ATI RN Comprehensive Predictor Exit Exam Practice
Test 2026 | 180+ Q&A | Verified Answers | A+ Study Guide
This comprehensive practice exam is designed to simulate the ATI RN Comprehensive
Predictor Exit Exam, a 180-item proctored test used to assess nursing students' readiness
for the NCLEX-RN. The questions cover all major content areas tested on the predictor
exam, including safe and effective care environment, health promotion and maintenance,
psychosocial integrity, and physiological integrity. Each question includes the correct
answer (highlighted in bold) and a detailed rationale to reinforce learning and clinical
reasoning.
Section 1: Management of Care (Delegation, Prioritization, Ethics, Legal Issues)
Question 1
A charge nurse is assigning client care on a medical-surgical unit. Which client should be
assigned to a newly licensed registered nurse (RN)?
A. A client with a chest tube and continuous bubbling in the water seal chamber
B. A client with new-onset atrial fibrillation receiving a heparin drip
C. A client with stable pneumonia receiving oral antibiotics
D. A client with a tracheostomy requiring suctioning every 2 hours
Correct Answer: C
Rationale: Newly licensed RNs should be assigned stable clients with predictable
outcomes. A client with stable pneumonia receiving oral antibiotics is appropriate for a
novice nurse. Clients requiring chest tube management, IV heparin, or tracheostomy
suctioning need more experienced nursing judgment and should be assigned to
experienced RNs.
Question 2
A nurse is delegating tasks to assistive personnel (AP). Which of the following tasks is
appropriate for the nurse to delegate?
A. Assessing a client's pain level
B. Obtaining vital signs on a stable postoperative client
C. Evaluating the effectiveness of a client's breathing treatment
D. Teaching a client how to use an incentive spirometer
Correct Answer: B
Rationale: Obtaining vital signs on a stable client is within the scope of AP. Assessment,
evaluation, and teaching are nursing responsibilities that cannot be delegated.
,Question 3
A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
client's family requests that the transfusion be given anyway. What action should the
nurse take?
A. Administer the transfusion as the family requests
B. Respect the client's refusal and notify the provider
C. Ask the facility ethics committee to override the client's decision
D. Document the family's request and proceed with the transfusion
Correct Answer: B
Rationale: A competent adult client has the right to refuse treatment, including life-
saving interventions, based on religious or personal beliefs. The nurse must respect
client autonomy and notify the provider.
Question 4
A charge nurse is making client assignments for a shift. Which client should be assigned
to a practical nurse (PN)?
A. A client with unstable angina requiring telemetry monitoring
B. A client with diabetes mellitus requiring initial teaching on insulin administration
C. A client with a urinary tract infection receiving oral antibiotics
D. A client with stroke who is receiving tissue plasminogen activator (tPA)
Correct Answer: C
Rationale: PNs can care for stable clients with predictable outcomes, such as a client
with a UTI receiving oral antibiotics. Unstable clients, those requiring complex
medication administration (tPA), or those needing initial teaching should be assigned to
RNs.
Question 5
A nurse is preparing to discharge a client who does not speak the same language as the
nurse. Which action should the nurse take to obtain informed consent for a procedure?
A. Ask the client's family member to translate
B. Use a professional medical interpreter
C. Provide written instructions in English only
D. Have the client sign the consent form without explanation
Correct Answer: B
Rationale: Professional medical interpreters should be used to ensure accurate
communication and informed consent. Family members may lack medical vocabulary or
have conflicts of interest.
Question 6
A nurse on a medical-surgical unit is caring for a client who is being discharged against
medical advice (AMA). Which action should the nurse take first?
,A. Notify the provider of the client's decision
B. Ask the client to sign the AMA form
C. Discuss the risks of leaving with the client
D. Contact security to detain the client
Correct Answer: C
Rationale: The nurse should first discuss the risks and consequences of leaving AMA to
ensure the client is making an informed decision. The provider should be notified, and
the AMA form signed, but these occur after the discussion.
Question 7
A charge nurse is observing a staff member who is preparing to insert a urinary catheter.
Which action by the staff member requires intervention?
A. Opening the sterile kit with the flap away from the body
B. Using sterile gloves and a sterile field
C. Touching the sterile field after applying sterile gloves
D. Placing the sterile drape on the bed beside the client
Correct Answer: C
Rationale: Once sterile gloves are applied, touching the sterile field or any non-sterile
item contaminates the gloves. The staff member should not touch the sterile field after
applying sterile gloves unless the gloves were applied using a closed method.
Question 8
A nurse is completing an incident report after a client falls. Which statement should the
nurse include in the incident report?
