➢ VATI PN Comprehensive Predictor Exam
Updated 2026 | 300+ NGN Practice
Questions & Verified Answers | Ultimate
Study Guide, Comprehensive Predictor
Review, NCLEX-PN Readiness
Assessment, Exam Prep Test Bank,
Fundamentals, Pharmacology, Adult
Medical-Surgical, Pediatrics, Maternal-
Newborn, Mental Health, Leadership,
Priority & Delegation, Detailed
Rationales
Question 1: A client with schizophrenia is experiencing auditory hallucinations
and is actively responding to internal stimuli. Which nursing intervention is
most therapeutic in the immediate moment?
A. Ask the client to describe the content of the hallucinations in detail.
B. Tell the client that the voices are not real and to ignore them.
C. Sit with the client and acknowledge the distress while focusing on reality-based
activities.
D. Isolate the client in their room to reduce external stimulation.
CORRECT ANSWER: C. Sit with the client and acknowledge the distress while
focusing on reality-based activities.
Rationale: The most therapeutic intervention is to acknowledge the client's distress
without validating the hallucinations and then gently redirect them to reality-based
activities. This provides support and a connection to reality. Option A can reinforce the
hallucinations; B dismisses the client's experience; D is punitive and increases isolation.
Question 2: A nurse is caring for a client with severe preeclampsia who is
receiving a magnesium sulfate infusion. Which assessment finding indicates
magnesium toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate of 14 breaths per minute
C. Urinary output of 30 mL/hr
D. Absent deep tendon reflexes
CORRECT ANSWER: D. Absent deep tendon reflexes
Rationale: The first sign of magnesium toxicity is the loss of deep tendon reflexes
(DTRs). Other signs include a respiratory rate below 12 and a urinary output below 30
mL/hr. Option A is a normal finding; B and C are borderline but not indicative of
toxicity on their own.
,Question 3: A practical nurse is preparing to administer a subcutaneous
injection of heparin. Which technique is most appropriate?
A. Massage the site vigorously after injection to promote absorption.
B. Aspirate for a blood return before injecting the medication.
C. Insert the needle at a 45- to 90-degree angle and do not aspirate.
D. Administer the injection into the vastus lateralis muscle.
CORRECT ANSWER: C. Insert the needle at a 45- to 90-degree angle and do not
aspirate.
Rationale: Heparin is given subcutaneously in the abdomen. The needle is inserted at a
45- to 90-degree angle, and aspiration is contraindicated to prevent hematoma
formation. Massaging the site can cause bruising, and the vastus lateralis is an IM site.
Question 4: The healthcare provider prescribes 1000 mL of normal saline to
infuse over 8 hours. The drop factor is 15 gtt/mL. What is the infusion rate in
gtt/min?
A. 21 gtt/min
B. 31 gtt/min
C. 42 gtt/min
D. 52 gtt/min
CORRECT ANSWER: B. 31 gtt/min
Rationale: Total volume (1000 mL) divided by total time (480 minutes) equals 2.08
mL/min. Multiply by the drop factor (15 gtt/mL) = 31.2, rounded to 31 gtt/min.
Question 5: A client with a tracheostomy tube is showing signs of respiratory
distress, and the nurse is unable to pass a suction catheter through the tube.
What should be the nurse's priority action?
A. Apply a pulse oximeter.
B. Deflate the cuff of the tracheostomy tube.
C. Attempt to suction the mouth and pharynx.
D. Remove the inner cannula and replace the obturator.
CORRECT ANSWER: D. Remove the inner cannula and replace the obturator.
Rationale: If the catheter cannot pass, the tracheostomy tube may be blocked.
Removing the inner cannula and using the obturator to reinsert a new tube allows for a
patent airway. Suctioning the mouth or deflating the cuff will not clear a blocked
tracheostomy tube.
Question 6: A client who is postoperative following a right total hip
arthroplasty has a new prescription for enoxaparin. What is the primary
purpose of this medication?
A. To prevent infection.
B. To manage postoperative pain.
,C. To prevent venous thromboembolism.
