ATI RN Comprehensive Predictor 2026/2027: Ultimate NGN Prep
Bundle — Verified Questions & Rationales (99% NCLEX Probability)
Achieve a 99% NCLEX pass probability with this comprehensive ATI RN Comprehensive
Predictor 2026/2027 study bundle featuring over 400 verified practice questions. It includes in-
depth rationales for Next Gen NCLEX (NGN) case studies and high-yield summaries of Med-
Surg, Pharmacology, and Delegation. Fully updated for the latest testing cycle, this guide is the
definitive tool for students aiming to meet their program's exit benchmark on the first attempt.
Part 1: Management of Care, Prioritization & Safety
A nurse receives shift report on four clients. Which client should the nurse
assess first?
A) A client with a hip fracture reporting pain of 7/10.
B) A client with a chest tube showing 150 mL of bright red drainage in
the last hour.
C) A client with diabetes who has a morning blood glucose of 180 mg/dL.
D) A client with pneumonia who is scheduled for IV antibiotics in 30 minutes.
Rationale: Excessive chest tube drainage (>70–100 mL/hr) indicates
active hemorrhage and is the highest priority.
Which task is most appropriate for the RN to delegate to an Assistive
Personnel (AP)?
A) Checking the skin of a client with a new pressure injury.
B) Applying a condom catheter to a client with urinary incontinence.
C) Feeding a client who is being evaluated for dysphagia.
D) Teaching a client how to use a walker.
Rationale: RNs cannot delegate "EAT" (Evaluation, Assessment,
Teaching). Routine, non-invasive tasks like hygiene/device
application are safe for APs.
A nurse finds a small electrical fire in a client's room. What is the correct
sequence of actions?
A) Extinguish, Rescue, Alarm, Confine.
B) Alarm, Rescue, Confine, Extinguish.
C) Rescue, Alarm, Confine, Extinguish.
D) Confine, Alarm, Rescue, Extinguish.
, Rationale: The RACE acronym dictates that moving the client to safety
is always the first priority.
Which client should be placed on Airborne Precautions?
A) A client with Pertussis.
B) A client with Varicella (Chickenpox).
C) A client with C. difficile.
D) A client with Influenza.
Rationale: Airborne is for TB, Measles, and Varicella. Pertussis and Flu
are Droplet; C. diff is Contact.
A nurse is caring for a client with a T6 spinal cord injury who has a pounding
headache and is sweating. What should the nurse do first?
A) Check the client’s bladder for distention.
B) Administer a PRN antihypertensive.
C) Elevate the head of the bed to 90 degrees.
D) Remove the client's elastic stockings.
Rationale: Autonomic Dysreflexia is a medical emergency. Elevating the
HOB is the fastest way to utilize orthostatic pressure to lower BP.
Which action by a nurse indicates a breach of client confidentiality?
A) Discussing a client's care with the physical therapist assigned to the case.
B) Sharing a client's laboratory results with their sibling over the phone
without permission.
C) Viewing the electronic record of a client on a different unit to "learn" about
a rare disease.
D) Giving a report to the oncoming nurse at the bedside.
Rationale: HIPAA prohibits sharing info with anyone, including family,
without the client's explicit consent.
A nurse is witnessing an informed consent for a surgical procedure. What is
the nurse's primary responsibility?
A) To explain the surgical risks to the client.
B) To verify the client is competent and the signature is authentic.
C) To determine if the surgery is actually necessary.
D) To provide a second opinion.
Rationale: The surgeon explains the procedure; the nurse confirms the
client was informed and voluntarily signed.
A nurse is caring for an older adult client who is confused and repeatedly tries
to get out of bed. Which is the least restrictive intervention?
, A) Applying a vest restraint.
B) Placing a bed alarm on the client's mattress.
C) Administering a sedative.
D) Tying all four side rails in the "up" position.
Rationale: Bed alarms are non-restrictive safety measures. Restraints
and chemical sedatives are last resorts.
Which laboratory value should be reported immediately for a client on a
Heparin drip?
A) aPTT of 60 seconds.
B) INR of 1.2.
C) Platelet count of 90,000/mm³.
D) Hemoglobin of 12 g/dL.
Rationale: This indicates Heparin-Induced Thrombocytopenia (HIT), a
life-threatening complication that requires stopping the Heparin.
A nurse is assessing a client after a thyroidectomy and notes a positive
Chvostek's sign. What medication should be available?
