ATI NGN Comprehensive Predictor 2026–
2027 Complete Study Guide with NGN
Practice Questions, Clinical Judgment Cases &
Verified Rationales
Question 1
A nurse is assessing a client who is 4 hours post-operative following
abdominal surgery. Which of the following findings should the nurse report to
the provider FIRST?
A) Temperature 39.2°C (102.6°F)
B) Heart rate 88/min
C) Blood pressure 118/76 mm Hg
D) Respiratory rate 18/min
Rationale: A temperature of 39.2°C (102.6°F) indicates a potential infection
or malignant hyperthermia, which requires immediate reporting. The other
vital signs are within normal limits.
Question 2
A nurse is providing discharge teaching to a client who has a new prescription
for warfarin. Which of the following statements by the client indicates an
understanding of the teaching?
A) "I will use a soft toothbrush to prevent bleeding."
B) "I will take ibuprofen for pain if needed."
C) "I will eat more leafy green vegetables."
D) "I will stop taking the medication if I notice bruising."
Rationale: Using a soft toothbrush helps prevent bleeding, a major risk with
warfarin. Ibuprofen increases bleeding risk, leafy green vegetables contain
vitamin K (which interferes with warfarin), and bruising is expected but
should be reported.
,Question 3
NGN Case Study: Chest Pain
A 65-year-old client is admitted with chest pain that radiates to the left arm.
The client reports nausea and shortness of breath. Which of the following
actions should the nurse take FIRST?
A) Administer aspirin
B) Administer nitroglycerin
C) Obtain a 12-lead ECG
D) Administer oxygen
Rationale: Aspirin should be administered immediately to prevent further
clot formation in a suspected myocardial infarction. Oxygen, nitroglycerin, and
ECG are also important but aspirin is the priority.
Question 4
NGN Case Study: Chest Pain - Continued
The client's ECG shows ST-segment elevation in leads V1-V4. Which of the
following conditions should the nurse suspect?
A) Anteroseptal myocardial infarction
B) Inferior myocardial infarction
C) Lateral myocardial infarction
D) Posterior myocardial infarction
Rationale: ST-segment elevation in leads V1-V4 indicates an anteroseptal MI.
Inferior MI is seen in leads II, III, and aVF, lateral MI in I, aVL, V5-V6, and
posterior MI in V7-V9.
Question 5
NGN Case Study: Chest Pain - Continued
,The provider orders tissue plasminogen activator (tPA). Which of the
following is a contraindication to tPA administration?
A) Onset of symptoms 2 hours ago
B) Systolic blood pressure 140 mm Hg
C) Age 65 years
D) Blood glucose 120 mg/dL
Rationale: tPA is contraindicated with onset of symptoms >3 hours. Systolic
blood pressure <185 mm Hg, age, and blood glucose within normal limits are
not contraindications.
Question 6
A nurse is caring for a client who is receiving IV fluids and develops shortness
of breath and crackles. Which of the following actions should the nurse take
FIRST?
A) Slow the IV infusion rate
B) Notify the provider
C) Administer a diuretic
D) Place the client in a supine position
Rationale: Slowing the IV infusion rate is the priority to prevent further fluid
overload. The nurse should then notify the provider, administer diuretics, and
elevate the head of the bed.
Question 7
A nurse is assessing a client who has a new diagnosis of diabetes mellitus.
Which of the following findings should the nurse expect?
A) Polyuria and polydipsia
B) Weight gain and heat intolerance
C) Bradycardia and lethargy
D) Constipation and dry skin
, Rationale: Polyuria (frequent urination) and polydipsia (excessive thirst) are
classic signs of diabetes mellitus. Weight gain, heat intolerance, bradycardia,
lethargy, constipation, and dry skin are associated with hypothyroidism.
Question 8
A nurse is providing teaching to a client who has a new prescription for an
ACE inhibitor. Which of the following adverse effects should the nurse instruct
the client to report?
A) Persistent dry cough
B) Hyperglycemia
C) Tachycardia
D) Weight loss
Rationale: A persistent dry cough is a common adverse effect of ACE
inhibitors that should be reported. Hyperglycemia, tachycardia, and weight
loss are not typically associated with ACE inhibitors.
Question 9
NGN Case Study: Postoperative Care
A 72-year-old client is 2 days post-operative following a total knee
replacement. The client suddenly reports shortness of breath and chest pain.
Which of the following actions should the nurse take FIRST?
A) Apply oxygen and elevate the head of the bed
B) Administer morphine sulfate
C) Notify the provider
D) Obtain a 12-lead ECG
Rationale: The client is exhibiting signs of a possible pulmonary embolism.
The priority is to apply oxygen and elevate the head of the bed to improve
oxygenation and ventilation.
