ACTUAL 2026/2027 VERSION ATI/RN
COMPREHENSIVE PREDITOR EXIT EXAM WITH 180
Page | 1
QUESTIONS AND ANSWERS TO PASS |NGN
GUARANTEED PASS
Question 1
A nurse in the emergency department is caring for a client who arrives with a headache, dizziness,
and shortness of breath. The client's oxygen saturation is 88% on room air. Which of the following
actions should the nurse take first?
A) Administer 100% oxygen via non-rebreather mask
B) Obtain a stat chest x-ray
C) Start an IV line with 0.9% normal saline
D) Draw arterial blood gases (ABGs)
Answer: A
The client's low oxygen saturation (88%) indicates hypoxemia, which is a life-threatening finding
that requires immediate correction. Airway and breathing are always the priority. Administering
oxygen is the first action to improve oxygenation before further diagnostic tests or IV access. Chest
x-ray and ABGs can be obtained after oxygen therapy is initiated.*
Question 2 (NGN – Bowtie)
A nurse is assessing a client who has a new tracheostomy. Complete the following bowtie by
dragging and dropping the appropriate option to each of the four sections.
(Condition: Tracheostomy tube obstruction)
(Intervention: Suction the tracheostomy tube)
(Sign/Symptom: Inability to pass a suction catheter)
(Outcome: Patent airway)
Answer: Condition = Tracheostomy tube obstruction; Intervention = Suction the tracheostomy tube;
Sign/Symptom = Inability to pass a suction catheter; Outcome = Patent airway
Tracheostomy tube obstruction presents with inability to pass a suction catheter, oxygen
desaturation, respiratory distress, and absent breath sounds. The priority intervention is to suction
, the tube to remove the obstruction. If the obstruction cannot be cleared, the tracheostomy tube
must be replaced. The desired outcome is a patent airway and improved oxygenation.
Question 3
Page | 2 A nurse is providing discharge teaching to a client who has a new prescription for warfarin
(Coumadin). Which of the following statements by the client indicates an understanding of the
teaching?
A) "I will eat more leafy green vegetables to increase vitamin K."
B) "I will use a straight razor when shaving."
C) "I will report any unexplained bruising or bleeding to my provider."
D) "I will take ibuprofen for headaches instead of acetaminophen."
Answer: C
Unexplained bruising or bleeding may indicate excessive anticoagulation (INR too high) and must
be reported. Leafy greens (vitamin K) decrease warfarin effectiveness and should be eaten
consistently, not increased. Electric razors are safer than straight razors to prevent bleeding.
Acetaminophen is safer than NSAIDs (ibuprofen) because NSAIDs increase bleeding risk.
Question 4 (NGN – Matrix)
A nurse is reviewing the laboratory results of four clients. Select the client who requires immediate
intervention.
Client A: Potassium 5.2 mEq/L (3.5-5.0) – mild hyperkalemia
Client B: Platelets 18,000/mm³ (150,000-400,000) – severe thrombocytopenia
Client C: Hemoglobin 10.5 g/dL (12-16) – mild anemia
Client D: BUN 25 mg/dL (10-20) – mild elevation
Answer: Client B
*Platelets of 18,000/mm³ indicate severe thrombocytopenia, placing the client at high risk for
spontaneous bleeding, including intracranial hemorrhage. This finding requires immediate
intervention (platelet transfusion, bleeding precautions). The other values are less critical:
potassium 5.2 is mild hyperkalemia (no ECG changes mentioned), Hgb 10.5 is mild anemia (not
immediately life-threatening), BUN 25 is mild elevation (possibly dehydration).*
Question 5
A nurse is caring for a client who is postoperative following a total knee arthroplasty. Which of the
following actions should the nurse take to prevent deep vein thrombosis (DVT)?
A) Keep the client's knees flexed at 90 degrees
B) Apply sequential compression devices (SCDs) to the lower extremities
C) Massage the client's calves every 2 hours
D) Place a pillow under the client's knees
, Answer: B
SCDs promote venous return by intermittently compressing the legs, reducing venous stasis and
DVT risk. Knees should be slightly flexed (not 90 degrees) to prevent popliteal vein compression.
