TI RN COMPREHENSIVE PREDICTOR 2026 – EXIT EXAM
180 QUESTIONS WITH ANSWERS & RATIONALES Q&A
UPDATED FOR NGN | LEVEL 3 FOCUS | ACTUAL EXAM
CONTENT
SECTION 1: MANAGEMENT OF CARE (25 Questions)
1. A charge nurse is making client assignments on a medical-surgical unit. Which client should
be assigned to the most experienced RN?
A) A client with DM requiring insulin
B) A client with pneumonia requiring q4h vitals
C) A client with chest tubes and new-onset respiratory distress
D) A client with a UTI requiring IV antibiotics
Answer: C
Rationale: The client with chest tubes and respiratory distress is unstable and requires complex
assessment and intervention, which should be assigned to the most experienced RN. Stable
clients can be assigned to LPNs or less experienced RNs .
2. A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
family requests the transfusion be given anyway. What is the priority action?
A) Administer the transfusion as the family requests
B) Notify the healthcare provider of the client’s refusal
C) Contact the ethics committee for a consultation
D) Ask the client to reconsider the family’s wishes
Answer: B
Rationale: A competent adult has the legal right to refuse treatment. The nurse must notify the
provider and respect the client’s autonomy. Coercion or ignoring the refusal violates ethical
principles .
3. A nurse is caring for a client who is scheduled for surgery and states, "I don't want to have
this surgery anymore." Which response is most appropriate?
A) “Your doctor thinks the surgery is necessary.”
,B) “Let me review the procedure so you can understand.”
C) “You have the right to refuse the procedure.”
D) “We can manage your care without complications.”
Answer: C
Rationale: A competent adult client has the absolute right to refuse treatment. The nurse must
acknowledge and respect this right. Once a client withdraws consent, the nurse should advocate
for the client’s autonomy, document the refusal, and notify the provider .
4. A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate to
delegate?
A) Assessing a postoperative incision
B) Administering a tube feeding
C) Ambulating a stable client with a walker
D) Teaching incentive spirometer use
Answer: C
Rationale: Ambulating a stable client is within AP scope. Assessment, teaching, and tube
feedings require licensed nursing judgment and cannot be delegated to AP .
5. A charge nurse assigns a float RN from postpartum to a medical-surgical unit. Which client
is most appropriate to assign to this RN?
A) Client in diabetic ketoacidosis (DKA)
B) Client postoperative day 2 following appendectomy, stable
C) Client with a chest tube for pneumothorax
D) Client receiving IV heparin for DVT
Answer: B
Rationale: A stable, low-acuity postoperative client is safest for a float nurse from a different
specialty. Complex or high-risk clients require an RN with current experience in those areas .
6. A nurse is preparing to delegate tasks to an LPN. Which task is appropriate?
A) Initial admission assessment
B) Evaluation of client outcomes
C) Nasopharyngeal suctioning for stable pneumonia client
D) Teaching about new diabetes diagnosis
,Answer: C
Rationale: LPNs can perform stable, predictable procedures like suctioning. Initial assessment,
evaluation, and teaching are RN responsibilities .
7. A charge nurse is making assignments. Which client should be assigned to an LPN?
A) Client with new-onset chest pain
B) Client 4 hours post-cardiac catheterization
C) Client requiring blood transfusion
D) Client with stable COPD for routine morning care
Answer: D
Rationale: LPNs can provide routine care for stable clients. Unstable clients or those requiring
complex assessments should be assigned to RNs .
8. A nurse is preparing a handoff report using SBAR. Which information belongs in the "B"
component?
A) “The client is short of breath.”
B) “I think the client may need a chest X-ray.”
C) “The client has a history of COPD.”
D) “The client’s oxygen saturation is 88%.”
Answer: C
Rationale: SBAR = Situation, Background, Assessment, Recommendation. The "B" (Background)
includes relevant history such as diagnosis of COPD .
9. A nurse is participating in a disaster drill. Using START triage, a patient breathing
spontaneously after airway repositioning with a respiratory rate of 35/min and palpable radial
pulse receives which color tag?
A) Green (minor)
B) Yellow (delayed)
C) Red (immediate)
D) Black (deceased)
Answer: C
Rationale: In START triage, a patient breathing but with respiratory rate >30/min is tagged Red
(immediate)—life-threatening but potentially survivable .
, 10. A nurse is caring for a confused client trying to climb out of bed. Which intervention
should be attempted before applying restraints?
A) Administer a PRN sedative
B) Place the bed in the highest position
C) Use a bed alarm and assign a sitter
D) Raise all four side rails
Answer: C
Rationale: Least restrictive measures should be tried first: bed alarm, reduced stimuli, frequent
rounding, and a sitter are appropriate before chemical or physical restraints .
11. A nurse is applying wrist restraints to a client pulling at IV lines. Which action is required?
A) Obtain a written order from the provider before application
B) Tie the restraints to the bed rail for easy access
C) Release the restraints every hour for range of motion
D) Document the client’s behavior every 2 hours
Answer: C
Rationale: Restraints must be released at least every 2 hours for ROM, skin assessment,
toileting, and nutrition. An order is obtained as soon as possible, preferably before application .
12. An assistive personnel (AP) angrily tells the charge nurse that her assignment is too
demanding. What should the nurse do to resolve the conflict?
A) Reassign the AP’s tasks immediately
B) Ask the AP to discuss the issue in a private area
C) Report the AP to the unit manager
D) Ignore the complaint to avoid conflict
Answer: B
Rationale: Conflict resolution requires a private, structured conversation. Discussing the issue
away from others promotes open communication and problem-solving .
13. A nurse is supervising a newly licensed nurse. For which action should the supervising
nurse intervene?
