**Crush your nursing exams with this definitive, high-yield question
bank meticulously crafted to mirror ATI, HESI, and NCLEX-RN NGN
standards. Featuring over 100 practice questions with detailed
rationales, this guide is your essential tool for acing nursing exams
nationwide.**
---
# 2026 | Comprehensive Nursing Review & ATI RN Exit Exam Prep |
Ultimate NGN Questions & Rationales | Pass on First Attempt
---
1. A client who is 24 hours post-operative from an abdominal hysterectomy reports sudden, severe
chest pain and shortness of breath. The nurse notes the client is tachycardic and hypoxic. What is the
priority nursing action?
A) Administer prescribed PRN pain medication
B) Encourage deep breathing and coughing
C) Apply oxygen and prepare for a possible pulmonary embolism
D) Place the client in a Trendelenburg position
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** The client is exhibiting classic signs of a pulmonary embolism, a life-threatening
post-operative complication. The priority is to apply oxygen and prepare for further diagnostic testing
and treatment. This is a critical med-surg nursing concept for the NCLEX-RN and HESI Exit Exam.
2. A nurse is providing discharge teaching to a client with a new prescription for enoxaparin (Lovenox).
Which statement by the client indicates a need for further teaching?
A) "I will inject the medication into my abdomen."
,B) "I will pinch the skin before injecting."
C) "I will rub the injection site after giving it."
D) "I will not take aspirin while on this medication."
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** The client should not rub the injection site after administering enoxaparin, as
this can cause bruising. The client should inject into the abdomen, pinch the skin, and avoid aspirin
(NSAIDs) to prevent bleeding. This is a common medication administration error topic on nursing exams.
3. A client is admitted with a diagnosis of heart failure. Which of the following findings is a classic
symptom of right-sided heart failure?
A) Crackles in the lungs
B) Orthopnea
C) Peripheral edema
D) Paroxysmal nocturnal dyspnea
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Peripheral edema is a classic sign of right-sided heart failure, caused by fluid
backing up into the systemic circulation. Crackles, orthopnea, and paroxysmal nocturnal dyspnea are
symptoms of left-sided heart failure. Differentiating between right and left-sided heart failure is
essential for nursing care and is frequently tested on the ATI RN Comprehensive Predictor.
4. A client with a history of asthma is experiencing an acute exacerbation. Which of the following
medications should the nurse administer first?
A) Inhaled corticosteroid (e.g., fluticasone)
B) Long-acting beta-agonist (e.g., salmeterol)
C) Short-acting beta-agonist (e.g., albuterol)
D) Leukotriene modifier (e.g., montelukast)
**💫ANSWER✔️✔️: C**
,**💫RATIONALE✔️✔️:** A short-acting beta-agonist (SABA) like albuterol is the first-line treatment for an
acute asthma attack, providing rapid bronchodilation. Inhaled corticosteroids and leukotriene modifiers
are for long-term control, and LABA's are not used for acute exacerbations due to delayed onset. This is
a crucial pharmacology priority for the ATI RN Exit Exam.
5. A nurse is assessing a client with a head injury. Which of the following is an early sign of increased
intracranial pressure (ICP)?
A) Pupil dilation
B) Decerebrate posturing
C) Headache and vomiting
D) Cushing's triad
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Headache, vomiting, and a change in level of consciousness are early signs of
increased ICP. Pupil dilation, posturing, and Cushing's triad (hypertension, bradycardia, irregular
respirations) are late signs. This is a key neurological assessment concept for the NCLEX-RN.
6. A client is prescribed lithium for bipolar disorder. Which of the following is a sign of lithium toxicity?
A) Polyuria and polydipsia
B) Fine hand tremors
C) Nausea and vomiting
D) Hypothyroidism
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Nausea and vomiting are early signs of lithium toxicity. Polyuria and polydipsia
are common side effects, fine tremors are an expected side effect, and hypothyroidism is a long-term
side effect. This is a key pharmacology and psychiatric nursing concept.
7. A client is receiving a blood transfusion and suddenly develops dyspnea, crackles, and frothy sputum.
What is the nurse's priority action?
A) Slow the transfusion rate
B) Stop the transfusion and administer diuretics as prescribed
, C) Administer diphenhydramine
D) Increase the infusion rate of the transfusion
**💫ANSWER✔️✔️: B**
**💫RATIONALE✔️✔️:** The client is showing signs of fluid overload (TACO). The priority is to stop the
transfusion and administer diuretics. The other actions are not appropriate. This is a critical transfusion
reaction question for the ATI RN Exit Exam.
8. A client with diabetes mellitus type 1 is experiencing nausea, vomiting, and abdominal pain. The nurse
notes a fruity odor on the client's breath. Which condition is the client most likely experiencing?
A) Hypoglycemia
B) Hyperglycemic hyperosmolar state (HHS)
C) Diabetic ketoacidosis (DKA)
D) Lactic acidosis
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** The classic signs of DKA include nausea, vomiting, abdominal pain, and a fruity
odor on the breath (due to ketone production). This is a high-yield endocrine emergency question for
the HESI Exit Exam.
9. A client is prescribed an ACE inhibitor. Which of the following side effects should the nurse include in
the teaching plan?
