ATI RN COMPREHENSIVE PREDICTOR
AND NGN PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A nurse is caring for a client who has a prescription for lithium carbonate to treat bipolar
disorder. Which of the following findings should the nurse identify as an early indicator of
lithium toxicity?
A. Coarse hand tremors
B. Severe hypertension
C. Urinary retention
D. Muscle rigidity
Answer: A
Conceptual Explanation: Early signs of lithium toxicity include fine hand tremors that
progress to coarse tremors, nausea, vomiting, and diarrhea. Severe hypertension is not
associated with lithium toxicity; rather, hypotension can occur in late stages.
,2. A nurse is reviewing the arterial blood gas (ABG) results for a client: pH 7.50, PaCO2 32 mm
Hg, and HCO3 24 mEq/L. The nurse should interpret these findings as which of the following?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: A
Conceptual Explanation: A pH above 7.45 indicates alkalosis. A PaCO2 below 35 mm Hg
indicates a respiratory cause. Since the HCO3 is within the normal range (22-26 mEq/L),
this represents uncompensated respiratory alkalosis.
3. A nurse is assessing a client who is 2 hours postoperative following an abdominal
hysterectomy. Which of the following findings is the priority for the nurse to report to the
provider?
A. Serosanguineous drainage on the abdominal dressing
B. Urinary output of 20 mL/hr
C. Decreased bowel sounds in all four quadrants
D. Client report of pain as 6 on a scale of 0 to 10
Answer: B
, Conceptual Explanation: Using the ABC priority framework, a urinary output of less than
30 mL/hr can indicate decreased renal perfusion, hypovolemia, or shock, and requires
immediate intervention.
4. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the
following actions should the nurse take first?
A. Check the client’s most recent serum potassium level
B. Review the client’s digoxin therapeutic level
C. Administer the medication with a full glass of water
D. Assess the client’s apical pulse for 1 full minute
Answer: D
Conceptual Explanation: The first action the nurse should take when using the nursing
process is assessment. The nurse must check the apical pulse to ensure it is at least 60/min
before administration.
5. A nurse is caring for a client who is in active labor and has a prescription for oxytocin. The
nurse notes late decelerations on the fetal monitor strip. Which of the following actions
should the nurse take first?
A. Increase the rate of the maintenance IV fluid
B. Apply oxygen at 10 L/min via nonrebreather mask
C. Discontinue the oxytocin infusion
AND NGN PRACTICE EXAM
QUESTIONS AND ANSWERS
1. A nurse is caring for a client who has a prescription for lithium carbonate to treat bipolar
disorder. Which of the following findings should the nurse identify as an early indicator of
lithium toxicity?
A. Coarse hand tremors
B. Severe hypertension
C. Urinary retention
D. Muscle rigidity
Answer: A
Conceptual Explanation: Early signs of lithium toxicity include fine hand tremors that
progress to coarse tremors, nausea, vomiting, and diarrhea. Severe hypertension is not
associated with lithium toxicity; rather, hypotension can occur in late stages.
,2. A nurse is reviewing the arterial blood gas (ABG) results for a client: pH 7.50, PaCO2 32 mm
Hg, and HCO3 24 mEq/L. The nurse should interpret these findings as which of the following?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Answer: A
Conceptual Explanation: A pH above 7.45 indicates alkalosis. A PaCO2 below 35 mm Hg
indicates a respiratory cause. Since the HCO3 is within the normal range (22-26 mEq/L),
this represents uncompensated respiratory alkalosis.
3. A nurse is assessing a client who is 2 hours postoperative following an abdominal
hysterectomy. Which of the following findings is the priority for the nurse to report to the
provider?
A. Serosanguineous drainage on the abdominal dressing
B. Urinary output of 20 mL/hr
C. Decreased bowel sounds in all four quadrants
D. Client report of pain as 6 on a scale of 0 to 10
Answer: B
, Conceptual Explanation: Using the ABC priority framework, a urinary output of less than
30 mL/hr can indicate decreased renal perfusion, hypovolemia, or shock, and requires
immediate intervention.
4. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the
following actions should the nurse take first?
A. Check the client’s most recent serum potassium level
B. Review the client’s digoxin therapeutic level
C. Administer the medication with a full glass of water
D. Assess the client’s apical pulse for 1 full minute
Answer: D
Conceptual Explanation: The first action the nurse should take when using the nursing
process is assessment. The nurse must check the apical pulse to ensure it is at least 60/min
before administration.
5. A nurse is caring for a client who is in active labor and has a prescription for oxytocin. The
nurse notes late decelerations on the fetal monitor strip. Which of the following actions
should the nurse take first?
A. Increase the rate of the maintenance IV fluid
B. Apply oxygen at 10 L/min via nonrebreather mask
C. Discontinue the oxytocin infusion
