ATI RN Adult Medical Surgical (MedSurg) Proctored
Exam NGN 2025 – Full Case Study Bank | 100
Questions & 100% Verified Answers with
Rationales
### Sample NGN Case Study
**Client Scenario**: A 58-year-old male is admitted with abdominal pain and a history of
alcohol use disorder. Vital signs: BP 100/60 mmHg, HR 112/min, RR 20/min, Temp 38.2°C
(100.8°F). Lab results: Amylase 450 U/L, lipase 600 U/L, white blood cell count 14,000/mm³. The
provider suspects acute pancreatitis and orders IV fluids, morphine for pain, and a CT scan. The
client reports nausea and has diminished bowel sounds.
**Question 1**: Which action should the nurse take first?
- A. Administer IV fluids
- B. Give morphine for pain
- C. Prepare the client for a CT scan
- D. Insert a nasogastric tube
**Answer**: : A. Administer IV fluids
- **Rationale**: IV fluids are the priority to address hypovolemia and support organ perfusion
in acute pancreatitis.
**Question 2**: After initiating IV fluids, the client’s BP improves to 110/70 mmHg, but pain
persists. Which intervention should the nurse implement next? (Select all that apply)
, - A. Administer morphine as prescribed
- B. Place the client in a semi-Fowler’s position
- C. Encourage oral intake of clear liquids
- D. Monitor for respiratory depression
**Answer**: : A, B, D
- **Rationale**: Morphine relieves pain, semi-Fowler’s position reduces abdominal pressure,
and monitoring for respiratory depression is essential with opioids. Oral intake is
contraindicated.
**Question 3**: The client develops a fever of 39°C (102.2°F) and tachycardia. Which
complication should the nurse suspect?
- A. Pancreatic pseudocyst
- B. Infection
- C. Hypoglycemia
- D. Acute kidney injury
**Answer**: : B. Infection
- **Rationale**: Fever and tachycardia suggest an infection, a common complication in acute
pancreatitis due to necrosis or abscess.
**Question 4**: The provider orders a nasogastric tube for decompression. Which action
should the nurse take to verify placement?
- A. Auscultate for air over the stomach after injecting air
- B. Check the pH of aspirated fluid
- C. Observe for coughing during insertion
- D. Measure the tube length before insertion
**Answer**: : B. Check the pH of aspirated fluid
- **Rationale**: Checking the pH (typically 1-5.5) confirms gastric placement, improving safety
over auscultation alone.
Exam NGN 2025 – Full Case Study Bank | 100
Questions & 100% Verified Answers with
Rationales
### Sample NGN Case Study
**Client Scenario**: A 58-year-old male is admitted with abdominal pain and a history of
alcohol use disorder. Vital signs: BP 100/60 mmHg, HR 112/min, RR 20/min, Temp 38.2°C
(100.8°F). Lab results: Amylase 450 U/L, lipase 600 U/L, white blood cell count 14,000/mm³. The
provider suspects acute pancreatitis and orders IV fluids, morphine for pain, and a CT scan. The
client reports nausea and has diminished bowel sounds.
**Question 1**: Which action should the nurse take first?
- A. Administer IV fluids
- B. Give morphine for pain
- C. Prepare the client for a CT scan
- D. Insert a nasogastric tube
**Answer**: : A. Administer IV fluids
- **Rationale**: IV fluids are the priority to address hypovolemia and support organ perfusion
in acute pancreatitis.
**Question 2**: After initiating IV fluids, the client’s BP improves to 110/70 mmHg, but pain
persists. Which intervention should the nurse implement next? (Select all that apply)
, - A. Administer morphine as prescribed
- B. Place the client in a semi-Fowler’s position
- C. Encourage oral intake of clear liquids
- D. Monitor for respiratory depression
**Answer**: : A, B, D
- **Rationale**: Morphine relieves pain, semi-Fowler’s position reduces abdominal pressure,
and monitoring for respiratory depression is essential with opioids. Oral intake is
contraindicated.
**Question 3**: The client develops a fever of 39°C (102.2°F) and tachycardia. Which
complication should the nurse suspect?
- A. Pancreatic pseudocyst
- B. Infection
- C. Hypoglycemia
- D. Acute kidney injury
**Answer**: : B. Infection
- **Rationale**: Fever and tachycardia suggest an infection, a common complication in acute
pancreatitis due to necrosis or abscess.
**Question 4**: The provider orders a nasogastric tube for decompression. Which action
should the nurse take to verify placement?
- A. Auscultate for air over the stomach after injecting air
- B. Check the pH of aspirated fluid
- C. Observe for coughing during insertion
- D. Measure the tube length before insertion
**Answer**: : B. Check the pH of aspirated fluid
- **Rationale**: Checking the pH (typically 1-5.5) confirms gastric placement, improving safety
over auscultation alone.
