ATI RN Comprehensive Predictor 2026 NGN Complete
Exam Prep Bundle | 200 Practice Questions and
Correct Answers with Detailed Rationales | Next
Generation NCLEX-RN Clinical Judgment,
Prioritization, Delegation, SATA & Case Study Review
Guide.
Introduction
The ATI RN Comprehensive Predictor is designed to assess nursing students' readiness for the
NCLEX-RN by evaluating clinical judgment, prioritization, delegation, pharmacology,
leadership, maternity, pediatrics, mental health, and medical-surgical nursing concepts. The
Next Generation NCLEX (NGN) emphasizes clinical judgment and decision-making through
case studies, bow-tie questions, matrix items, and multiple-response formats.
1. A nurse is assessing a client who has acute respiratory distress. Which finding
requires immediate intervention?
A. Respiratory rate 24/min
B. Oxygen saturation 84% on room air
C. Heart rate 104/min
D. Temperature 37.4°C (99.3°F)
Answer: B. Oxygen saturation 84% on room air
Rationale: An oxygen saturation of 84% indicates severe hypoxemia and requires immediate
intervention to restore adequate oxygenation.
,2. A nurse is caring for a client who reports chest pain rated 8/10. Which action
should the nurse take first?
A. Administer prescribed analgesic
B. Obtain a 12-lead ECG
C. Assess vital signs and oxygen saturation
D. Notify the provider
Answer: C. Assess vital signs and oxygen saturation
Rationale: Assessment is the first step of the nursing process and helps determine the severity
of the client's condition.
3. Which client should the nurse assess first?
A. A client with diabetes whose blood glucose is 240 mg/dL
B. A client with a fractured arm reporting pain 7/10
C. A client with COPD whose oxygen saturation is 88%
D. A client requesting discharge instructions
Answer: C. A client with COPD whose oxygen saturation is 88%
Rationale: Airway and breathing issues take priority according to ABC principles.
4. A nurse is delegating tasks to an assistive personnel (AP). Which task is
appropriate?
A. Assessing pain level
B. Administering oral medications
C. Reinforcing teaching about insulin injections
D. Obtaining routine vital signs on a stable client
Answer: D. Obtaining routine vital signs on a stable client
Rationale: AP can collect routine data but cannot assess, teach, or administer medications.
5. A client receiving warfarin has an INR of 5.0. Which action should the nurse
anticipate?
,A. Increase the dose
B. Continue medication as prescribed
C. Hold the medication and notify the provider
D. Administer aspirin
Answer: C. Hold the medication and notify the provider
Rationale: An INR of 5.0 places the client at risk for bleeding and requires provider
notification.
6. Which assessment finding is expected in a client experiencing hypoglycemia?
A. Warm dry skin
B. Fruity breath odor
C. Cool clammy skin
D. Kussmaul respirations
Answer: C. Cool clammy skin
Rationale: Hypoglycemia activates the sympathetic nervous system, causing diaphoresis and
clammy skin.
7. A nurse is caring for a client with heart failure. Which assessment finding
indicates fluid overload?
A. Dry mucous membranes
B. Crackles in the lungs
C. Decreased jugular venous pressure
D. Weight loss
Answer: B. Crackles in the lungs
Rationale: Crackles indicate pulmonary fluid accumulation associated with heart failure.
8. Which laboratory value should the nurse report immediately?
A. Sodium 138 mEq/L
B. Calcium 9.4 mg/dL
C. Potassium 6.2 mEq/L
D. Magnesium 2.0 mEq/L
, Answer: C. Potassium 6.2 mEq/L
Rationale: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias.
9. A postpartum client is saturating one perineal pad every 15 minutes. Which
action should the nurse take first?
A. Notify the provider
B. Increase IV fluids
C. Assess the uterine fundus
D. Obtain hemoglobin level
Answer: C. Assess the uterine fundus
Rationale: Uterine atony is a common cause of postpartum hemorrhage and should be
assessed immediately.
10. Which client is at highest risk for developing a pressure injury?
A. Ambulatory client with hypertension
B. Client on prolonged bedrest
C. Client with seasonal allergies
D. Client with controlled asthma
Answer: B. Client on prolonged bedrest
Rationale: Immobility significantly increases the risk for pressure injuries.
11. A nurse is teaching a client about nitroglycerin tablets. Which statement
indicates understanding?
A. "I will swallow the tablet with water."
B. "I will store the tablets in a clear plastic bag."
C. "I will keep the tablets in the original dark container."
D. "I will take the medication only at bedtime."
Answer: C. "I will keep the tablets in the original dark container."
Rationale: Nitroglycerin is sensitive to moisture, heat, and light and should remain in its
original container.
