ATI RN Comprehensive Predictor 2026 Exit
Exam with NGN ANSWERs and Rationales
Original Practice Questions
Question 1
A client who has a diagnosis of complete placenta previa is admitted to the labor and delivery suite at 36
weeks gestation with contractions 5 minutes apart in frequency and 1 minute in duration. Which of the
following actions should the nurse take first?
A. Rupture the amniotic sac
B. Medicate the client for pain
C. Prepare the client for a cesarean section
D. Perform a vaginal exam
ANSWER: C. Prepare the client for a cesarean section
Rationale:
Option A - Incorrect: Rupturing the amniotic sac is contraindicated in placenta previa because it can
cause severe hemorrhage. The placenta is covering the cervical os, and any disruption can lead to life-
threatening bleeding for both mother and fetus.
Option B - Incorrect: While pain management is important, it is not the priority intervention. The
immediate concern is preparing for safe delivery via cesarean section to prevent maternal and fetal
complications.
Option C - Correct: Complete placenta previa requires cesarean delivery because the placenta
completely covers the cervical os, making vaginal delivery impossible and dangerous. Preparing for
cesarean section is the priority to prevent severe hemorrhage and ensure fetal safety.
Option D - Incorrect: Performing a vaginal exam is absolutely contraindicated in placenta previa as it can
cause catastrophic hemorrhage by disrupting the placenta. This could be fatal for both mother and baby.
Question 2
,A nurse enters a client's room and finds the client lying on the floor in a puddle of water. Which of the
following statements should the nurse document in an incident report?
A. Client fell out of bed because an assistive personnel left the rails of the bed down
B. Client's roommate thinks the client is confused and fell when getting out of bed
C. Client appears to have slipped in water but reports no injuries
D. Client found lying on the floor near the bedside table
ANSWER: D. Client found lying on the floor near the bedside table
Rationale:
Option A - Incorrect: Incident reports should contain only objective, factual observations. Blaming staff
members or making assumptions about causation is inappropriate and unprofessional documentation.
Option B - Incorrect: Documenting what a roommate "thinks" is hearsay and speculation, not factual
data. Incident reports must contain only objective, observable facts.
Option C - Incorrect: Stating the client "appears to have slipped" is an assumption, not an objective
observation. The nurse did not witness the fall and cannot determine the cause.
Option D - Correct: This statement provides objective, factual information about what the nurse actually
observed. Incident reports should include only what was seen, heard, or measured, without
assumptions, blame, or speculation.
Question 3
A charge nurse on a pediatric unit is making assignments for a float nurse from the medical unit. Which
of the following clients is most appropriate to assign to the float nurse?
A. A 10-year-old client who has pneumonia and is receiving respiratory treatments
B. A 4-year-old client who has a Wilms tumor and is receiving chemotherapy
C. An 8-month-old client who is scheduled for a surgical repair of a ventricular septal defect tomorrow
D. A 14-year-old client who is scheduled for discharge today following placement of a Harrington rod
ANSWER: A. A 10-year-old client who has pneumonia and is receiving respiratory treatments
Rationale:
Option A - Correct: A medical unit float nurse would be most familiar with caring for a client with
pneumonia and respiratory treatments, as this is a common medical diagnosis. This client is stable and
the care is within the float nurse's expertise.
Option B - Incorrect: A child receiving chemotherapy for Wilms tumor requires specialized oncology
knowledge and handling of hazardous medications. This requires specific training that a medical unit
float nurse may not have.
,Option C - Incorrect: An infant scheduled for cardiac surgery requires specialized pediatric cardiac
knowledge and preoperative care. This is too complex for a float nurse from the medical unit.
Option D - Incorrect: A client being discharged after spinal surgery (Harrington rod placement) requires
extensive discharge teaching about activity restrictions, pain management, and wound care. This should
be handled by a nurse familiar with the client's entire hospital course.
Question 4
A nurse is preparing to administer vancomycin to a client who has an infected wound. The nurse should
plan to monitor for which of the following adverse reactions?
A. Hepatotoxicity
B. Ototoxicity
C. Hypercalcemia
D. Hypertension
ANSWER: B. Ototoxicity
Rationale:
Option A - Incorrect: While vancomycin can cause some liver enzyme elevation, hepatotoxicity is not a
primary adverse effect. The nurse should monitor liver function, but this is not the most critical adverse
reaction.
Option B - Correct: Vancomycin is ototoxic and can cause hearing loss, tinnitus, and vertigo. The nurse
should monitor for these symptoms, especially with high doses, prolonged therapy, or concurrent use of
other ototoxic medications.
Option C - Incorrect: Hypercalcemia is not associated with vancomycin therapy. This adverse effect is
more commonly associated with thiazide diuretics, vitamin D toxicity, or hyperparathyroidism.
