**Ace your nursing exams with this ultimate, high-yield question bank
covering ATI, HESI, and NCLEX-style content. Designed for nursing
students nationwide, this comprehensive prep guide includes over
100 practice questions with detailed rationales to ensure your success
on the first attempt.**
---
# 2025/2026 | ATI RN Comprehensive Predictor & HESI Exit Exam |
Ultimate NGN Review with Rationales | Pass on First Attempt
---
1. A client is admitted with a diagnosis of heart failure. Which of the following medications is a priority
for the nurse to administer to reduce preload?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Lisinopril
**💫ANSWER✔️✔️: B**
**💫RATIONALE✔️✔️:** Furosemide is a loop diuretic that reduces preload by decreasing fluid volume.
This is a key concept in med-surg nursing for managing heart failure, frequently tested on the ATI and
HESI exams.
2. A nurse is assessing a client who is post-operative day 2 following a colectomy. The client reports
sudden severe abdominal pain and a rigid, board-like abdomen. What is the nurse's priority action?
A) Administer prescribed pain medication
B) Encourage the client to ambulate
,C) Notify the healthcare provider immediately
D) Apply a warm compress to the abdomen
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** A rigid, board-like abdomen with severe pain is a sign of peritonitis, a life-
threatening complication. The priority is to notify the healthcare provider immediately. This is a critical
assessment finding for the NCLEX-RN and HESI Exit Exam.
3. A client is prescribed enoxaparin (Lovenox) post-operatively. Which of the following is a correct
statement about this medication?
A) It is administered orally
B) It is a vitamin K antagonist
C) It is given subcutaneously in the abdomen
D) It requires monitoring of aPTT levels
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Enoxaparin is a low-molecular-weight heparin (LMWH) given subcutaneously in
the abdomen. It does not require aPTT monitoring. This is a fundamental pharmacology concept for the
ATI RN Comprehensive Predictor.
4. A client with a history of diabetes mellitus type 2 is prescribed metformin. The nurse should instruct
the client to hold the medication and notify the provider if which of the following occurs?
A) Mild nausea
B) Weight loss
C) Signs of lactic acidosis (muscle pain, weakness)
D) Headache
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Metformin can cause lactic acidosis, a serious adverse effect. The client should
be taught to report symptoms like muscle pain, weakness, and difficulty breathing. This is a high-yield
pharmacology question for the NCLEX-RN.
,5. A client is receiving a blood transfusion. Which of the following is the most important action the nurse
should take during the first 15 minutes of the transfusion?
A) Monitor the client's vital signs every 15 minutes
B) Administer an antihistamine pre-medication
C) Assess the client's skin for flushing and hives
D) Increase the infusion rate to 200 mL/hr
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** The first 15 minutes of a transfusion are the most critical for a reaction. The
nurse should stay with the client and assess for signs of an allergic or hemolytic reaction, such as
flushing, hives, or wheezing. This is a key safety concept for nursing exam practice.
6. A client is admitted with a diagnosis of a stroke. The nurse performs a swallow screen. Why is this
assessment a priority?
A) To determine the client's level of consciousness
B) To prevent aspiration pneumonia
C) To assess the client's ability to speak
D) To evaluate motor function
**💫ANSWER✔️✔️: B**
**💫RATIONALE✔️✔️:** A swallow screen is a priority to assess the client's risk for aspiration, which can
lead to aspiration pneumonia. This is a critical intervention in stroke care, often tested on the ATI and
HESI exams.
7. A client is prescribed warfarin. The nurse notes that the client's INR is 4.5. What is the nurse's priority
action?
A) Administer the scheduled dose of warfarin
B) Hold the next dose of warfarin and notify the provider
C) Increase the dose of warfarin
D) Administer vitamin K immediately
, **💫ANSWER✔️✔️: B**
**💫RATIONALE✔️✔️:** An INR of 4.5 is above the therapeutic range (2-3), indicating a high risk of
bleeding. The priority is to hold the next dose and notify the provider. This is a key concept in
anticoagulation management.
8. A client is admitted with a urinary tract infection (UTI) and is prescribed ciprofloxacin. Which of the
following is a priority teaching point?
A) Take the medication with an antacid to prevent GI upset
B) Avoid taking the medication with dairy products
C) The medication is safe to take with warfarin
D) Report any tendon pain or swelling
**💫ANSWER✔️✔️: D**
**💫RATIONALE✔️✔️:** Ciprofloxacin can cause tendonitis or tendon rupture. The client should be
instructed to report any tendon pain or swelling. This is a key safety concept for fluoroquinolone
antibiotics.
9. A nurse is caring for a client with a nasogastric (NG) tube to low continuous suction. Which of the
following is a priority assessment?
A) Checking the pH of the gastric contents
B) Assessing for bowel sounds
C) Monitoring serum potassium levels
D) Measuring the length of the tube
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Continuous NG suction can lead to electrolyte imbalances, particularly
hypokalemia. Monitoring serum potassium is a priority. This is a key concept in gastrointestinal nursing.
