ATI PN Comprehensive Predictor 2026 Exit Exam with NGN180 Questions and
Rationales Comprehensive Study Guide | Practice Questions | Detailed Rationales
2026 Edition
STUDY GUIDE — ORIGINAL PRACTICE QUESTIONS All questions are original and created for educational
purposes.
,
, Question 1 of 180 | Musculoskeletal / Orthopedic Care
A nurse is caring for a client who has a fractured femur and is in Buck's traction. Which of the
following actions should the nurse take?
○ A. Apply a 9 kg (20 lb) weight to the traction.
○ B. Remove the weights while the client is eating.
○ C. Clean the pin insertion sites on a daily basis.
○ D. Ensure that the weights are hanging freely.
✓ Correct Answer: D. Ensure that the weights are hanging freely.
Rationale: In Buck's traction (skin traction), the weights must hang freely at all times and must not rest on
the floor or bed frame. This maintains the prescribed tension needed to reduce muscle spasms and keep the
fracture aligned.
Why Other Options Are Incorrect:
• Option A: 9 kg (20 lb) is too heavy for skin traction. Buck's traction typically uses 2.3–4.5 kg (5–10 lb) to
prevent skin breakdown.
• Option B: Traction must be continuous. Removing weights interrupts the therapeutic pull and allows muscle
spasms to worsen.
• Option C: Buck's traction is skin traction, not skeletal traction; there are no pin sites to clean.
Question 2 of 180 | Musculoskeletal / Orthopedic Care
A nurse is caring for a client in skeletal traction for a fractured tibia. Which finding requires
immediate intervention?
○ A. Client reports mild itching around the traction tape.
○ B. The traction weight bag is resting on the floor.
○ C. The client's foot is in a neutral position.
○ D. A small amount of serous drainage is noted at the pin site.
✓ Correct Answer: B. The traction weight bag is resting on the floor.
Rationale: Traction weights must hang freely. If the bag rests on the floor, the therapeutic pull is lost, the
fracture can override, and muscle spasms intensify. This is a priority safety concern requiring immediate
correction.
Why Other Options Are Incorrect:
• Option A: Mild itching under traction tape is common and does not require immediate intervention.
• Option C: Neutral foot position is expected and appropriate in tibial traction.
, • Option D: Small amounts of serous drainage at pin sites are expected; purulent drainage or odor would be the
concern.
Question 3 of 180 | Musculoskeletal / Orthopedic Care
A nurse is teaching a client who has a newly applied plaster cast on the right leg. Which statement by
the client indicates understanding of the teaching?
○ A. 'I will use a hair dryer on high heat to speed up the drying.'
○ B. 'I will use a pencil to scratch itchy skin under the cast.'
○ C. 'I will elevate my leg above the level of my heart.'
○ D. 'I will apply lotion around the cast edges each night.'
✓ Correct Answer: C. 'I will elevate my leg above the level of my heart.'
Rationale: Elevating the casted extremity above heart level reduces edema and promotes venous return,
decreasing risk of compartment syndrome.
Why Other Options Are Incorrect:
• Option A: Heat from a hair dryer can cause burns under the cast due to impaired sensation; use cool air only.
• Option B: Inserting objects under the cast can break skin, cause infection, or damage the cast.
• Option D: Lotion under or around cast edges can soften the plaster and cause skin maceration.
Question 4 of 180 | Musculoskeletal / Orthopedic Care
A nurse is assessing a client post-operatively following a right total hip arthroplasty. Which position
places the client at greatest risk for hip dislocation?
○ A. Supine with the right leg abducted using a wedge pillow.
○ B. Side-lying on the left with a pillow between the knees.
○ C. Legs crossed at the ankles while lying in bed.
○ D. Head of bed elevated 45 degrees with legs extended.
✓ Correct Answer: C. Legs crossed at the ankles while lying in bed.
Rationale: Crossing the legs causes hip adduction and internal rotation past the midline, which are the
movements most likely to dislocate a prosthetic hip joint in the early postoperative period.
Why Other Options Are Incorrect:
• Option A: Abduction with a wedge pillow is the standard preventive positioning after total hip arthroplasty.
• Option B: Pillow between knees maintains abduction and is appropriate.
