"ATI Predictor & NCLEX Practice Exam Bundle: High-Yield
Pharmacology, Leadership, Med-Surg, Peds/OB, Psych +
Answer Key"
1.Management of Care (leadership, delegation, prioritization,
ethical/legal issues, disaster response, continuity of care)
2. Safety & Infection Control (standard vs. transmission
precautions, PPE sequence, device care, restraints, fall
prevention, fire safety, central lines, sterile technique)
3. Pharmacology (autonomic, cardiac, antibiotics, insulin,
anticoagulants, antidotes, psych meds)
4. Medical-Surgical Nursing I (cardiac + respiratory).
5. Medical-Surgical Nursing II (renal, neuro, endocrine).
6. Pediatric & Obstetric Nursing.
7. Psychiatric Nursing (therapeutic communication, crisis
intervention, depression, schizophrenia, bipolar, anxiety,
substance use, suicide precautions, psychopharmacology)
8. light review + practice set for the final prep day before the
ATI Predictor exam
,1) Leadership / Delegation — Item 1 (MCQ, single best
answer)
A 68-year-old male on a medical-surgical unit (post-op day 1
following total hip replacement) reports increasing shortness of
breath. Setting: med-surg unit. Vitals: BP 128/76 mmHg, HR 110
bpm, RR 28/min, SpO₂ 88% on room air. Current meds: patient-
controlled analgesia (PCA) with morphine; using incentive
spirometer. Chief concern: acute dyspnea.
Which action should the RN prioritize immediately?
Options:
A. Call the rapid response team (RRT).
B. Increase oxygen to 2 L via nasal cannula and reassess SpO₂.
C. Administer IV morphine bolus per PCA settings to reduce
pain and improve ventilation.
D. Obtain a portable chest x-ray order from the provider.
Metadata:
Topic/subtopic: Delegation/Initial prioritization of acute
deterioration
NCLEX Client Needs Category & Subcategory: Management of
Care — Assignment/Delegation
Cognitive level (Bloom): Application
Difficulty (1–5): 3 (medium)
Learning objective: Demonstrate immediate nursing actions for
an acutely hypoxemic postoperative patient.
,Correct answer: B
Rationale (≈55 words):
The patient is hypoxemic (SpO₂ 88%, RR 28), so immediate
provision of oxygen is the fastest, most time-sensitive
intervention to improve oxygenation and prevent further
deterioration. This is within RN scope and must occur before
calling RRT unless the patient is in arrest. Reassessment after
oxygen will guide further escalation.
Incorrect option explanations (10–20 words each):
A. Calling RRT delays immediate oxygen delivery; indicated if
patient doesn’t respond to interventions.
C. Administering IV morphine may worsen respiratory
depression and hypoxia — unsafe now.
D. Obtaining chest x-ray will delay urgent oxygen therapy;
imaging is not first action.
Test-taking tip: Prioritize the fastest intervention that directly
addresses life-threatening findings (e.g., hypoxemia) before
diagnostics or non-urgent treatments.
2) Leadership / Delegation — Item 2 (SATA; 2 correct)
A 54-year-old female with type 2 diabetes is ready for discharge
from a medical-surgical unit. The RN is delegating discharge
tasks to the care team. Which tasks are appropriate to assign to
UAP (unlicensed assistive personnel)? (Select all that apply.) (2
correct)
, Options (4):
A. Reinforce teaching about insulin injection technique.
B. Assist the patient to collect personal belongings and escort to
the unit exit.
C. Measure and record the patient's blood glucose immediately
prior to discharge.
D. Provide written discharge paperwork and explain scheduled
follow-up appointments.
Metadata:
Topic/subtopic: Delegation — UAP tasks at discharge
NCLEX Client Needs Category & Subcategory: Management of
Care — Assignment/Delegation
Cognitive level (Bloom): Application
Difficulty (1–5): 3 (medium)
Learning objective: Identify tasks appropriate for UAP
delegation during discharge.
Correct answers: B, C
Rationale (≈55 words):
UAP may perform non-delegable, routine tasks such as assisting
with personal belongings and measuring/recording blood
glucose (if trained and facility policy allows). They cannot
perform teaching (A) or explain discharge
instructions/appointments (D) because those are nursing
responsibilities requiring professional judgment and assessment
of patient understanding.
