ATI Comprehensive Predictor
Exam Review (2026/2027)
Pre-Licensure NCLEX-RN Readiness Assessment
70 Questions with Correct Answers and Rationales
NGN-Integrated | NCSBN Client Needs Aligned
Aligned with NCSBN NCLEX-RN Detailed Test Plan 2023-2026
,Abstract
This document presents a comprehensive 70-question practice examination designed
to assess pre-licensure nursing students' readiness for the NCLEX-RN examination.
The exam review is aligned with the NCSBN NCLEX-RN Detailed Test Plan (2023-
2026) and organized across the four major Client Needs categories: Safe and Effective
Care Environment (24.3%), Health Promotion and Maintenance (11.4%),
Psychosocial Integrity (11.4%), and Physiological Integrity (47.1%). An additional
section integrates the NCSBN Clinical Judgment Measurement Model (CJMM) with
Next Generation NCLEX (NGN) item formats including bowtie analysis, trend
interpretation, matrix ranking, and scenario-based clinical judgment questions. Each
question includes four multiple-choice options with the correct answer highlighted
and a concise evidence-based rationale supported by authoritative nursing references.
The exam covers essential nursing content including delegation, infection control,
pharmacological safety, laboratory interpretation, physiological adaptation, and
therapeutic communication. This resource is intended as a self-assessment tool to
identify knowledge gaps and strengthen clinical reasoning skills in preparation for the
NCLEX-RN examination and entry-level nursing practice.
Keywords
ATI; NCLEX-RN; comprehensive predictor; clinical judgment; nursing education;
Next Generation NCLEX (NGN); Client Needs framework; patient safety
Domain Distribution Table
Domain Content Focus Questions Percentage
Safe & Effective Delegation, 10 14.3%
Care — Prioritization,
Management of Care Legal/Ethical,
Advocacy,
Discharge Planning
Safe & Effective Precautions, PPE, 7 10.0%
Care — Safety & Fall Prevention, Fire
Infection Control Safety, Sharps
, ATI Comprehensive Predictor Exam Review 2026/2027
Safety
Health Promotion Growth & 8 11.4%
and Maintenance Development,
Screening,
Immunizations,
Prenatal Care
Psychosocial Therapeutic 8 11.4%
Integrity Communication,
Mental Health,
Grief, Cultural
Sensitivity
Physiological — Pain Assessment, 7 10.0%
Basic Care & Nutrition, ADLs,
Comfort Skin Integrity,
Activity
Physiological — Medication Rights, 8 11.4%
Pharmacological & High-Alert Drugs,
Parenteral Calculations,
Anticoagulants
Physiological — Vital Signs, Lab 10 14.3%
Reduction of Risk Values, ABGs,
Potential Transfusions, IV
Therapy
Physiological — Heart Failure, 8 11.4%
Physiological COPD, DKA, PE,
Adaptation Cirrhosis,
Electrolytes
Clinical Judgment & CJMM Steps, NGN 4 5.7%
NGN Integration Item Types, Bowtie,
Trend, Matrix
TOTAL 9 Domains — 70 70 100%
Questions
3
, ATI Comprehensive Predictor Exam Review 2026/2027
Domain 1: Safe and Effective Care Environment —
Management of Care
Question 1: A charge nurse on a medical-surgical unit is making client assignments.
Which task is MOST appropriate to delegate to a licensed practical nurse (LPN)?
A) A) Administering an initial admission assessment for a new client with chest
pain
B) B) Administering enoxaparin subcutaneously to a client with deep vein
thrombosis
C) C) Developing an individualized nursing care plan for a postoperative client
D) D) Evaluating client response to pain management interventions after
surgery
Correct Answer: B — Administering enoxaparin subcutaneously to a client with
deep vein thrombosis
Rationale: The Five Rights of Delegation require the right task for the right person.
Administering routine medications such as subcutaneous anticoagulants is within the
LPN scope of practice under RN supervision. Initial assessments, care planning, and
evaluation are RN responsibilities (NCSBN, 2023; Potter & Perry, 10th ed.).
References: NCSBN, 2023; Potter & Perry, 10th ed.
Question 2: The nurse receives change-of-shift report on four clients. Which client
should the nurse assess FIRST?