10. A client is diagnosed with acute pancreatitis. Which of the following is the priority nursing
intervention?
covering ATI, HESI, and NCLEX-style content. Designed for nursing
students nationwide, this comprehensive prep guide includes over
100 practice questions with detailed rationales to ensure your success
on the first attempt.**
---
# 2025/2026 | ATI RN Comprehensive Predictor & HESI Exit Exam |
Ultimate NGN Review with Rationales | Pass on First Attempt
---
1. A client is admitted with a diagnosis of heart failure. Which of the following medications is a priority
for the nurse to administer to reduce preload?
A) Digoxin
B) Furosemide
C) Metoprolol
D) Lisinopril
**💫ANSWER✔️✔️: B**
**💫RATIONALE✔️✔️:** Furosemide is a loop diuretic that reduces preload by decreasing fluid volume.
This is a key concept in med-surg nursing for managing heart failure, frequently tested on the ATI and
HESI exams.
2. A nurse is assessing a client who is post-operative day 2 following a colectomy. The client reports
sudden severe abdominal pain and a rigid, board-like abdomen. What is the nurse's priority action?
A) Administer prescribed pain medication
B) Encourage the client to ambulate
,C) Notify the healthcare provider immediately
D) Apply a warm compress to the abdomen
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** A rigid, board-like abdomen with severe pain is a sign of peritonitis, a life-
threatening complication. The priority is to notify the healthcare provider immediately. This is a critical
assessment finding for the NCLEX-RN and HESI Exit Exam.
3. A client is prescribed enoxaparin (Lovenox) post-operatively. Which of the following is a correct
statement about this medication?
A) It is administered orally
B) It is a vitamin K antagonist
C) It is given subcutaneously in the abdomen
D) It requires monitoring of aPTT levels
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Enoxaparin is a low-molecular-weight heparin (LMWH) given subcutaneously in
the abdomen. It does not require aPTT monitoring. This is a fundamental pharmacology concept for the
ATI RN Comprehensive Predictor.
4. A client with a history of diabetes mellitus type 2 is prescribed metformin. The nurse should instruct
the client to hold the medication and notify the provider if which of the following occurs?
A) Mild nausea
B) Weight loss
C) Signs of lactic acidosis (muscle pain, weakness)
D) Headache
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Metformin can cause lactic acidosis, a serious adverse effect. The client should
be taught to report symptoms like muscle pain, weakness, and difficulty breathing. This is a high-yield
pharmacology question for the NCLEX-RN.
,5. A client is receiving a blood transfusion. Which of the following is the most important action the nurse
should take during the first 15 minutes of the transfusion?
A) Monitor the client's vital signs every 15 minutes
B) Administer an antihistamine pre-medication
C) Assess the client's skin for flushing and hives
D) Increase the infusion rate to 200 mL/hr
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** The first 15 minutes of a transfusion are the most critical for a reaction. The
nurse should stay with the client and assess for signs of an allergic or hemolytic reaction, such as
flushing, hives, or wheezing. This is a key safety concept for nursing exam practice.
6. A client is admitted with a diagnosis of a stroke. The nurse performs a swallow screen. Why is this
assessment a priority?
A) To determine the client's level of consciousness
B) To prevent aspiration pneumonia
C) To assess the client's ability to speak
D) To evaluate motor function
**💫ANSWER✔️✔️: B**
**💫RATIONALE✔️✔️:** A swallow screen is a priority to assess the client's risk for aspiration, which can
lead to aspiration pneumonia. This is a critical intervention in stroke care, often tested on the ATI and
HESI exams.
7. A client is prescribed warfarin. The nurse notes that the client's INR is 4.5. What is the nurse's priority
action?
A) Administer the scheduled dose of warfarin
B) Hold the next dose of warfarin and notify the provider
C) Increase the dose of warfarin
D) Administer vitamin K immediately
, **💫ANSWER✔️✔️: B**
**💫RATIONALE✔️✔️:** An INR of 4.5 is above the therapeutic range (2-3), indicating a high risk of
bleeding. The priority is to hold the next dose and notify the provider. This is a key concept in
anticoagulation management.
8. A client is admitted with a urinary tract infection (UTI) and is prescribed ciprofloxacin. Which of the
following is a priority teaching point?
A) Take the medication with an antacid to prevent GI upset
B) Avoid taking the medication with dairy products
C) The medication is safe to take with warfarin
D) Report any tendon pain or swelling
**💫ANSWER✔️✔️: D**
**💫RATIONALE✔️✔️:** Ciprofloxacin can cause tendonitis or tendon rupture. The client should be
instructed to report any tendon pain or swelling. This is a key safety concept for fluoroquinolone
antibiotics.
9. A nurse is caring for a client with a nasogastric (NG) tube to low continuous suction. Which of the
following is a priority assessment?
A) Checking the pH of the gastric contents
B) Assessing for bowel sounds
C) Monitoring serum potassium levels
D) Measuring the length of the tube
**💫ANSWER✔️✔️: C**
**💫RATIONALE✔️✔️:** Continuous NG suction can lead to electrolyte imbalances, particularly
hypokalemia. Monitoring serum potassium is a priority. This is a key concept in gastrointestinal nursing.
10. A client is diagnosed with acute pancreatitis. Which of the following is the priority nursing
intervention?
