ATI RN COMPREHENSIVE PREDICTOR 2023-2026
EXIT EXAM WITH NGN (NEXT GENERATION NCLEX)
Total Questions: 180
Time Limit: 4 hours (240 minutes)
Pause Time Available: 5 minutes total
Question: 1 of 180
A nurse is assessing a client who is 2 hours postoperative following a hip arthroplasty.
Exhibit 1
Exhibit 2
Exhibit 3
Nurses' Notes
0800:
Client alert and oriented x3. Vital signs stable. Pain reported as 4 on 0-10 scale. Incision clean,
dry, intact. Toes warm, able to wiggle bilaterally.
0830:
Client reports sudden shortness of breath and chest pain. Respiratory rate 28/min. SpO2 88%
on room air.
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an alert message sent to the
proctor and may result in the termination of the assessment.
Copyright 2025 Assessment Technologies Institute, LLC. All rights reserved
,Drag words from the choices below to fill in each blank in the following sentence.
The client is most likely experiencing ______ Target 1 ______, and the nurse should prepare
for ______ Target 2 ______.
• pulmonary embolism
• wound infection
• a CT scan or V/Q scan
• an immediate dose of oral pain medication
Answer & Rationale
Target 1: pulmonary embolism
Target 2: a CT scan or V/Q scan
Rationale: Postoperative hip arthroplasty clients are at high risk for deep vein thrombosis
(DVT) leading to pulmonary embolism (PE). Sudden shortness of breath, chest pain, tachypnea,
and hypoxemia are classic PE signs. Diagnostic confirmation requires CT angiography or V/Q
scan. Pain medication would not address the life-threatening condition. Wound infection does
not present with respiratory symptoms.
Question: 2 of 180
A nurse is caring for a client with heart failure who reports worsening dyspnea and weight gain
of 3 kg in 3 days.
Exhibit 1
Exhibit 2
Exhibit 3
Medication Administration Record
• Furosemide 40 mg IV push once daily
• Lisinopril 10 mg PO once daily
• Metoprolol 25 mg PO twice daily
• Digoxin 0.125 mg PO once daily
Laboratory Results
Potassium: 3.2 mEq/L (3.5-5.0)
Digoxin level: 2.0 ng/mL (0.8-2.0)
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an alert message sent to the
proctor and may result in the termination of the assessment.
Copyright 2025 Assessment Technologies Institute, LLC. All rights reserved
,Drag words from the choices below to fill in each blank in the following sentence.
The client is at risk for developing ______ Target 1 ______ due to ______ Target 2 ______.
• digoxin toxicity
• hyperkalemia
• hypokalemia
• hypokalemia potentiating digoxin toxicity
Answer & Rationale
Target 1: digoxin toxicity
Target 2: hypokalemia potentiating digoxin toxicity
Rationale: Hypokalemia (potassium 3.2) increases the risk of digoxin toxicity even at
therapeutic digoxin levels. Low potassium enhances digoxin binding to cardiac sodium-
potassium ATPase pumps, leading to dysrhythmias, nausea, and visual changes. The nurse
should hold digoxin, notify provider, and prepare for potassium replacement.
Question: 3 of 180
A nurse is providing discharge teaching to a client with a new diagnosis of diabetes mellitus.
Exhibit 1
Exhibit 2
Exhibit 3
Discharge Instructions
• Check blood glucose before meals and at bedtime
• Take metformin 500 mg twice daily with meals
• Call provider for blood glucose >250 mg/dL or <70 mg/dL
Client Statement
"I don't understand why I need to check my sugar so often. I feel fine."
Drag words from the choices below to fill in each blank in the following sentence.
The nurse should explain that frequent monitoring helps prevent ______ Target 1 ______ and
allows for early detection of ______ Target 2 ______.
• hypoglycemia unawareness
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an alert message sent to the
proctor and may result in the termination of the assessment.
Copyright 2025 Assessment Technologies Institute, LLC. All rights reserved
, • diabetic ketoacidosis
• hyperosmolar hyperglycemic state
• both hypo- and hyperglycemia
Answer & Rationale
Target 1: hypoglycemia unawareness
Target 2: both hypo- and hyperglycemia
Rationale: Frequent monitoring prevents hypoglycemia unawareness (loss of early warning
symptoms) and allows early detection of both low and high blood glucose. This reduces risk of
severe hypoglycemic events and acute hyperglycemic complications like DKA or HHS. The
client's statement "I feel fine" indicates potential lack of symptom recognition.
Question: 4 of 180
A nurse is assessing a client who is receiving a blood transfusion. 15 minutes after initiation,
the client reports low back pain and chills.
Exhibit 1
Exhibit 2
Exhibit 3
Vital Signs
Baseline:
BP 110/70, HR 80, RR 16, Temp 37.0°C (98.6°F)
Current:
BP 100/60, HR 110, RR 24, Temp 38.5°C (101.3°F)
Drag words from the choices below to fill in each blank in the following sentence.
The client is showing signs of a ______ Target 1 ______ transfusion reaction, and the nurse
should ______ Target 2 ______ first.
• hemolytic
• febrile
• allergic
• stop the transfusion
• slow the infusion rate
• administer acetaminophen
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an alert message sent to the
proctor and may result in the termination of the assessment.
