RN Concept-Based Assessment Level 3
Online Practice A with NGN – Exam
Questions and Answers (2026 Update)
Instructions: This practice exam is designed to help you prepare for the ATI
RN Concept-Based Assessment Level 3 Online Practice A with Next
Generation NCLEX (NGN) questions for the 2026 academic year. The exam
tests clinical judgment across multiple concepts including prioritization,
pharmacology, medical-surgical nursing, and maternal-child health. Choose
the single best answer for each question. Detailed rationales are provided.
SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT
1. A nurse is caring for four clients. Which client should the nurse assess
first?
A. A client with diabetes mellitus reports a blood glucose level of 180
mg/dL
B. A client with heart failure has gained 2 kg in the last 24 hours
C. A client with a history of asthma reports shortness of breath and
wheezing
D. A client with a urinary tract infection reports burning during urination
Correct Answer: C
Rationale: This client is experiencing respiratory distress, which is a priority
due to the risk of hypoxia and respiratory failure. The ABCs (Airway,
,Breathing, Circulation) framework guides prioritization, and respiratory
distress takes precedence over the other concerns.
2. A client receiving morphine via PCA becomes difficult to arouse, with a
respiratory rate of 8 breaths/min. What is the nurse's priority action?
A. Administer naloxone
B. Notify the provider
C. Stop the PCA infusion
D. Apply supplemental oxygen
Correct Answer: C
Rationale: The immediate priority is to discontinue the medication causing
the respiratory depression. While naloxone may be indicated, stopping the
infusion is the first action to prevent further respiratory compromise.
3. A client is 2 days post-myocardial infarction. Which complication should
the nurse monitor for closely?
A. Hyperglycemia
B. Cardiac dysrhythmias
C. Hypokalemia
D. Peptic ulcer disease
Correct Answer: B
Rationale: Cardiac dysrhythmias are the most common complication
following MI due to myocardial irritability and electrical instability.
Continuous ECG monitoring is essential during this period.
, 4. A nurse is caring for a client who is 1 day post-operative following a total
hip arthroplasty. Which finding requires immediate intervention?
A. Pain rated 6 on a scale of 0 to 10
B. Temperature of 37.5°C (99.5°F)
C. Pulse oximetry reading of 88%
D. Urinary output of 30 mL/hour
Correct Answer: C
Rationale: A pulse oximetry reading of 88% indicates hypoxemia and
requires immediate intervention. This could indicate complications such as
atelectasis, pulmonary embolism, or pneumonia.
5. A nurse is caring for a client with acute pancreatitis. Which laboratory
value should the nurse monitor closely?
A. Serum amylase
B. Serum glucose
C. Serum calcium
D. All of the above
Correct Answer: D
Rationale: In acute pancreatitis, serum amylase and lipase are elevated.
Serum glucose may be elevated due to pancreatic damage affecting insulin
production. Serum calcium may decrease due to saponification with fatty
acids (hypocalcemia). All three should be monitored.
SECTION 2: PHARMACOLOGY
6. A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which
statement by the client indicates a need for further teaching?
Online Practice A with NGN – Exam
Questions and Answers (2026 Update)
Instructions: This practice exam is designed to help you prepare for the ATI
RN Concept-Based Assessment Level 3 Online Practice A with Next
Generation NCLEX (NGN) questions for the 2026 academic year. The exam
tests clinical judgment across multiple concepts including prioritization,
pharmacology, medical-surgical nursing, and maternal-child health. Choose
the single best answer for each question. Detailed rationales are provided.
SECTION 1: PRIORITIZATION & CLINICAL JUDGMENT
1. A nurse is caring for four clients. Which client should the nurse assess
first?
A. A client with diabetes mellitus reports a blood glucose level of 180
mg/dL
B. A client with heart failure has gained 2 kg in the last 24 hours
C. A client with a history of asthma reports shortness of breath and
wheezing
D. A client with a urinary tract infection reports burning during urination
Correct Answer: C
Rationale: This client is experiencing respiratory distress, which is a priority
due to the risk of hypoxia and respiratory failure. The ABCs (Airway,
,Breathing, Circulation) framework guides prioritization, and respiratory
distress takes precedence over the other concerns.
2. A client receiving morphine via PCA becomes difficult to arouse, with a
respiratory rate of 8 breaths/min. What is the nurse's priority action?
A. Administer naloxone
B. Notify the provider
C. Stop the PCA infusion
D. Apply supplemental oxygen
Correct Answer: C
Rationale: The immediate priority is to discontinue the medication causing
the respiratory depression. While naloxone may be indicated, stopping the
infusion is the first action to prevent further respiratory compromise.
3. A client is 2 days post-myocardial infarction. Which complication should
the nurse monitor for closely?
A. Hyperglycemia
B. Cardiac dysrhythmias
C. Hypokalemia
D. Peptic ulcer disease
Correct Answer: B
Rationale: Cardiac dysrhythmias are the most common complication
following MI due to myocardial irritability and electrical instability.
Continuous ECG monitoring is essential during this period.
, 4. A nurse is caring for a client who is 1 day post-operative following a total
hip arthroplasty. Which finding requires immediate intervention?
A. Pain rated 6 on a scale of 0 to 10
B. Temperature of 37.5°C (99.5°F)
C. Pulse oximetry reading of 88%
D. Urinary output of 30 mL/hour
Correct Answer: C
Rationale: A pulse oximetry reading of 88% indicates hypoxemia and
requires immediate intervention. This could indicate complications such as
atelectasis, pulmonary embolism, or pneumonia.
5. A nurse is caring for a client with acute pancreatitis. Which laboratory
value should the nurse monitor closely?
A. Serum amylase
B. Serum glucose
C. Serum calcium
D. All of the above
Correct Answer: D
Rationale: In acute pancreatitis, serum amylase and lipase are elevated.
Serum glucose may be elevated due to pancreatic damage affecting insulin
production. Serum calcium may decrease due to saponification with fatty
acids (hypocalcemia). All three should be monitored.
SECTION 2: PHARMACOLOGY
6. A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which
statement by the client indicates a need for further teaching?
