ATI PN COMPREHENSIVE 2026/2027 PROCTORED EXAMINATION Page 1
ATI PN COMPREHENSIVE 2026/2027 PROCTORED
Comprehensive Proctored Examination - Practical Nursing (PN) Licensure Preparation
180 Questions - 8 Test Plan Sections - Aligned with NCLEX-PN Test Plan and ATI PN Comprehensive Predictor Blueprint
EXAM BLUEPRINT OVERVIEW
This examination contains 180 questions distributed across the eight content areas of the ATI PN
Comprehensive Predictor Blueprint. Cognitive level distribution is approximately 20% recall, 50%
application, and 30% analysis. Approximately 75% of items are scenario-based, with 25% direct
knowledge. Special inclusions: 25 priority-setting questions, 25 pharmacology questions, 15
delegation questions (LPN vs. UAP scope of practice), and 5 integrated case-study clusters. Each
question provides the correct answer marked *[CORRECT]*, a Correct Answer key, and a 2-4
sentence rationale referencing ATI PN Comprehensive blueprint, NCLEX-PN standards, and
evidence-based practical nursing practice.
Section 1 Management of Care Questions: 25
Section 2 Safety & Infection Control Questions: 22
Section 3 Health Promotion & Maintenance Questions: 20
Section 4 Psychosocial Integrity Questions: 18
Section 5 Basic Care & Comfort Questions: 22
Section 6 Pharmacological & Parenteral Therapies Questions: 25
Section 7 Reduction of Risk Potential Questions: 25
Section 8 Physiological Adaptation Questions: 23
TOTAL All Sections Questions: 180
Instructions: Read each question carefully. Select the ONE best answer. Rationales are provided immediately after
each question.
180 Questions - Practical Nursing Licensure Preparation - 2026/2027 Edition
,ATI PN COMPREHENSIVE 2026/2027 PROCTORED EXAMINATION Page 2
Section 1: Management of Care
Content focus: Client rights, advocacy, legal/ethical issues, informed consent, advance directives, delegation,
prioritization, SBAR, HIPAA, mandatory reporting, ethical principles, scope of practice.
Q1: An LPN is assigned to care for four clients on a medical-surgical unit. Which client should the
LPN assess first after receiving shift report?
A. A client who is 2 days postoperative from a hip replacement and requesting pain medication.
B. A client with chronic kidney disease whose potassium level is 5.8 mEq/L and is
complaining of muscle weakness. *[CORRECT]*
C. A client with type 2 diabetes mellitus who has a fasting blood glucose of 140 mg/dL.
D. A client who was admitted with pneumonia and has an oxygen saturation of 94% on room air.
Correct Answer: B
Rationale: A potassium level of 5.8 mEq/L with muscle weakness suggests hyperkalemia, which can lead to
life-threatening cardiac dysrhythmias and represents the greatest physiological threat. The LPN must assess this
client first and notify the RN or provider immediately. Pain management, a mildly elevated glucose, and a
saturation of 94% are all important but do not pose the same immediate risk.
Q2: An LPN is preparing to administer a blood transfusion. The client has signed the consent form
but states, "I'm not sure I want this anymore." Which action by the LPN is most appropriate?
A. Proceed with the transfusion since the consent form is already signed.
B. Notify the RN and the provider immediately and do not administer the blood. *[CORRECT]*
C. Encourage the client to proceed because blood is already in the refrigerator.
D. Document the client's statement but give the transfusion as scheduled.
Correct Answer: B
Rationale: Consent is an ongoing process, and a client has the right to refuse treatment at any time, even after
signing the form. The LPN must stop, notify the RN and provider, and respect the client's autonomy per the
Patient Self-Determination Act. Proceeding would constitute battery. Documentation should occur after the
provider is notified.
Q3: Which of the following tasks can the LPN appropriately delegate to an unlicensed assistive
personnel (UAP)?
A. Teaching a client about a newly prescribed low-sodium diet.
B. Measuring intake and output for a client with heart failure. *[CORRECT]*
C. Assessing a client's surgical incision for signs of infection.
D. Evaluating the effectiveness of a newly administered pain medication.
Correct Answer: B
Rationale: Measuring intake and output is a routine, standardized task that falls within the UAP scope of practice.
Teaching, assessing, and evaluating are nursing processes that require licensure and clinical judgment, which
the UAP does not possess. The LPN retains accountability for verifying UAP competency and ensuring safe
delegation per the Nurse Practice Act and the Five Rights of Delegation.
