ATI COMPREHENSIVE
PREDICTOR EXAM
____________________________________________________________
150 Questions | Questions & Answers | Verified Solutions | 100% Correct | Graded A+
Assessment Technologies Institute (ATI) Proctored Assessment
NCLEX-RN Readiness Evaluation
ATI/NGN-Aligned Format
NCSBN Clinical Judgment Measurement Model (CJMM)
Based on ATI Comprehensive Predictor Test Blueprint, NCSBN NCLEX-RN Test Plan (2023-
2026), and standard nursing textbooks.
TABLE OF CONTENTS
Nursing Process & Clinical Judgment (CJMM) (Questions 1-15) 1
Adult Health - Cardiovascular Nursing (Questions 16-30)16
Adult Health - Respiratory Nursing (Questions 31-50) 31
Adult Health - Gastrointestinal Nursing (Questions 51-65) 51
Adult Health - Renal & Endocrine Nursing (Questions 66-75) 66
Adult Health - Neurological Nursing (Questions 76-85) 76
Adult Health - Musculoskeletal & Immune Disorders (Questions 86-100) 86
Hematology & Oncology Nursing (Questions 91-100) 91
Maternal-Newborn Nursing (Questions 101-115) 101
Pediatric Nursing (Questions 116-130) 116
Mental Health Nursing (Questions 131-140) 131
Fundamentals of Nursing (Questions 141-147) 141
Leadership, Management & Pharmacology (Questions 148-150) 148
, EXAM STRUCTURE & INTRODUCTION
This ATI Comprehensive Predictor Exam format for 2026/2027 reflects the standardized
competency assessment administered by Assessment Technologies Institute (ATI) to evaluate
readiness for NCLEX-RN licensure among pre-licensure nursing students. The exam measures
knowledge of fundamental nursing principles, medical-surgical care, maternal-child health,
pediatric nursing, psychiatric-mental health practice, pharmacology, leadership/management, and
scenario-based clinical decision-making using Next Generation NCLEX-aligned item types. The
standard ATI Comprehensive Predictor examination consists of approximately 150 multiple-choice
and NGN-style questions covering these critical nursing domains, designed to predict NCLEX-RN
success with high validity and identify areas for focused remediation.
Total Questions: 150 multiple-choice and Next Generation NCLEX-style questions
Question Types: Single-best-answer, SATA, Bowtie, Trend, Highlight, Matrix, Ordered Response,
and Scenario-based Clinical Judgment items
Testing Time: Approximately 3 hours (180 minutes; computer-based, proctored format)
Passing Score: Institution-specific benchmark (typically 75-85% equivalent or ATI scaled score
threshold)
NCLEX Predictiveness: 99% predictiveness at 85% score
Focus Areas: Evidence-based nursing practice, NCLEX-RN test plan alignment, NCSBN CJMM
and NGN standards
Core Domains Tested:
• Nursing Process & Clinical Judgment (NCSBN CJMM)
• Adult Health Medical-Surgical Nursing (Cardiovascular, Respiratory, GI, Renal, Endocrine,
Neurological, Musculoskeletal, Immune)
• Maternal-Newborn Nursing (Antepartum, Intrapartum, Postpartum, Newborn Care,
Complications)
• Pediatric Nursing (Growth/Development, Childhood Illnesses, Family-Centered Care,
Medication Safety)
• Mental Health Nursing (Therapeutic Communication, Psychopharmacology, Crisis
Intervention, Disorders)
• Fundamentals of Nursing (Safety, Infection Control, Basic Care, Comfort, Vital Signs, Hygiene)
• Leadership & Management (Delegation, Prioritization, Ethical/Legal Practice, Quality
Improvement)
• Pharmacology (Medication Administration, Drug Classes, Calculations, Adverse Effects,
Interactions)
• Scenario-Based Clinical Decision-Making with NGN-Aligned Critical Thinking Items
, ATI Comprehensive Predictor Exam 2026/2027
Nursing Process & Clinical Judgment
15 Questions
Question 1 [Multiple Choice]
Domain: Nursing Process & Clinical Judgment
A nurse is caring for Maria Gonzalez, a 68-year-old admitted with dehydration and a
urinary tract infection. The nurse assesses the following findings: heart rate 112 bpm,
blood pressure 98/60 mmHg (baseline 130/78 mmHg), dry mucous membranes,
decreased skin turgor, and urine output of 20 mL over the past 2 hours. Using the
NCSBN Clinical Judgment Measurement Model, which action should the nurse take
FIRST?
