_____________________________________________
ATI PN Comprehensive Predictor 2026 Exit Exam with
NGN | Complete 180- Exam Questions Test Bank with
Verified Correct Answers & Rationales
______________________________________________
Question 1
A nurse is preparing to administer a unit of packed red blood cells to a client. Which of the
following actions should the nurse take?
A. Infuse the blood using a Y-tubing set primed with normal saline.
B. Administer the blood through a 22-gauge IV catheter.
C. Allow the blood to infuse rapidly over 15 minutes.
D. Prime the tubing with Lactated Ringer’s solution.
Correct Answer: A
Rationale: Blood must be administered through a Y-tubing set that is primed with 0.9%
sodium chloride (normal saline). A 22-gauge catheter is too small and could cause hemolysis.
Blood should infuse over 1 to 4 hours, not rapidly. Lactated Ringer’s contains calcium, which
can cause clotting in the blood tubing.
Question 2
A nurse is evaluating a client’s understanding of a low-sodium diet. Which of the following
meal selections indicates the client understands the dietary restrictions?
A. Grilled chicken breast, steamed broccoli, and fresh apple slices.
B. Canned tomato soup, a turkey sandwich, and potato chips.
C. Sausage and cheese omelet with white toast.
D. Deli ham, coleslaw, and a dill pickle.
Correct Answer: A
Rationale: Fresh, unprocessed foods like grilled chicken, steamed vegetables, and fresh fruit
are naturally low in sodium. Canned soups, deli meats, cheese, and pickles are notoriously
high in sodium and should be avoided.
Question 3
A nurse is preparing to insert an indwelling urinary catheter for a male client. At which of the
following angles should the nurse insert the catheter?
A. 90 degrees toward the ceiling.
B. 45 degrees toward the client’s abdomen.
C. 60 degrees upward toward the umbilicus.
D. 30 degrees downward toward the floor.
Correct Answer: C
Rationale: In male clients, the urethra has a natural curve. The nurse should hold the penis at
,a 60 to 90-degree angle upward (toward the umbilicus) to straighten the urethral curve and
facilitate smooth insertion.
Question 4
A nurse is assessing a client who has recently experienced a stroke. The client is unable to
move the left arm and leg but is able to smile symmetrically. Which of the following areas of
the brain is most likely affected?
A. Right hemisphere.
B. Left hemisphere.
C. Brainstem.
D. Cerebellum.
Correct Answer: A
Rationale: Motor functions are controlled by the contralateral (opposite) side of the brain.
The right hemisphere controls the left side of the body. The brainstem controls vital functions
like breathing, and the cerebellum controls coordination.
Question 5
A nurse is reviewing the laboratory results of a client who is taking warfarin. The client’s INR is
5.2. Which of the following actions should the nurse take?
A. Administer vitamin K as prescribed.
B. Administer the next scheduled dose of warfarin as ordered.
C. Administer protamine sulfate.
D. Continue to monitor the client’s labs.
Correct Answer: A
Rationale: A therapeutic INR for warfarin is typically 2.0 to 3.0. An INR of 5.2 indicates severe
toxicity and places the client at high risk for bleeding. The nurse should withhold the next
dose, notify the provider, and prepare to administer vitamin K (the antidote) as ordered.
Protamine sulfate is the antidote for heparin.
Question 6
A client who is 2 hours postpartum after a vaginal delivery is reporting severe perineal pain.
The nurse assesses a large, purple, bulging mass at the perineum. Which of the following
conditions should the nurse suspect?
A. Uterine atony.
B. Vaginal hematoma.
C. Cervical laceration.
D. Retained placenta.
Correct Answer: B
Rationale: A large, bulging, purple mass at the perineum that causes severe pain is the classic
presentation of a vaginal or vulvar hematoma. This requires immediate notification of the
provider, as surgical evacuation may be necessary.
Question 7
A nurse is teaching an adolescent client who has type 1 diabetes about managing sick days.
Which of the following instructions should the nurse include?
A. "Do not take your insulin if you are unable to eat."
B. "Check your blood glucose and urine ketones every 4 hours."
C. "Increase your fluid intake by drinking sports drinks with sugar."
D. "Wait until you feel better to check your blood sugar."
,Correct Answer: B
Rationale: During illness, stress hormones cause blood glucose to rise, increasing the risk of
diabetic ketoacidosis (DKA). The client must check blood glucose and urine ketones every 3 to
4 hours. Insulin should never be withheld, even if the client cannot eat. Clients should drink
sugar-free fluids to stay hydrated.
