ATI RN Comprehensive Predictor:
Final Exam Prep 2026|||Questions And
Answers With Rationales/Graded
A+/2026 Update/100% Correct
/Instant Download
Total Questions: 85
Format: Multiple choice, select all that apply, ordered response, and NGN case
study
Instructions: Choose the best answer. Correct answers are bolded. Rationales are
provided.
Section 1: Prioritization & Delegation (Items 1–15)
1. A nurse receives report on 4 clients. Which client should be assessed first?
a) Client with COPD and O2 saturation of 91% on 2L nasal cannula
b) Client post-hip replacement reporting pain of 4/10
c) Client with new-onset confusion and HR 110 bpm
d) Client with chest tube and sudden absence of tidaling in water seal
chamber
Rationale: Sudden absence of tidaling indicates possible obstruction or
displacement. Airway/breathing/circulation (ABC) priority.
2. A charge nurse is assigning staff. Which task can be delegated to an LPN?
a) Initial admission assessment
b) Teaching a newly diagnosed diabetic about insulin injections
c) Administering a tube feeding to a stable client
d) Evaluating a client’s response to pain medication
Rationale: LPNs can administer meds/tube feedings to stable clients. Assessment,
teaching, and evaluation are RN responsibilities.
,3–5. Select all that apply: Which clients should be assigned to an RN rather than
an LPN?
☑ Client 1 hour post-cardiac catheterization with groin bleed
☑ Client requiring blood transfusion initiation
☐ Client with chronic UTI on oral antibiotics
☑ Client with chest pain and troponin ordered
☐ Client requesting discharge teaching for home oxygen
Rationale: Unstable, invasive procedures, blood products, and acute cardiac
symptoms require RN.
6. A nurse on a med-surg unit is overwhelmed. Which action demonstrates
appropriate delegation?
a) Ask the UAP to check a post-op client’s lung sounds
b) Request the LPN to assess a client with sudden dyspnea
c) Have the UAP perform a bedside blood glucose on a stable diabetic
d) Delegate IV push morphine to the LPN
Rationale: UAP can perform fingersticks if trained. Assessment and IV push meds
cannot be delegated.
7. Four clients call the nurse at the same time. Which should the nurse address
first?
a) Client with new colostomy asking for bag change
b) Client post-thyroidectomy reporting tingling around the mouth
c) Client asking for PRN acetaminophen for headache
d) Client requesting help to the bathroom
Rationale: Tingling post-thyroidectomy suggests hypocalcemia (possible
laryngospasm). ABC + potential emergency.
8. A nurse is delegating ambulation of a client with right-sided weakness. To whom
can this be delegated?
a) LPN only
b) UAP after demonstrating proper use of gait belt
c) Another RN
d) No one—nurse must perform alone
Rationale: UAP can ambulate stable clients after training and supervision.
9. Which statement by a new nurse indicates correct understanding of delegation?
a) “I can delegate assessment to UAP if they are experienced.”
, b) “I am accountable for the client even after delegation.”
c) “LPNs cannot administer any medications.”
d) “Delegation means I no longer need to supervise.”
Rationale: RN retains accountability for delegation and outcomes.
10–12. Ordered Response: Prioritize clients for morning rounds (1=first to see).
1. Client with chest pain, diaphoresis, BP 80/50
2. Client post-op day 1 with O2 sat 89% on room air
3. Client with dementia pulling at IV line
4. Client requesting pain med for chronic back pain
Rationale: Hemodynamic instability → hypoxia → safety issue → chronic
stable issue.
13. Which client is appropriate to assign to a float RN from a postpartum unit?
a) Client on a ventilator with sedation
b) Client with acute stroke and dysphagia
c) Client with mastitis requiring IV antibiotic
d) Client post-cardiac arrest
Rationale: Mastitis is a complication of lactation; float RN is competent. Others
are high-acuity.
14. A UAP reports a client’s BP as 180/100. What should the RN do first?
a) Document the finding
b) Ask UAP to recheck in 15 minutes
c) Assess the client and review medications
d) Call the provider immediately
Rationale: RN must verify and assess before notifying provider.
15. A nurse manager is evaluating delegation. Which action requires intervention?
a) RN asks LPN to insert a Foley catheter
b) RN asks UAP to evaluate a pressure injury
c) RN asks UAP to measure I&O
d) RN asks LPN to administer nebulizer
Rationale: Evaluation/assessment is RN-only.