Document the findings and reassess in 4 hours
Administer prescribed oral fluids and reassess
Notify the provider immediately of the decreased urine output and hypotension
Elevate the head of the bed and apply oxygen
Correct Answer: Notify the provider immediately of the decreased urine output and
hypotension
Rationale: The nurse is in the Recognize Cues layer of the CJMM. Ms. Gonzalez is demonstrating
signs of hypovolemic shock: tachycardia (HR 112), significant hypotension (98/60 vs. baseline
130/78), severe dehydration (dry mucous membranes, poor skin turgor), and oliguria (20 mL/2
hr). These findings require immediate provider notification because the patient is progressing
toward acute kidney injury and hemodynamic instability. According to the NCSBN CJMM
framework, recognizing and acting on these critical cues is the foundation of clinical judgment.
The ABC framework prioritizes circulation in this scenario. AORN and Surviving Sepsis
Campaign guidelines emphasize early identification and escalation of hemodynamic compromise
(Evans et al., 2021).
--------------------------------------------------------------------------------
Question 2 [Multiple Choice]
Domain: Nursing Process & Clinical Judgment
James Wright, a 55-year-old with type 2 diabetes mellitus, is post-operative day 1
following a right total knee arthroplasty. The nurse reviews the following morning
laboratory results: glucose 286 mg/dL, hemoglobin A1C 8.9%, white blood cell count
14,200/μL, sodium 130 mEq/L, potassium 3.1 mEq/L, and creatinine 1.8 mg/dL
(baseline 0.9 mg/dL). The nurse should analyze these findings and identify which
condition as the priority concern?
Hyperglycemia requiring insulin adjustment
Hyponatremia requiring sodium replacement
Acute kidney injury requiring fluid optimization
Hypokalemia requiring potassium replacement
Correct Answer: Acute kidney injury requiring fluid optimization
Page 3
, ATI Comprehensive Predictor Exam 2026/2027
Rationale: In the Analyze Cues layer, the nurse synthesizes multiple data points. Mr. Wright's
creatinine has doubled from baseline (0.9 → 1.8 mg/dL), indicating acute kidney injury (AKI).
The hyponatremia (130 mEq/L), hypokalemia (3.1 mEq/L), and hyperglycemia (286 mg/dL) are
likely secondary to AKI and postoperative stress. The elevated WBC (14,200/μL) may reflect
surgical inflammation or early infection. Using Maslow's hierarchy, physiologic needs take
priority. AKI is the most life-threatening finding because it affects fluid/electrolyte balance,
medication clearance, and overall homeostasis. The KDIGO guidelines (2012) define AKI as an
increase in serum creatinine ≥ 0.3 mg/dL within 48 hours or ≥ 1.5 times baseline. Fluid
optimization is the first-line intervention per KDIGO and the American College of Surgeons
NSQIP guidelines.
--------------------------------------------------------------------------------
Question 3 [Select All That Apply (SATA)]
Domain: Nursing Process & Clinical Judgment
Patricia Chen, a 72-year-old, is admitted to the medical-surgical unit with a diagnosis
of community-acquired pneumonia. She has a history of heart failure, COPD, and
atrial fibrillation. Her current vital signs are: temperature 101.4°F (38.6°C), heart
rate 108 bpm (irregular), respiratory rate 28 breaths/min, oxygen saturation 89% on
room air, and blood pressure 148/92 mmHg. She appears dyspneic and is using
accessory muscles to breathe. The nurse is in the Prioritize Hypotheses layer of the
CJMM. Which of the following hypotheses should the nurse identify as the HIGHEST
priority? (Select ALL that apply)
Impaired gas exchange related to alveolar consolidation and COPD
Risk for fluid overload related to heart failure and IV fluid therapy
Risk for bleeding related to anticoagulation therapy for atrial fibrillation
Ineffective airway clearance related to increased secretions and inflammation
Acute confusion related to hypoxia and infection in an older adult
Risk for falls related to hypoxia, dyspnea, and deconditioning
Correct Answer: Impaired gas exchange related to alveolar consolidation and COPD;
Ineffective airway clearance related to increased secretions and inflammation; Risk
for fluid overload related to heart failure and IV fluid therapy
Rationale: Using the Prioritize Hypotheses layer and the ABC framework, the nurse must rank
hypotheses by immediacy of threat. (1) Impaired gas exchange is the highest priority because
SpO2 is 89% with respiratory rate of 28 and accessory muscle use—this is a life-threatening
airway/breathing issue. (2) Ineffective airway clearance is the second priority because secretions
from pneumonia will worsen gas exchange if not managed. (3) Risk for fluid overload is third
because her heart failure history combined with pneumonia treatment (IV fluids) creates a
significant risk of pulmonary edema that would further compromise oxygenation. While bleeding
risk (anticoagulation), acute confusion (a possible B in ABC), and falls are important, they do not
take immediate precedence over oxygenation and hemodynamic stability. The 2026 NCLEX-RN
test plan emphasizes clinical judgment focused on the most urgent threats to life (NCSBN, 2025).