180 Questions - Practical Nursing Licensure Preparation - 2026/2027 Edition
,ATI PN COMPREHENSIVE 2026/2027 PROCTORED EXAMINATION Page 3
Q4: A client tells the LPN, "I think my roommate has my phone." Which action by the LPN best
demonstrates client advocacy?
A. Tell the client to speak with the roommate directly to resolve the issue.
B. Investigate the situation and report concerns to the RN or charge nurse. *[CORRECT]*
C. Document the client's complaint and take no further action.
D. Search the roommate's belongings to find the missing phone.
Correct Answer: B
Rationale: Advocacy requires the LPN to investigate client concerns and escalate them appropriately while
protecting the rights of both clients. Searching the roommate's belongings violates privacy rights, and ignoring the
complaint disregards the client's needs. The LPN should communicate with the RN and follow facility policy to
resolve the issue respectfully.
Q5: An LPN discovers that a colleague made a medication error but did not report it. Which action
should the LPN take first?
A. Confront the colleague directly and demand they report the error.
B. Notify the charge nurse immediately about the unreported medication error. *[CORRECT]*
C. Document the error in the client's chart without naming the colleague.
D. Wait to see if the colleague self-reports before taking action.
Correct Answer: B
Rationale: Patient safety is the priority, and unreported medication errors risk client harm and violate facility policy
and the Nurse Practice Act. The LPN has a duty to report through the chain of command to ensure the client is
monitored and the error is documented. Waiting or only confronting the colleague does not ensure client safety or
proper incident reporting.
Q6: A client is scheduled for surgery and has an advance directive stating no blood transfusions
under any circumstances. The client's family insists the client receive blood if needed. Which
action should the LPN take?
A. Follow the family's wishes since they are next of kin.
B. Honor the advance directive and notify the surgical team. *[CORRECT]*
C. Ask the client to reconsider the directive before surgery.
D. Document the conflict but wait until surgery to decide.
Correct Answer: B
Rationale: The Patient Self-Determination Act requires healthcare providers to honor a competent adult's
advance directive. Family members cannot override a valid advance directive unless the client revokes it. The
LPN must advocate for the client's autonomy by ensuring the surgical team is aware of the directive before any
intervention.
180 Questions - Practical Nursing Licensure Preparation - 2026/2027 Edition
, ATI PN COMPREHENSIVE 2026/2027 PROCTORED EXAMINATION Page 4
Q7: Which scenario represents a violation of HIPAA regulations by the LPN?
A. Discussing a client's care with the oncoming nurse during shift report in a private area.
B. Sharing a client's diagnosis with a coworker who is not involved in the client's care.
*[CORRECT]*
C. Documenting the client's response to medication in the medical record.
D. Providing discharge instructions to the client and designated family caregiver.
Correct Answer: B
Rationale: HIPAA requires that protected health information (PHI) be shared only on a need-to-know basis with
those directly involved in the client's care. Sharing information with an uninvolved coworker violates
confidentiality. The other actions represent appropriate communication, documentation, and education within
legal and ethical boundaries.
Q8: An LPN is caring for a client who is scheduled for discharge. The client states, "I don't
understand these discharge instructions." Which action by the LPN best addresses health literacy
needs?
A. Give the client written instructions and tell them to read them at home.
B. Use teach-back method to assess understanding and clarify instructions. *[CORRECT]*
C. Ask the family to explain the instructions to the client later.
D. Document that the client refused discharge teaching.
Correct Answer: B
Rationale: The teach-back method confirms client understanding by having them restate instructions in their own
words, which is the gold standard for addressing health literacy barriers. Simply providing written materials
without verification does not ensure comprehension. Documentation of refusal is inaccurate since the client
simply expressed confusion, not refusal.
Q9: An LPN is caring for a client who is a Jehovah's Witness and refuses a prescribed blood
transfusion. The client's hemoglobin is 6.5 g/dL. Which ethical principle is being upheld by
respecting this refusal?
A. Beneficence
B. Nonmaleficence
C. Autonomy *[CORRECT]*
D. Justice
Correct Answer: C
Rationale: Autonomy respects the client's right to make decisions about their own body and treatment, even when
those decisions conflict with medical recommendations. Beneficence focuses on doing good, nonmaleficence on
avoiding harm, and justice on fairness. A competent adult has the legal and ethical right to refuse treatment
based on personal or religious beliefs.