Option D - Incorrect: Hypertension is not a typical adverse effect of vancomycin. However, rapid infusion
can cause "Red Man Syndrome" characterized by flushing, rash, and hypotension, not hypertension.
Question 5
A nurse is assessing an infant who has water intoxication. Which of the following findings should the
nurse expect?
A. Generalized edema
B. Elevated urine specific gravity
C. Thready pulse
D. Increased hematocrit
ANSWER: A. Generalized edema
Rationale:
, Option A - Correct: Water intoxication causes hyponatremia and fluid overload, leading to generalized
edema. The excess water dilutes serum sodium and causes fluid to shift into cells and interstitial spaces.
Option B - Incorrect: Urine specific gravity would be decreased (dilute urine), not elevated, as the body
attempts to eliminate excess water. Elevated specific gravity indicates concentrated urine from
dehydration.
Option C - Incorrect: A thready pulse is associated with hypovolemia and dehydration, not water
intoxication. Water intoxication typically causes bounding pulses due to fluid overload.
Option D - Incorrect: Hematocrit would be decreased (hemodilution) in water intoxication, not
increased. Increased hematocrit occurs with dehydration when the blood becomes more concentrated.
Question 6
A home health nurse is conducting an initial home visit for a client who has terminal breast cancer. The
client has two school-age children and a limited support system. Which of the following is the priority
nursing action?
A. Inform the client of available community resources
B. Assist the client in finding child care options
C. Agree upon short-term goals for the client
D. Ask the client about their understanding of the diagnosis
ANSWER: A. Inform the client of available community resources
Rationale:
Option A - Correct: With a limited support system and school-age children, connecting the client to
community resources is the priority. This addresses immediate needs for support, respite care, and
assistance with children while the client manages terminal illness.
Option B - Incorrect: While child care is important, this is only one aspect of the client's needs.
Community resources can provide comprehensive support including child care, making this a
component of option A.
Option C - Incorrect: Goal setting is important but should occur after assessing immediate needs and
available resources. Goals without support systems in place are difficult to achieve.
Option D - Incorrect: Assessing understanding is important for education, but addressing the immediate
need for support systems takes priority given the client's limited support and dependent children.
Question 7
A nurse in an emergency department is assessing a client who has a nasal fracture. Which of the
following findings should cause the nurse to suspect a skull fracture?
A. Clear fluid drainage from the nares
B. Report of pain around the eyes
Exam with NGN ANSWERs and Rationales
Original Practice Questions
Question 1
A client who has a diagnosis of complete placenta previa is admitted to the labor and delivery suite at 36
weeks gestation with contractions 5 minutes apart in frequency and 1 minute in duration. Which of the
following actions should the nurse take first?
A. Rupture the amniotic sac
B. Medicate the client for pain
C. Prepare the client for a cesarean section
D. Perform a vaginal exam
ANSWER: C. Prepare the client for a cesarean section
Rationale:
Option A - Incorrect: Rupturing the amniotic sac is contraindicated in placenta previa because it can
cause severe hemorrhage. The placenta is covering the cervical os, and any disruption can lead to life-
threatening bleeding for both mother and fetus.
Option B - Incorrect: While pain management is important, it is not the priority intervention. The
immediate concern is preparing for safe delivery via cesarean section to prevent maternal and fetal
complications.
Option C - Correct: Complete placenta previa requires cesarean delivery because the placenta
completely covers the cervical os, making vaginal delivery impossible and dangerous. Preparing for
cesarean section is the priority to prevent severe hemorrhage and ensure fetal safety.
Option D - Incorrect: Performing a vaginal exam is absolutely contraindicated in placenta previa as it can
cause catastrophic hemorrhage by disrupting the placenta. This could be fatal for both mother and baby.
Question 2
,A nurse enters a client's room and finds the client lying on the floor in a puddle of water. Which of the
following statements should the nurse document in an incident report?
A. Client fell out of bed because an assistive personnel left the rails of the bed down
B. Client's roommate thinks the client is confused and fell when getting out of bed
C. Client appears to have slipped in water but reports no injuries
D. Client found lying on the floor near the bedside table
ANSWER: D. Client found lying on the floor near the bedside table
Rationale:
Option A - Incorrect: Incident reports should contain only objective, factual observations. Blaming staff
members or making assumptions about causation is inappropriate and unprofessional documentation.
Option B - Incorrect: Documenting what a roommate "thinks" is hearsay and speculation, not factual
data. Incident reports must contain only objective, observable facts.
Option C - Incorrect: Stating the client "appears to have slipped" is an assumption, not an objective
observation. The nurse did not witness the fall and cannot determine the cause.
Option D - Correct: This statement provides objective, factual information about what the nurse actually
observed. Incident reports should include only what was seen, heard, or measured, without
assumptions, blame, or speculation.