Pharmacology, Leadership, Med-Surg, Peds/OB, Psych +
Answer Key"
1.Management of Care (leadership, delegation, prioritization,
ethical/legal issues, disaster response, continuity of care)
2. Safety & Infection Control (standard vs. transmission
precautions, PPE sequence, device care, restraints, fall
prevention, fire safety, central lines, sterile technique)
3. Pharmacology (autonomic, cardiac, antibiotics, insulin,
anticoagulants, antidotes, psych meds)
4. Medical-Surgical Nursing I (cardiac + respiratory).
5. Medical-Surgical Nursing II (renal, neuro, endocrine).
6. Pediatric & Obstetric Nursing.
7. Psychiatric Nursing (therapeutic communication, crisis
intervention, depression, schizophrenia, bipolar, anxiety,
substance use, suicide precautions, psychopharmacology)
8. light review + practice set for the final prep day before the
ATI Predictor exam
,1) Leadership / Delegation — Item 1 (MCQ, single best
answer)
A 68-year-old male on a medical-surgical unit (post-op day 1
following total hip replacement) reports increasing shortness of
breath. Setting: med-surg unit. Vitals: BP 128/76 mmHg, HR 110
bpm, RR 28/min, SpO₂ 88% on room air. Current meds: patient-
controlled analgesia (PCA) with morphine; using incentive
spirometer. Chief concern: acute dyspnea.
Which action should the RN prioritize immediately?
Options:
A. Call the rapid response team (RRT).
B. Increase oxygen to 2 L via nasal cannula and reassess SpO₂.
C. Administer IV morphine bolus per PCA settings to reduce
pain and improve ventilation.
D. Obtain a portable chest x-ray order from the provider.
Metadata:
Topic/subtopic: Delegation/Initial prioritization of acute
deterioration
NCLEX Client Needs Category & Subcategory: Management of
Care — Assignment/Delegation
Cognitive level (Bloom): Application
Difficulty (1–5): 3 (medium)
Learning objective: Demonstrate immediate nursing actions for
an acutely hypoxemic postoperative patient.
,Correct answer: B
Rationale (≈55 words):
The patient is hypoxemic (SpO₂ 88%, RR 28), so immediate
provision of oxygen is the fastest, most time-sensitive
intervention to improve oxygenation and prevent further
deterioration. This is within RN scope and must occur before
calling RRT unless the patient is in arrest. Reassessment after
oxygen will guide further escalation.
Incorrect option explanations (10–20 words each):
A. Calling RRT delays immediate oxygen delivery; indicated if
patient doesn’t respond to interventions.
C. Administering IV morphine may worsen respiratory
depression and hypoxia — unsafe now.
D. Obtaining chest x-ray will delay urgent oxygen therapy;
imaging is not first action.
Test-taking tip: Prioritize the fastest intervention that directly
addresses life-threatening findings (e.g., hypoxemia) before
diagnostics or non-urgent treatments.
2) Leadership / Delegation — Item 2 (SATA; 2 correct)
A 54-year-old female with type 2 diabetes is ready for discharge
from a medical-surgical unit. The RN is delegating discharge
tasks to the care team. Which tasks are appropriate to assign to
UAP (unlicensed assistive personnel)? (Select all that apply.) (2
correct)
, Options (4):
A. Reinforce teaching about insulin injection technique.
B. Assist the patient to collect personal belongings and escort to
the unit exit.
C. Measure and record the patient's blood glucose immediately
prior to discharge.
D. Provide written discharge paperwork and explain scheduled
follow-up appointments.
Metadata:
Topic/subtopic: Delegation — UAP tasks at discharge
NCLEX Client Needs Category & Subcategory: Management of
Care — Assignment/Delegation
Cognitive level (Bloom): Application
Difficulty (1–5): 3 (medium)
Learning objective: Identify tasks appropriate for UAP
delegation during discharge.
Correct answers: B, C
Rationale (≈55 words):
UAP may perform non-delegable, routine tasks such as assisting
with personal belongings and measuring/recording blood
glucose (if trained and facility policy allows). They cannot
perform teaching (A) or explain discharge
instructions/appointments (D) because those are nursing
responsibilities requiring professional judgment and assessment
of patient understanding.
