NGN ATI PN COMPREHENSIVE PREDICTOR EXAM
2026/2027 | Latest Graded A+ | NCLEX-PN Test Plan | ATI
Curriculum | Pass Guaranteed - A+ Graded
Section 1: Safe & Effective Care Environment: Management of
Care (Questions 1-32)
Q1. A PN is caring for four clients on a medical-surgical unit. Which client should the
PN assess FIRST?
A. A client with pneumonia who has an oxygen saturation of 92% on 2L NC
B. A client with a new colostomy who reports incisional pain rated 4/10
C. A client with heart failure who has 2+ pitting edema in bilateral lower extremities
D. A client with type 2 diabetes whose blood glucose is 248 mg/dL
Rationale: The pneumonia client has compromised oxygenation (SpO2 92%), which
is an airway/breathing priority per ABC framework. Pain (B), edema (C), and
hyperglycemia (D) are important but not immediately life-threatening. [CORRECT]
Correct Answer: A
Q2. [NGN - Drop-Down] A PN receives report on a client admitted with acute
pancreatitis. The PN recognizes cues indicating potential complications. Select the
appropriate nursing action for each cue.
The client reports severe, unrelenting abdominal pain radiating to the back. The PN
should [SELECT: administer morphine sulfate 4mg IV / obtain a stat abdominal x-ray /
place the client in high-Fowler's position / notify the provider immediately].
The client's blood pressure is 88/52 mmHg, HR 118 bpm, RR 28/min. The PN should
[SELECT: encourage oral fluid intake / initiate IV fluid resuscitation per protocol /
administer scheduled antihypertensive / document and continue monitoring].
,The client's serum calcium is 7.2 mg/dL (normal: 8.5-10.5). The PN should [SELECT:
administer calcium gluconate per protocol / restrict dietary calcium / apply cardiac
monitoring / encourage ambulation].
Rationale: Severe unrelenting pain in pancreatitis may indicate hemorrhagic
necrosis—notify provider immediately. Hypotension with tachycardia indicates
hypovolemic shock—initiate IV fluid resuscitation. Hypocalcemia requires cardiac
monitoring for dysrhythmias and potential calcium replacement.
Correct Answers: notify the provider immediately; initiate IV fluid resuscitation per
protocol; apply cardiac monitoring
Q3. A PN is delegating tasks to unlicensed assistive personnel (UAP) on a busy unit.
Which task is MOST APPROPRIATE to delegate to the UAP?
A. Assessing a postoperative client for signs of hemorrhage
B. Feeding a client with dysphagia who requires thickened liquids
C. Reinforcing discharge teaching about wound care
D. Evaluating the effectiveness of a client's pain medication
Rationale: Feeding a stable client with dysphagia (with clear instructions on
thickened liquids) is within UAP scope. Assessment (A), teaching (C), and evaluation
(D) are PN/RN responsibilities and cannot be delegated. [CORRECT]
Correct Answer: B
Q4. [NGN - Bowtie] A 68-year-old client is admitted with confusion, lethargy, and a
sodium level of 118 mEq/L. The PN recognizes this as syndrome of inappropriate
antidiuretic hormone (SIADH).
Condition: [SELECT: Hypernatremia / Hyponatremia / Hyperkalemia / Hypokalemia]
Actions to Take: (Select all that apply)
• [ ] Restrict free water intake to 800-1200 mL/day
, • [ ] Administer 3% saline per provider order
• [ ] Encourage increased oral fluid intake
• [ ] Monitor neurologic status every 2 hours
• [ ] Place client on seizure precautions
• [ ] Administer furosemide as ordered
Parameters to Monitor: (Select all that apply)
• [ ] Serum sodium levels
• [ ] Daily weights
• [ ] Urine specific gravity
• [ ] Neurologic status
• [ ] Blood glucose
• [ ] Potassium levels
Rationale: SIADH causes dilutional hyponatremia. Actions include fluid restriction,
hypertonic saline if severe, seizure precautions, and neurologic monitoring.
Parameters to monitor include sodium, neurologic status, and urine specific gravity.
Furosemide and increased fluids are contraindicated.