Copyright 2025 Assessment Technologies Institute, LLC. All rights reserved
EXIT EXAM WITH NGN (NEXT GENERATION NCLEX)
Total Questions: 180
Time Limit: 4 hours (240 minutes)
Pause Time Available: 5 minutes total
Question: 1 of 180
A nurse is assessing a client who is 2 hours postoperative following a hip arthroplasty.
Exhibit 1
Exhibit 2
Exhibit 3
Nurses' Notes
0800:
Client alert and oriented x3. Vital signs stable. Pain reported as 4 on 0-10 scale. Incision clean,
dry, intact. Toes warm, able to wiggle bilaterally.
0830:
Client reports sudden shortness of breath and chest pain. Respiratory rate 28/min. SpO2 88%
on room air.
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an alert message sent to the
proctor and may result in the termination of the assessment.
Copyright 2025 Assessment Technologies Institute, LLC. All rights reserved
,Drag words from the choices below to fill in each blank in the following sentence.
The client is most likely experiencing ______ Target 1 ______, and the nurse should prepare
for ______ Target 2 ______.
• pulmonary embolism
• wound infection
• a CT scan or V/Q scan
• an immediate dose of oral pain medication
Answer & Rationale
Target 1: pulmonary embolism
Target 2: a CT scan or V/Q scan
Rationale: Postoperative hip arthroplasty clients are at high risk for deep vein thrombosis
(DVT) leading to pulmonary embolism (PE). Sudden shortness of breath, chest pain, tachypnea,
and hypoxemia are classic PE signs. Diagnostic confirmation requires CT angiography or V/Q
scan. Pain medication would not address the life-threatening condition. Wound infection does
not present with respiratory symptoms.
Question: 2 of 180
A nurse is caring for a client with heart failure who reports worsening dyspnea and weight gain
of 3 kg in 3 days.
Exhibit 1
Exhibit 2
Exhibit 3
Medication Administration Record
• Furosemide 40 mg IV push once daily
• Lisinopril 10 mg PO once daily
• Metoprolol 25 mg PO twice daily
• Digoxin 0.125 mg PO once daily
Laboratory Results
Potassium: 3.2 mEq/L (3.5-5.0)
Digoxin level: 2.0 ng/mL (0.8-2.0)
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an alert message sent to the
proctor and may result in the termination of the assessment.
Copyright 2025 Assessment Technologies Institute, LLC. All rights reserved
,Drag words from the choices below to fill in each blank in the following sentence.
The client is at risk for developing ______ Target 1 ______ due to ______ Target 2 ______.
• digoxin toxicity
• hyperkalemia
• hypokalemia
• hypokalemia potentiating digoxin toxicity
Answer & Rationale
Target 1: digoxin toxicity
Target 2: hypokalemia potentiating digoxin toxicity
Rationale: Hypokalemia (potassium 3.2) increases the risk of digoxin toxicity even at
therapeutic digoxin levels. Low potassium enhances digoxin binding to cardiac sodium-
potassium ATPase pumps, leading to dysrhythmias, nausea, and visual changes. The nurse
should hold digoxin, notify provider, and prepare for potassium replacement.
Question: 3 of 180
A nurse is providing discharge teaching to a client with a new diagnosis of diabetes mellitus.
Exhibit 1
Exhibit 2
Exhibit 3
Discharge Instructions
• Check blood glucose before meals and at bedtime
• Take metformin 500 mg twice daily with meals
• Call provider for blood glucose >250 mg/dL or <70 mg/dL
Client Statement
"I don't understand why I need to check my sugar so often. I feel fine."
Drag words from the choices below to fill in each blank in the following sentence.
The nurse should explain that frequent monitoring helps prevent ______ Target 1 ______ and
allows for early detection of ______ Target 2 ______.
• hypoglycemia unawareness
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an alert message sent to the
proctor and may result in the termination of the assessment.
Copyright 2025 Assessment Technologies Institute, LLC. All rights reserved
, • diabetic ketoacidosis
• hyperosmolar hyperglycemic state
• both hypo- and hyperglycemia
Answer & Rationale
Target 1: hypoglycemia unawareness
Target 2: both hypo- and hyperglycemia
Rationale: Frequent monitoring prevents hypoglycemia unawareness (loss of early warning
symptoms) and allows early detection of both low and high blood glucose. This reduces risk of
severe hypoglycemic events and acute hyperglycemic complications like DKA or HHS. The
client's statement "I feel fine" indicates potential lack of symptom recognition.
Question: 4 of 180
A nurse is assessing a client who is receiving a blood transfusion. 15 minutes after initiation,
the client reports low back pain and chills.
Exhibit 1
Exhibit 2
Exhibit 3
Vital Signs
Baseline:
BP 110/70, HR 80, RR 16, Temp 37.0°C (98.6°F)
Current:
BP 100/60, HR 110, RR 24, Temp 38.5°C (101.3°F)
Drag words from the choices below to fill in each blank in the following sentence.
The client is showing signs of a ______ Target 1 ______ transfusion reaction, and the nurse
should ______ Target 2 ______ first.
• hemolytic
• febrile
• allergic
• stop the transfusion
• slow the infusion rate
• administer acetaminophen
Full screen mode is in effect during your proctored testing.
Please Note: Attempting to exit out of full screen mode or pressing the escape button will result in an alert message sent to the
proctor and may result in the termination of the assessment.
Copyright 2025 Assessment Technologies Institute, LLC. All rights reserved