Massaging the calves is contraindicated (may dislodge an existing clot). Pillows under the knees
can cause venous stasis and increase DVT risk.
Page | 3
Question 6 (NGN – Cloze)
A nurse is assessing a client who has a head injury. Select the correct Glasgow Coma Scale (GCS)
score for a client who opens eyes to pain, speaks in incomprehensible words, and withdraws from
pain.
(Options: 6, 7, 8, 9, 10, 11)
Answer: 8
*GCS scoring: Eye opening to pain = 2 points; Verbal response = incomprehensible words = 2
points; Motor response = withdrawal to pain = 4 points. Total = 8. A GCS of 8 or less indicates
severe brain injury and is an indication for intubation ("GCS 8, intubate").*
Question 7
A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. Which of the
following findings should the nurse expect?
A) Polyphagia, polydipsia, polyuria, and weight loss
B) Hypertension and obesity
C) Hypoglycemia and bradycardia
D) Constipation and abdominal pain
Answer: A
The classic symptoms of type 1 diabetes are polyphagia (increased hunger), polydipsia (increased
thirst), polyuria (increased urination), and weight loss due to insulin deficiency and catabolism.
Hypertension and obesity are more common in type 2 diabetes. Hypoglycemia is a complication of
treatment, not a presenting sign.
Question 8 (NGN – Enhanced Hot Spot)
A nurse is reviewing a client's ECG strip. Identify the rhythm that shows ventricular tachycardia
(VT).
(Description: Wide QRS complexes, rate 150-250 bpm, no discernible P waves, regular or slightly
irregular)
Answer: Wide QRS complexes, rate 180 bpm, no P waves, regular rhythm.
Ventricular tachycardia is characterized by wide QRS complexes (>0.12 sec), rapid rate (usually
>120 bpm), absence of P waves, and regular or slightly irregular rhythm. VT can be monomorphic
, (same shape) or polymorphic (torsades de pointes). VT may be pulseless (emergency, defibrillate)
or with a pulse (treat with amiodarone or lidocaine).
Question 9
Page | 4 A nurse is caring for a client who has a prescription for enoxaparin (Lovenox) 40 mg
subcutaneously daily. Which of the following actions should the nurse take?
A) Expel the air bubble from the prefilled syringe before injection
B) Aspirate before injecting to check for blood return
C) Massage the injection site after administration
D) Inject into the abdomen while pinching the skin fold
Answer: D
Enoxaparin is given subcutaneously in the abdomen (best absorption) while pinching the skin to
ensure subcutaneous (not intramuscular) injection. The air bubble in the prefilled syringe should
NOT be expelled (ensures full dose). Do NOT aspirate (hematoma risk). Do NOT massage
(bruising/hematoma risk).
Question 10 (NGN – Matrix)
A nurse on a medical-surgical unit is delegating tasks to an LPN/VN and an assistive personnel
(AP). Which of the following tasks should the nurse assign to the LPN/VN?
A) Ambulate a client who is postoperative day 2 following hip arthroplasty (AP)
B) Administer a tap water enema to a client scheduled for a colonoscopy (LPN)
C) Perform a sterile dressing change on a client with a pressure injury (RN or LPN depending on
state laws)
D) Suction a client with a tracheostomy who has thick secretions (RN)
Answer: B
LPN/VN can administer enemas, perform clean dressing changes, monitor stable clients, and
administer medications (except IV push in some states). Suctioning of a tracheostomy (especially
with thick secretions) requires assessment and critical thinking of an RN. Sterile dressing changes
may be performed by LPNs in some states if stable and no complications. Ambulation can be
delegated to AP after the RN has assessed the client's stability and trained the AP.
Question 11
A nurse is assessing a client who is 6 hours postpartum following a vaginal delivery. The client's
fundus is firm at the umbilicus and deviated to the right. The client reports moderate lochia with
clots. Which of the following actions should the nurse take first?
