygen saturation 82%. What is
the PN's PRIORITY action?
A) Administer naloxone per standing protocol
B) Apply oxygen at 4 L/min via nasal cannula
C) Attempt to arouse the client and encourage deep breathing
D) Notify the provider immediately
Correct Answer: A
Rationale: The client is exhibiting opioid-induced respiratory depression
(unresponsiveness, bradypnea, hypoxia). Naloxone is the opioid antagonist that
reverses respiratory depression and should be administered immediately per
standing protocol. Applying oxygen (B) is supportive but does not reverse the
opioid effect. Attempting to arouse (C) is insufficient for severe depression.
Notifying the provider (D) is necessary but not the immediate priority when a
standing order exists.
8. A PN is reinforcing teaching about advance directives. Which statement by
the client indicates understanding?
A) "Once I sign, I cannot change my advance directives."
B) "My family can override my decisions if they disagree."
C) "Advance directives only apply if I am unable to make decisions."
D) "I must have a lawyer present to create advance directives."
Correct Answer: C
Rationale: Advance directives provide guidance when the client cannot
communicate their wishes. Clients can change directives at any time as long as
they are competent (A is incorrect). Family cannot override them (B is incorrect).
A lawyer is not required (D is incorrect).
