ATI RN COMPREHENSIVE
PREDICTOR 2026 MEGA
PRACTICE TEST|||questions and
answers with rationales/graded
A+/2026 update/100% correct /instant
download
Comprehensive Examination for Nursing Student Readiness Assessment
Exam Duration: 180 minutes (3 hours) | Total Questions: 300 | Format: Multiple
Choice, Select All That Apply, Bow-Tie, Enhanced Hot Spot
EXAM INSTRUCTIONS:
This comprehensive practice test is designed to simulate the actual ATI RN
Comprehensive Predictor Exam, which assesses readiness for the NCLEX-RN.
Answer all questions based on evidence-based nursing practice and current
guidelines. Choose the BEST answer for each question. Correct answers are
highlighted in bold text with rationales provided.
SECTION 1: MANAGEMENT OF CARE (Items 1-35)
1. A charge nurse is assigning staff for a medical-surgical unit. Which client
should be assigned to the most experienced RN?
• A. A client with diabetes mellitus requiring bedside glucose monitoring
• B. A client with pneumonia requiring IV antibiotic administration every 8
hours
• C. A client who is 24 hours post-operative following a laryngectomy with
a new tracheostomy
, • D. A client with osteoarthritis requiring assistance with ambulation
Rationale: The client with a new tracheostomy is at highest risk for airway
complications and requires complex assessment skills and clinical judgment. The
most experienced RN should care for unstable or complex patients requiring
critical decision-making .
2. A nurse is preparing to delegate tasks to an unlicensed assistive personnel
(UAP). Which task is appropriate to delegate?
• A. Assess the client's pain level on a 0-10 scale
• B. Evaluate the effectiveness of a client's pain medication
• C. Measure and record a client's intake and output
• D. Teach a client how to use an incentive spirometer
Rationale: UAPs can measure and document I&O as it is a routine, non-invasive
task that does not require nursing judgment. Assessment, evaluation, and teaching
require licensed nursing knowledge and cannot be delegated .
3. A nurse is caring for a client who refuses a blood transfusion due to
religious beliefs. The client's family requests the transfusion. What action
should the nurse take?
• A. Administer the transfusion as the family has the client's best interests in
mind
• B. Contact the hospital ethics committee for a decision
• C. Respect the client's refusal and document the client's decision
• D. Ask the provider to speak with the client about the risks of refusal
Rationale: The client's autonomy must be respected. Competent adults have the
legal right to refuse medical treatment, including life-saving interventions, based
on religious or personal beliefs. The nurse advocates for the client's decision .
4. A nurse discovers a small fire in a client's trash can. What is the priority
action?
• A. Remove the client from the room (RACE - Rescue)
• B. Activate the fire alarm
, • C. Use the fire extinguisher to put out the fire
• D. Close all doors to contain the fire
Rationale: The RACE acronym guides fire response: Rescue clients in immediate
danger, Activate alarm, Contain fire, Extinguish. Client safety is always the
priority .
5. A nurse is preparing a client for discharge following a myocardial
infarction. Which statement by the client indicates understanding of the
discharge teaching?
• A. "I will stop taking my aspirin if I experience ringing in my ears."
• B. "I will take my nitroglycerin every 5 minutes for chest pain for up to
3 doses."
• C. "I will only walk if I do not have any chest pain at that time."
• D. "I can stop taking my statin medication if my cholesterol levels are
normal."
Rationale: Nitroglycerin should be taken every 5 minutes for up to 3 doses. If pain
is not relieved after one dose, emergency services should be called. Aspirin is
typically lifelong therapy post-MI, and statins are continued regardless of
cholesterol levels for their cardiac protective effects .
6. A nurse is triaging clients following a mass casualty disaster. Which client
should receive the highest priority (red tag)?
