ATI RN Comprehensive Predictor Exit Exam 2026
180Questions with Answers and Rationales
(NGN)
Instructions: Read each question carefully. Select the best answer. For NGN
items, follow the specific instructions for each question type.
Q1.
A nurse is caring for a client with heart failure who is receiving intravenous
furosemide. Which of the following findings should the nurse monitor as an
adverse effect of this medication?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes increased excretion of
potassium, leading to hypokalemia. The nurse should monitor serum potassium
levels closely and assess for signs such as muscle weakness, dysrhythmias, and
fatigue. Hyperkalemia is associated with potassium-sparing diuretics. Hyponatremia
and hypercalcemia are not the primary concerns with loop diuretics.
Q2.
A client with type 2 diabetes mellitus is prescribed metformin. The nurse should
instruct the client to report which of the following symptoms that could indicate
lactic acidosis?
A. Hypoglycemia
B. Muscle pain and weakness
C. Increased urination
D. Blurred vision
Correct Answer: B
Rationale: Lactic acidosis is a rare but life-threatening complication of metformin.
Page 1
,Symptoms include unusual muscle pain, weakness, trouble breathing, dizziness, and
feeling cold. The client should report these immediately. Hypoglycemia and blurred
vision are not typical of lactic acidosis; they are more related to the diabetes itself
or other medications.
Q3.
A nurse is assessing a client who has a chest tube following a thoracotomy. The
nurse notes continuous bubbling in the water seal chamber. Which of the
following actions should the nurse take?
A. Document the finding and continue monitoring
B. Check for an air leak in the system
C. Clamp the chest tube
D. Increase the suction to the chest drainage system
Correct Answer: B
Page 2
,Rationale: Continuous bubbling in the water seal chamber indicates an air leak
in the drainage system. The nurse should locate and correct the source by
checking all connections from the client to the drainage unit. Clamping is
contraindicated unless specifically ordered, as it can cause a tension
pneumothorax. Increasing suction does not address an air leak in the system
itself.
Q4.
Select All That Apply (NGN)
A nurse is planning care for a client who is postoperative following a total hip
arthroplasty. Which of the following interventions should the nurse include in the
plan of care? (Select all that apply)
A. Maintain abduction of the affected hip
B. Place a pillow between the legs when turning
C. Elevate the head of the bed to 90 degrees
D. Use an abductor splint when the client is in bed
E. Encourage crossing legs to promote circulation
Correct Answer: A, B, D
Rationale: After hip arthroplasty, the nurse should maintain abduction to prevent
dislocation. A pillow between the legs and an abductor splint help maintain proper
hip alignment. Elevating the head of bed to 90 degrees can cause excessive hip
flexion beyond the safe limit. Crossing legs is strictly contraindicated as it
significantly increases the risk of prosthesis dislocation.
Q5.
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 eat large amounts of leafy green vegetables daily."
B. "I will use an electric razor to shave."
C. "I will take ibuprofen for headaches."
D. "I will double my dose if I miss a dose."
Correct Answer: B
Rationale: Using an electric razor reduces bleeding risk, which is critical with
warfarin therapy. Large amounts of leafy greens contain vitamin K that
Page 3
, counteracts warfarin. Ibuprofen increases bleeding risk and should be avoided.
Doubling a missed dose is dangerous and increases hemorrhage risk; the client
should take the missed dose as soon as remembered or contact the provider.
Q6.
A nurse is caring for a client with acute pancreatitis. Which of the following
findings should the nurse expect?
A. Decreased amylase and lipase levels
B. Hypocalcemia
C. Bradycardia
D. Hyperactive bowel sounds
Correct Answer: B
Rationale: Acute pancreatitis commonly causes hypocalcemia due to fat necrosis
and calcium soap formation in peripancreatic tissue. Amylase and lipase levels are
elevated, not decreased. Tachycardia is common due to pain and hypovolemia.
Bowel sounds are typically decreased or absent due to paralytic ileus, not
hyperactive.