180 Questions - Practical Nursing Licensure Preparation - 2026/2027 Edition
ATI PN COMPREHENSIVE 2026/2027 PROCTORED
Comprehensive Proctored Examination - Practical Nursing (PN) Licensure Preparation
180 Questions - 8 Test Plan Sections - Aligned with NCLEX-PN Test Plan and ATI PN Comprehensive Predictor Blueprint
EXAM BLUEPRINT OVERVIEW
This examination contains 180 questions distributed across the eight content areas of the ATI PN
Comprehensive Predictor Blueprint. Cognitive level distribution is approximately 20% recall, 50%
application, and 30% analysis. Approximately 75% of items are scenario-based, with 25% direct
knowledge. Special inclusions: 25 priority-setting questions, 25 pharmacology questions, 15
delegation questions (LPN vs. UAP scope of practice), and 5 integrated case-study clusters. Each
question provides the correct answer marked *[CORRECT]*, a Correct Answer key, and a 2-4
sentence rationale referencing ATI PN Comprehensive blueprint, NCLEX-PN standards, and
evidence-based practical nursing practice.
Section 1 Management of Care Questions: 25
Section 2 Safety & Infection Control Questions: 22
Section 3 Health Promotion & Maintenance Questions: 20
Section 4 Psychosocial Integrity Questions: 18
Section 5 Basic Care & Comfort Questions: 22
Section 6 Pharmacological & Parenteral Therapies Questions: 25
Section 7 Reduction of Risk Potential Questions: 25
Section 8 Physiological Adaptation Questions: 23
TOTAL All Sections Questions: 180
Instructions: Read each question carefully. Select the ONE best answer. Rationales are provided immediately after
each question.
180 Questions - Practical Nursing Licensure Preparation - 2026/2027 Edition
,ATI PN COMPREHENSIVE 2026/2027 PROCTORED EXAMINATION Page 2
Section 1: Management of Care
Content focus: Client rights, advocacy, legal/ethical issues, informed consent, advance directives, delegation,
prioritization, SBAR, HIPAA, mandatory reporting, ethical principles, scope of practice.
Q1: An LPN is assigned to care for four clients on a medical-surgical unit. Which client should the
LPN assess first after receiving shift report?
A. A client who is 2 days postoperative from a hip replacement and requesting pain medication.
B. A client with chronic kidney disease whose potassium level is 5.8 mEq/L and is
complaining of muscle weakness. *[CORRECT]*
C. A client with type 2 diabetes mellitus who has a fasting blood glucose of 140 mg/dL.
D. A client who was admitted with pneumonia and has an oxygen saturation of 94% on room air.
Correct Answer: B
Rationale: A potassium level of 5.8 mEq/L with muscle weakness suggests hyperkalemia, which can lead to
life-threatening cardiac dysrhythmias and represents the greatest physiological threat. The LPN must assess this
client first and notify the RN or provider immediately. Pain management, a mildly elevated glucose, and a
saturation of 94% are all important but do not pose the same immediate risk.
Q2: An LPN is preparing to administer a blood transfusion. The client has signed the consent form
but states, "I'm not sure I want this anymore." Which action by the LPN is most appropriate?
A. Proceed with the transfusion since the consent form is already signed.
B. Notify the RN and the provider immediately and do not administer the blood. *[CORRECT]*
C. Encourage the client to proceed because blood is already in the refrigerator.
D. Document the client's statement but give the transfusion as scheduled.
Correct Answer: B
Rationale: Consent is an ongoing process, and a client has the right to refuse treatment at any time, even after
signing the form. The LPN must stop, notify the RN and provider, and respect the client's autonomy per the
Patient Self-Determination Act. Proceeding would constitute battery. Documentation should occur after the
provider is notified.
Q3: Which of the following tasks can the LPN appropriately delegate to an unlicensed assistive
personnel (UAP)?
A. Teaching a client about a newly prescribed low-sodium diet.
B. Measuring intake and output for a client with heart failure. *[CORRECT]*
C. Assessing a client's surgical incision for signs of infection.
D. Evaluating the effectiveness of a newly administered pain medication.
Correct Answer: B
Rationale: Measuring intake and output is a routine, standardized task that falls within the UAP scope of practice.
Teaching, assessing, and evaluating are nursing processes that require licensure and clinical judgment, which
the UAP does not possess. The LPN retains accountability for verifying UAP competency and ensuring safe
delegation per the Nurse Practice Act and the Five Rights of Delegation.