A. "The client was confused and tried to get up alone."
B. "The call light was not answered for 15 minutes."
C. "The client fell when attempting to ambulate to the bathroom."
D. "The nursing assistant was negligent in supervising the client."
Correct Answer: C
Rationale: Incident reports should contain objective, factual information about what
occurred. Judgmental statements (A, D) and blame (B) should be avoided. The incident
report is not part of the medical record.
Question 9
A nurse is planning care for a client who has a living will. The client's family requests that
the client receive cardiopulmonary resuscitation (CPR) if the client's heart stops. What
should the nurse do?
A. Follow the family's request
B. Follow the living will
C. Ask the ethics committee to decide
D. Contact the facility legal department
, Correct Answer: B
Rationale: A living will is a legal document that expresses the client's wishes regarding
end-of-life care. The nurse must honor the client's advance directive. The family's wishes
do not override the client's documented preferences.
Question 10
A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client with diabetes mellitus who has a blood glucose of 150 mg/dL
B. A client with pneumonia who has an oxygen saturation of 89% on room air
C. A client with hypertension who has a blood pressure of 150/90 mm Hg
D. A client with heart failure who has 1+ pitting edema in the lower extremities
Correct Answer: B
Rationale: An oxygen saturation of 89% indicates hypoxemia and requires immediate
intervention. This client is at risk for respiratory failure. The other findings are abnormal
but not immediately life-threatening.
Question 11
A nurse is preparing to give change-of-shift report. Which communication tool should
the nurse use to ensure comprehensive handoff?
A. SOAP (Subjective, Objective, Assessment, Plan)
B. SBAR (Situation, Background, Assessment, Recommendation)
C. PIE (Problem, Intervention, Evaluation)
D. DAR (Data, Action, Response)
Correct Answer: B
Rationale: SBAR is a standardized communication tool that ensures comprehensive,
clear, and concise handoff between healthcare providers. It reduces errors and improves
patient safety.
Question 12
A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's
family is upset and demands that the client receive CPR if needed. What should the
nurse do?
A. Call a code blue if the client arrests
B. Explain the DNR order and notify the provider
C. Remove the DNR order from the chart
D. Ask the family to leave the facility
Correct Answer: B
Rationale: The nurse should explain the DNR order to the family and notify the provider,
who can discuss the order further with the family. The DNR order remains in effect
unless rescinded by the provider per client/family request.
Test 2026 | 180+ Q&A | Verified Answers | A+ Study Guide
This comprehensive practice exam is designed to simulate the ATI RN Comprehensive
Predictor Exit Exam, a 180-item proctored test used to assess nursing students' readiness
for the NCLEX-RN. The questions cover all major content areas tested on the predictor
exam, including safe and effective care environment, health promotion and maintenance,
psychosocial integrity, and physiological integrity. Each question includes the correct
answer (highlighted in bold) and a detailed rationale to reinforce learning and clinical
reasoning.
Section 1: Management of Care (Delegation, Prioritization, Ethics, Legal Issues)
Question 1
A charge nurse is assigning client care on a medical-surgical unit. Which client should be
assigned to a newly licensed registered nurse (RN)?
A. A client with a chest tube and continuous bubbling in the water seal chamber
B. A client with new-onset atrial fibrillation receiving a heparin drip
C. A client with stable pneumonia receiving oral antibiotics
D. A client with a tracheostomy requiring suctioning every 2 hours
Correct Answer: C
Rationale: Newly licensed RNs should be assigned stable clients with predictable
outcomes. A client with stable pneumonia receiving oral antibiotics is appropriate for a
novice nurse. Clients requiring chest tube management, IV heparin, or tracheostomy
suctioning need more experienced nursing judgment and should be assigned to
experienced RNs.
Question 2
A nurse is delegating tasks to assistive personnel (AP). Which of the following tasks is
appropriate for the nurse to delegate?
A. Assessing a client's pain level
B. Obtaining vital signs on a stable postoperative client
C. Evaluating the effectiveness of a client's breathing treatment
D. Teaching a client how to use an incentive spirometer
Correct Answer: B
Rationale: Obtaining vital signs on a stable client is within the scope of AP. Assessment,
evaluation, and teaching are nursing responsibilities that cannot be delegated.
,Question 3
A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
client's family requests that the transfusion be given anyway. What action should the
nurse take?
A. Administer the transfusion as the family requests
B. Respect the client's refusal and notify the provider
C. Ask the facility ethics committee to override the client's decision
D. Document the family's request and proceed with the transfusion
Correct Answer: B
Rationale: A competent adult client has the right to refuse treatment, including life-
saving interventions, based on religious or personal beliefs. The nurse must respect
client autonomy and notify the provider.