A) Logging off the computer after documenting
180 QUESTIONS WITH ANSWERS & RATIONALES Q&A
UPDATED FOR NGN | LEVEL 3 FOCUS | ACTUAL EXAM
CONTENT
SECTION 1: MANAGEMENT OF CARE (25 Questions)
1. A charge nurse is making client assignments on a medical-surgical unit. Which client should
be assigned to the most experienced RN?
A) A client with DM requiring insulin
B) A client with pneumonia requiring q4h vitals
C) A client with chest tubes and new-onset respiratory distress
D) A client with a UTI requiring IV antibiotics
Answer: C
Rationale: The client with chest tubes and respiratory distress is unstable and requires complex
assessment and intervention, which should be assigned to the most experienced RN. Stable
clients can be assigned to LPNs or less experienced RNs .
2. A nurse is caring for a client who refuses a blood transfusion due to religious beliefs. The
family requests the transfusion be given anyway. What is the priority action?
A) Administer the transfusion as the family requests
B) Notify the healthcare provider of the client’s refusal
C) Contact the ethics committee for a consultation
D) Ask the client to reconsider the family’s wishes
Answer: B
Rationale: A competent adult has the legal right to refuse treatment. The nurse must notify the
provider and respect the client’s autonomy. Coercion or ignoring the refusal violates ethical
principles .
3. A nurse is caring for a client who is scheduled for surgery and states, "I don't want to have
this surgery anymore." Which response is most appropriate?
A) “Your doctor thinks the surgery is necessary.”
,B) “Let me review the procedure so you can understand.”
C) “You have the right to refuse the procedure.”
D) “We can manage your care without complications.”
Answer: C
Rationale: A competent adult client has the absolute right to refuse treatment. The nurse must
acknowledge and respect this right. Once a client withdraws consent, the nurse should advocate
for the client’s autonomy, document the refusal, and notify the provider .
4. A nurse is delegating tasks to an assistive personnel (AP). Which task is appropriate to
delegate?
A) Assessing a postoperative incision
B) Administering a tube feeding
C) Ambulating a stable client with a walker
D) Teaching incentive spirometer use
Answer: C
Rationale: Ambulating a stable client is within AP scope. Assessment, teaching, and tube
feedings require licensed nursing judgment and cannot be delegated to AP .
5. A charge nurse assigns a float RN from postpartum to a medical-surgical unit. Which client
is most appropriate to assign to this RN?
A) Client in diabetic ketoacidosis (DKA)
B) Client postoperative day 2 following appendectomy, stable
C) Client with a chest tube for pneumothorax
D) Client receiving IV heparin for DVT
Answer: B
Rationale: A stable, low-acuity postoperative client is safest for a float nurse from a different
specialty. Complex or high-risk clients require an RN with current experience in those areas .
6. A nurse is preparing to delegate tasks to an LPN. Which task is appropriate?
A) Initial admission assessment
B) Evaluation of client outcomes
C) Nasopharyngeal suctioning for stable pneumonia client
D) Teaching about new diabetes diagnosis
,Answer: C
Rationale: LPNs can perform stable, predictable procedures like suctioning. Initial assessment,
evaluation, and teaching are RN responsibilities .
7. A charge nurse is making assignments. Which client should be assigned to an LPN?
A) Client with new-onset chest pain
B) Client 4 hours post-cardiac catheterization
C) Client requiring blood transfusion
D) Client with stable COPD for routine morning care
Answer: D
Rationale: LPNs can provide routine care for stable clients. Unstable clients or those requiring
complex assessments should be assigned to RNs .
8. A nurse is preparing a handoff report using SBAR. Which information belongs in the "B"
component?
A) “The client is short of breath.”
B) “I think the client may need a chest X-ray.”
C) “The client has a history of COPD.”
D) “The client’s oxygen saturation is 88%.”
Answer: C
Rationale: SBAR = Situation, Background, Assessment, Recommendation. The "B" (Background)
includes relevant history such as diagnosis of COPD .
9. A nurse is participating in a disaster drill. Using START triage, a patient breathing
spontaneously after airway repositioning with a respiratory rate of 35/min and palpable radial
pulse receives which color tag?
A) Green (minor)
B) Yellow (delayed)
C) Red (immediate)
D) Black (deceased)
Answer: C
Rationale: In START triage, a patient breathing but with respiratory rate >30/min is tagged Red
(immediate)—life-threatening but potentially survivable .
, 10. A nurse is caring for a confused client trying to climb out of bed. Which intervention
should be attempted before applying restraints?
A) Administer a PRN sedative
B) Place the bed in the highest position
C) Use a bed alarm and assign a sitter
D) Raise all four side rails
Answer: C
Rationale: Least restrictive measures should be tried first: bed alarm, reduced stimuli, frequent
rounding, and a sitter are appropriate before chemical or physical restraints .
11. A nurse is applying wrist restraints to a client pulling at IV lines. Which action is required?
A) Obtain a written order from the provider before application
B) Tie the restraints to the bed rail for easy access
C) Release the restraints every hour for range of motion
D) Document the client’s behavior every 2 hours
Answer: C
Rationale: Restraints must be released at least every 2 hours for ROM, skin assessment,
toileting, and nutrition. An order is obtained as soon as possible, preferably before application .
12. An assistive personnel (AP) angrily tells the charge nurse that her assignment is too
demanding. What should the nurse do to resolve the conflict?
A) Reassign the AP’s tasks immediately
B) Ask the AP to discuss the issue in a private area
C) Report the AP to the unit manager
D) Ignore the complaint to avoid conflict
Answer: B
Rationale: Conflict resolution requires a private, structured conversation. Discussing the issue
away from others promotes open communication and problem-solving .
13. A nurse is supervising a newly licensed nurse. For which action should the supervising
nurse intervene?
A) Logging off the computer after documenting