• Option D: Head elevation with legs extended does not compromise hip alignment.
Rationales Comprehensive Study Guide | Practice Questions | Detailed Rationales
2026 Edition
STUDY GUIDE — ORIGINAL PRACTICE QUESTIONS All questions are original and created for educational
purposes.
,
, Question 1 of 180 | Musculoskeletal / Orthopedic Care
A nurse is caring for a client who has a fractured femur and is in Buck's traction. Which of the
following actions should the nurse take?
○ A. Apply a 9 kg (20 lb) weight to the traction.
○ B. Remove the weights while the client is eating.
○ C. Clean the pin insertion sites on a daily basis.
○ D. Ensure that the weights are hanging freely.
✓ Correct Answer: D. Ensure that the weights are hanging freely.
Rationale: In Buck's traction (skin traction), the weights must hang freely at all times and must not rest on
the floor or bed frame. This maintains the prescribed tension needed to reduce muscle spasms and keep the
fracture aligned.
Why Other Options Are Incorrect:
• Option A: 9 kg (20 lb) is too heavy for skin traction. Buck's traction typically uses 2.3–4.5 kg (5–10 lb) to
prevent skin breakdown.
• Option B: Traction must be continuous. Removing weights interrupts the therapeutic pull and allows muscle
spasms to worsen.
• Option C: Buck's traction is skin traction, not skeletal traction; there are no pin sites to clean.
Question 2 of 180 | Musculoskeletal / Orthopedic Care
A nurse is caring for a client in skeletal traction for a fractured tibia. Which finding requires
immediate intervention?
○ A. Client reports mild itching around the traction tape.
○ B. The traction weight bag is resting on the floor.
○ C. The client's foot is in a neutral position.
○ D. A small amount of serous drainage is noted at the pin site.
✓ Correct Answer: B. The traction weight bag is resting on the floor.
Rationale: Traction weights must hang freely. If the bag rests on the floor, the therapeutic pull is lost, the
fracture can override, and muscle spasms intensify. This is a priority safety concern requiring immediate
correction.
Why Other Options Are Incorrect:
• Option A: Mild itching under traction tape is common and does not require immediate intervention.
• Option C: Neutral foot position is expected and appropriate in tibial traction.
, • Option D: Small amounts of serous drainage at pin sites are expected; purulent drainage or odor would be the
concern.
Question 3 of 180 | Musculoskeletal / Orthopedic Care
A nurse is teaching a client who has a newly applied plaster cast on the right leg. Which statement by
the client indicates understanding of the teaching?
○ A. 'I will use a hair dryer on high heat to speed up the drying.'
○ B. 'I will use a pencil to scratch itchy skin under the cast.'
○ C. 'I will elevate my leg above the level of my heart.'
○ D. 'I will apply lotion around the cast edges each night.'
✓ Correct Answer: C. 'I will elevate my leg above the level of my heart.'
Rationale: Elevating the casted extremity above heart level reduces edema and promotes venous return,
decreasing risk of compartment syndrome.
Why Other Options Are Incorrect:
• Option A: Heat from a hair dryer can cause burns under the cast due to impaired sensation; use cool air only.
• Option B: Inserting objects under the cast can break skin, cause infection, or damage the cast.
• Option D: Lotion under or around cast edges can soften the plaster and cause skin maceration.
Question 4 of 180 | Musculoskeletal / Orthopedic Care
A nurse is assessing a client post-operatively following a right total hip arthroplasty. Which position
places the client at greatest risk for hip dislocation?
○ A. Supine with the right leg abducted using a wedge pillow.
○ B. Side-lying on the left with a pillow between the knees.
○ C. Legs crossed at the ankles while lying in bed.
○ D. Head of bed elevated 45 degrees with legs extended.
✓ Correct Answer: C. Legs crossed at the ankles while lying in bed.
Rationale: Crossing the legs causes hip adduction and internal rotation past the midline, which are the
movements most likely to dislocate a prosthetic hip joint in the early postoperative period.
Why Other Options Are Incorrect:
• Option A: Abduction with a wedge pillow is the standard preventive positioning after total hip arthroplasty.
• Option B: Pillow between knees maintains abduction and is appropriate.
• Option D: Head elevation with legs extended does not compromise hip alignment.