A) Dry cough
B) Constipation
C) Dizziness
D) Insomnia
**💫ANSWER✔️✔️: A**
**💫RATIONALE✔️✔️:** A persistent dry cough is a common side effect of ACE inhibitors and should be
reported. This is a fundamental pharmacology concept for the NCLEX-RN.
bank meticulously crafted to mirror ATI, HESI, and NCLEX-RN NGN
standards. Featuring over 100 practice questions with detailed
rationales, this guide is your essential tool for acing nursing exams
nationwide.**
---
# 2026 | Comprehensive Nursing Review & ATI RN Exit Exam Prep |
Ultimate NGN Questions & Rationales | Pass on First Attempt
---
1. A client who is 24 hours post-operative from an abdominal hysterectomy reports sudden, severe
chest pain and shortness of breath. The nurse notes the client is tachycardic and hypoxic. What is the
priority nursing action?
A) Administer prescribed PRN pain medication
B) Encourage deep breathing and coughing
C) Apply oxygen and prepare for a possible pulmonary embolism
D) Place the client in a Trendelenburg position
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** The client is exhibiting classic signs of a pulmonary embolism, a life-threatening
post-operative complication. The priority is to apply oxygen and prepare for further diagnostic testing
and treatment. This is a critical med-surg nursing concept for the NCLEX-RN and HESI Exit Exam.
2. A nurse is providing discharge teaching to a client with a new prescription for enoxaparin (Lovenox).
Which statement by the client indicates a need for further teaching?
A) "I will inject the medication into my abdomen."
,B) "I will pinch the skin before injecting."
C) "I will rub the injection site after giving it."
D) "I will not take aspirin while on this medication."
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** The client should not rub the injection site after administering enoxaparin, as
this can cause bruising. The client should inject into the abdomen, pinch the skin, and avoid aspirin
(NSAIDs) to prevent bleeding. This is a common medication administration error topic on nursing exams.
3. A client is admitted with a diagnosis of heart failure. Which of the following findings is a classic
symptom of right-sided heart failure?
A) Crackles in the lungs
B) Orthopnea
C) Peripheral edema
D) Paroxysmal nocturnal dyspnea
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Peripheral edema is a classic sign of right-sided heart failure, caused by fluid
backing up into the systemic circulation. Crackles, orthopnea, and paroxysmal nocturnal dyspnea are
symptoms of left-sided heart failure. Differentiating between right and left-sided heart failure is
essential for nursing care and is frequently tested on the ATI RN Comprehensive Predictor.
4. A client with a history of asthma is experiencing an acute exacerbation. Which of the following
medications should the nurse administer first?
A) Inhaled corticosteroid (e.g., fluticasone)
B) Long-acting beta-agonist (e.g., salmeterol)
C) Short-acting beta-agonist (e.g., albuterol)
D) Leukotriene modifier (e.g., montelukast)
**💫ANSWER✔️✔️: C**
,**💫RATIONALE✔️✔️:** A short-acting beta-agonist (SABA) like albuterol is the first-line treatment for an
acute asthma attack, providing rapid bronchodilation. Inhaled corticosteroids and leukotriene modifiers
are for long-term control, and LABA's are not used for acute exacerbations due to delayed onset. This is
a crucial pharmacology priority for the ATI RN Exit Exam.
5. A nurse is assessing a client with a head injury. Which of the following is an early sign of increased
intracranial pressure (ICP)?
A) Pupil dilation
B) Decerebrate posturing
C) Headache and vomiting
D) Cushing's triad
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Headache, vomiting, and a change in level of consciousness are early signs of
increased ICP. Pupil dilation, posturing, and Cushing's triad (hypertension, bradycardia, irregular
respirations) are late signs. This is a key neurological assessment concept for the NCLEX-RN.
6. A client is prescribed lithium for bipolar disorder. Which of the following is a sign of lithium toxicity?
A) Polyuria and polydipsia
B) Fine hand tremors
C) Nausea and vomiting
D) Hypothyroidism
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Nausea and vomiting are early signs of lithium toxicity. Polyuria and polydipsia
are common side effects, fine tremors are an expected side effect, and hypothyroidism is a long-term
side effect. This is a key pharmacology and psychiatric nursing concept.
7. A client is receiving a blood transfusion and suddenly develops dyspnea, crackles, and frothy sputum.
What is the nurse's priority action?
A) Slow the transfusion rate
B) Stop the transfusion and administer diuretics as prescribed
, C) Administer diphenhydramine
D) Increase the infusion rate of the transfusion
**💫ANSWER✔️✔️: B**
**💫RATIONALE✔️✔️:** The client is showing signs of fluid overload (TACO). The priority is to stop the
transfusion and administer diuretics. The other actions are not appropriate. This is a critical transfusion
reaction question for the ATI RN Exit Exam.
8. A client with diabetes mellitus type 1 is experiencing nausea, vomiting, and abdominal pain. The nurse
notes a fruity odor on the client's breath. Which condition is the client most likely experiencing?
A) Hypoglycemia
B) Hyperglycemic hyperosmolar state (HHS)
C) Diabetic ketoacidosis (DKA)
D) Lactic acidosis
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** The classic signs of DKA include nausea, vomiting, abdominal pain, and a fruity
odor on the breath (due to ketone production). This is a high-yield endocrine emergency question for
the HESI Exit Exam.
9. A client is prescribed an ACE inhibitor. Which of the following side effects should the nurse include in
the teaching plan?
A) Dry cough
B) Constipation
C) Dizziness
D) Insomnia
**💫ANSWER✔️✔️: A**
**💫RATIONALE✔️✔️:** A persistent dry cough is a common side effect of ACE inhibitors and should be
reported. This is a fundamental pharmacology concept for the NCLEX-RN.