Question 8
A nurse is caring for a client with a closed head injury. The nurse notes that the client’s blood
pressure is 150/90 mm Hg, pulse is 55/min, and respirations are 10/min. Which of the
following actions should the nurse take first?
A. Notify the provider.
B. Administer the prescribed antihypertensive medication.
C. Place the client in a supine position.
D. Document the findings in the chart.
Correct Answer: A
Rationale: The client’s vital signs show Cushing’s triad (hypertension, bradycardia, and
irregular respirations), which is a late, ominous sign of increased intracranial pressure (ICP)
and impending herniation. The nurse must notify the provider immediately. Antihypertensives
are generally contraindicated as they reduce cerebral perfusion pressure.
Question 9
A nurse is administering an intramuscular injection to a 4-year-old child. Which of the
following sites should the nurse select?
A. Deltoid.
B. Dorsogluteal.
C. Vastus lateralis.
D. Ventrogluteal.
Correct Answer: C
Rationale: The vastus lateralis is the preferred and safest site for IM injections in infants and
young children because it is the largest muscle mass and is free of major nerves and blood
vessels. The dorsogluteal site is avoided in children under 3 years due to the sciatic nerve risk.
Question 10
A nurse is providing teaching to a client who is about to start taking an SSRI for depression.
Which of the following statements should the nurse include?
A. "You may notice an immediate improvement in your mood."
B. "You should stop taking the medication if you experience sexual dysfunction."
C. "It can take up to 4 to 6 weeks to feel the full therapeutic effect."
D. "Taking this medication with a glass of grapefruit juice will speed up absorption."
Correct Answer: C
Rationale: SSRIs take several weeks to achieve therapeutic levels in the brain. The nurse must
educate the client that the full effect may take 4 to 6 weeks to avoid discouragement or
discontinuation. They should also warn the client not to stop abruptly.
Question 11
A nurse is caring for a client who has a tracheostomy. Which of the following actions should
the nurse take when suctioning the tracheostomy?
A. Apply suction as the catheter is being inserted.
B. Limit the suctioning time to 10 to 15 seconds.
, C. Hyperventilate the client with 100% oxygen before and after suctioning.
D. Use a clean technique for the procedure.
Correct Answer: C
Rationale: Suctioning removes oxygen from the airway. To prevent hypoxia, the nurse should
pre-oxygenate the client with 100% oxygen before and after suctioning. Suction should be
applied during withdrawal, not insertion. The duration should be limited to 5 to 10 seconds.
Question 12
A client is receiving an IV infusion of 1000 mL of normal saline over 8 hours. The IV tubing
drop factor is 15 gtt/mL. How many drops per minute should the nurse set the manual IV flow
rate to? (Round to the nearest whole number).
A. 15 gtt/min
B. 21 gtt/min
C. 31 gtt/min
D. 42 gtt/min
Correct Answer: C
Rationale: Formula: (Volume [mL] ÷ Time [minutes]) × Drop factor = gtt/min.
Time in minutes = 8 hours × 60 minutes = 480 minutes.
(1000 mL ÷ 480 min) × 15 gtt/mL = 2.083 × 15 = 31.25. Round to 31 gtt/min.
Question 13
A nurse is assessing a client who has just returned from a cardiac catheterization. Which of
the following findings requires immediate follow-up?
A. A palpable pulse at the insertion site.
B. A small hematoma at the insertion site.
C. Cool, pale, and mottled skin on the distal extremity.
D. A blood pressure of 118/72 mm Hg.
Correct Answer: C
Rationale: Cool, pale, and mottled skin distal to the catheter insertion site indicates
compromised arterial blood flow. This is a sign of arterial occlusion and is a medical
emergency requiring immediate intervention. A palpable pulse and BP are good signs. A small
hematoma might be expected and monitored.
Question 14
A nurse is caring for a client with a seizure disorder. The client begins to experience a
generalized tonic-clonic seizure. Which of the following actions should the nurse take?
A. Restrain the client's arms and legs.
B. Place a padded tongue blade between the client's teeth.
C. Turn the client to the side and protect the head.
D. Remove the client's oxygen mask.
Correct Answer: C
Rationale: During a seizure, the nurse's priority is to protect the client's airway and prevent
injury. The client should be turned to the side to allow secretions to drain and protect the
head with a pillow or hands to prevent trauma. The nurse should never restrain the client or
place anything in the mouth.
Question 15
A nurse is performing a sterile dressing change and accidentally contaminates the sterile field
by dropping a non-sterile item onto it. Which of the following actions should the nurse take?