Q7.
Page 4
180Questions with Answers and Rationales
(NGN)
Instructions: Read each question carefully. Select the best answer. For NGN
items, follow the specific instructions for each question type.
Q1.
A nurse is caring for a client with heart failure who is receiving intravenous
furosemide. Which of the following findings should the nurse monitor as an
adverse effect of this medication?
A. Hyperkalemia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that causes increased excretion of
potassium, leading to hypokalemia. The nurse should monitor serum potassium
levels closely and assess for signs such as muscle weakness, dysrhythmias, and
fatigue. Hyperkalemia is associated with potassium-sparing diuretics. Hyponatremia
and hypercalcemia are not the primary concerns with loop diuretics.
Q2.
A client with type 2 diabetes mellitus is prescribed metformin. The nurse should
instruct the client to report which of the following symptoms that could indicate
lactic acidosis?
A. Hypoglycemia
B. Muscle pain and weakness
C. Increased urination
D. Blurred vision
Correct Answer: B
Rationale: Lactic acidosis is a rare but life-threatening complication of metformin.
Page 1
,Symptoms include unusual muscle pain, weakness, trouble breathing, dizziness, and
feeling cold. The client should report these immediately. Hypoglycemia and blurred
vision are not typical of lactic acidosis; they are more related to the diabetes itself
or other medications.
Q3.
A nurse is assessing a client who has a chest tube following a thoracotomy. The
nurse notes continuous bubbling in the water seal chamber. Which of the
following actions should the nurse take?
A. Document the finding and continue monitoring
B. Check for an air leak in the system
C. Clamp the chest tube
D. Increase the suction to the chest drainage system
Correct Answer: B
Page 2
,Rationale: Continuous bubbling in the water seal chamber indicates an air leak
in the drainage system. The nurse should locate and correct the source by
checking all connections from the client to the drainage unit. Clamping is
contraindicated unless specifically ordered, as it can cause a tension
pneumothorax. Increasing suction does not address an air leak in the system
itself.
Q4.
Select All That Apply (NGN)
A nurse is planning care for a client who is postoperative following a total hip
arthroplasty. Which of the following interventions should the nurse include in the
plan of care? (Select all that apply)
A. Maintain abduction of the affected hip
B. Place a pillow between the legs when turning
C. Elevate the head of the bed to 90 degrees
D. Use an abductor splint when the client is in bed
E. Encourage crossing legs to promote circulation
Correct Answer: A, B, D
Rationale: After hip arthroplasty, the nurse should maintain abduction to prevent
dislocation. A pillow between the legs and an abductor splint help maintain proper
hip alignment. Elevating the head of bed to 90 degrees can cause excessive hip
flexion beyond the safe limit. Crossing legs is strictly contraindicated as it
significantly increases the risk of prosthesis dislocation.
Q5.
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 eat large amounts of leafy green vegetables daily."
B. "I will use an electric razor to shave."
C. "I will take ibuprofen for headaches."
D. "I will double my dose if I miss a dose."
Correct Answer: B
Rationale: Using an electric razor reduces bleeding risk, which is critical with
warfarin therapy. Large amounts of leafy greens contain vitamin K that
Page 3
, counteracts warfarin. Ibuprofen increases bleeding risk and should be avoided.
Doubling a missed dose is dangerous and increases hemorrhage risk; the client
should take the missed dose as soon as remembered or contact the provider.
Q6.
A nurse is caring for a client with acute pancreatitis. Which of the following
findings should the nurse expect?
A. Decreased amylase and lipase levels
B. Hypocalcemia
C. Bradycardia
D. Hyperactive bowel sounds
Correct Answer: B
Rationale: Acute pancreatitis commonly causes hypocalcemia due to fat necrosis
and calcium soap formation in peripancreatic tissue. Amylase and lipase levels are
elevated, not decreased. Tachycardia is common due to pain and hypovolemia.
Bowel sounds are typically decreased or absent due to paralytic ileus, not
hyperactive.
Q7.
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