NGN ATI RN VATI COMPREHENSIVE EXAM BLUEPRINT: 200
HIGH-YIELD PRACTICE QUESTIONS WITH CORRECT ANSWERS,
EVIDENCE-BASED RATIONALES, COVERING ALL TESTED
NURSING DOMAINS (MEDICAL-SURGICAL, PHARMACOLOGY,
MATERNAL-NEWBORN, PEDIATRICS, PSYCHIATRIC-MENTAL
HEALTH, LEADERSHIP, AND CRITICAL CARE)
1. A nurse is planning care for a client who is at risk for falls. Which of
the following interventions should the nurse include?
A. Keep the bed in the lowest position with the side rails up.
B. Place a fall risk alert sign above the client's bed.
C. Encourage the client to wear non-skid socks when ambulating.
D. Restrain the client to prevent injury.
Answer: C
Rationale: Non-skid footwear reduces the risk of slipping. Side rails up
can increase fall risk if the client tries to climb over. Restraints are a last
resort and require a provider order.
2. A nurse is administering digoxin to a client with heart failure. Which
of the following findings indicates toxicity?
A. Heart rate of 72/min
B. Blood pressure 130/80 mmHg
C. Visual disturbances such as yellow halos
D. Weight gain of 1 kg in 24 hours
Answer: C
,Rationale: Visual disturbances (yellow or green halos, blurred vision) are
classic signs of digoxin toxicity. Bradycardia (not 72) is also a sign, but
visual changes are more specific.
3. A nurse is caring for a client post-operative day one after a total hip
arthroplasty. Which position is contraindicated?
A. Supine with a pillow between the legs
B. Side-lying on the non-operative side
C. Crossing the legs at the ankles
D. Semi-Fowler's position with knees slightly flexed
Answer: C
Rationale: Crossing the legs causes hip adduction and internal rotation,
which can dislocate the new hip joint. Maintaining abduction with a
pillow is correct.
4. A nurse is providing dietary teaching to a client with chronic kidney
disease. Which food should the nurse instruct the client to avoid?
A. Apples
B. White rice
C. Bananas
D. Cabbage
Answer: C
Rationale: Bananas are high in potassium. Clients with CKD often have
hyperkalemia and should restrict high-potassium foods like bananas,
oranges, and tomatoes.
5. A nurse is assessing a client who has pneumonia. Which finding
indicates a need for immediate intervention?
A. Temperature of 38.3°C (101°F)
B. Pulse oximetry of 88% on room air
,C. Productive cough with green sputum
D. Respiratory rate of 22/min
Answer: B
Rationale: An SpO2 of 88% indicates severe hypoxemia requiring
immediate oxygen therapy. The other findings are expected with
pneumonia but not immediately life-threatening.
6. A nurse is preparing a client for a colonoscopy. Which medication
should the nurse anticipate administering to promote bowel
emptying?
A. Loperamide
B. Polyethylene glycol
C. Bismuth subsalicylate
D. Docusate sodium
Answer: B
Rationale: Polyethylene glycol (GoLYTELY) is an osmotic laxative used for
bowel prep to cleanse the colon. Loperamide and bismuth stop
diarrhea, and docusate is a stool softener.
7. A nurse is caring for a client who is receiving total parenteral
nutrition (TPN). Which complication should the nurse monitor for
closely?
A. Hypoglycemia upon abrupt cessation
B. Fluid volume deficit
C. Hyperkalemia
D. Metabolic alkalosis
Answer: A
Rationale: TPN has high glucose content; stopping it abruptly causes
rebound hypoglycemia. It should be tapered off.
, 8. A nurse is educating a client about the use of a metered-dose
inhaler (MDI). Which action indicates proper technique?
A. Inhaling while pressing down on the canister
B. Exhaling fully after pressing the inhaler
C. Holding the breath for 1 second after inhalation
D. Shaking the inhaler once before use
Answer: A
Rationale: Coordination of inhalation with actuation ensures medication
reaches the lungs. Breath should be held for 5-10 seconds, and the
inhaler should be shaken well (not just once).
9. A nurse is assessing a client in active labor. Which fetal heart rate
pattern requires immediate intervention?
A. Accelerations with fetal movement
B. Early decelerations
C. Variable decelerations that are shallow
D. Late decelerations
Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency and
fetal hypoxia, requiring immediate action (position change, oxygen,
notify provider).
10. A nurse is caring for a client who has a nasogastric tube for gastric
decompression. Which finding indicates tube displacement?