180 Questions - Practical Nursing Licensure Preparation - 2026/2027 Edition
,ATI PN COMPREHENSIVE 2026/2027 PROCTORED EXAMINATION Page 3
Q4: A client tells the LPN, "I think my roommate has my phone." Which action by the LPN best
demonstrates client advocacy?
A. Tell the client to speak with the roommate directly to resolve the issue.
B. Investigate the situation and report concerns to the RN or charge nurse. *[CORRECT]*
C. Document the client's complaint and take no further action.
D. Search the roommate's belongings to find the missing phone.
Correct Answer: B
Rationale: Advocacy requires the LPN to investigate client concerns and escalate them appropriately while
protecting the rights of both clients. Searching the roommate's belongings violates privacy rights, and ignoring the
complaint disregards the client's needs. The LPN should communicate with the RN and follow facility policy to
resolve the issue respectfully.
Q5: An LPN discovers that a colleague made a medication error but did not report it. Which action
should the LPN take first?
A. Confront the colleague directly and demand they report the error.
B. Notify the charge nurse immediately about the unreported medication error. *[CORRECT]*
C. Document the error in the client's chart without naming the colleague.
D. Wait to see if the colleague self-reports before taking action.
Correct Answer: B
Rationale: Patient safety is the priority, and unreported medication errors risk client harm and violate facility policy
and the Nurse Practice Act. The LPN has a duty to report through the chain of command to ensure the client is
monitored and the error is documented. Waiting or only confronting the colleague does not ensure client safety or
proper incident reporting.
Q6: A client is scheduled for surgery and has an advance directive stating no blood transfusions
under any circumstances. The client's family insists the client receive blood if needed. Which
action should the LPN take?
A. Follow the family's wishes since they are next of kin.
B. Honor the advance directive and notify the surgical team. *[CORRECT]*
C. Ask the client to reconsider the directive before surgery.
D. Document the conflict but wait until surgery to decide.
Correct Answer: B
Rationale: The Patient Self-Determination Act requires healthcare providers to honor a competent adult's
advance directive. Family members cannot override a valid advance directive unless the client revokes it. The
LPN must advocate for the client's autonomy by ensuring the surgical team is aware of the directive before any
intervention.
180 Questions - Practical Nursing Licensure Preparation - 2026/2027 Edition
, ATI PN COMPREHENSIVE 2026/2027 PROCTORED EXAMINATION Page 4
Q7: Which scenario represents a violation of HIPAA regulations by the LPN?
A. Discussing a client's care with the oncoming nurse during shift report in a private area.
B. Sharing a client's diagnosis with a coworker who is not involved in the client's care.
*[CORRECT]*
C. Documenting the client's response to medication in the medical record.
D. Providing discharge instructions to the client and designated family caregiver.
Correct Answer: B
Rationale: HIPAA requires that protected health information (PHI) be shared only on a need-to-know basis with
those directly involved in the client's care. Sharing information with an uninvolved coworker violates
confidentiality. The other actions represent appropriate communication, documentation, and education within
legal and ethical boundaries.
Q8: An LPN is caring for a client who is scheduled for discharge. The client states, "I don't
understand these discharge instructions." Which action by the LPN best addresses health literacy
needs?
A. Give the client written instructions and tell them to read them at home.
B. Use teach-back method to assess understanding and clarify instructions. *[CORRECT]*
C. Ask the family to explain the instructions to the client later.
D. Document that the client refused discharge teaching.
Correct Answer: B
Rationale: The teach-back method confirms client understanding by having them restate instructions in their own
words, which is the gold standard for addressing health literacy barriers. Simply providing written materials
without verification does not ensure comprehension. Documentation of refusal is inaccurate since the client
simply expressed confusion, not refusal.
Q9: An LPN is caring for a client who is a Jehovah's Witness and refuses a prescribed blood
transfusion. The client's hemoglobin is 6.5 g/dL. Which ethical principle is being upheld by
respecting this refusal?
A. Beneficence
B. Nonmaleficence
C. Autonomy *[CORRECT]*
D. Justice
Correct Answer: C
Rationale: Autonomy respects the client's right to make decisions about their own body and treatment, even when
those decisions conflict with medical recommendations. Beneficence focuses on doing good, nonmaleficence on
avoiding harm, and justice on fairness. A competent adult has the legal and ethical right to refuse treatment
based on personal or religious beliefs.
180 Questions - Practical Nursing Licensure Preparation - 2026/2027 Edition
