ATI RN COMPREHENSIVE PROCTORED
EXAM PREP (NGN 2026/2027)
QUESTIONS AND ANSWERS
1. A nurse is caring for a client who has a prescription for potassium chloride 20 mEq IV bolus.
Which of the following actions should the nurse take first?
A. Dilute the medication in 100 mL of 0.9% sodium chloride.
B. Verify the prescription with the healthcare provider.
C. Check the client’s most recent serum potassium level.
D. Assess the patency of the peripheral IV site.
Answer: B
Conceptual Explanation: Potassium chloride must never be given as an IV bolus (push)
because it causes immediate cardiac arrest. The nurse must clarify this dangerous
prescription with the provider immediately.
2. A nurse is assessing a client who has a chest tube and notes continuous bubbling in the
water-seal chamber. What should the nurse interpret this finding as?
A. A system leak in the chest tube drainage unit.
B. An expected finding for a client with a pneumothorax.
,C. High suction pressure being applied to the pleura.
D. The lung has fully re-expanded.
Answer: A
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak in the system. Intermittent bubbling is expected in a client with a pneumothorax, but
continuous bubbling requires troubleshooting the tubing and connections.
3. A nurse is teaching a client who has a new diagnosis of Type 1 Diabetes Mellitus about the
Somogyi effect. Which of the following statements should the nurse include?
A. It is hyperglycemia that occurs in the morning due to growth hormone release.
B. It is a rebound high blood sugar level following an episode of hypoglycemia during the
night.
C. It is a rise in blood glucose caused by eating a late-night snack.
D. It is caused by an insufficient dose of intermediate-acting insulin.
Answer: B
Conceptual Explanation: The Somogyi effect is characterized by morning hyperglycemia
that occurs in response to hypoglycemia during the night. The body releases counter-
regulatory hormones to increase glucose levels.
, 4. A nurse is assessing a client with preeclampsia who is receiving magnesium sulfate. Which
of the following findings is the priority to report?
A. Feeling of warmth and flushing.
B. Urinary output of 40 mL/hr.
C. 1+ deep tendon reflexes.
D. Respiratory rate of 10/min.
Answer: D
Conceptual Explanation: Magnesium toxicity can cause respiratory depression. A
respiratory rate below 12/min is a critical indicator of toxicity and requires immediate
intervention (stopping the infusion and potentially giving calcium gluconate).
5. A client is 24 hours post-thyroidectomy. The nurse notes the client has a positive
Chvostek’s sign. Which medication should the nurse anticipate administering?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Levothyroxine
Answer: B
EXAM PREP (NGN 2026/2027)
QUESTIONS AND ANSWERS
1. A nurse is caring for a client who has a prescription for potassium chloride 20 mEq IV bolus.
Which of the following actions should the nurse take first?
A. Dilute the medication in 100 mL of 0.9% sodium chloride.
B. Verify the prescription with the healthcare provider.
C. Check the client’s most recent serum potassium level.
D. Assess the patency of the peripheral IV site.
Answer: B
Conceptual Explanation: Potassium chloride must never be given as an IV bolus (push)
because it causes immediate cardiac arrest. The nurse must clarify this dangerous
prescription with the provider immediately.
2. A nurse is assessing a client who has a chest tube and notes continuous bubbling in the
water-seal chamber. What should the nurse interpret this finding as?
A. A system leak in the chest tube drainage unit.
B. An expected finding for a client with a pneumothorax.
,C. High suction pressure being applied to the pleura.
D. The lung has fully re-expanded.
Answer: A
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates an air
leak in the system. Intermittent bubbling is expected in a client with a pneumothorax, but
continuous bubbling requires troubleshooting the tubing and connections.
3. A nurse is teaching a client who has a new diagnosis of Type 1 Diabetes Mellitus about the
Somogyi effect. Which of the following statements should the nurse include?
A. It is hyperglycemia that occurs in the morning due to growth hormone release.
B. It is a rebound high blood sugar level following an episode of hypoglycemia during the
night.
C. It is a rise in blood glucose caused by eating a late-night snack.
D. It is caused by an insufficient dose of intermediate-acting insulin.
Answer: B
Conceptual Explanation: The Somogyi effect is characterized by morning hyperglycemia
that occurs in response to hypoglycemia during the night. The body releases counter-
regulatory hormones to increase glucose levels.
, 4. A nurse is assessing a client with preeclampsia who is receiving magnesium sulfate. Which
of the following findings is the priority to report?
A. Feeling of warmth and flushing.
B. Urinary output of 40 mL/hr.
C. 1+ deep tendon reflexes.
D. Respiratory rate of 10/min.
Answer: D
Conceptual Explanation: Magnesium toxicity can cause respiratory depression. A
respiratory rate below 12/min is a critical indicator of toxicity and requires immediate
intervention (stopping the infusion and potentially giving calcium gluconate).
5. A client is 24 hours post-thyroidectomy. The nurse notes the client has a positive
Chvostek’s sign. Which medication should the nurse anticipate administering?
A. Potassium chloride
B. Calcium gluconate
C. Magnesium sulfate
D. Levothyroxine
Answer: B