A. pH of gastric aspirate is 4.0
B. Client reports a sore throat
C. Aspirate has a greenish color
D. The tube is taped to the nose without tension
Answer: B (Wait, sore throat can be normal. Let me correct: Actually, a
sudden increase in drainage or coughing, but better option is if aspirate
HIGH-YIELD PRACTICE QUESTIONS WITH CORRECT ANSWERS,
EVIDENCE-BASED RATIONALES, COVERING ALL TESTED
NURSING DOMAINS (MEDICAL-SURGICAL, PHARMACOLOGY,
MATERNAL-NEWBORN, PEDIATRICS, PSYCHIATRIC-MENTAL
HEALTH, LEADERSHIP, AND CRITICAL CARE)
1. A nurse is planning care for a client who is at risk for falls. Which of
the following interventions should the nurse include?
A. Keep the bed in the lowest position with the side rails up.
B. Place a fall risk alert sign above the client's bed.
C. Encourage the client to wear non-skid socks when ambulating.
D. Restrain the client to prevent injury.
Answer: C
Rationale: Non-skid footwear reduces the risk of slipping. Side rails up
can increase fall risk if the client tries to climb over. Restraints are a last
resort and require a provider order.
2. A nurse is administering digoxin to a client with heart failure. Which
of the following findings indicates toxicity?
A. Heart rate of 72/min
B. Blood pressure 130/80 mmHg
C. Visual disturbances such as yellow halos
D. Weight gain of 1 kg in 24 hours
Answer: C
,Rationale: Visual disturbances (yellow or green halos, blurred vision) are
classic signs of digoxin toxicity. Bradycardia (not 72) is also a sign, but
visual changes are more specific.
3. A nurse is caring for a client post-operative day one after a total hip
arthroplasty. Which position is contraindicated?
A. Supine with a pillow between the legs
B. Side-lying on the non-operative side
C. Crossing the legs at the ankles
D. Semi-Fowler's position with knees slightly flexed
Answer: C
Rationale: Crossing the legs causes hip adduction and internal rotation,
which can dislocate the new hip joint. Maintaining abduction with a
pillow is correct.
4. A nurse is providing dietary teaching to a client with chronic kidney
disease. Which food should the nurse instruct the client to avoid?
A. Apples
B. White rice
C. Bananas
D. Cabbage
Answer: C
Rationale: Bananas are high in potassium. Clients with CKD often have
hyperkalemia and should restrict high-potassium foods like bananas,
oranges, and tomatoes.
5. A nurse is assessing a client who has pneumonia. Which finding
indicates a need for immediate intervention?
A. Temperature of 38.3°C (101°F)
B. Pulse oximetry of 88% on room air
,C. Productive cough with green sputum
D. Respiratory rate of 22/min
Answer: B
Rationale: An SpO2 of 88% indicates severe hypoxemia requiring
immediate oxygen therapy. The other findings are expected with
pneumonia but not immediately life-threatening.
6. A nurse is preparing a client for a colonoscopy. Which medication
should the nurse anticipate administering to promote bowel
emptying?
A. Loperamide
B. Polyethylene glycol
C. Bismuth subsalicylate
D. Docusate sodium
Answer: B
Rationale: Polyethylene glycol (GoLYTELY) is an osmotic laxative used for
bowel prep to cleanse the colon. Loperamide and bismuth stop
diarrhea, and docusate is a stool softener.
7. A nurse is caring for a client who is receiving total parenteral
nutrition (TPN). Which complication should the nurse monitor for
closely?
A. Hypoglycemia upon abrupt cessation
B. Fluid volume deficit
C. Hyperkalemia
D. Metabolic alkalosis
Answer: A
Rationale: TPN has high glucose content; stopping it abruptly causes
rebound hypoglycemia. It should be tapered off.
, 8. A nurse is educating a client about the use of a metered-dose
inhaler (MDI). Which action indicates proper technique?
A. Inhaling while pressing down on the canister
B. Exhaling fully after pressing the inhaler
C. Holding the breath for 1 second after inhalation
D. Shaking the inhaler once before use
Answer: A
Rationale: Coordination of inhalation with actuation ensures medication
reaches the lungs. Breath should be held for 5-10 seconds, and the
inhaler should be shaken well (not just once).
9. A nurse is assessing a client in active labor. Which fetal heart rate
pattern requires immediate intervention?
A. Accelerations with fetal movement
B. Early decelerations
C. Variable decelerations that are shallow
D. Late decelerations
Answer: D
Rationale: Late decelerations indicate uteroplacental insufficiency and
fetal hypoxia, requiring immediate action (position change, oxygen,
notify provider).
10. A nurse is caring for a client who has a nasogastric tube for gastric
decompression. Which finding indicates tube displacement?
A. pH of gastric aspirate is 4.0
B. Client reports a sore throat
C. Aspirate has a greenish color
D. The tube is taped to the nose without tension
Answer: B (Wait, sore throat can be normal. Let me correct: Actually, a
sudden increase in drainage or coughing, but better option is if aspirate
