ATI RN Comprehensive Predictor 2026 Exit Prep: 250-
Question NGN-Style Practice Exam with Answers and
Rationales for Nursing Students and NCLEX-RN
Readiness
Section 1: Medical-Surgical Nursing (Questions 1-50)
1. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. Which assessment finding indicates the client is experiencing oxygen
toxicity?
A. Respiratory rate of 18 breaths/min
B. Oxygen saturation of 94%
C. Nonproductive cough and substernal pain
D. Productive cough with green sputum
Correct Answer: C. Nonproductive cough and substernal pain
Rationale: Oxygen toxicity is a complication of prolonged high-concentration oxygen therapy.
Early signs include nonproductive cough, substernal pain, nausea, and fatigue. As toxicity
progresses, the client may experience dyspnea and decreased vital capacity. The nurse should
,monitor clients receiving oxygen and report signs of toxicity promptly. A respiratory rate of 18
and O2 sat of 94% are acceptable findings.
2. A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which laboratory
value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that can cause hypokalemia by increasing potassium
excretion in the distal tubule. The nurse should monitor serum potassium levels closely and
assess for signs of hypokalemia, including muscle weakness, fatigue, and cardiac dysrhythmias.
Serum sodium, calcium, and magnesium may also be affected but potassium is the most critical
electrolyte to monitor.
,3. A client with diabetes mellitus type 1 is experiencing hypoglycemia. The client is alert and
oriented. Which intervention should the nurse implement first?
A. Administer 50% dextrose IV push
B. Give 15 grams of fast-acting carbohydrate
C. Call the healthcare provider
D. Administer glucagon 1 mg IM
Correct Answer: B. Give 15 grams of fast-acting carbohydrate
Rationale: For a client who is alert and oriented with hypoglycemia, the first intervention is to
administer 15 grams of fast-acting carbohydrate (e.g., 4 oz of fruit juice, 3 glucose tablets, or 6
oz of regular soda). The blood glucose should be rechecked in 15 minutes. If the client is
unconscious or unable to swallow, IV dextrose or glucagon would be indicated.
4. The nurse is caring for a client with acute pancreatitis. Which laboratory finding is most
consistent with this diagnosis?
A. Elevated serum amylase
B. Decreased serum lipase
, C. Elevated serum bilirubin
D. Decreased serum calcium
Correct Answer: A. Elevated serum amylase
Rationale: Serum amylase and lipase are elevated in acute pancreatitis due to release of
pancreatic enzymes into the bloodstream. Amylase typically rises within 2-12 hours and returns
to normal in 3-5 days. Lipase is more specific to the pancreas and remains elevated longer.
Elevated bilirubin may indicate biliary obstruction, and decreased calcium may occur with
severe pancreatitis but is not the hallmark finding.
5. A client with cirrhosis is exhibiting signs of hepatic encephalopathy. Which assessment
finding is most concerning?
A. Asterixis
B. Jaundice
C. Ascites
D. Spider angiomas
Correct Answer: A. Asterixis
Question NGN-Style Practice Exam with Answers and
Rationales for Nursing Students and NCLEX-RN
Readiness
Section 1: Medical-Surgical Nursing (Questions 1-50)
1. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min
via nasal cannula. Which assessment finding indicates the client is experiencing oxygen
toxicity?
A. Respiratory rate of 18 breaths/min
B. Oxygen saturation of 94%
C. Nonproductive cough and substernal pain
D. Productive cough with green sputum
Correct Answer: C. Nonproductive cough and substernal pain
Rationale: Oxygen toxicity is a complication of prolonged high-concentration oxygen therapy.
Early signs include nonproductive cough, substernal pain, nausea, and fatigue. As toxicity
progresses, the client may experience dyspnea and decreased vital capacity. The nurse should
,monitor clients receiving oxygen and report signs of toxicity promptly. A respiratory rate of 18
and O2 sat of 94% are acceptable findings.
2. A client with heart failure is prescribed furosemide (Lasix) 40 mg IV push. Which laboratory
value should the nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Correct Answer: B. Serum potassium
Rationale: Furosemide is a loop diuretic that can cause hypokalemia by increasing potassium
excretion in the distal tubule. The nurse should monitor serum potassium levels closely and
assess for signs of hypokalemia, including muscle weakness, fatigue, and cardiac dysrhythmias.
Serum sodium, calcium, and magnesium may also be affected but potassium is the most critical
electrolyte to monitor.
,3. A client with diabetes mellitus type 1 is experiencing hypoglycemia. The client is alert and
oriented. Which intervention should the nurse implement first?
A. Administer 50% dextrose IV push
B. Give 15 grams of fast-acting carbohydrate
C. Call the healthcare provider
D. Administer glucagon 1 mg IM
Correct Answer: B. Give 15 grams of fast-acting carbohydrate
Rationale: For a client who is alert and oriented with hypoglycemia, the first intervention is to
administer 15 grams of fast-acting carbohydrate (e.g., 4 oz of fruit juice, 3 glucose tablets, or 6
oz of regular soda). The blood glucose should be rechecked in 15 minutes. If the client is
unconscious or unable to swallow, IV dextrose or glucagon would be indicated.
4. The nurse is caring for a client with acute pancreatitis. Which laboratory finding is most
consistent with this diagnosis?
A. Elevated serum amylase
B. Decreased serum lipase
, C. Elevated serum bilirubin
D. Decreased serum calcium
Correct Answer: A. Elevated serum amylase
Rationale: Serum amylase and lipase are elevated in acute pancreatitis due to release of
pancreatic enzymes into the bloodstream. Amylase typically rises within 2-12 hours and returns
to normal in 3-5 days. Lipase is more specific to the pancreas and remains elevated longer.
Elevated bilirubin may indicate biliary obstruction, and decreased calcium may occur with
severe pancreatitis but is not the hallmark finding.
5. A client with cirrhosis is exhibiting signs of hepatic encephalopathy. Which assessment
finding is most concerning?
A. Asterixis
B. Jaundice
C. Ascites
D. Spider angiomas
Correct Answer: A. Asterixis
