ATI RN Comprehensive Predictor 2026 –
Comprehensive Readiness Assessment B
| NGN Clinical Judgment Case Studies,
Verified Answers, & Comprehensive
Rationales
Question 1
A nurse is caring for a client 24 hr after a thyroidectomy.
Which finding requires immediate intervention?
A. Hoarse voice
B. Pain rated 6/10
C. Stridor during inspiration
D. Small amount of serosanguineous drainage
Rationale: Stridor indicates airway obstruction from laryngeal
edema, hemorrhage, or nerve injury and is a life-threatening
emergency requiring immediate action. Hoarseness is
expected initially. Moderate pain and minimal drainage are
common postoperative findings.
Question 2
A nurse is assessing a client with heart failure. Which
assessment finding indicates worsening left-sided heart
failure?
,A. Jugular venous distention
B. Peripheral edema
C. Hepatomegaly
D. Crackles in both lung bases
Rationale: Left-sided heart failure causes pulmonary
congestion resulting in crackles, dyspnea, and orthopnea.
JVD, hepatomegaly, and peripheral edema are more
commonly associated with right-sided heart failure.
Question 3
A nurse is caring for a client receiving a continuous heparin
infusion. Which laboratory value indicates therapeutic
anticoagulation?
A. INR 2.5
B. Platelets 150,000/mm³
C. aPTT 65 seconds
D. Hgb 13 g/dL
Rationale: Therapeutic heparin therapy generally produces an
aPTT 1.5 to 2.5 times the control value. INR is used to monitor
warfarin therapy. Platelets and hemoglobin do not measure
anticoagulant effectiveness.
Question 4
A nurse is teaching a client who has tuberculosis. Which
statement by the client indicates understanding?
,A. "I can stop my medications when my symptoms improve."
B. "I should avoid all dairy products."
C. "I need to take all prescribed medications for the full
treatment course."
D. "I am no longer contagious after one dose of medication."
Rationale: TB treatment requires strict adherence to the
entire multidrug regimen to prevent resistance and relapse.
Symptoms often improve before infection is eradicated.
Question 5
A nurse receives report on four clients. Which client should
the nurse assess first?
A. Stable angina client requesting pain medication
B. Postoperative client with urine output 40 mL/hr
C. Client with pneumonia and oxygen saturation 92%
D. Client with diabetes who is confused and diaphoretic
Rationale: Confusion and diaphoresis suggest hypoglycemia,
an immediate threat to neurological function. Applying ABCs
and acute versus chronic priorities, this client requires
assessment first.
Question 6
A nurse is caring for a client with SIADH. Which laboratory
finding should the nurse expect?
A. Hypernatremia
B. Elevated serum osmolality
, C. Hyponatremia
D. Increased urine output
Rationale: Excess ADH causes water retention, dilutional
hyponatremia, decreased serum osmolality, and concentrated
urine.
Question 7
A nurse is assessing a newborn. Which finding should be
reported immediately?
A. Acrocyanosis at 4 hr of age
B. Heart rate 130/min
C. Central cyanosis
D. Respiratory rate 50/min
Rationale: Central cyanosis indicates inadequate oxygenation
and requires immediate evaluation. Acrocyanosis is common
during the first 24 to 48 hr of life.
Question 8
A nurse is caring for a client who has acute pancreatitis.
Which prescription should the nurse anticipate?
A. High-fat diet
B. Supine positioning after meals
C. NPO status
D. Increased oral intake
Comprehensive Readiness Assessment B
| NGN Clinical Judgment Case Studies,
Verified Answers, & Comprehensive
Rationales
Question 1
A nurse is caring for a client 24 hr after a thyroidectomy.
Which finding requires immediate intervention?
A. Hoarse voice
B. Pain rated 6/10
C. Stridor during inspiration
D. Small amount of serosanguineous drainage
Rationale: Stridor indicates airway obstruction from laryngeal
edema, hemorrhage, or nerve injury and is a life-threatening
emergency requiring immediate action. Hoarseness is
expected initially. Moderate pain and minimal drainage are
common postoperative findings.
Question 2
A nurse is assessing a client with heart failure. Which
assessment finding indicates worsening left-sided heart
failure?
,A. Jugular venous distention
B. Peripheral edema
C. Hepatomegaly
D. Crackles in both lung bases
Rationale: Left-sided heart failure causes pulmonary
congestion resulting in crackles, dyspnea, and orthopnea.
JVD, hepatomegaly, and peripheral edema are more
commonly associated with right-sided heart failure.
Question 3
A nurse is caring for a client receiving a continuous heparin
infusion. Which laboratory value indicates therapeutic
anticoagulation?
A. INR 2.5
B. Platelets 150,000/mm³
C. aPTT 65 seconds
D. Hgb 13 g/dL
Rationale: Therapeutic heparin therapy generally produces an
aPTT 1.5 to 2.5 times the control value. INR is used to monitor
warfarin therapy. Platelets and hemoglobin do not measure
anticoagulant effectiveness.
Question 4
A nurse is teaching a client who has tuberculosis. Which
statement by the client indicates understanding?
,A. "I can stop my medications when my symptoms improve."
B. "I should avoid all dairy products."
C. "I need to take all prescribed medications for the full
treatment course."
D. "I am no longer contagious after one dose of medication."
Rationale: TB treatment requires strict adherence to the
entire multidrug regimen to prevent resistance and relapse.
Symptoms often improve before infection is eradicated.
Question 5
A nurse receives report on four clients. Which client should
the nurse assess first?
A. Stable angina client requesting pain medication
B. Postoperative client with urine output 40 mL/hr
C. Client with pneumonia and oxygen saturation 92%
D. Client with diabetes who is confused and diaphoretic
Rationale: Confusion and diaphoresis suggest hypoglycemia,
an immediate threat to neurological function. Applying ABCs
and acute versus chronic priorities, this client requires
assessment first.
Question 6
A nurse is caring for a client with SIADH. Which laboratory
finding should the nurse expect?
A. Hypernatremia
B. Elevated serum osmolality
, C. Hyponatremia
D. Increased urine output
Rationale: Excess ADH causes water retention, dilutional
hyponatremia, decreased serum osmolality, and concentrated
urine.
Question 7
A nurse is assessing a newborn. Which finding should be
reported immediately?
A. Acrocyanosis at 4 hr of age
B. Heart rate 130/min
C. Central cyanosis
D. Respiratory rate 50/min
Rationale: Central cyanosis indicates inadequate oxygenation
and requires immediate evaluation. Acrocyanosis is common
during the first 24 to 48 hr of life.
Question 8
A nurse is caring for a client who has acute pancreatitis.
Which prescription should the nurse anticipate?
A. High-fat diet
B. Supine positioning after meals
C. NPO status
D. Increased oral intake