D. To promote wound healing.
CORRECT ANSWER: C. To prevent venous thromboembolism.
Rationale: Enoxaparin is a low-molecular-weight heparin used as thromboprophylaxis
to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) in clients
undergoing major orthopedic surgery.
Question 7: A client is admitted with diabetic ketoacidosis (DKA). Which
finding is most consistent with this diagnosis?
A. Blood glucose of 150 mg/dL and pH of 7.40.
B. Deep, rapid respirations and fruity-scented breath.
C. Slow, shallow respirations and bradycardia.
D. Blood glucose of 60 mg/dL and diaphoresis.
CORRECT ANSWER: B. Deep, rapid respirations and fruity-scented breath.
Rationale: Kussmaul respirations (deep, rapid) are the body's attempt to blow off
carbon dioxide to compensate for metabolic acidosis. Fruity-scented breath is due to
ketones. Option A is a normal state; C describes a different condition; D describes
hypoglycemia.
Question 8: A client is diagnosed with bacterial conjunctivitis. Which
instruction is most important for the nurse to provide regarding infection
control?
A. "Wash your hands frequently and avoid sharing towels."
B. "Apply warm compresses to the eyes three times a day."
C. "Instill eye drops even if you don't have symptoms in the other eye."
D. "Wear sunglasses to decrease photosensitivity."
CORRECT ANSWER: A. "Wash your hands frequently and avoid sharing
towels."
Rationale: Bacterial conjunctivitis is highly contagious. Hand hygiene and avoiding
sharing personal items are the most effective ways to prevent spread. Warm compresses
provide comfort but aren't infection control.
Question 9: A nurse is caring for a client with a nasogastric (NG) tube attached
to low intermittent suction. The nurse notes that the client's gastric residual is
200 mL. What should the nurse do?
A. Discard the residual and continue the feeding.
B. Reinstill the residual and continue the feeding.
C. Hold the feeding and notify the provider.
D. Increase the rate of the infusion to compensate for the residual.
CORRECT ANSWER: B. Reinstill the residual and continue the feeding.
, Rationale: Generally, if the residual is less than 250 mL, the standard practice is to
reinstill it and continue the feeding. This prevents electrolyte loss. A residual of 200 mL
is not an indication to hold the feeding or notify the provider unless specified by the
facility or the client shows signs of distress.
Question 10: A client with cirrhosis develops ascites. Which dietary
modification is most important for the nurse to reinforce?
A. High-protein diet.
B. Fluid restriction to 1-2 L per day.
C. Low-sodium diet.
D. High-fat diet.
CORRECT ANSWER: C. Low-sodium diet.
Rationale: Ascites is the accumulation of fluid in the abdomen due to portal
hypertension and low serum albumin. A low-sodium diet is the primary dietary
intervention to reduce fluid retention. Fluid restriction may be used but is secondary to
sodium restriction.
Question 11: During a mental status assessment, a client states, "I am the
president of the United States and I own all the hospitals." Which term best
describes this statement?
A. Delusion of persecution.
B. Grandiose delusion.
C. Hallucination.
D. Loose association.
CORRECT ANSWER: B. Grandiose delusion.
Rationale: A grandiose delusion is a false belief of inflated power, wealth, or identity
(e.g., being the president). Option A is a belief of being harmed; C is a sensory
perception without stimulus; D is a thought disorder.
Question 12: A nurse is performing a cardiovascular assessment on an older
adult client. Which finding should be reported to the provider?
A. Capillary refill of 3 seconds.
B. Blood pressure of 120/80 mmHg.
C. Bilateral lower extremity edema.
D. Heart rate of 70 beats per minute.
CORRECT ANSWER: C. Bilateral lower extremity edema.
Rationale: Edema can indicate heart failure or venous insufficiency and should be
evaluated. A capillary refill of 3 seconds is within normal limits (less than 3-5 seconds).
A normal BP and HR are expected.
Question 13: A client is receiving furosemide for heart failure. The nurse
should monitor the client for which potential electrolyte imbalance?