A) A) A client with type 2 diabetes requesting discharge teaching
B) B) A client with pneumonia who is due for a scheduled antibiotic in 30
minutes
C) C) A client with chronic heart failure reporting new onset dyspnea at
rest
4
Exam Review (2026/2027)
Pre-Licensure NCLEX-RN Readiness Assessment
70 Questions with Correct Answers and Rationales
NGN-Integrated | NCSBN Client Needs Aligned
Aligned with NCSBN NCLEX-RN Detailed Test Plan 2023-2026
,Abstract
This document presents a comprehensive 70-question practice examination designed
to assess pre-licensure nursing students' readiness for the NCLEX-RN examination.
The exam review is aligned with the NCSBN NCLEX-RN Detailed Test Plan (2023-
2026) and organized across the four major Client Needs categories: Safe and Effective
Care Environment (24.3%), Health Promotion and Maintenance (11.4%),
Psychosocial Integrity (11.4%), and Physiological Integrity (47.1%). An additional
section integrates the NCSBN Clinical Judgment Measurement Model (CJMM) with
Next Generation NCLEX (NGN) item formats including bowtie analysis, trend
interpretation, matrix ranking, and scenario-based clinical judgment questions. Each
question includes four multiple-choice options with the correct answer highlighted
and a concise evidence-based rationale supported by authoritative nursing references.
The exam covers essential nursing content including delegation, infection control,
pharmacological safety, laboratory interpretation, physiological adaptation, and
therapeutic communication. This resource is intended as a self-assessment tool to
identify knowledge gaps and strengthen clinical reasoning skills in preparation for the
NCLEX-RN examination and entry-level nursing practice.
Keywords
ATI; NCLEX-RN; comprehensive predictor; clinical judgment; nursing education;
Next Generation NCLEX (NGN); Client Needs framework; patient safety
Domain Distribution Table
Domain Content Focus Questions Percentage
Safe & Effective Delegation, 10 14.3%
Care — Prioritization,
Management of Care Legal/Ethical,
Advocacy,
Discharge Planning
Safe & Effective Precautions, PPE, 7 10.0%
Care — Safety & Fall Prevention, Fire
Infection Control Safety, Sharps
, ATI Comprehensive Predictor Exam Review 2026/2027
Safety
Health Promotion Growth & 8 11.4%
and Maintenance Development,
Screening,
Immunizations,
Prenatal Care
Psychosocial Therapeutic 8 11.4%
Integrity Communication,
Mental Health,
Grief, Cultural
Sensitivity
Physiological — Pain Assessment, 7 10.0%
Basic Care & Nutrition, ADLs,
Comfort Skin Integrity,
Activity
Physiological — Medication Rights, 8 11.4%
Pharmacological & High-Alert Drugs,
Parenteral Calculations,
Anticoagulants
Physiological — Vital Signs, Lab 10 14.3%
Reduction of Risk Values, ABGs,
Potential Transfusions, IV
Therapy
Physiological — Heart Failure, 8 11.4%
Physiological COPD, DKA, PE,
Adaptation Cirrhosis,
Electrolytes
Clinical Judgment & CJMM Steps, NGN 4 5.7%
NGN Integration Item Types, Bowtie,
Trend, Matrix
TOTAL 9 Domains — 70 70 100%
Questions
3
, ATI Comprehensive Predictor Exam Review 2026/2027
Domain 1: Safe and Effective Care Environment —
Management of Care
Question 1: A charge nurse on a medical-surgical unit is making client assignments.
Which task is MOST appropriate to delegate to a licensed practical nurse (LPN)?
A) A) Administering an initial admission assessment for a new client with chest
pain
B) B) Administering enoxaparin subcutaneously to a client with deep vein
thrombosis
C) C) Developing an individualized nursing care plan for a postoperative client
D) D) Evaluating client response to pain management interventions after
surgery
Correct Answer: B — Administering enoxaparin subcutaneously to a client with
deep vein thrombosis
Rationale: The Five Rights of Delegation require the right task for the right person.
Administering routine medications such as subcutaneous anticoagulants is within the
LPN scope of practice under RN supervision. Initial assessments, care planning, and
evaluation are RN responsibilities (NCSBN, 2023; Potter & Perry, 10th ed.).
References: NCSBN, 2023; Potter & Perry, 10th ed.
Question 2: The nurse receives change-of-shift report on four clients. Which client
should the nurse assess FIRST?
A) A) A client with type 2 diabetes requesting discharge teaching
B) B) A client with pneumonia who is due for a scheduled antibiotic in 30
minutes
C) C) A client with chronic heart failure reporting new onset dyspnea at
rest
4