ATI PN Comprehensive Predictor 2026 Exit Exam with
NGN | Complete 180- Exam Questions Test Bank with
Verified Correct Answers & Rationales
______________________________________________
Question 1
A nurse is preparing to administer a unit of packed red blood cells to a client. Which of the
following actions should the nurse take?
A. Infuse the blood using a Y-tubing set primed with normal saline.
B. Administer the blood through a 22-gauge IV catheter.
C. Allow the blood to infuse rapidly over 15 minutes.
D. Prime the tubing with Lactated Ringer’s solution.
Correct Answer: A
Rationale: Blood must be administered through a Y-tubing set that is primed with 0.9%
sodium chloride (normal saline). A 22-gauge catheter is too small and could cause hemolysis.
Blood should infuse over 1 to 4 hours, not rapidly. Lactated Ringer’s contains calcium, which
can cause clotting in the blood tubing.
Question 2
A nurse is evaluating a client’s understanding of a low-sodium diet. Which of the following
meal selections indicates the client understands the dietary restrictions?
A. Grilled chicken breast, steamed broccoli, and fresh apple slices.
B. Canned tomato soup, a turkey sandwich, and potato chips.
C. Sausage and cheese omelet with white toast.
D. Deli ham, coleslaw, and a dill pickle.
Correct Answer: A
Rationale: Fresh, unprocessed foods like grilled chicken, steamed vegetables, and fresh fruit
are naturally low in sodium. Canned soups, deli meats, cheese, and pickles are notoriously
high in sodium and should be avoided.
Question 3
A nurse is preparing to insert an indwelling urinary catheter for a male client. At which of the
following angles should the nurse insert the catheter?
A. 90 degrees toward the ceiling.
B. 45 degrees toward the client’s abdomen.
C. 60 degrees upward toward the umbilicus.
D. 30 degrees downward toward the floor.
Correct Answer: C
Rationale: In male clients, the urethra has a natural curve. The nurse should hold the penis at
,a 60 to 90-degree angle upward (toward the umbilicus) to straighten the urethral curve and
facilitate smooth insertion.
Question 4
A nurse is assessing a client who has recently experienced a stroke. The client is unable to
move the left arm and leg but is able to smile symmetrically. Which of the following areas of
the brain is most likely affected?
A. Right hemisphere.
B. Left hemisphere.
C. Brainstem.
D. Cerebellum.
Correct Answer: A
Rationale: Motor functions are controlled by the contralateral (opposite) side of the brain.
The right hemisphere controls the left side of the body. The brainstem controls vital functions
like breathing, and the cerebellum controls coordination.
Question 5
A nurse is reviewing the laboratory results of a client who is taking warfarin. The client’s INR is
5.2. Which of the following actions should the nurse take?
A. Administer vitamin K as prescribed.
B. Administer the next scheduled dose of warfarin as ordered.
C. Administer protamine sulfate.
D. Continue to monitor the client’s labs.
Correct Answer: A
Rationale: A therapeutic INR for warfarin is typically 2.0 to 3.0. An INR of 5.2 indicates severe
toxicity and places the client at high risk for bleeding. The nurse should withhold the next
dose, notify the provider, and prepare to administer vitamin K (the antidote) as ordered.
Protamine sulfate is the antidote for heparin.
Question 6
A client who is 2 hours postpartum after a vaginal delivery is reporting severe perineal pain.
The nurse assesses a large, purple, bulging mass at the perineum. Which of the following
conditions should the nurse suspect?
A. Uterine atony.
B. Vaginal hematoma.
C. Cervical laceration.
D. Retained placenta.
Correct Answer: B
Rationale: A large, bulging, purple mass at the perineum that causes severe pain is the classic
presentation of a vaginal or vulvar hematoma. This requires immediate notification of the
provider, as surgical evacuation may be necessary.
Question 7
A nurse is teaching an adolescent client who has type 1 diabetes about managing sick days.
Which of the following instructions should the nurse include?
A. "Do not take your insulin if you are unable to eat."
B. "Check your blood glucose and urine ketones every 4 hours."
C. "Increase your fluid intake by drinking sports drinks with sugar."
D. "Wait until you feel better to check your blood sugar."
,Correct Answer: B
Rationale: During illness, stress hormones cause blood glucose to rise, increasing the risk of
diabetic ketoacidosis (DKA). The client must check blood glucose and urine ketones every 3 to
4 hours. Insulin should never be withheld, even if the client cannot eat. Clients should drink
sugar-free fluids to stay hydrated.
