NGN ATI RN Comprehensive Predictor
2026/2027Original Practice Questions With
Answers & Detailed Rationales
Practice Set 2 — Questions 21–40
21. A nurse is caring for a client with heart failure who reports increasing shortness of
breath. Which finding requires immediate intervention?
A. 1+ bilateral ankle edema
B. Weight gain of 1 kg over 1 week
C. Pink, frothy sputum
D. Fatigue after walking
Answer: C. Pink, frothy sputum
Rationale: Pink, frothy sputum can indicate acute pulmonary edema, a life-threatening
complication of heart failure. The client requires immediate assessment and intervention to
improve oxygenation and reduce pulmonary congestion.
22. A client receiving a continuous heparin infusion has an aPTT that is significantly above
the therapeutic range. Which action should the nurse anticipate?
A. Increase the infusion rate
B. Hold or decrease the infusion according to protocol
C. Administer vitamin K
D. Give an additional dose of heparin
Answer: B. Hold or decrease the infusion according to protocol
Rationale: An excessively prolonged aPTT indicates increased anticoagulant effect and bleeding
risk. Heparin dosing should be adjusted according to the institution's protocol. Vitamin K
reverses warfarin, not heparin.
23. A nurse is assessing a client with suspected hypoglycemia. Which findings should the
nurse expect? Select all that apply.
A. Diaphoresis
B. Tremors
,C. Tachycardia
D. Warm, dry skin
E. Confusion
Answers: A, B, C, E
Rationale: Hypoglycemia activates the sympathetic nervous system, causing sweating, tremors,
tachycardia, anxiety, and hunger. Neuroglucopenia can produce confusion and altered
consciousness.
24. A client with COPD is receiving oxygen therapy. Which nursing action is appropriate?
A. Administer oxygen at the highest possible flow rate
B. Maintain oxygen therapy at the prescribed level and monitor respiratory status
C. Discontinue oxygen when the client becomes sleepy
D. Encourage prolonged breath-holding
Answer: B. Maintain oxygen therapy at the prescribed level and monitor respiratory status
Rationale: Oxygen should be titrated according to the prescribed target and the client's clinical
condition. Excessive oxygen administration can worsen gas-exchange abnormalities in some
clients with severe COPD.
25. A postoperative client suddenly develops dyspnea, pleuritic chest pain, tachycardia, and
anxiety. What should the nurse do first?
A. Encourage ambulation
B. Apply oxygen and rapidly assess the client
C. Offer oral fluids
D. Place the client in a supine position
Answer: B. Apply oxygen and rapidly assess the client
Rationale: The findings are concerning for pulmonary embolism. Airway and breathing take
priority. Oxygen should be provided while the nurse performs an immediate assessment and
activates appropriate emergency management.
26. A client taking lisinopril reports swelling of the lips and tongue. Which action is the
priority?
, A. Administer the next dose with food
B. Document the expected adverse effect
C. Assess the airway and obtain emergency assistance
D. Encourage increased oral fluids
Answer: C. Assess the airway and obtain emergency assistance
Rationale: Facial, lip, or tongue swelling may indicate angioedema, which can rapidly
compromise the airway. The medication should not be administered again unless specifically
directed after evaluation.
27. A nurse is teaching a client taking furosemide. Which statement indicates correct
understanding?
A. “I should take this medication at bedtime.”
B. “I should monitor my weight regularly.”
C. “I should avoid all foods containing potassium.”
D. “I should stop taking it when my swelling improves.”
Answer: B. “I should monitor my weight regularly.”
Rationale: Daily weight monitoring helps identify fluid retention or excessive fluid loss.
Furosemide increases urine output and can cause electrolyte abnormalities, particularly
hypokalemia.
28. A client has a potassium level of 2.8 mEq/L. Which finding is most concerning?
A. Muscle weakness
B. Irregular cardiac rhythm
C. Mild nausea
D. Increased thirst
Answer: B. Irregular cardiac rhythm
Rationale: Significant hypokalemia can interfere with cardiac conduction and cause potentially
dangerous dysrhythmias. Cardiac monitoring and appropriate potassium replacement may be
required.
29. A nurse is caring for a client with a new diagnosis of stroke. Which finding requires
immediate notification of the healthcare provider?
