ATI PN Comprehensive Predictor 2026 Exit Exam Prep | Original NGN
Practice Questions, Clinical Judgment Cases, Prioritization,
Pharmacology, Med-Surg, Maternal-Newborn, Pediatrics, Mental Health,
and Leadership Review with Detailed Rationales
Questions 1–45: Fundamentals, Safety, and Pharmacology
Questions 46–90: Adult Medical-Surgical Nursing
Questions 91–120: Maternal-Newborn and Pediatric Nursing
Questions 121–150: Mental Health, Leadership, and Prioritization
Questions 151–180: NGN Clinical Judgment Cases and Comprehensive Review
1.
A practical nurse is caring for a client who suddenly develops shortness of breath,
restlessness, and an oxygen saturation of 84% on room air. Which action should the nurse
take first?
A. Notify the provider immediately.
B. Place the client in high-Fowler's position and administer oxygen as prescribed.
C. Document the findings in the medical record.
D. Encourage the client to use an incentive spirometer.
Answer: B. Place the client in high-Fowler's position and administer oxygen as
prescribed.
Rationale: Airway and breathing take priority. Positioning the client upright and
administering oxygen can improve oxygenation while additional interventions are arranged.
2.
A client with type 1 diabetes reports feeling shaky, sweaty, and dizzy. The client's blood
glucose level is 54 mg/dL. Which intervention should the nurse implement first?
,A. Administer regular insulin.
B. Give 15 g of a rapid-acting carbohydrate.
C. Encourage the client to exercise.
D. Restrict oral intake.
Answer: B. Give 15 g of a rapid-acting carbohydrate.
Rationale: The client is experiencing symptomatic hypoglycemia. Immediate treatment with
a rapid-acting carbohydrate is indicated.
3.
A practical nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires withholding the medication and notifying the provider?
A. Blood pressure of 132/80 mmHg
B. Respiratory rate of 18/min
C. Apical pulse of 54/min
D. Temperature of 37.1°C (98.8°F)
Answer: C. Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. An apical pulse below prescribed parameters
requires withholding the medication and notifying the provider.
4.
A client receiving intravenous morphine becomes difficult to arouse and has a respiratory
rate of 8/min. Which action should the nurse take first?
A. Place the client in Trendelenburg position.
B. Encourage deep breathing exercises.
C. Stop the opioid administration and assess airway and breathing.
D. Obtain a urine specimen.
Answer: C. Stop the opioid administration and assess airway and breathing.
Rationale: Respiratory depression is a life-threatening adverse effect of opioid therapy.
5.
,A client with chronic obstructive pulmonary disease suddenly becomes restless and
confused. Which finding should the nurse recognize as the most likely cause?
A. Improved oxygenation
B. Hyperglycemia
C. Hypoxemia
D. Hypercalcemia
Answer: C. Hypoxemia
Rationale: Restlessness and confusion are early signs of inadequate oxygenation in clients
with respiratory disorders.
6.
A practical nurse is caring for a client receiving furosemide therapy. Which assessment
finding should be reported immediately?
A. Potassium level of 2.9 mEq/L
B. Blood pressure of 128/76 mmHg
C. Heart rate of 82/min
D. Respiratory rate of 18/min
Answer: A. Potassium level of 2.9 mEq/L
Rationale: Severe hypokalemia places the client at risk for cardiac dysrhythmias and
requires prompt intervention.
7.
A client with a fractured femur suddenly develops severe dyspnea, confusion, and
petechiae on the upper chest. Which complication should the nurse suspect?
A. Pulmonary edema
B. Fat embolism syndrome
C. Hyperglycemia
D. Atelectasis
Answer: B. Fat embolism syndrome
, Rationale: The classic triad of fat embolism syndrome includes respiratory distress,
neurological changes, and petechiae.
8.
A nurse is teaching a client prescribed warfarin. Which statement by the client indicates
understanding of the teaching?
A. "I can take aspirin for headaches whenever needed."
B. "I should have my INR checked regularly."
C. "I no longer need monitoring once I am discharged."
D. "I should double the dose if I miss one."
Answer: B. "I should have my INR checked regularly."
Rationale: Warfarin therapy requires regular INR monitoring to maintain therapeutic
anticoagulation and prevent complications.
9.
A client who had abdominal surgery reports sudden calf pain, warmth, and swelling in one
leg. Which complication should the nurse suspect?
A. Pneumonia
B. Deep vein thrombosis
C. Urinary retention
D. Wound dehiscence
Answer: B. Deep vein thrombosis
Rationale: Unilateral leg pain, swelling, and warmth are characteristic findings of deep vein
thrombosis.
10.
A client with heart failure suddenly develops pink, frothy sputum and severe dyspnea.
Which action should the nurse take first?