--------------------------------------------------------------------------------
Question 4 [Multiple Choice]
Page 4
PREDICTOR EXAM
____________________________________________________________
150 Questions | Questions & Answers | Verified Solutions | 100% Correct | Graded A+
Assessment Technologies Institute (ATI) Proctored Assessment
NCLEX-RN Readiness Evaluation
ATI/NGN-Aligned Format
NCSBN Clinical Judgment Measurement Model (CJMM)
Based on ATI Comprehensive Predictor Test Blueprint, NCSBN NCLEX-RN Test Plan (2023-
2026), and standard nursing textbooks.
TABLE OF CONTENTS
Nursing Process & Clinical Judgment (CJMM) (Questions 1-15) 1
Adult Health - Cardiovascular Nursing (Questions 16-30)16
Adult Health - Respiratory Nursing (Questions 31-50) 31
Adult Health - Gastrointestinal Nursing (Questions 51-65) 51
Adult Health - Renal & Endocrine Nursing (Questions 66-75) 66
Adult Health - Neurological Nursing (Questions 76-85) 76
Adult Health - Musculoskeletal & Immune Disorders (Questions 86-100) 86
Hematology & Oncology Nursing (Questions 91-100) 91
Maternal-Newborn Nursing (Questions 101-115) 101
Pediatric Nursing (Questions 116-130) 116
Mental Health Nursing (Questions 131-140) 131
Fundamentals of Nursing (Questions 141-147) 141
Leadership, Management & Pharmacology (Questions 148-150) 148
, EXAM STRUCTURE & INTRODUCTION
This ATI Comprehensive Predictor Exam format for 2026/2027 reflects the standardized
competency assessment administered by Assessment Technologies Institute (ATI) to evaluate
readiness for NCLEX-RN licensure among pre-licensure nursing students. The exam measures
knowledge of fundamental nursing principles, medical-surgical care, maternal-child health,
pediatric nursing, psychiatric-mental health practice, pharmacology, leadership/management, and
scenario-based clinical decision-making using Next Generation NCLEX-aligned item types. The
standard ATI Comprehensive Predictor examination consists of approximately 150 multiple-choice
and NGN-style questions covering these critical nursing domains, designed to predict NCLEX-RN
success with high validity and identify areas for focused remediation.
Total Questions: 150 multiple-choice and Next Generation NCLEX-style questions
Question Types: Single-best-answer, SATA, Bowtie, Trend, Highlight, Matrix, Ordered Response,
and Scenario-based Clinical Judgment items
Testing Time: Approximately 3 hours (180 minutes; computer-based, proctored format)
Passing Score: Institution-specific benchmark (typically 75-85% equivalent or ATI scaled score
threshold)
NCLEX Predictiveness: 99% predictiveness at 85% score
Focus Areas: Evidence-based nursing practice, NCLEX-RN test plan alignment, NCSBN CJMM
and NGN standards
Core Domains Tested:
• Nursing Process & Clinical Judgment (NCSBN CJMM)
• Adult Health Medical-Surgical Nursing (Cardiovascular, Respiratory, GI, Renal, Endocrine,
Neurological, Musculoskeletal, Immune)
• Maternal-Newborn Nursing (Antepartum, Intrapartum, Postpartum, Newborn Care,
Complications)
• Pediatric Nursing (Growth/Development, Childhood Illnesses, Family-Centered Care,
Medication Safety)
• Mental Health Nursing (Therapeutic Communication, Psychopharmacology, Crisis
Intervention, Disorders)
• Fundamentals of Nursing (Safety, Infection Control, Basic Care, Comfort, Vital Signs, Hygiene)
• Leadership & Management (Delegation, Prioritization, Ethical/Legal Practice, Quality
Improvement)
• Pharmacology (Medication Administration, Drug Classes, Calculations, Adverse Effects,
Interactions)
• Scenario-Based Clinical Decision-Making with NGN-Aligned Critical Thinking Items
, ATI Comprehensive Predictor Exam 2026/2027
Nursing Process & Clinical Judgment
15 Questions
Question 1 [Multiple Choice]
Domain: Nursing Process & Clinical Judgment
A nurse is caring for Maria Gonzalez, a 68-year-old admitted with dehydration and a
urinary tract infection. The nurse assesses the following findings: heart rate 112 bpm,
blood pressure 98/60 mmHg (baseline 130/78 mmHg), dry mucous membranes,
decreased skin turgor, and urine output of 20 mL over the past 2 hours. Using the
NCSBN Clinical Judgment Measurement Model, which action should the nurse take
FIRST?
