Virtual ATI Predictor
Green Light Exam
2025–2026 Comprehensive NCLEX-RN Readiness Assessment
Exam-Style Review Questions with Evidence-Based Rationales
All NCLEX Client Needs Domains Covered
Safe and Effective Care Environment • Health Promotion and Maintenance
Psychosocial Integrity • Physiological Integrity
Prepared: May 2026
Correct answers are highlighted in bold cyan
,Table of Contents
Section I: Safe and Effective Care Environment: Management of Care (Questions 1–12)
Section II: Safe and Effective Care Environment: Safety and Infection Control (Questions 13–22)
Section III: Health Promotion and Maintenance (Questions 23–32)
Section IV: Psychosocial Integrity (Questions 33–42)
Section V: Physiological Integrity: Basic Care and Comfort (Questions 43–50)
Section VI: Physiological Integrity: Pharmacological and Parenteral Therapies (Questions 51–60)
Section VII: Physiological Integrity: Reduction of Risk Potential (Questions 61–70)
Section VIII: Physiological Integrity: Physiological Adaptation (Questions 71–80)
Answer Key Summary
,SECTION I: SAFE AND EFFECTIVE CARE ENVIRONMENT —
MANAGEMENT OF CARE
Question 1
A nurse on a medical-surgical unit receives shift report on four assigned clients. Which client
should the nurse assess first?
[Domain: Management of Care | Subdomain: Prioritization/Delegation | Difficulty: Moderate]
A. A client who is 1 day postoperative following a total hip replacement and reports pain
of 4 on a 0–10 scale
B. A client who has type 2 diabetes mellitus and a fasting blood glucose level of 142
mg/dL
C. A client who has heart failure and reports increasing dyspnea over the past 2
hours
D. A client who has a new colostomy and requests assistance with changing the ostomy
appliance
Rationale: The client with heart failure reporting increasing dyspnea should be assessed first
because this finding may indicate worsening fluid overload, pulmonary edema, or cardiac
decompensation—any of which can rapidly progress to a life-threatening respiratory emergency.
The ABC (Airway, Breathing, Circulation) prioritization framework directs the nurse to address
breathing difficulties before other concerns. Postoperative hip pain at a level of 4, a mildly
elevated fasting glucose, and a routine ostomy care request are all lower-acuity findings that can
be addressed after the unstable client is stabilized.
Question 2
A charge nurse is assigning tasks to an LPN and a UAP on a busy medical unit. Which task is
most appropriate for the nurse to delegate to the UAP?
[Domain: Management of Care | Subdomain: Delegation | Difficulty: Easy]
, A. Measuring and recording intake and output for a client with acute kidney injury
B. Evaluating the effectiveness of a new antiemetic medication for a postoperative client
C. Performing the initial admission assessment on a newly transferred client
D. Providing discharge teaching about home insulin administration to a client with
diabetes
Rationale: Measuring and recording intake and output is a standardized, unchanging procedure
that falls within the UAP's scope of practice. The UAP may collect and document measurable
data such as I&O, vital signs, and weights. Evaluating medication effectiveness and performing
initial assessments require the clinical judgment of a licensed nurse (RN or LPN). Providing
discharge teaching on insulin administration requires the specialized knowledge and assessment
skills of an RN and therefore cannot be delegated to a UAP. The RN retains accountability for all
delegated tasks.
Question 3
A nurse manager is reviewing the unit's fall prevention protocol. Which intervention is the most
evidence-based strategy for reducing inpatient falls?