Correct Answers: Condition: Hyponatremia; Actions: Restrict free water intake,
Administer 3% saline, Monitor neurologic status, Place on seizure precautions;
Parameters: Serum sodium, Urine specific gravity, Neurologic status
Q5. A PN is reviewing the assignment for the shift. Which client situation requires the
PN to seek clarification from the charge nurse before accepting the assignment?
A. A client with a new tracheostomy requiring suctioning every 2 hours
B. A client with a PICC line requiring IV antibiotic administration
C. A client in the first 24 hours post-op from gastric bypass surgery
D. A client receiving chemotherapy via peripheral IV
Rationale: The first 24 hours post-gastric bypass requires specialized monitoring for
anastomotic leaks, bleeding, and fluid shifts that may exceed PN scope or
, competency without proper training/assignment. This requires clarification.
[CORRECT]
Correct Answer: C
Q6. [NGN - Multiple Response] A PN is caring for a client who had a total hip
arthroplasty 2 days ago. Which actions by the PN demonstrate appropriate use of the
clinical judgment measurement model? (Select all that apply.)
• [ ] The PN recognizes that the client's sudden onset of dyspnea and chest pain
may indicate a pulmonary embolism
• [ ] The PN prioritizes checking the client's pedal pulses before assessing pain
• [ ] The PN analyzes the client's sudden drop in hemoglobin from 10.2 to 7.8 g/dL
as potential postoperative hemorrhage
• [ ] The PN generates a solution to apply sequential compression devices to
prevent DVT
• [ ] The PN takes action by elevating the head of the bed and applying oxygen for
the dyspneic client
• [ ] The PN evaluates that the client's pain medication is effective when the pain
rating decreases from 8 to 3
Rationale: All options demonstrate steps of the CJM: recognizing cues (A, C),
analyzing cues (C), prioritizing hypotheses (B), generating solutions (D), taking
actions (E), and evaluating outcomes (F). [CORRECT]
Correct Answer: A, B, C, D, E, F
Q7. A PN is supervising a newly hired UAP. The UAP performs which action that
requires IMMEDIATE intervention by the PN?
A. The UAP places a "No Visitors" sign on the door of a client in airborne precautions
B. The UAP uses an alcohol-based hand rub after removing gloves from a client with
C. difficile
2026/2027 | Latest Graded A+ | NCLEX-PN Test Plan | ATI
Curriculum | Pass Guaranteed - A+ Graded
Section 1: Safe & Effective Care Environment: Management of
Care (Questions 1-32)
Q1. A PN is caring for four clients on a medical-surgical unit. Which client should the
PN assess FIRST?
A. A client with pneumonia who has an oxygen saturation of 92% on 2L NC
B. A client with a new colostomy who reports incisional pain rated 4/10
C. A client with heart failure who has 2+ pitting edema in bilateral lower extremities
D. A client with type 2 diabetes whose blood glucose is 248 mg/dL
Rationale: The pneumonia client has compromised oxygenation (SpO2 92%), which
is an airway/breathing priority per ABC framework. Pain (B), edema (C), and
hyperglycemia (D) are important but not immediately life-threatening. [CORRECT]
Correct Answer: A
Q2. [NGN - Drop-Down] A PN receives report on a client admitted with acute
pancreatitis. The PN recognizes cues indicating potential complications. Select the
appropriate nursing action for each cue.
The client reports severe, unrelenting abdominal pain radiating to the back. The PN
should [SELECT: administer morphine sulfate 4mg IV / obtain a stat abdominal x-ray /
place the client in high-Fowler's position / notify the provider immediately].
The client's blood pressure is 88/52 mmHg, HR 118 bpm, RR 28/min. The PN should
[SELECT: encourage oral fluid intake / initiate IV fluid resuscitation per protocol /
administer scheduled antihypertensive / document and continue monitoring].
,The client's serum calcium is 7.2 mg/dL (normal: 8.5-10.5). The PN should [SELECT:
administer calcium gluconate per protocol / restrict dietary calcium / apply cardiac
monitoring / encourage ambulation].
Rationale: Severe unrelenting pain in pancreatitis may indicate hemorrhagic
necrosis—notify provider immediately. Hypotension with tachycardia indicates
hypovolemic shock—initiate IV fluid resuscitation. Hypocalcemia requires cardiac
monitoring for dysrhythmias and potential calcium replacement.