Document the findings and reassess in 4 hours
Administer prescribed oral fluids and reassess
Notify the provider immediately of the decreased urine output and hypotension
Elevate the head of the bed and apply oxygen
Correct Answer: Notify the provider immediately of the decreased urine output and
hypotension
Rationale: The nurse is in the Recognize Cues layer of the CJMM. Ms. Gonzalez is demonstrating
signs of hypovolemic shock: tachycardia (HR 112), significant hypotension (98/60 vs. baseline
130/78), severe dehydration (dry mucous membranes, poor skin turgor), and oliguria (20 mL/2
hr). These findings require immediate provider notification because the patient is progressing
toward acute kidney injury and hemodynamic instability. According to the NCSBN CJMM
framework, recognizing and acting on these critical cues is the foundation of clinical judgment.
The ABC framework prioritizes circulation in this scenario. AORN and Surviving Sepsis
Campaign guidelines emphasize early identification and escalation of hemodynamic compromise
(Evans et al., 2021).
--------------------------------------------------------------------------------
Question 2 [Multiple Choice]
Domain: Nursing Process & Clinical Judgment
James Wright, a 55-year-old with type 2 diabetes mellitus, is post-operative day 1
following a right total knee arthroplasty. The nurse reviews the following morning
laboratory results: glucose 286 mg/dL, hemoglobin A1C 8.9%, white blood cell count
14,200/μL, sodium 130 mEq/L, potassium 3.1 mEq/L, and creatinine 1.8 mg/dL
(baseline 0.9 mg/dL). The nurse should analyze these findings and identify which
condition as the priority concern?
Hyperglycemia requiring insulin adjustment
Hyponatremia requiring sodium replacement
Acute kidney injury requiring fluid optimization
Hypokalemia requiring potassium replacement
Correct Answer: Acute kidney injury requiring fluid optimization
Page 3
, ATI Comprehensive Predictor Exam 2026/2027
Rationale: In the Analyze Cues layer, the nurse synthesizes multiple data points. Mr. Wright's
creatinine has doubled from baseline (0.9 → 1.8 mg/dL), indicating acute kidney injury (AKI).
The hyponatremia (130 mEq/L), hypokalemia (3.1 mEq/L), and hyperglycemia (286 mg/dL) are
likely secondary to AKI and postoperative stress. The elevated WBC (14,200/μL) may reflect
surgical inflammation or early infection. Using Maslow's hierarchy, physiologic needs take
priority. AKI is the most life-threatening finding because it affects fluid/electrolyte balance,
medication clearance, and overall homeostasis. The KDIGO guidelines (2012) define AKI as an
increase in serum creatinine ≥ 0.3 mg/dL within 48 hours or ≥ 1.5 times baseline. Fluid
optimization is the first-line intervention per KDIGO and the American College of Surgeons
NSQIP guidelines.
--------------------------------------------------------------------------------
Question 3 [Select All That Apply (SATA)]
Domain: Nursing Process & Clinical Judgment
Patricia Chen, a 72-year-old, is admitted to the medical-surgical unit with a diagnosis
of community-acquired pneumonia. She has a history of heart failure, COPD, and
atrial fibrillation. Her current vital signs are: temperature 101.4°F (38.6°C), heart
rate 108 bpm (irregular), respiratory rate 28 breaths/min, oxygen saturation 89% on
room air, and blood pressure 148/92 mmHg. She appears dyspneic and is using
accessory muscles to breathe. The nurse is in the Prioritize Hypotheses layer of the
CJMM. Which of the following hypotheses should the nurse identify as the HIGHEST
priority? (Select ALL that apply)
Impaired gas exchange related to alveolar consolidation and COPD
Risk for fluid overload related to heart failure and IV fluid therapy
Risk for bleeding related to anticoagulation therapy for atrial fibrillation
Ineffective airway clearance related to increased secretions and inflammation
Acute confusion related to hypoxia and infection in an older adult
Risk for falls related to hypoxia, dyspnea, and deconditioning
Correct Answer: Impaired gas exchange related to alveolar consolidation and COPD;
Ineffective airway clearance related to increased secretions and inflammation; Risk
for fluid overload related to heart failure and IV fluid therapy
Rationale: Using the Prioritize Hypotheses layer and the ABC framework, the nurse must rank
hypotheses by immediacy of threat. (1) Impaired gas exchange is the highest priority because
SpO2 is 89% with respiratory rate of 28 and accessory muscle use—this is a life-threatening
airway/breathing issue. (2) Ineffective airway clearance is the second priority because secretions
from pneumonia will worsen gas exchange if not managed. (3) Risk for fluid overload is third
because her heart failure history combined with pneumonia treatment (IV fluids) creates a
significant risk of pulmonary edema that would further compromise oxygenation. While bleeding
risk (anticoagulation), acute confusion (a possible B in ABC), and falls are important, they do not
take immediate precedence over oxygenation and hemodynamic stability. The 2026 NCLEX-RN
test plan emphasizes clinical judgment focused on the most urgent threats to life (NCSBN, 2025).
--------------------------------------------------------------------------------
Question 4 [Multiple Choice]
Page 4