A) Assist the client to empty her bladder (full bladder displaces the uterus)
B) Administer oxytocin (Pitocin) as prescribed
COMPREHENSIVE PREDITOR EXIT EXAM WITH 180
Page | 1
QUESTIONS AND ANSWERS TO PASS |NGN
GUARANTEED PASS
Question 1
A nurse in the emergency department is caring for a client who arrives with a headache, dizziness,
and shortness of breath. The client's oxygen saturation is 88% on room air. Which of the following
actions should the nurse take first?
A) Administer 100% oxygen via non-rebreather mask
B) Obtain a stat chest x-ray
C) Start an IV line with 0.9% normal saline
D) Draw arterial blood gases (ABGs)
Answer: A
The client's low oxygen saturation (88%) indicates hypoxemia, which is a life-threatening finding
that requires immediate correction. Airway and breathing are always the priority. Administering
oxygen is the first action to improve oxygenation before further diagnostic tests or IV access. Chest
x-ray and ABGs can be obtained after oxygen therapy is initiated.*
Question 2 (NGN – Bowtie)
A nurse is assessing a client who has a new tracheostomy. Complete the following bowtie by
dragging and dropping the appropriate option to each of the four sections.
(Condition: Tracheostomy tube obstruction)
(Intervention: Suction the tracheostomy tube)
(Sign/Symptom: Inability to pass a suction catheter)
(Outcome: Patent airway)
Answer: Condition = Tracheostomy tube obstruction; Intervention = Suction the tracheostomy tube;
Sign/Symptom = Inability to pass a suction catheter; Outcome = Patent airway
Tracheostomy tube obstruction presents with inability to pass a suction catheter, oxygen
desaturation, respiratory distress, and absent breath sounds. The priority intervention is to suction
, the tube to remove the obstruction. If the obstruction cannot be cleared, the tracheostomy tube
must be replaced. The desired outcome is a patent airway and improved oxygenation.
Question 3
Page | 2 A nurse is providing discharge teaching to a client who has a new prescription for warfarin
(Coumadin). Which of the following statements by the client indicates an understanding of the
teaching?
A) "I will eat more leafy green vegetables to increase vitamin K."
B) "I will use a straight razor when shaving."
C) "I will report any unexplained bruising or bleeding to my provider."
D) "I will take ibuprofen for headaches instead of acetaminophen."
Answer: C
Unexplained bruising or bleeding may indicate excessive anticoagulation (INR too high) and must
be reported. Leafy greens (vitamin K) decrease warfarin effectiveness and should be eaten
consistently, not increased. Electric razors are safer than straight razors to prevent bleeding.
Acetaminophen is safer than NSAIDs (ibuprofen) because NSAIDs increase bleeding risk.
Question 4 (NGN – Matrix)
A nurse is reviewing the laboratory results of four clients. Select the client who requires immediate
intervention.
Client A: Potassium 5.2 mEq/L (3.5-5.0) – mild hyperkalemia
Client B: Platelets 18,000/mm³ (150,000-400,000) – severe thrombocytopenia
Client C: Hemoglobin 10.5 g/dL (12-16) – mild anemia
Client D: BUN 25 mg/dL (10-20) – mild elevation
Answer: Client B
*Platelets of 18,000/mm³ indicate severe thrombocytopenia, placing the client at high risk for
spontaneous bleeding, including intracranial hemorrhage. This finding requires immediate
intervention (platelet transfusion, bleeding precautions). The other values are less critical:
potassium 5.2 is mild hyperkalemia (no ECG changes mentioned), Hgb 10.5 is mild anemia (not
immediately life-threatening), BUN 25 is mild elevation (possibly dehydration).*
Question 5
A nurse is caring for a client who is postoperative following a total knee arthroplasty. Which of the
following actions should the nurse take to prevent deep vein thrombosis (DVT)?
A) Keep the client's knees flexed at 90 degrees
B) Apply sequential compression devices (SCDs) to the lower extremities
C) Massage the client's calves every 2 hours
D) Place a pillow under the client's knees
, Answer: B
SCDs promote venous return by intermittently compressing the legs, reducing venous stasis and
DVT risk. Knees should be slightly flexed (not 90 degrees) to prevent popliteal vein compression.