2026/2027Original Practice Questions With
Answers & Detailed Rationales
Practice Set 2 — Questions 21–40
21. A nurse is caring for a client with heart failure who reports increasing shortness of
breath. Which finding requires immediate intervention?
A. 1+ bilateral ankle edema
B. Weight gain of 1 kg over 1 week
C. Pink, frothy sputum
D. Fatigue after walking
Answer: C. Pink, frothy sputum
Rationale: Pink, frothy sputum can indicate acute pulmonary edema, a life-threatening
complication of heart failure. The client requires immediate assessment and intervention to
improve oxygenation and reduce pulmonary congestion.
22. A client receiving a continuous heparin infusion has an aPTT that is significantly above
the therapeutic range. Which action should the nurse anticipate?
A. Increase the infusion rate
B. Hold or decrease the infusion according to protocol
C. Administer vitamin K
D. Give an additional dose of heparin
Answer: B. Hold or decrease the infusion according to protocol
Rationale: An excessively prolonged aPTT indicates increased anticoagulant effect and bleeding
risk. Heparin dosing should be adjusted according to the institution's protocol. Vitamin K
reverses warfarin, not heparin.
23. A nurse is assessing a client with suspected hypoglycemia. Which findings should the
nurse expect? Select all that apply.
A. Diaphoresis
B. Tremors
,C. Tachycardia
D. Warm, dry skin
E. Confusion
Answers: A, B, C, E
Rationale: Hypoglycemia activates the sympathetic nervous system, causing sweating, tremors,
tachycardia, anxiety, and hunger. Neuroglucopenia can produce confusion and altered
consciousness.
24. A client with COPD is receiving oxygen therapy. Which nursing action is appropriate?
A. Administer oxygen at the highest possible flow rate
B. Maintain oxygen therapy at the prescribed level and monitor respiratory status
C. Discontinue oxygen when the client becomes sleepy
D. Encourage prolonged breath-holding
Answer: B. Maintain oxygen therapy at the prescribed level and monitor respiratory status
Rationale: Oxygen should be titrated according to the prescribed target and the client's clinical
condition. Excessive oxygen administration can worsen gas-exchange abnormalities in some
clients with severe COPD.
25. A postoperative client suddenly develops dyspnea, pleuritic chest pain, tachycardia, and
anxiety. What should the nurse do first?
A. Encourage ambulation
B. Apply oxygen and rapidly assess the client
C. Offer oral fluids
D. Place the client in a supine position
Answer: B. Apply oxygen and rapidly assess the client
Rationale: The findings are concerning for pulmonary embolism. Airway and breathing take
priority. Oxygen should be provided while the nurse performs an immediate assessment and
activates appropriate emergency management.
26. A client taking lisinopril reports swelling of the lips and tongue. Which action is the
priority?
, A. Administer the next dose with food
B. Document the expected adverse effect
C. Assess the airway and obtain emergency assistance
D. Encourage increased oral fluids
Answer: C. Assess the airway and obtain emergency assistance
Rationale: Facial, lip, or tongue swelling may indicate angioedema, which can rapidly
compromise the airway. The medication should not be administered again unless specifically
directed after evaluation.
27. A nurse is teaching a client taking furosemide. Which statement indicates correct
understanding?
A. “I should take this medication at bedtime.”
B. “I should monitor my weight regularly.”
C. “I should avoid all foods containing potassium.”
D. “I should stop taking it when my swelling improves.”
Answer: B. “I should monitor my weight regularly.”
Rationale: Daily weight monitoring helps identify fluid retention or excessive fluid loss.
Furosemide increases urine output and can cause electrolyte abnormalities, particularly
hypokalemia.
28. A client has a potassium level of 2.8 mEq/L. Which finding is most concerning?
A. Muscle weakness
B. Irregular cardiac rhythm
C. Mild nausea
D. Increased thirst
Answer: B. Irregular cardiac rhythm
Rationale: Significant hypokalemia can interfere with cardiac conduction and cause potentially
dangerous dysrhythmias. Cardiac monitoring and appropriate potassium replacement may be
required.
29. A nurse is caring for a client with a new diagnosis of stroke. Which finding requires
immediate notification of the healthcare provider?
