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ATI PN COMPREHENSIVE PREDICTOR 2026
EXIT EXAM Next Generation NCLEX (NGN)
Style Practice Questions Advanced/Hard
Difficulty Level
Question 1
A practical nurse is reinforcing teaching with a client who has a new prescription for warfarin
following a pulmonary embolism. Which statement by the client indicates a need for further
teaching?
A. "I will use a soft toothbrush to brush my teeth."
B. "I will eat a consistent amount of green leafy vegetables each week."
C. "I will take ibuprofen for my headache because acetaminophen is not strong enough."
D. "I will have my INR checked regularly as scheduled."
Correct Answer: C
Explanation: Ibuprofen (an NSAID) increases the risk of gastrointestinal bleeding when taken
with warfarin. Acetaminophen is the preferred analgesic for clients on anticoagulants.
Consistent vitamin K intake and regular INR monitoring are correct practices .
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Question 2
A nurse in a long-term care facility is assessing a client with advanced dementia during the 0700
shift. The client is unresponsive to verbal stimuli, has respirations of 8/min and shallow, a pulse
of 42 bpm and weak, and an SpO2 of 84% on room air. The client has a DNR/AND order. Which
action should the PN take FIRST?
A. Administer oxygen via non-rebreather mask.
B. Call the client's family to inform them of the change.
C. Reposition the client to facilitate airway clearance.
D. Place the client in a supine position with a pillow under the head.
Correct Answer: C
Explanation: In an unresponsive client with shallow respirations, the priority is airway patency
(ABC framework). The PN must first open the airway and clear secretions. Repositioning (side-
lying) helps drain secretions and prevents aspiration. Oxygen is ineffective without a patent
airway. DNR/AND status means no CPR or intubation, but supportive care is still provided .
Question 3
A nurse is caring for a client who has been prescribed lithium carbonate for bipolar disorder.
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Which instructions should the nurse reinforce? (Select all that apply)
A. "Maintain consistent fluid and sodium intake while taking this medication."
B. "Report signs of toxicity, such as tremors, confusion, or diarrhea."
C. "Do not take NSAIDs without consulting your provider."
D. "Blood levels will need to be checked regularly to ensure safety."
Correct Answer: A, B, C, D
Explanation: Lithium has a narrow therapeutic index, requiring consistent hydration and sodium
intake to maintain safe levels. Toxicity signs include tremors, confusion, gastrointestinal upset,
and ataxia. NSAIDs reduce renal clearance of lithium, increasing toxicity risk. Regular blood
monitoring ensures therapeutic but non-toxic serum levels .
Question 4
A client with heart failure is prescribed digoxin. Which finding should indicate to the nurse that
the medication should be withheld?
A. Heart rate 62/min
B. Potassium level 3.2 mEq/L
C. Blood pressure 130/80 mm Hg
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D. Urine output 40 mL/hr
Correct Answer: B
Explanation: Hypokalemia (K+ <3.5 mEq/L) increases the risk of digoxin toxicity. NCLEX-PN's
Reduction of Risk Potential stresses electrolyte monitoring. Hypokalemia potentiates
arrhythmias .
Question 5
The nurse observes a newly licensed nurse donning sterile gloves. Which action requires
correction?
A. Touching only the inside surface of the first glove.
B. Adjusting the glove cuff after both gloves are on.
C. Picking up the first glove by the folded cuff.
D. Pulling the glove over the gown cuff.
Correct Answer: D
Explanation: The sterile glove cuff should be pulled over the gown cuff only if the gown's cuffs
are sterile (surgical setting). In standard procedures, pulling over a non-sterile gown cuff
contaminates the glove .
ATI PN COMPREHENSIVE PREDICTOR 2026
EXIT EXAM Next Generation NCLEX (NGN)
Style Practice Questions Advanced/Hard
Difficulty Level
Question 1
A practical nurse is reinforcing teaching with a client who has a new prescription for warfarin
following a pulmonary embolism. Which statement by the client indicates a need for further
teaching?
A. "I will use a soft toothbrush to brush my teeth."
B. "I will eat a consistent amount of green leafy vegetables each week."
C. "I will take ibuprofen for my headache because acetaminophen is not strong enough."
D. "I will have my INR checked regularly as scheduled."
Correct Answer: C
Explanation: Ibuprofen (an NSAID) increases the risk of gastrointestinal bleeding when taken
with warfarin. Acetaminophen is the preferred analgesic for clients on anticoagulants.
Consistent vitamin K intake and regular INR monitoring are correct practices .
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Question 2
A nurse in a long-term care facility is assessing a client with advanced dementia during the 0700
shift. The client is unresponsive to verbal stimuli, has respirations of 8/min and shallow, a pulse
of 42 bpm and weak, and an SpO2 of 84% on room air. The client has a DNR/AND order. Which
action should the PN take FIRST?
A. Administer oxygen via non-rebreather mask.
B. Call the client's family to inform them of the change.
C. Reposition the client to facilitate airway clearance.
D. Place the client in a supine position with a pillow under the head.
Correct Answer: C
Explanation: In an unresponsive client with shallow respirations, the priority is airway patency
(ABC framework). The PN must first open the airway and clear secretions. Repositioning (side-
lying) helps drain secretions and prevents aspiration. Oxygen is ineffective without a patent
airway. DNR/AND status means no CPR or intubation, but supportive care is still provided .
Question 3
A nurse is caring for a client who has been prescribed lithium carbonate for bipolar disorder.
, 3
Which instructions should the nurse reinforce? (Select all that apply)
A. "Maintain consistent fluid and sodium intake while taking this medication."
B. "Report signs of toxicity, such as tremors, confusion, or diarrhea."
C. "Do not take NSAIDs without consulting your provider."
D. "Blood levels will need to be checked regularly to ensure safety."
Correct Answer: A, B, C, D
Explanation: Lithium has a narrow therapeutic index, requiring consistent hydration and sodium
intake to maintain safe levels. Toxicity signs include tremors, confusion, gastrointestinal upset,
and ataxia. NSAIDs reduce renal clearance of lithium, increasing toxicity risk. Regular blood
monitoring ensures therapeutic but non-toxic serum levels .
Question 4
A client with heart failure is prescribed digoxin. Which finding should indicate to the nurse that
the medication should be withheld?
A. Heart rate 62/min
B. Potassium level 3.2 mEq/L
C. Blood pressure 130/80 mm Hg
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D. Urine output 40 mL/hr
Correct Answer: B
Explanation: Hypokalemia (K+ <3.5 mEq/L) increases the risk of digoxin toxicity. NCLEX-PN's
Reduction of Risk Potential stresses electrolyte monitoring. Hypokalemia potentiates
arrhythmias .
Question 5
The nurse observes a newly licensed nurse donning sterile gloves. Which action requires
correction?
A. Touching only the inside surface of the first glove.
B. Adjusting the glove cuff after both gloves are on.
C. Picking up the first glove by the folded cuff.
D. Pulling the glove over the gown cuff.
Correct Answer: D
Explanation: The sterile glove cuff should be pulled over the gown cuff only if the gown's cuffs
are sterile (surgical setting). In standard procedures, pulling over a non-sterile gown cuff
contaminates the glove .