Question 10
2027 Complete Study Guide with NGN
Practice Questions, Clinical Judgment Cases &
Verified Rationales
Question 1
A nurse is assessing a client who is 4 hours post-operative following
abdominal surgery. Which of the following findings should the nurse report to
the provider FIRST?
A) Temperature 39.2°C (102.6°F)
B) Heart rate 88/min
C) Blood pressure 118/76 mm Hg
D) Respiratory rate 18/min
Rationale: A temperature of 39.2°C (102.6°F) indicates a potential infection
or malignant hyperthermia, which requires immediate reporting. The other
vital signs are within normal limits.
Question 2
A nurse is providing discharge teaching to a client who has a new prescription
for warfarin. Which of the following statements by the client indicates an
understanding of the teaching?
A) "I will use a soft toothbrush to prevent bleeding."
B) "I will take ibuprofen for pain if needed."
C) "I will eat more leafy green vegetables."
D) "I will stop taking the medication if I notice bruising."
Rationale: Using a soft toothbrush helps prevent bleeding, a major risk with
warfarin. Ibuprofen increases bleeding risk, leafy green vegetables contain
vitamin K (which interferes with warfarin), and bruising is expected but
should be reported.
,Question 3
NGN Case Study: Chest Pain
A 65-year-old client is admitted with chest pain that radiates to the left arm.
The client reports nausea and shortness of breath. Which of the following
actions should the nurse take FIRST?
A) Administer aspirin
B) Administer nitroglycerin
C) Obtain a 12-lead ECG
D) Administer oxygen
Rationale: Aspirin should be administered immediately to prevent further
clot formation in a suspected myocardial infarction. Oxygen, nitroglycerin, and
ECG are also important but aspirin is the priority.
Question 4
NGN Case Study: Chest Pain - Continued
The client's ECG shows ST-segment elevation in leads V1-V4. Which of the
following conditions should the nurse suspect?
A) Anteroseptal myocardial infarction
B) Inferior myocardial infarction
C) Lateral myocardial infarction
D) Posterior myocardial infarction
Rationale: ST-segment elevation in leads V1-V4 indicates an anteroseptal MI.
Inferior MI is seen in leads II, III, and aVF, lateral MI in I, aVL, V5-V6, and
posterior MI in V7-V9.
Question 5
NGN Case Study: Chest Pain - Continued
,The provider orders tissue plasminogen activator (tPA). Which of the
following is a contraindication to tPA administration?
A) Onset of symptoms 2 hours ago
B) Systolic blood pressure 140 mm Hg
C) Age 65 years
D) Blood glucose 120 mg/dL
Rationale: tPA is contraindicated with onset of symptoms >3 hours. Systolic
blood pressure <185 mm Hg, age, and blood glucose within normal limits are
not contraindications.
Question 6
A nurse is caring for a client who is receiving IV fluids and develops shortness
of breath and crackles. Which of the following actions should the nurse take
FIRST?
A) Slow the IV infusion rate
B) Notify the provider
C) Administer a diuretic
D) Place the client in a supine position
Rationale: Slowing the IV infusion rate is the priority to prevent further fluid
overload. The nurse should then notify the provider, administer diuretics, and
elevate the head of the bed.
Question 7
A nurse is assessing a client who has a new diagnosis of diabetes mellitus.
Which of the following findings should the nurse expect?
A) Polyuria and polydipsia
B) Weight gain and heat intolerance
C) Bradycardia and lethargy
D) Constipation and dry skin
, Rationale: Polyuria (frequent urination) and polydipsia (excessive thirst) are
classic signs of diabetes mellitus. Weight gain, heat intolerance, bradycardia,
lethargy, constipation, and dry skin are associated with hypothyroidism.
Question 8
A nurse is providing teaching to a client who has a new prescription for an
ACE inhibitor. Which of the following adverse effects should the nurse instruct
the client to report?
A) Persistent dry cough
B) Hyperglycemia
C) Tachycardia
D) Weight loss
Rationale: A persistent dry cough is a common adverse effect of ACE
inhibitors that should be reported. Hyperglycemia, tachycardia, and weight
loss are not typically associated with ACE inhibitors.
Question 9
NGN Case Study: Postoperative Care
A 72-year-old client is 2 days post-operative following a total knee
replacement. The client suddenly reports shortness of breath and chest pain.
Which of the following actions should the nurse take FIRST?
A) Apply oxygen and elevate the head of the bed
B) Administer morphine sulfate
C) Notify the provider
D) Obtain a 12-lead ECG
Rationale: The client is exhibiting signs of a possible pulmonary embolism.
The priority is to apply oxygen and elevate the head of the bed to improve
oxygenation and ventilation.
Question 10