Question 4
A charge nurse is making client assignments for a shift. Which client should be assigned
to a practical nurse (PN)?
A. A client with unstable angina requiring telemetry monitoring
B. A client with diabetes mellitus requiring initial teaching on insulin administration
C. A client with a urinary tract infection receiving oral antibiotics
D. A client with stroke who is receiving tissue plasminogen activator (tPA)
Correct Answer: C
Rationale: PNs can care for stable clients with predictable outcomes, such as a client
with a UTI receiving oral antibiotics. Unstable clients, those requiring complex
medication administration (tPA), or those needing initial teaching should be assigned to
RNs.
Question 5
A nurse is preparing to discharge a client who does not speak the same language as the
nurse. Which action should the nurse take to obtain informed consent for a procedure?
A. Ask the client's family member to translate
B. Use a professional medical interpreter
C. Provide written instructions in English only
D. Have the client sign the consent form without explanation
Correct Answer: B
Rationale: Professional medical interpreters should be used to ensure accurate
communication and informed consent. Family members may lack medical vocabulary or
have conflicts of interest.
Question 6
A nurse on a medical-surgical unit is caring for a client who is being discharged against
medical advice (AMA). Which action should the nurse take first?
,A. Notify the provider of the client's decision
B. Ask the client to sign the AMA form
C. Discuss the risks of leaving with the client
D. Contact security to detain the client
Correct Answer: C
Rationale: The nurse should first discuss the risks and consequences of leaving AMA to
ensure the client is making an informed decision. The provider should be notified, and
the AMA form signed, but these occur after the discussion.
Question 7
A charge nurse is observing a staff member who is preparing to insert a urinary catheter.
Which action by the staff member requires intervention?
A. Opening the sterile kit with the flap away from the body
B. Using sterile gloves and a sterile field
C. Touching the sterile field after applying sterile gloves
D. Placing the sterile drape on the bed beside the client
Correct Answer: C
Rationale: Once sterile gloves are applied, touching the sterile field or any non-sterile
item contaminates the gloves. The staff member should not touch the sterile field after
applying sterile gloves unless the gloves were applied using a closed method.
Question 8
A nurse is completing an incident report after a client falls. Which statement should the
nurse include in the incident report?
A. "The client was confused and tried to get up alone."
B. "The call light was not answered for 15 minutes."
C. "The client fell when attempting to ambulate to the bathroom."
D. "The nursing assistant was negligent in supervising the client."
Correct Answer: C
Rationale: Incident reports should contain objective, factual information about what
occurred. Judgmental statements (A, D) and blame (B) should be avoided. The incident
report is not part of the medical record.
Question 9
A nurse is planning care for a client who has a living will. The client's family requests that
the client receive cardiopulmonary resuscitation (CPR) if the client's heart stops. What
should the nurse do?
A. Follow the family's request
B. Follow the living will
C. Ask the ethics committee to decide
D. Contact the facility legal department
, Correct Answer: B
Rationale: A living will is a legal document that expresses the client's wishes regarding
end-of-life care. The nurse must honor the client's advance directive. The family's wishes
do not override the client's documented preferences.
Question 10
A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client with diabetes mellitus who has a blood glucose of 150 mg/dL
B. A client with pneumonia who has an oxygen saturation of 89% on room air
C. A client with hypertension who has a blood pressure of 150/90 mm Hg
D. A client with heart failure who has 1+ pitting edema in the lower extremities
Correct Answer: B
Rationale: An oxygen saturation of 89% indicates hypoxemia and requires immediate
intervention. This client is at risk for respiratory failure. The other findings are abnormal
but not immediately life-threatening.
Question 11
A nurse is preparing to give change-of-shift report. Which communication tool should
the nurse use to ensure comprehensive handoff?
A. SOAP (Subjective, Objective, Assessment, Plan)
B. SBAR (Situation, Background, Assessment, Recommendation)
C. PIE (Problem, Intervention, Evaluation)
D. DAR (Data, Action, Response)
Correct Answer: B
Rationale: SBAR is a standardized communication tool that ensures comprehensive,
clear, and concise handoff between healthcare providers. It reduces errors and improves
patient safety.
Question 12
A nurse is caring for a client who has a do-not-resuscitate (DNR) order. The client's
family is upset and demands that the client receive CPR if needed. What should the
nurse do?
A. Call a code blue if the client arrests
B. Explain the DNR order and notify the provider
C. Remove the DNR order from the chart
D. Ask the family to leave the facility
Correct Answer: B
Rationale: The nurse should explain the DNR order to the family and notify the provider,
who can discuss the order further with the family. The DNR order remains in effect
unless rescinded by the provider per client/family request.