Updated 2026 | 300+ NGN Practice
Questions & Verified Answers | Ultimate
Study Guide, Comprehensive Predictor
Review, NCLEX-PN Readiness
Assessment, Exam Prep Test Bank,
Fundamentals, Pharmacology, Adult
Medical-Surgical, Pediatrics, Maternal-
Newborn, Mental Health, Leadership,
Priority & Delegation, Detailed
Rationales
Question 1: A client with schizophrenia is experiencing auditory hallucinations
and is actively responding to internal stimuli. Which nursing intervention is
most therapeutic in the immediate moment?
A. Ask the client to describe the content of the hallucinations in detail.
B. Tell the client that the voices are not real and to ignore them.
C. Sit with the client and acknowledge the distress while focusing on reality-based
activities.
D. Isolate the client in their room to reduce external stimulation.
CORRECT ANSWER: C. Sit with the client and acknowledge the distress while
focusing on reality-based activities.
Rationale: The most therapeutic intervention is to acknowledge the client's distress
without validating the hallucinations and then gently redirect them to reality-based
activities. This provides support and a connection to reality. Option A can reinforce the
hallucinations; B dismisses the client's experience; D is punitive and increases isolation.
Question 2: A nurse is caring for a client with severe preeclampsia who is
receiving a magnesium sulfate infusion. Which assessment finding indicates
magnesium toxicity?
A. Deep tendon reflexes 2+
B. Respiratory rate of 14 breaths per minute
C. Urinary output of 30 mL/hr
D. Absent deep tendon reflexes
CORRECT ANSWER: D. Absent deep tendon reflexes
Rationale: The first sign of magnesium toxicity is the loss of deep tendon reflexes
(DTRs). Other signs include a respiratory rate below 12 and a urinary output below 30
mL/hr. Option A is a normal finding; B and C are borderline but not indicative of
toxicity on their own.
,Question 3: A practical nurse is preparing to administer a subcutaneous
injection of heparin. Which technique is most appropriate?
A. Massage the site vigorously after injection to promote absorption.
B. Aspirate for a blood return before injecting the medication.
C. Insert the needle at a 45- to 90-degree angle and do not aspirate.
D. Administer the injection into the vastus lateralis muscle.
CORRECT ANSWER: C. Insert the needle at a 45- to 90-degree angle and do not
aspirate.
Rationale: Heparin is given subcutaneously in the abdomen. The needle is inserted at a
45- to 90-degree angle, and aspiration is contraindicated to prevent hematoma
formation. Massaging the site can cause bruising, and the vastus lateralis is an IM site.
Question 4: The healthcare provider prescribes 1000 mL of normal saline to
infuse over 8 hours. The drop factor is 15 gtt/mL. What is the infusion rate in
gtt/min?
A. 21 gtt/min
B. 31 gtt/min
C. 42 gtt/min
D. 52 gtt/min
CORRECT ANSWER: B. 31 gtt/min
Rationale: Total volume (1000 mL) divided by total time (480 minutes) equals 2.08
mL/min. Multiply by the drop factor (15 gtt/mL) = 31.2, rounded to 31 gtt/min.
Question 5: A client with a tracheostomy tube is showing signs of respiratory
distress, and the nurse is unable to pass a suction catheter through the tube.
What should be the nurse's priority action?
A. Apply a pulse oximeter.
B. Deflate the cuff of the tracheostomy tube.
C. Attempt to suction the mouth and pharynx.
D. Remove the inner cannula and replace the obturator.
CORRECT ANSWER: D. Remove the inner cannula and replace the obturator.
Rationale: If the catheter cannot pass, the tracheostomy tube may be blocked.
Removing the inner cannula and using the obturator to reinsert a new tube allows for a
patent airway. Suctioning the mouth or deflating the cuff will not clear a blocked
tracheostomy tube.
Question 6: A client who is postoperative following a right total hip
arthroplasty has a new prescription for enoxaparin. What is the primary
purpose of this medication?
A. To prevent infection.
B. To manage postoperative pain.
,C. To prevent venous thromboembolism.