A. Encourage oral fluids.
B. Place the client flat in bed.
Practice Questions, Clinical Judgment Cases, Prioritization,
Pharmacology, Med-Surg, Maternal-Newborn, Pediatrics, Mental Health,
and Leadership Review with Detailed Rationales
Questions 1–45: Fundamentals, Safety, and Pharmacology
Questions 46–90: Adult Medical-Surgical Nursing
Questions 91–120: Maternal-Newborn and Pediatric Nursing
Questions 121–150: Mental Health, Leadership, and Prioritization
Questions 151–180: NGN Clinical Judgment Cases and Comprehensive Review
1.
A practical nurse is caring for a client who suddenly develops shortness of breath,
restlessness, and an oxygen saturation of 84% on room air. Which action should the nurse
take first?
A. Notify the provider immediately.
B. Place the client in high-Fowler's position and administer oxygen as prescribed.
C. Document the findings in the medical record.
D. Encourage the client to use an incentive spirometer.
Answer: B. Place the client in high-Fowler's position and administer oxygen as
prescribed.
Rationale: Airway and breathing take priority. Positioning the client upright and
administering oxygen can improve oxygenation while additional interventions are arranged.
2.
A client with type 1 diabetes reports feeling shaky, sweaty, and dizzy. The client's blood
glucose level is 54 mg/dL. Which intervention should the nurse implement first?
,A. Administer regular insulin.
B. Give 15 g of a rapid-acting carbohydrate.
C. Encourage the client to exercise.
D. Restrict oral intake.
Answer: B. Give 15 g of a rapid-acting carbohydrate.
Rationale: The client is experiencing symptomatic hypoglycemia. Immediate treatment with
a rapid-acting carbohydrate is indicated.
3.
A practical nurse is preparing to administer digoxin to a client with heart failure. Which
assessment finding requires withholding the medication and notifying the provider?
A. Blood pressure of 132/80 mmHg
B. Respiratory rate of 18/min
C. Apical pulse of 54/min
D. Temperature of 37.1°C (98.8°F)
Answer: C. Apical pulse of 54/min
Rationale: Digoxin can cause bradycardia. An apical pulse below prescribed parameters
requires withholding the medication and notifying the provider.
4.
A client receiving intravenous morphine becomes difficult to arouse and has a respiratory
rate of 8/min. Which action should the nurse take first?
A. Place the client in Trendelenburg position.
B. Encourage deep breathing exercises.
C. Stop the opioid administration and assess airway and breathing.
D. Obtain a urine specimen.
Answer: C. Stop the opioid administration and assess airway and breathing.
Rationale: Respiratory depression is a life-threatening adverse effect of opioid therapy.
5.
,A client with chronic obstructive pulmonary disease suddenly becomes restless and
confused. Which finding should the nurse recognize as the most likely cause?
A. Improved oxygenation
B. Hyperglycemia
C. Hypoxemia
D. Hypercalcemia
Answer: C. Hypoxemia
Rationale: Restlessness and confusion are early signs of inadequate oxygenation in clients
with respiratory disorders.
6.
A practical nurse is caring for a client receiving furosemide therapy. Which assessment
finding should be reported immediately?
A. Potassium level of 2.9 mEq/L
B. Blood pressure of 128/76 mmHg
C. Heart rate of 82/min
D. Respiratory rate of 18/min
Answer: A. Potassium level of 2.9 mEq/L
Rationale: Severe hypokalemia places the client at risk for cardiac dysrhythmias and
requires prompt intervention.
7.
A client with a fractured femur suddenly develops severe dyspnea, confusion, and
petechiae on the upper chest. Which complication should the nurse suspect?
A. Pulmonary edema
B. Fat embolism syndrome
C. Hyperglycemia
D. Atelectasis
Answer: B. Fat embolism syndrome
, Rationale: The classic triad of fat embolism syndrome includes respiratory distress,
neurological changes, and petechiae.
8.
A nurse is teaching a client prescribed warfarin. Which statement by the client indicates
understanding of the teaching?
A. "I can take aspirin for headaches whenever needed."
B. "I should have my INR checked regularly."
C. "I no longer need monitoring once I am discharged."
D. "I should double the dose if I miss one."
Answer: B. "I should have my INR checked regularly."
Rationale: Warfarin therapy requires regular INR monitoring to maintain therapeutic
anticoagulation and prevent complications.
9.
A client who had abdominal surgery reports sudden calf pain, warmth, and swelling in one
leg. Which complication should the nurse suspect?
A. Pneumonia
B. Deep vein thrombosis
C. Urinary retention
D. Wound dehiscence
Answer: B. Deep vein thrombosis
Rationale: Unilateral leg pain, swelling, and warmth are characteristic findings of deep vein
thrombosis.
10.
A client with heart failure suddenly develops pink, frothy sputum and severe dyspnea.
Which action should the nurse take first?
A. Encourage oral fluids.
B. Place the client flat in bed.