[Domain: Management of Care | Subdomain: Quality Improvement/Patient Safety | Difficulty: Moderate]
A. Placing all clients aged 65 and older on strict bed rest
B. Completing a standardized fall risk assessment on admission and after every shift
C. Using physical restraints for clients identified as high risk for falls
D. Restricting all clients to their rooms during nighttime hours
Rationale: The most evidence-based approach to fall prevention involves systematic risk
identification using validated tools such as the Morse Fall Scale or Hendrich II Fall Risk Model,
conducted on admission and with each shift change. This allows the care team to implement
individualized, tiered interventions for clients at varying risk levels. Research consistently
demonstrates that restraint use actually increases fall risk and injury severity, and bed rest
contributes to deconditioning, delirium, and additional fall risk. Universal fall precautions
Green Light Exam
2025–2026 Comprehensive NCLEX-RN Readiness Assessment
Exam-Style Review Questions with Evidence-Based Rationales
All NCLEX Client Needs Domains Covered
Safe and Effective Care Environment • Health Promotion and Maintenance
Psychosocial Integrity • Physiological Integrity
Prepared: May 2026
Correct answers are highlighted in bold cyan
,Table of Contents
Section I: Safe and Effective Care Environment: Management of Care (Questions 1–12)
Section II: Safe and Effective Care Environment: Safety and Infection Control (Questions 13–22)
Section III: Health Promotion and Maintenance (Questions 23–32)
Section IV: Psychosocial Integrity (Questions 33–42)
Section V: Physiological Integrity: Basic Care and Comfort (Questions 43–50)
Section VI: Physiological Integrity: Pharmacological and Parenteral Therapies (Questions 51–60)
Section VII: Physiological Integrity: Reduction of Risk Potential (Questions 61–70)
Section VIII: Physiological Integrity: Physiological Adaptation (Questions 71–80)
Answer Key Summary
,SECTION I: SAFE AND EFFECTIVE CARE ENVIRONMENT —
MANAGEMENT OF CARE
Question 1
A nurse on a medical-surgical unit receives shift report on four assigned clients. Which client
should the nurse assess first?
[Domain: Management of Care | Subdomain: Prioritization/Delegation | Difficulty: Moderate]
A. A client who is 1 day postoperative following a total hip replacement and reports pain
of 4 on a 0–10 scale
B. A client who has type 2 diabetes mellitus and a fasting blood glucose level of 142
mg/dL
C. A client who has heart failure and reports increasing dyspnea over the past 2
hours
D. A client who has a new colostomy and requests assistance with changing the ostomy
appliance
Rationale: The client with heart failure reporting increasing dyspnea should be assessed first
because this finding may indicate worsening fluid overload, pulmonary edema, or cardiac
decompensation—any of which can rapidly progress to a life-threatening respiratory emergency.
The ABC (Airway, Breathing, Circulation) prioritization framework directs the nurse to address
breathing difficulties before other concerns. Postoperative hip pain at a level of 4, a mildly
elevated fasting glucose, and a routine ostomy care request are all lower-acuity findings that can
be addressed after the unstable client is stabilized.
Question 2
A charge nurse is assigning tasks to an LPN and a UAP on a busy medical unit. Which task is
most appropriate for the nurse to delegate to the UAP?
[Domain: Management of Care | Subdomain: Delegation | Difficulty: Easy]
, A. Measuring and recording intake and output for a client with acute kidney injury
B. Evaluating the effectiveness of a new antiemetic medication for a postoperative client
C. Performing the initial admission assessment on a newly transferred client
D. Providing discharge teaching about home insulin administration to a client with
diabetes
Rationale: Measuring and recording intake and output is a standardized, unchanging procedure
that falls within the UAP's scope of practice. The UAP may collect and document measurable
data such as I&O, vital signs, and weights. Evaluating medication effectiveness and performing
initial assessments require the clinical judgment of a licensed nurse (RN or LPN). Providing
discharge teaching on insulin administration requires the specialized knowledge and assessment
skills of an RN and therefore cannot be delegated to a UAP. The RN retains accountability for all
delegated tasks.
Question 3
A nurse manager is reviewing the unit's fall prevention protocol. Which intervention is the most
evidence-based strategy for reducing inpatient falls?
[Domain: Management of Care | Subdomain: Quality Improvement/Patient Safety | Difficulty: Moderate]
A. Placing all clients aged 65 and older on strict bed rest
B. Completing a standardized fall risk assessment on admission and after every shift
C. Using physical restraints for clients identified as high risk for falls
D. Restricting all clients to their rooms during nighttime hours
Rationale: The most evidence-based approach to fall prevention involves systematic risk
identification using validated tools such as the Morse Fall Scale or Hendrich II Fall Risk Model,
conducted on admission and with each shift change. This allows the care team to implement
individualized, tiered interventions for clients at varying risk levels. Research consistently
demonstrates that restraint use actually increases fall risk and injury severity, and bed rest
contributes to deconditioning, delirium, and additional fall risk. Universal fall precautions