Massaging the calves is contraindicated (may dislodge an existing clot). Pillows under the knees
can cause venous stasis and increase DVT risk.
Page | 3
Question 6 (NGN – Cloze)
A nurse is assessing a client who has a head injury. Select the correct Glasgow Coma Scale (GCS)
score for a client who opens eyes to pain, speaks in incomprehensible words, and withdraws from
pain.
(Options: 6, 7, 8, 9, 10, 11)
Answer: 8
*GCS scoring: Eye opening to pain = 2 points; Verbal response = incomprehensible words = 2
points; Motor response = withdrawal to pain = 4 points. Total = 8. A GCS of 8 or less indicates
severe brain injury and is an indication for intubation ("GCS 8, intubate").*
Question 7
A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. Which of the
following findings should the nurse expect?
A) Polyphagia, polydipsia, polyuria, and weight loss
B) Hypertension and obesity
C) Hypoglycemia and bradycardia
D) Constipation and abdominal pain
Answer: A
The classic symptoms of type 1 diabetes are polyphagia (increased hunger), polydipsia (increased
thirst), polyuria (increased urination), and weight loss due to insulin deficiency and catabolism.
Hypertension and obesity are more common in type 2 diabetes. Hypoglycemia is a complication of
treatment, not a presenting sign.
Question 8 (NGN – Enhanced Hot Spot)
A nurse is reviewing a client's ECG strip. Identify the rhythm that shows ventricular tachycardia
(VT).
(Description: Wide QRS complexes, rate 150-250 bpm, no discernible P waves, regular or slightly
irregular)
Answer: Wide QRS complexes, rate 180 bpm, no P waves, regular rhythm.
Ventricular tachycardia is characterized by wide QRS complexes (>0.12 sec), rapid rate (usually
>120 bpm), absence of P waves, and regular or slightly irregular rhythm. VT can be monomorphic
, (same shape) or polymorphic (torsades de pointes). VT may be pulseless (emergency, defibrillate)
or with a pulse (treat with amiodarone or lidocaine).
Question 9
Page | 4 A nurse is caring for a client who has a prescription for enoxaparin (Lovenox) 40 mg
subcutaneously daily. Which of the following actions should the nurse take?
A) Expel the air bubble from the prefilled syringe before injection
B) Aspirate before injecting to check for blood return
C) Massage the injection site after administration
D) Inject into the abdomen while pinching the skin fold
Answer: D
Enoxaparin is given subcutaneously in the abdomen (best absorption) while pinching the skin to
ensure subcutaneous (not intramuscular) injection. The air bubble in the prefilled syringe should
NOT be expelled (ensures full dose). Do NOT aspirate (hematoma risk). Do NOT massage
(bruising/hematoma risk).
Question 10 (NGN – Matrix)
A nurse on a medical-surgical unit is delegating tasks to an LPN/VN and an assistive personnel
(AP). Which of the following tasks should the nurse assign to the LPN/VN?
A) Ambulate a client who is postoperative day 2 following hip arthroplasty (AP)
B) Administer a tap water enema to a client scheduled for a colonoscopy (LPN)
C) Perform a sterile dressing change on a client with a pressure injury (RN or LPN depending on
state laws)
D) Suction a client with a tracheostomy who has thick secretions (RN)
Answer: B
LPN/VN can administer enemas, perform clean dressing changes, monitor stable clients, and
administer medications (except IV push in some states). Suctioning of a tracheostomy (especially
with thick secretions) requires assessment and critical thinking of an RN. Sterile dressing changes
may be performed by LPNs in some states if stable and no complications. Ambulation can be
delegated to AP after the RN has assessed the client's stability and trained the AP.
Question 11
A nurse is assessing a client who is 6 hours postpartum following a vaginal delivery. The client's
fundus is firm at the umbilicus and deviated to the right. The client reports moderate lochia with
clots. Which of the following actions should the nurse take first?
A) Assist the client to empty her bladder (full bladder displaces the uterus)
B) Administer oxytocin (Pitocin) as prescribed