• A. A client with a simple fracture of the left arm who is alert and oriented
• B. A client with minor abrasions who is walking and talking
• C. A client with 95% full-thickness body burns who is unconscious
• D. A client with an open femur fracture and absent distal pulses
Rationale: In disaster triage, the client with absent distal pulses (indicating
circulatory compromise) requires immediate life-saving intervention. The client
with 95% burns is black-tagged (expectant) due to extremely low survival
probability. The walking wounded are green-tagged .
7. A nurse is completing an incident report after a medication error. Which
action demonstrates appropriate documentation?
, • A. Document in the client's chart that an incident report was filed
• B. Include objective facts about the error in the incident report
• C. Place a copy of the incident report in the client's medical record
• D. Share the incident report details with the client's family
Rationale: Incident reports should contain objective, factual information about the
event. They are confidential quality improvement documents and should NOT be
referenced in the client's medical record or shared with the family. The medical
record should contain only factual information about the event and subsequent
care .
8. A nurse is planning care for a client who has a new ileal conduit (urinary
diversion). Which intervention should the nurse include in the plan of care?
• A. Encourage the client to drink at least 2-3 L of fluid daily
• B. Change the appliance every 7-10 days
• C. Clean the stoma with alcohol-based wipes
• D. Apply a skin barrier only if leakage occurs
Rationale: Increased fluid intake (2-3 L/day) helps flush mucus from the conduit
and prevents infection and stone formation. The appliance should be changed every
3-7 days, and stoma care requires gentle cleaning with water and mild soap. Skin
barriers are essential to prevent breakdown .
9. A nurse is reviewing critical pathways with a newly licensed nurse. Which
statement accurately describes critical pathways?
• A. "Critical pathways are used to reduce healthcare costs and length of
stay."
• B. "Critical pathways replace the need for nursing care plans."
• C. "Critical pathways are legal documents that cannot be modified."
• D. "Critical pathways are only used in intensive care units."
Rationale: Critical pathways are interdisciplinary tools designed to standardize
care, reduce variation, decrease length of stay, and control healthcare costs while
maintaining quality outcomes .
PREDICTOR 2026 MEGA
PRACTICE TEST|||questions and
answers with rationales/graded
A+/2026 update/100% correct /instant
download
Comprehensive Examination for Nursing Student Readiness Assessment
Exam Duration: 180 minutes (3 hours) | Total Questions: 300 | Format: Multiple
Choice, Select All That Apply, Bow-Tie, Enhanced Hot Spot
EXAM INSTRUCTIONS:
This comprehensive practice test is designed to simulate the actual ATI RN
Comprehensive Predictor Exam, which assesses readiness for the NCLEX-RN.
Answer all questions based on evidence-based nursing practice and current
guidelines. Choose the BEST answer for each question. Correct answers are
highlighted in bold text with rationales provided.
SECTION 1: MANAGEMENT OF CARE (Items 1-35)
1. A charge nurse is assigning staff for a medical-surgical unit. Which client
should be assigned to the most experienced RN?
• A. A client with diabetes mellitus requiring bedside glucose monitoring
• B. A client with pneumonia requiring IV antibiotic administration every 8
hours
• C. A client who is 24 hours post-operative following a laryngectomy with
a new tracheostomy
, • D. A client with osteoarthritis requiring assistance with ambulation
Rationale: The client with a new tracheostomy is at highest risk for airway
complications and requires complex assessment skills and clinical judgment. The
most experienced RN should care for unstable or complex patients requiring
critical decision-making .
2. A nurse is preparing to delegate tasks to an unlicensed assistive personnel
(UAP). Which task is appropriate to delegate?
• A. Assess the client's pain level on a 0-10 scale
• B. Evaluate the effectiveness of a client's pain medication
• C. Measure and record a client's intake and output
• D. Teach a client how to use an incentive spirometer
Rationale: UAPs can measure and document I&O as it is a routine, non-invasive
task that does not require nursing judgment. Assessment, evaluation, and teaching
require licensed nursing knowledge and cannot be delegated .