Correct Answers: notify the provider immediately; initiate IV fluid resuscitation per
protocol; apply cardiac monitoring
Q3. A PN is delegating tasks to unlicensed assistive personnel (UAP) on a busy unit.
Which task is MOST APPROPRIATE to delegate to the UAP?
A. Assessing a postoperative client for signs of hemorrhage
B. Feeding a client with dysphagia who requires thickened liquids
C. Reinforcing discharge teaching about wound care
D. Evaluating the effectiveness of a client's pain medication
Rationale: Feeding a stable client with dysphagia (with clear instructions on
thickened liquids) is within UAP scope. Assessment (A), teaching (C), and evaluation
(D) are PN/RN responsibilities and cannot be delegated. [CORRECT]
Correct Answer: B
Q4. [NGN - Bowtie] A 68-year-old client is admitted with confusion, lethargy, and a
sodium level of 118 mEq/L. The PN recognizes this as syndrome of inappropriate
antidiuretic hormone (SIADH).
Condition: [SELECT: Hypernatremia / Hyponatremia / Hyperkalemia / Hypokalemia]
Actions to Take: (Select all that apply)
• [ ] Restrict free water intake to 800-1200 mL/day
, • [ ] Administer 3% saline per provider order
• [ ] Encourage increased oral fluid intake
• [ ] Monitor neurologic status every 2 hours
• [ ] Place client on seizure precautions
• [ ] Administer furosemide as ordered
Parameters to Monitor: (Select all that apply)
• [ ] Serum sodium levels
• [ ] Daily weights
• [ ] Urine specific gravity
• [ ] Neurologic status
• [ ] Blood glucose
• [ ] Potassium levels
Rationale: SIADH causes dilutional hyponatremia. Actions include fluid restriction,
hypertonic saline if severe, seizure precautions, and neurologic monitoring.
Parameters to monitor include sodium, neurologic status, and urine specific gravity.
Furosemide and increased fluids are contraindicated.
Correct Answers: Condition: Hyponatremia; Actions: Restrict free water intake,
Administer 3% saline, Monitor neurologic status, Place on seizure precautions;
Parameters: Serum sodium, Urine specific gravity, Neurologic status
Q5. A PN is reviewing the assignment for the shift. Which client situation requires the
PN to seek clarification from the charge nurse before accepting the assignment?
A. A client with a new tracheostomy requiring suctioning every 2 hours
B. A client with a PICC line requiring IV antibiotic administration
C. A client in the first 24 hours post-op from gastric bypass surgery
D. A client receiving chemotherapy via peripheral IV
Rationale: The first 24 hours post-gastric bypass requires specialized monitoring for
anastomotic leaks, bleeding, and fluid shifts that may exceed PN scope or
, competency without proper training/assignment. This requires clarification.
[CORRECT]
Correct Answer: C
Q6. [NGN - Multiple Response] A PN is caring for a client who had a total hip
arthroplasty 2 days ago. Which actions by the PN demonstrate appropriate use of the
clinical judgment measurement model? (Select all that apply.)
• [ ] The PN recognizes that the client's sudden onset of dyspnea and chest pain
may indicate a pulmonary embolism
• [ ] The PN prioritizes checking the client's pedal pulses before assessing pain
• [ ] The PN analyzes the client's sudden drop in hemoglobin from 10.2 to 7.8 g/dL
as potential postoperative hemorrhage
• [ ] The PN generates a solution to apply sequential compression devices to
prevent DVT
• [ ] The PN takes action by elevating the head of the bed and applying oxygen for
the dyspneic client
• [ ] The PN evaluates that the client's pain medication is effective when the pain
rating decreases from 8 to 3
Rationale: All options demonstrate steps of the CJM: recognizing cues (A, C),
analyzing cues (C), prioritizing hypotheses (B), generating solutions (D), taking
actions (E), and evaluating outcomes (F). [CORRECT]
Correct Answer: A, B, C, D, E, F
Q7. A PN is supervising a newly hired UAP. The UAP performs which action that
requires IMMEDIATE intervention by the PN?
A. The UAP places a "No Visitors" sign on the door of a client in airborne precautions
B. The UAP uses an alcohol-based hand rub after removing gloves from a client with
C. difficile