Section 2: Pharmacology (Items 16–30)
Final Exam Prep 2026|||Questions And
Answers With Rationales/Graded
A+/2026 Update/100% Correct
/Instant Download
Total Questions: 85
Format: Multiple choice, select all that apply, ordered response, and NGN case
study
Instructions: Choose the best answer. Correct answers are bolded. Rationales are
provided.
Section 1: Prioritization & Delegation (Items 1–15)
1. A nurse receives report on 4 clients. Which client should be assessed first?
a) Client with COPD and O2 saturation of 91% on 2L nasal cannula
b) Client post-hip replacement reporting pain of 4/10
c) Client with new-onset confusion and HR 110 bpm
d) Client with chest tube and sudden absence of tidaling in water seal
chamber
Rationale: Sudden absence of tidaling indicates possible obstruction or
displacement. Airway/breathing/circulation (ABC) priority.
2. A charge nurse is assigning staff. Which task can be delegated to an LPN?
a) Initial admission assessment
b) Teaching a newly diagnosed diabetic about insulin injections
c) Administering a tube feeding to a stable client
d) Evaluating a client’s response to pain medication
Rationale: LPNs can administer meds/tube feedings to stable clients. Assessment,
teaching, and evaluation are RN responsibilities.
,3–5. Select all that apply: Which clients should be assigned to an RN rather than
an LPN?
☑ Client 1 hour post-cardiac catheterization with groin bleed
☑ Client requiring blood transfusion initiation
☐ Client with chronic UTI on oral antibiotics
☑ Client with chest pain and troponin ordered
☐ Client requesting discharge teaching for home oxygen
Rationale: Unstable, invasive procedures, blood products, and acute cardiac
symptoms require RN.
6. A nurse on a med-surg unit is overwhelmed. Which action demonstrates
appropriate delegation?
a) Ask the UAP to check a post-op client’s lung sounds
b) Request the LPN to assess a client with sudden dyspnea
c) Have the UAP perform a bedside blood glucose on a stable diabetic
d) Delegate IV push morphine to the LPN
Rationale: UAP can perform fingersticks if trained. Assessment and IV push meds
cannot be delegated.
7. Four clients call the nurse at the same time. Which should the nurse address
first?
a) Client with new colostomy asking for bag change
b) Client post-thyroidectomy reporting tingling around the mouth
c) Client asking for PRN acetaminophen for headache
d) Client requesting help to the bathroom
Rationale: Tingling post-thyroidectomy suggests hypocalcemia (possible
laryngospasm). ABC + potential emergency.
8. A nurse is delegating ambulation of a client with right-sided weakness. To whom
can this be delegated?
a) LPN only
b) UAP after demonstrating proper use of gait belt
c) Another RN
d) No one—nurse must perform alone
Rationale: UAP can ambulate stable clients after training and supervision.
9. Which statement by a new nurse indicates correct understanding of delegation?
a) “I can delegate assessment to UAP if they are experienced.”
, b) “I am accountable for the client even after delegation.”
c) “LPNs cannot administer any medications.”
d) “Delegation means I no longer need to supervise.”
Rationale: RN retains accountability for delegation and outcomes.
10–12. Ordered Response: Prioritize clients for morning rounds (1=first to see).
1. Client with chest pain, diaphoresis, BP 80/50
2. Client post-op day 1 with O2 sat 89% on room air
3. Client with dementia pulling at IV line
4. Client requesting pain med for chronic back pain
Rationale: Hemodynamic instability → hypoxia → safety issue → chronic
stable issue.
13. Which client is appropriate to assign to a float RN from a postpartum unit?
a) Client on a ventilator with sedation
b) Client with acute stroke and dysphagia
c) Client with mastitis requiring IV antibiotic
d) Client post-cardiac arrest
Rationale: Mastitis is a complication of lactation; float RN is competent. Others
are high-acuity.
14. A UAP reports a client’s BP as 180/100. What should the RN do first?
a) Document the finding
b) Ask UAP to recheck in 15 minutes
c) Assess the client and review medications
d) Call the provider immediately
Rationale: RN must verify and assess before notifying provider.
15. A nurse manager is evaluating delegation. Which action requires intervention?
a) RN asks LPN to insert a Foley catheter
b) RN asks UAP to evaluate a pressure injury
c) RN asks UAP to measure I&O
d) RN asks LPN to administer nebulizer
Rationale: Evaluation/assessment is RN-only.
Section 2: Pharmacology (Items 16–30)