Question 8
A nurse is caring for a client with a closed head injury. The nurse notes that the client’s blood
pressure is 150/90 mm Hg, pulse is 55/min, and respirations are 10/min. Which of the
following actions should the nurse take first?
A. Notify the provider.
B. Administer the prescribed antihypertensive medication.
C. Place the client in a supine position.
D. Document the findings in the chart.
Correct Answer: A
Rationale: The client’s vital signs show Cushing’s triad (hypertension, bradycardia, and
irregular respirations), which is a late, ominous sign of increased intracranial pressure (ICP)
and impending herniation. The nurse must notify the provider immediately. Antihypertensives
are generally contraindicated as they reduce cerebral perfusion pressure.
Question 9
A nurse is administering an intramuscular injection to a 4-year-old child. Which of the
following sites should the nurse select?
A. Deltoid.
B. Dorsogluteal.
C. Vastus lateralis.
D. Ventrogluteal.
Correct Answer: C
Rationale: The vastus lateralis is the preferred and safest site for IM injections in infants and
young children because it is the largest muscle mass and is free of major nerves and blood
vessels. The dorsogluteal site is avoided in children under 3 years due to the sciatic nerve risk.
Question 10
A nurse is providing teaching to a client who is about to start taking an SSRI for depression.
Which of the following statements should the nurse include?
A. "You may notice an immediate improvement in your mood."
B. "You should stop taking the medication if you experience sexual dysfunction."
C. "It can take up to 4 to 6 weeks to feel the full therapeutic effect."
D. "Taking this medication with a glass of grapefruit juice will speed up absorption."
Correct Answer: C
Rationale: SSRIs take several weeks to achieve therapeutic levels in the brain. The nurse must
educate the client that the full effect may take 4 to 6 weeks to avoid discouragement or
discontinuation. They should also warn the client not to stop abruptly.
Question 11
A nurse is caring for a client who has a tracheostomy. Which of the following actions should
the nurse take when suctioning the tracheostomy?
A. Apply suction as the catheter is being inserted.
B. Limit the suctioning time to 10 to 15 seconds.
, C. Hyperventilate the client with 100% oxygen before and after suctioning.
D. Use a clean technique for the procedure.
Correct Answer: C
Rationale: Suctioning removes oxygen from the airway. To prevent hypoxia, the nurse should
pre-oxygenate the client with 100% oxygen before and after suctioning. Suction should be
applied during withdrawal, not insertion. The duration should be limited to 5 to 10 seconds.
Question 12
A client is receiving an IV infusion of 1000 mL of normal saline over 8 hours. The IV tubing
drop factor is 15 gtt/mL. How many drops per minute should the nurse set the manual IV flow
rate to? (Round to the nearest whole number).
A. 15 gtt/min
B. 21 gtt/min
C. 31 gtt/min
D. 42 gtt/min
Correct Answer: C
Rationale: Formula: (Volume [mL] ÷ Time [minutes]) × Drop factor = gtt/min.
Time in minutes = 8 hours × 60 minutes = 480 minutes.
(1000 mL ÷ 480 min) × 15 gtt/mL = 2.083 × 15 = 31.25. Round to 31 gtt/min.
Question 13
A nurse is assessing a client who has just returned from a cardiac catheterization. Which of
the following findings requires immediate follow-up?
A. A palpable pulse at the insertion site.
B. A small hematoma at the insertion site.
C. Cool, pale, and mottled skin on the distal extremity.
D. A blood pressure of 118/72 mm Hg.
Correct Answer: C
Rationale: Cool, pale, and mottled skin distal to the catheter insertion site indicates
compromised arterial blood flow. This is a sign of arterial occlusion and is a medical
emergency requiring immediate intervention. A palpable pulse and BP are good signs. A small
hematoma might be expected and monitored.
Question 14
A nurse is caring for a client with a seizure disorder. The client begins to experience a
generalized tonic-clonic seizure. Which of the following actions should the nurse take?
A. Restrain the client's arms and legs.
B. Place a padded tongue blade between the client's teeth.
C. Turn the client to the side and protect the head.
D. Remove the client's oxygen mask.
Correct Answer: C
Rationale: During a seizure, the nurse's priority is to protect the client's airway and prevent
injury. The client should be turned to the side to allow secretions to drain and protect the
head with a pillow or hands to prevent trauma. The nurse should never restrain the client or
place anything in the mouth.
Question 15
A nurse is performing a sterile dressing change and accidentally contaminates the sterile field
by dropping a non-sterile item onto it. Which of the following actions should the nurse take?
