ATI RN Fundamentals NGN-
Style Clinical Judgment
Practice Exam 2026 Update
Focus: cue recognition, prioritization, clinical judgment, intervention selection,
evaluation
Format: MCQ + SATA + NGN case-based items
Instruction: Choose the best answer unless otherwise stated.
SECTION A: MULTIPLE CHOICE (1–40)
1. A nurse assesses a client with shortness of breath, RR 28, and cyanosis. What is
the priority action?
A. Obtain a chest x-ray
B. Apply oxygen immediately
C. Encourage deep breathing
D. Document findings
2. A postoperative client reports sudden chest pain and dyspnea. What is the
nurse’s first action?
A. Administer pain medication
B. Elevate head of bed
C. Notify provider
D. Check vital signs
3. Which finding requires immediate intervention?
A. Temp 37.8°C
B. HR 110 bpm
,C. BP 180/110 mmHg
D. RR 18/min
4. A client is receiving morphine. Which assessment is priority?
A. Bowel sounds
B. Respiratory rate
C. Urine output
D. Skin turgor
5. A nurse notes wheezing and use of accessory muscles. What is the priority
nursing action?
A. Encourage fluids
B. Administer bronchodilator
C. Obtain sputum sample
D. Position supine
6. A client is confused and restless. Which assessment should the nurse perform
first?
A. Blood glucose
B. Pain level
C. Pupillary response
D. Temperature
7. A nurse identifies hypotension and tachycardia in a trauma patient. This
suggests:
A. Infection
B. Shock
C. Hypertension
D. Anxiety
8. Which intervention has highest priority for a client at risk of aspiration?
A. High-Fowler’s position
B. Fluid restriction
C. Bed rest
D. Incentive spirometry
,9. A client with diabetes has shakiness and sweating. What is the first action?
A. Give insulin
B. Check blood glucose
C. Give orange juice
D. Call provider
10. A postoperative client has absent bowel sounds. What does the nurse
suspect?
A. Normal finding
B. Paralytic ileus
C. Diarrhea
D. Infection
11. Which lab value is most concerning?
A. Na 140
B. K 6.2
C. Glucose 90
D. Hgb 14
12. A client is receiving IV potassium. What is priority assessment?
A. Lung sounds
B. Urine output
C. Vision changes
D. Skin color
13. A client becomes unresponsive. First action?
A. Call family
B. Start CPR
C. Check airway
D. Document
14. Which symptom indicates hypoxia?
A. Bradycardia
B. Cyanosis
, C. Hypertension
D. Fever
15. A nurse prioritizes care for which client first?
A. Stable fracture
B. Asthma with wheezing
C. Mild headache
D. Discharge teaching
16. A client reports severe abdominal pain with rigid abdomen. Action?
A. Apply heat
B. Notify provider
C. Give laxative
D. Encourage fluids
17. Which finding indicates infection?
A. WBC 4,000
B. WBC 15,000
C. Hgb 13
D. Platelets 250,000
18. A client has oxygen saturation 85%. What is priority?
A. Encourage cough
B. Apply oxygen
C. Recheck in 1 hr
D. Document
19. A nurse suspects sepsis. Early sign?
A. Hypothermia
B. Bradycardia
C. Hypertension
D. Constipation
20. A client is vomiting blood. Priority action?
A. Monitor vitals
B. Prepare IV access
Style Clinical Judgment
Practice Exam 2026 Update
Focus: cue recognition, prioritization, clinical judgment, intervention selection,
evaluation
Format: MCQ + SATA + NGN case-based items
Instruction: Choose the best answer unless otherwise stated.
SECTION A: MULTIPLE CHOICE (1–40)
1. A nurse assesses a client with shortness of breath, RR 28, and cyanosis. What is
the priority action?
A. Obtain a chest x-ray
B. Apply oxygen immediately
C. Encourage deep breathing
D. Document findings
2. A postoperative client reports sudden chest pain and dyspnea. What is the
nurse’s first action?
A. Administer pain medication
B. Elevate head of bed
C. Notify provider
D. Check vital signs
3. Which finding requires immediate intervention?
A. Temp 37.8°C
B. HR 110 bpm
,C. BP 180/110 mmHg
D. RR 18/min
4. A client is receiving morphine. Which assessment is priority?
A. Bowel sounds
B. Respiratory rate
C. Urine output
D. Skin turgor
5. A nurse notes wheezing and use of accessory muscles. What is the priority
nursing action?
A. Encourage fluids
B. Administer bronchodilator
C. Obtain sputum sample
D. Position supine
6. A client is confused and restless. Which assessment should the nurse perform
first?
A. Blood glucose
B. Pain level
C. Pupillary response
D. Temperature
7. A nurse identifies hypotension and tachycardia in a trauma patient. This
suggests:
A. Infection
B. Shock
C. Hypertension
D. Anxiety
8. Which intervention has highest priority for a client at risk of aspiration?
A. High-Fowler’s position
B. Fluid restriction
C. Bed rest
D. Incentive spirometry
,9. A client with diabetes has shakiness and sweating. What is the first action?
A. Give insulin
B. Check blood glucose
C. Give orange juice
D. Call provider
10. A postoperative client has absent bowel sounds. What does the nurse
suspect?
A. Normal finding
B. Paralytic ileus
C. Diarrhea
D. Infection
11. Which lab value is most concerning?
A. Na 140
B. K 6.2
C. Glucose 90
D. Hgb 14
12. A client is receiving IV potassium. What is priority assessment?
A. Lung sounds
B. Urine output
C. Vision changes
D. Skin color
13. A client becomes unresponsive. First action?
A. Call family
B. Start CPR
C. Check airway
D. Document
14. Which symptom indicates hypoxia?
A. Bradycardia
B. Cyanosis
, C. Hypertension
D. Fever
15. A nurse prioritizes care for which client first?
A. Stable fracture
B. Asthma with wheezing
C. Mild headache
D. Discharge teaching
16. A client reports severe abdominal pain with rigid abdomen. Action?
A. Apply heat
B. Notify provider
C. Give laxative
D. Encourage fluids
17. Which finding indicates infection?
A. WBC 4,000
B. WBC 15,000
C. Hgb 13
D. Platelets 250,000
18. A client has oxygen saturation 85%. What is priority?
A. Encourage cough
B. Apply oxygen
C. Recheck in 1 hr
D. Document
19. A nurse suspects sepsis. Early sign?
A. Hypothermia
B. Bradycardia
C. Hypertension
D. Constipation
20. A client is vomiting blood. Priority action?
A. Monitor vitals
B. Prepare IV access