3. A nurse is caring for a client who refuses a blood transfusion due to
religious beliefs. The client's family requests the transfusion. What action
should the nurse take?
• A. Administer the transfusion as the family has the client's best interests in
mind
• B. Contact the hospital ethics committee for a decision
• C. Respect the client's refusal and document the client's decision
• D. Ask the provider to speak with the client about the risks of refusal
Rationale: The client's autonomy must be respected. Competent adults have the
legal right to refuse medical treatment, including life-saving interventions, based
on religious or personal beliefs. The nurse advocates for the client's decision .
4. A nurse discovers a small fire in a client's trash can. What is the priority
action?
• A. Remove the client from the room (RACE - Rescue)
• B. Activate the fire alarm
, • C. Use the fire extinguisher to put out the fire
• D. Close all doors to contain the fire
Rationale: The RACE acronym guides fire response: Rescue clients in immediate
danger, Activate alarm, Contain fire, Extinguish. Client safety is always the
priority .
5. A nurse is preparing a client for discharge following a myocardial
infarction. Which statement by the client indicates understanding of the
discharge teaching?
• A. "I will stop taking my aspirin if I experience ringing in my ears."
• B. "I will take my nitroglycerin every 5 minutes for chest pain for up to
3 doses."
• C. "I will only walk if I do not have any chest pain at that time."
• D. "I can stop taking my statin medication if my cholesterol levels are
normal."
Rationale: Nitroglycerin should be taken every 5 minutes for up to 3 doses. If pain
is not relieved after one dose, emergency services should be called. Aspirin is
typically lifelong therapy post-MI, and statins are continued regardless of
cholesterol levels for their cardiac protective effects .
6. A nurse is triaging clients following a mass casualty disaster. Which client
should receive the highest priority (red tag)?
• A. A client with a simple fracture of the left arm who is alert and oriented
• B. A client with minor abrasions who is walking and talking
• C. A client with 95% full-thickness body burns who is unconscious
• D. A client with an open femur fracture and absent distal pulses
Rationale: In disaster triage, the client with absent distal pulses (indicating
circulatory compromise) requires immediate life-saving intervention. The client
with 95% burns is black-tagged (expectant) due to extremely low survival
probability. The walking wounded are green-tagged .
7. A nurse is completing an incident report after a medication error. Which
action demonstrates appropriate documentation?
, • A. Document in the client's chart that an incident report was filed
• B. Include objective facts about the error in the incident report
• C. Place a copy of the incident report in the client's medical record
• D. Share the incident report details with the client's family
Rationale: Incident reports should contain objective, factual information about the
event. They are confidential quality improvement documents and should NOT be
referenced in the client's medical record or shared with the family. The medical
record should contain only factual information about the event and subsequent
care .
8. A nurse is planning care for a client who has a new ileal conduit (urinary
diversion). Which intervention should the nurse include in the plan of care?
• A. Encourage the client to drink at least 2-3 L of fluid daily
• B. Change the appliance every 7-10 days
• C. Clean the stoma with alcohol-based wipes
• D. Apply a skin barrier only if leakage occurs
Rationale: Increased fluid intake (2-3 L/day) helps flush mucus from the conduit
and prevents infection and stone formation. The appliance should be changed every
3-7 days, and stoma care requires gentle cleaning with water and mild soap. Skin
barriers are essential to prevent breakdown .
9. A nurse is reviewing critical pathways with a newly licensed nurse. Which
statement accurately describes critical pathways?
• A. "Critical pathways are used to reduce healthcare costs and length of
stay."
• B. "Critical pathways replace the need for nursing care plans."
• C. "Critical pathways are legal documents that cannot be modified."
• D. "Critical pathways are only used in intensive care units."
Rationale: Critical pathways are interdisciplinary tools designed to standardize
care, reduce variation, decrease length of stay, and control healthcare costs while
maintaining quality outcomes .