A) Potassium chloride.
B) Calcium gluconate.
C) Magnesium sulfate.
D) Sodium bicarbonate.
Rationale: Chvostek's sign indicates hypocalcemia (low calcium),
common after thyroid/parathyroid surgery.
Part 2: Pharmacology & Electrolytes
What is the priority assessment for a client receiving Magnesium Sulfate IV for
preeclampsia?
A) Blood pressure every 4 hours.
B) Deep tendon reflexes (DTRs).
C) Bowel sounds.
D) Skin turgor.
Rationale: Loss of DTRs is the first sign of Magnesium toxicity, which
can lead to respiratory arrest.
A client is prescribed Spironolactone. Which food should the nurse tell the client
to avoid?
A) White rice.
B) Bananas and salt substitutes.
, C) Applesauce.
D) Green beans.
Rationale: Spironolactone is potassium-sparing; excess potassium
intake can lead to hyperkalemia.
What is the therapeutic level for Lithium?
A) 0.1 to 0.5 mEq/L.
B) 0.6 to 1.2 mEq/L.
C) 1.5 to 2.0 mEq/L.
D) 2.5 to 3.0 mEq/L.
Rationale: Levels >1.5 are considered toxic.
Which medication is the antidote for Acetaminophen overdose?
A) Naloxone.
B) Acetylcysteine.
C) Vitamin K.
D) Flumazenil.
Rationale: Acetylcysteine protects the liver from damage caused by
toxic acetaminophen levels.
A client on Warfarin has an INR of 5.0. What should the nurse prepare to
administer?
A) Protamine sulfate.
B) Phytonadione (Vitamin K).
C) Heparin.
D) Enoxaparin.
Rationale: Vitamin K is the reversal agent for Warfarin.
Which sign is a common side effect of Digoxin toxicity?
A) Tachycardia.
B) Yellow-green halos around lights.
C) Hypertension.
D) Increased appetite.
Rationale: Visual changes and nausea/anorexia are the "classic" early
signs of toxicity.
A nurse is teaching a client about a new prescription for Alendronate. Which
instruction is vital?
A) Take with a meal.
B) Remain upright for 30 minutes after taking.
C) Take at bedtime.
Bundle — Verified Questions & Rationales (99% NCLEX Probability)
Achieve a 99% NCLEX pass probability with this comprehensive ATI RN Comprehensive
Predictor 2026/2027 study bundle featuring over 400 verified practice questions. It includes in-
depth rationales for Next Gen NCLEX (NGN) case studies and high-yield summaries of Med-
Surg, Pharmacology, and Delegation. Fully updated for the latest testing cycle, this guide is the
definitive tool for students aiming to meet their program's exit benchmark on the first attempt.
Part 1: Management of Care, Prioritization & Safety
A nurse receives shift report on four clients. Which client should the nurse
assess first?
A) A client with a hip fracture reporting pain of 7/10.
B) A client with a chest tube showing 150 mL of bright red drainage in
the last hour.
C) A client with diabetes who has a morning blood glucose of 180 mg/dL.
D) A client with pneumonia who is scheduled for IV antibiotics in 30 minutes.
Rationale: Excessive chest tube drainage (>70–100 mL/hr) indicates
active hemorrhage and is the highest priority.
Which task is most appropriate for the RN to delegate to an Assistive
Personnel (AP)?
A) Checking the skin of a client with a new pressure injury.
B) Applying a condom catheter to a client with urinary incontinence.
C) Feeding a client who is being evaluated for dysphagia.
D) Teaching a client how to use a walker.
Rationale: RNs cannot delegate "EAT" (Evaluation, Assessment,
Teaching). Routine, non-invasive tasks like hygiene/device
application are safe for APs.
A nurse finds a small electrical fire in a client's room. What is the correct
sequence of actions?
A) Extinguish, Rescue, Alarm, Confine.
B) Alarm, Rescue, Confine, Extinguish.
C) Rescue, Alarm, Confine, Extinguish.
D) Confine, Alarm, Rescue, Extinguish.
, Rationale: The RACE acronym dictates that moving the client to safety
is always the first priority.
Which client should be placed on Airborne Precautions?
A) A client with Pertussis.
B) A client with Varicella (Chickenpox).
C) A client with C. difficile.
D) A client with Influenza.