D. To promote wound healing.
CORRECT ANSWER: C. To prevent venous thromboembolism.
Rationale: Enoxaparin is a low-molecular-weight heparin used as thromboprophylaxis
to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE) in clients
undergoing major orthopedic surgery.
Question 7: A client is admitted with diabetic ketoacidosis (DKA). Which
finding is most consistent with this diagnosis?
A. Blood glucose of 150 mg/dL and pH of 7.40.
B. Deep, rapid respirations and fruity-scented breath.
C. Slow, shallow respirations and bradycardia.
D. Blood glucose of 60 mg/dL and diaphoresis.
CORRECT ANSWER: B. Deep, rapid respirations and fruity-scented breath.
Rationale: Kussmaul respirations (deep, rapid) are the body's attempt to blow off
carbon dioxide to compensate for metabolic acidosis. Fruity-scented breath is due to
ketones. Option A is a normal state; C describes a different condition; D describes
hypoglycemia.
Question 8: A client is diagnosed with bacterial conjunctivitis. Which
instruction is most important for the nurse to provide regarding infection
control?
A. "Wash your hands frequently and avoid sharing towels."
B. "Apply warm compresses to the eyes three times a day."
C. "Instill eye drops even if you don't have symptoms in the other eye."
D. "Wear sunglasses to decrease photosensitivity."
CORRECT ANSWER: A. "Wash your hands frequently and avoid sharing
towels."
Rationale: Bacterial conjunctivitis is highly contagious. Hand hygiene and avoiding
sharing personal items are the most effective ways to prevent spread. Warm compresses
provide comfort but aren't infection control.
Question 9: A nurse is caring for a client with a nasogastric (NG) tube attached
to low intermittent suction. The nurse notes that the client's gastric residual is
200 mL. What should the nurse do?
A. Discard the residual and continue the feeding.
B. Reinstill the residual and continue the feeding.
C. Hold the feeding and notify the provider.
D. Increase the rate of the infusion to compensate for the residual.
CORRECT ANSWER: B. Reinstill the residual and continue the feeding.
, Rationale: Generally, if the residual is less than 250 mL, the standard practice is to
reinstill it and continue the feeding. This prevents electrolyte loss. A residual of 200 mL
is not an indication to hold the feeding or notify the provider unless specified by the
facility or the client shows signs of distress.
Question 10: A client with cirrhosis develops ascites. Which dietary
modification is most important for the nurse to reinforce?
A. High-protein diet.
B. Fluid restriction to 1-2 L per day.
C. Low-sodium diet.
D. High-fat diet.
CORRECT ANSWER: C. Low-sodium diet.
Rationale: Ascites is the accumulation of fluid in the abdomen due to portal
hypertension and low serum albumin. A low-sodium diet is the primary dietary
intervention to reduce fluid retention. Fluid restriction may be used but is secondary to
sodium restriction.
Question 11: During a mental status assessment, a client states, "I am the
president of the United States and I own all the hospitals." Which term best
describes this statement?
A. Delusion of persecution.
B. Grandiose delusion.
C. Hallucination.
D. Loose association.
CORRECT ANSWER: B. Grandiose delusion.
Rationale: A grandiose delusion is a false belief of inflated power, wealth, or identity
(e.g., being the president). Option A is a belief of being harmed; C is a sensory
perception without stimulus; D is a thought disorder.
Question 12: A nurse is performing a cardiovascular assessment on an older
adult client. Which finding should be reported to the provider?
A. Capillary refill of 3 seconds.
B. Blood pressure of 120/80 mmHg.
C. Bilateral lower extremity edema.
D. Heart rate of 70 beats per minute.
CORRECT ANSWER: C. Bilateral lower extremity edema.
Rationale: Edema can indicate heart failure or venous insufficiency and should be
evaluated. A capillary refill of 3 seconds is within normal limits (less than 3-5 seconds).
A normal BP and HR are expected.
Question 13: A client is receiving furosemide for heart failure. The nurse
should monitor the client for which potential electrolyte imbalance?