Question 3
A charge nurse on a pediatric unit is making assignments for a float nurse from the medical unit. Which
of the following clients is most appropriate to assign to the float nurse?
A. A 10-year-old client who has pneumonia and is receiving respiratory treatments
B. A 4-year-old client who has a Wilms tumor and is receiving chemotherapy
C. An 8-month-old client who is scheduled for a surgical repair of a ventricular septal defect tomorrow
D. A 14-year-old client who is scheduled for discharge today following placement of a Harrington rod
ANSWER: A. A 10-year-old client who has pneumonia and is receiving respiratory treatments
Rationale:
Option A - Correct: A medical unit float nurse would be most familiar with caring for a client with
pneumonia and respiratory treatments, as this is a common medical diagnosis. This client is stable and
the care is within the float nurse's expertise.
Option B - Incorrect: A child receiving chemotherapy for Wilms tumor requires specialized oncology
knowledge and handling of hazardous medications. This requires specific training that a medical unit
float nurse may not have.
,Option C - Incorrect: An infant scheduled for cardiac surgery requires specialized pediatric cardiac
knowledge and preoperative care. This is too complex for a float nurse from the medical unit.
Option D - Incorrect: A client being discharged after spinal surgery (Harrington rod placement) requires
extensive discharge teaching about activity restrictions, pain management, and wound care. This should
be handled by a nurse familiar with the client's entire hospital course.
Question 4
A nurse is preparing to administer vancomycin to a client who has an infected wound. The nurse should
plan to monitor for which of the following adverse reactions?
A. Hepatotoxicity
B. Ototoxicity
C. Hypercalcemia
D. Hypertension
ANSWER: B. Ototoxicity
Rationale:
Option A - Incorrect: While vancomycin can cause some liver enzyme elevation, hepatotoxicity is not a
primary adverse effect. The nurse should monitor liver function, but this is not the most critical adverse
reaction.
Option B - Correct: Vancomycin is ototoxic and can cause hearing loss, tinnitus, and vertigo. The nurse
should monitor for these symptoms, especially with high doses, prolonged therapy, or concurrent use of
other ototoxic medications.
Option C - Incorrect: Hypercalcemia is not associated with vancomycin therapy. This adverse effect is
more commonly associated with thiazide diuretics, vitamin D toxicity, or hyperparathyroidism.
Option D - Incorrect: Hypertension is not a typical adverse effect of vancomycin. However, rapid infusion
can cause "Red Man Syndrome" characterized by flushing, rash, and hypotension, not hypertension.
Question 5
A nurse is assessing an infant who has water intoxication. Which of the following findings should the
nurse expect?
A. Generalized edema
B. Elevated urine specific gravity
C. Thready pulse
D. Increased hematocrit
ANSWER: A. Generalized edema
Rationale:
, Option A - Correct: Water intoxication causes hyponatremia and fluid overload, leading to generalized
edema. The excess water dilutes serum sodium and causes fluid to shift into cells and interstitial spaces.
Option B - Incorrect: Urine specific gravity would be decreased (dilute urine), not elevated, as the body
attempts to eliminate excess water. Elevated specific gravity indicates concentrated urine from
dehydration.
Option C - Incorrect: A thready pulse is associated with hypovolemia and dehydration, not water
intoxication. Water intoxication typically causes bounding pulses due to fluid overload.
Option D - Incorrect: Hematocrit would be decreased (hemodilution) in water intoxication, not
increased. Increased hematocrit occurs with dehydration when the blood becomes more concentrated.
Question 6
A home health nurse is conducting an initial home visit for a client who has terminal breast cancer. The
client has two school-age children and a limited support system. Which of the following is the priority
nursing action?
A. Inform the client of available community resources
B. Assist the client in finding child care options
C. Agree upon short-term goals for the client
D. Ask the client about their understanding of the diagnosis
ANSWER: A. Inform the client of available community resources
Rationale:
Option A - Correct: With a limited support system and school-age children, connecting the client to
community resources is the priority. This addresses immediate needs for support, respite care, and
assistance with children while the client manages terminal illness.
Option B - Incorrect: While child care is important, this is only one aspect of the client's needs.
Community resources can provide comprehensive support including child care, making this a
component of option A.
Option C - Incorrect: Goal setting is important but should occur after assessing immediate needs and
available resources. Goals without support systems in place are difficult to achieve.
Option D - Incorrect: Assessing understanding is important for education, but addressing the immediate
need for support systems takes priority given the client's limited support and dependent children.
Question 7
A nurse in an emergency department is assessing a client who has a nasal fracture. Which of the
following findings should cause the nurse to suspect a skull fracture?
A. Clear fluid drainage from the nares
B. Report of pain around the eyes