Rationale: Airborne is for TB, Measles, and Varicella. Pertussis and Flu
are Droplet; C. diff is Contact.
A nurse is caring for a client with a T6 spinal cord injury who has a pounding
headache and is sweating. What should the nurse do first?
A) Check the client’s bladder for distention.
B) Administer a PRN antihypertensive.
C) Elevate the head of the bed to 90 degrees.
D) Remove the client's elastic stockings.
Rationale: Autonomic Dysreflexia is a medical emergency. Elevating the
HOB is the fastest way to utilize orthostatic pressure to lower BP.
Which action by a nurse indicates a breach of client confidentiality?
A) Discussing a client's care with the physical therapist assigned to the case.
B) Sharing a client's laboratory results with their sibling over the phone
without permission.
C) Viewing the electronic record of a client on a different unit to "learn" about
a rare disease.
D) Giving a report to the oncoming nurse at the bedside.
Rationale: HIPAA prohibits sharing info with anyone, including family,
without the client's explicit consent.
A nurse is witnessing an informed consent for a surgical procedure. What is
the nurse's primary responsibility?
A) To explain the surgical risks to the client.
B) To verify the client is competent and the signature is authentic.
C) To determine if the surgery is actually necessary.
D) To provide a second opinion.
Rationale: The surgeon explains the procedure; the nurse confirms the
client was informed and voluntarily signed.
A nurse is caring for an older adult client who is confused and repeatedly tries
to get out of bed. Which is the least restrictive intervention?
, A) Applying a vest restraint.
B) Placing a bed alarm on the client's mattress.
C) Administering a sedative.
D) Tying all four side rails in the "up" position.
Rationale: Bed alarms are non-restrictive safety measures. Restraints
and chemical sedatives are last resorts.
Which laboratory value should be reported immediately for a client on a
Heparin drip?
A) aPTT of 60 seconds.
B) INR of 1.2.
C) Platelet count of 90,000/mm³.
D) Hemoglobin of 12 g/dL.
Rationale: This indicates Heparin-Induced Thrombocytopenia (HIT), a
life-threatening complication that requires stopping the Heparin.
A nurse is assessing a client after a thyroidectomy and notes a positive
Chvostek's sign. What medication should be available?
A) Potassium chloride.
B) Calcium gluconate.
C) Magnesium sulfate.
D) Sodium bicarbonate.
Rationale: Chvostek's sign indicates hypocalcemia (low calcium),
common after thyroid/parathyroid surgery.
Part 2: Pharmacology & Electrolytes
What is the priority assessment for a client receiving Magnesium Sulfate IV for
preeclampsia?
A) Blood pressure every 4 hours.
B) Deep tendon reflexes (DTRs).
C) Bowel sounds.
D) Skin turgor.
Rationale: Loss of DTRs is the first sign of Magnesium toxicity, which
can lead to respiratory arrest.
A client is prescribed Spironolactone. Which food should the nurse tell the client
to avoid?
A) White rice.
B) Bananas and salt substitutes.
, C) Applesauce.
D) Green beans.
Rationale: Spironolactone is potassium-sparing; excess potassium
intake can lead to hyperkalemia.
What is the therapeutic level for Lithium?
A) 0.1 to 0.5 mEq/L.
B) 0.6 to 1.2 mEq/L.
C) 1.5 to 2.0 mEq/L.
D) 2.5 to 3.0 mEq/L.
Rationale: Levels >1.5 are considered toxic.
Which medication is the antidote for Acetaminophen overdose?
A) Naloxone.
B) Acetylcysteine.
C) Vitamin K.
D) Flumazenil.
Rationale: Acetylcysteine protects the liver from damage caused by
toxic acetaminophen levels.
A client on Warfarin has an INR of 5.0. What should the nurse prepare to
administer?
A) Protamine sulfate.
B) Phytonadione (Vitamin K).
C) Heparin.
D) Enoxaparin.
Rationale: Vitamin K is the reversal agent for Warfarin.
Which sign is a common side effect of Digoxin toxicity?
A) Tachycardia.
B) Yellow-green halos around lights.
C) Hypertension.
D) Increased appetite.
Rationale: Visual changes and nausea/anorexia are the "classic" early
signs of toxicity.
A nurse is teaching a client about a new prescription for Alendronate. Which
instruction is vital?
A) Take with a meal.
B) Remain upright for 30 minutes after taking.
C) Take at bedtime.
