ATI RN Comprehensive Predictor 2026 –
Comprehensive Readiness Assessment A
| NGN Clinical Judgment Case Studies,
Verified Answers, & Comprehensive
Rationales
Question 1
A nurse is caring for a client who has heart failure and reports
increasing shortness of breath. Which assessment finding
requires immediate intervention?
A. Weight gain of 1 kg (2.2 lb) in 1 week
B. Bilateral ankle edema
C. Oxygen saturation of 86% on room air
D. Fatigue during activities of daily living
Rationale: An oxygen saturation of 86% indicates significant
hypoxemia and impaired gas exchange, which can rapidly
progress to respiratory failure. This finding takes priority over
edema, fatigue, or gradual weight gain because airway and
oxygenation concerns are addressed first according to ABC
priorities.
Question 2
,A nurse is reviewing laboratory results for a client receiving
warfarin therapy. Which finding indicates the medication is
therapeutic?
A. INR 1.0
B. INR 1.5
C. INR 2.5
D. INR 5.0
Rationale: The therapeutic INR range for most clients
receiving warfarin is 2.0 to 3.0. An INR of 2.5 indicates
adequate anticoagulation. Lower values increase thrombosis
risk, while higher values increase bleeding risk.
Question 3
A nurse is assessing a client who has increased intracranial
pressure. Which finding should the nurse report
immediately?
A. Headache rated 6/10
B. Restlessness
C. Decreased level of consciousness
D. Nausea
Rationale: A decreasing level of consciousness is often the
earliest and most significant indicator of worsening
intracranial pressure. Changes in neurological status suggest
reduced cerebral perfusion and require prompt intervention.
Question 4
,A nurse is caring for a client receiving a blood transfusion.
Which manifestation indicates an acute hemolytic transfusion
reaction?
A. Hypertension and bradycardia
B. Fever, chills, and low back pain
C. Peripheral edema
D. Hyperglycemia
Rationale: Fever, chills, flank or low back pain, tachycardia,
and hypotension are classic findings of an acute hemolytic
transfusion reaction. The transfusion should be stopped
immediately and emergency protocols initiated.
Question 5
A nurse is teaching a client who has type 1 diabetes mellitus
about hypoglycemia. Which manifestation should the nurse
include?
A. Fruity breath odor
B. Kussmaul respirations
C. Diaphoresis and tremors
D. Polyuria
Rationale: Hypoglycemia activates the sympathetic nervous
system, producing diaphoresis, shakiness, tachycardia, and
hunger. Fruity breath and Kussmaul respirations are
associated with diabetic ketoacidosis.
Question 6
, A nurse is caring for a client who has chronic kidney disease.
Which laboratory value should the nurse expect?
A. Decreased creatinine
B. Decreased BUN
C. Elevated serum potassium
D. Decreased phosphorus
Rationale: Chronic kidney disease reduces the kidneys' ability
to excrete potassium, often resulting in hyperkalemia.
Elevated potassium levels can cause life-threatening cardiac
dysrhythmias.
Question 7
A nurse is caring for a client who is 2 hr postoperative
following abdominal surgery. Which finding requires
immediate action?
A. Pain rating of 7/10
B. Urine output of 40 mL/hr
C. Respiratory rate of 8/min
D. Temperature of 37.4°C (99.3°F)
Rationale: A respiratory rate of 8/min indicates respiratory
depression, often related to opioid administration or
anesthesia effects. Impaired ventilation threatens
oxygenation and requires immediate intervention.
Question 8
Comprehensive Readiness Assessment A
| NGN Clinical Judgment Case Studies,
Verified Answers, & Comprehensive
Rationales
Question 1
A nurse is caring for a client who has heart failure and reports
increasing shortness of breath. Which assessment finding
requires immediate intervention?
A. Weight gain of 1 kg (2.2 lb) in 1 week
B. Bilateral ankle edema
C. Oxygen saturation of 86% on room air
D. Fatigue during activities of daily living
Rationale: An oxygen saturation of 86% indicates significant
hypoxemia and impaired gas exchange, which can rapidly
progress to respiratory failure. This finding takes priority over
edema, fatigue, or gradual weight gain because airway and
oxygenation concerns are addressed first according to ABC
priorities.
Question 2
,A nurse is reviewing laboratory results for a client receiving
warfarin therapy. Which finding indicates the medication is
therapeutic?
A. INR 1.0
B. INR 1.5
C. INR 2.5
D. INR 5.0
Rationale: The therapeutic INR range for most clients
receiving warfarin is 2.0 to 3.0. An INR of 2.5 indicates
adequate anticoagulation. Lower values increase thrombosis
risk, while higher values increase bleeding risk.
Question 3
A nurse is assessing a client who has increased intracranial
pressure. Which finding should the nurse report
immediately?
A. Headache rated 6/10
B. Restlessness
C. Decreased level of consciousness
D. Nausea
Rationale: A decreasing level of consciousness is often the
earliest and most significant indicator of worsening
intracranial pressure. Changes in neurological status suggest
reduced cerebral perfusion and require prompt intervention.
Question 4
,A nurse is caring for a client receiving a blood transfusion.
Which manifestation indicates an acute hemolytic transfusion
reaction?
A. Hypertension and bradycardia
B. Fever, chills, and low back pain
C. Peripheral edema
D. Hyperglycemia
Rationale: Fever, chills, flank or low back pain, tachycardia,
and hypotension are classic findings of an acute hemolytic
transfusion reaction. The transfusion should be stopped
immediately and emergency protocols initiated.
Question 5
A nurse is teaching a client who has type 1 diabetes mellitus
about hypoglycemia. Which manifestation should the nurse
include?
A. Fruity breath odor
B. Kussmaul respirations
C. Diaphoresis and tremors
D. Polyuria
Rationale: Hypoglycemia activates the sympathetic nervous
system, producing diaphoresis, shakiness, tachycardia, and
hunger. Fruity breath and Kussmaul respirations are
associated with diabetic ketoacidosis.
Question 6
, A nurse is caring for a client who has chronic kidney disease.
Which laboratory value should the nurse expect?
A. Decreased creatinine
B. Decreased BUN
C. Elevated serum potassium
D. Decreased phosphorus
Rationale: Chronic kidney disease reduces the kidneys' ability
to excrete potassium, often resulting in hyperkalemia.
Elevated potassium levels can cause life-threatening cardiac
dysrhythmias.
Question 7
A nurse is caring for a client who is 2 hr postoperative
following abdominal surgery. Which finding requires
immediate action?
A. Pain rating of 7/10
B. Urine output of 40 mL/hr
C. Respiratory rate of 8/min
D. Temperature of 37.4°C (99.3°F)
Rationale: A respiratory rate of 8/min indicates respiratory
depression, often related to opioid administration or
anesthesia effects. Impaired ventilation threatens
oxygenation and requires immediate intervention.
Question 8