Exam Prep Bundle | 200 Practice Questions and
Correct Answers with Detailed Rationales | Next
Generation NCLEX-RN Clinical Judgment,
Prioritization, Delegation, SATA & Case Study Review
Guide.
Introduction
The ATI RN Comprehensive Predictor is designed to assess nursing students' readiness for the
NCLEX-RN by evaluating clinical judgment, prioritization, delegation, pharmacology,
leadership, maternity, pediatrics, mental health, and medical-surgical nursing concepts. The
Next Generation NCLEX (NGN) emphasizes clinical judgment and decision-making through
case studies, bow-tie questions, matrix items, and multiple-response formats.
1. A nurse is assessing a client who has acute respiratory distress. Which finding
requires immediate intervention?
A. Respiratory rate 24/min
B. Oxygen saturation 84% on room air
C. Heart rate 104/min
D. Temperature 37.4°C (99.3°F)
Answer: B. Oxygen saturation 84% on room air
Rationale: An oxygen saturation of 84% indicates severe hypoxemia and requires immediate
intervention to restore adequate oxygenation.
,2. A nurse is caring for a client who reports chest pain rated 8/10. Which action
should the nurse take first?
A. Administer prescribed analgesic
B. Obtain a 12-lead ECG
C. Assess vital signs and oxygen saturation
D. Notify the provider
Answer: C. Assess vital signs and oxygen saturation
Rationale: Assessment is the first step of the nursing process and helps determine the severity
of the client's condition.
3. Which client should the nurse assess first?
A. A client with diabetes whose blood glucose is 240 mg/dL
B. A client with a fractured arm reporting pain 7/10
C. A client with COPD whose oxygen saturation is 88%
D. A client requesting discharge instructions
Answer: C. A client with COPD whose oxygen saturation is 88%
Rationale: Airway and breathing issues take priority according to ABC principles.
4. A nurse is delegating tasks to an assistive personnel (AP). Which task is
appropriate?
A. Assessing pain level
B. Administering oral medications
C. Reinforcing teaching about insulin injections
D. Obtaining routine vital signs on a stable client
Answer: D. Obtaining routine vital signs on a stable client
Rationale: AP can collect routine data but cannot assess, teach, or administer medications.
5. A client receiving warfarin has an INR of 5.0. Which action should the nurse
anticipate?
,A. Increase the dose
B. Continue medication as prescribed
C. Hold the medication and notify the provider
D. Administer aspirin
Answer: C. Hold the medication and notify the provider
Rationale: An INR of 5.0 places the client at risk for bleeding and requires provider
notification.
6. Which assessment finding is expected in a client experiencing hypoglycemia?
A. Warm dry skin
B. Fruity breath odor
C. Cool clammy skin
D. Kussmaul respirations
Answer: C. Cool clammy skin
Rationale: Hypoglycemia activates the sympathetic nervous system, causing diaphoresis and
clammy skin.
7. A nurse is caring for a client with heart failure. Which assessment finding
indicates fluid overload?
A. Dry mucous membranes
B. Crackles in the lungs
C. Decreased jugular venous pressure
D. Weight loss
Answer: B. Crackles in the lungs
Rationale: Crackles indicate pulmonary fluid accumulation associated with heart failure.
8. Which laboratory value should the nurse report immediately?
A. Sodium 138 mEq/L
B. Calcium 9.4 mg/dL
C. Potassium 6.2 mEq/L
D. Magnesium 2.0 mEq/L
, Answer: C. Potassium 6.2 mEq/L
Rationale: Severe hyperkalemia can cause life-threatening cardiac dysrhythmias.
9. A postpartum client is saturating one perineal pad every 15 minutes. Which
action should the nurse take first?
A. Notify the provider
B. Increase IV fluids
C. Assess the uterine fundus
D. Obtain hemoglobin level
Answer: C. Assess the uterine fundus
Rationale: Uterine atony is a common cause of postpartum hemorrhage and should be
assessed immediately.
10. Which client is at highest risk for developing a pressure injury?
A. Ambulatory client with hypertension
B. Client on prolonged bedrest
C. Client with seasonal allergies
D. Client with controlled asthma
Answer: B. Client on prolonged bedrest
Rationale: Immobility significantly increases the risk for pressure injuries.
11. A nurse is teaching a client about nitroglycerin tablets. Which statement
indicates understanding?
A. "I will swallow the tablet with water."
B. "I will store the tablets in a clear plastic bag."
C. "I will keep the tablets in the original dark container."
D. "I will take the medication only at bedtime."
Answer: C. "I will keep the tablets in the original dark container."
Rationale: Nitroglycerin is sensitive to moisture, heat, and light and should remain in its
original container.
