Pass the ATI, HESI, or NCLEX on Your First Try! This comprehensive
exam guide features over 60 high-yield practice questions with
detailed rationales, covering Medical-Surgical, Pharmacology,
Leadership, and Fundamentals for nursing students at Chamberlain,
Walden, and Grand Canyon.
---
## 🏆 2025/2026 | Ultimate Nursing Exam Prep Bundle | ATI, HESI &
NCLEX-RN Mastery | Complete NGN Questions & Rationales for BSN
Success (V1-V7)
---
**1. A client with chronic obstructive pulmonary disease (COPD) is prescribed theophylline. Which
assessment finding indicates a therapeutic response to the medication?**
A) Increased heart rate
B) Decreased shortness of breath
C) Productive cough with green sputum
D) Increased respiratory rate at rest
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Theophylline is a bronchodilator that relaxes smooth muscles in the airways, leading
to decreased shortness of breath and improved ventilation. This is a key therapeutic goal for COPD
management, a common topic on the NCLEX and HESI exams. Options A and D indicate adverse effects
(tachycardia and tachypnea), while C suggests an infection, not a therapeutic response. For Chamberlain
BSN students, understanding bronchodilator therapy is fundamental to nursing exam guide success.
**2. A nurse is preparing to administer a blood transfusion to a client. Which IV solution is compatible
with the blood product?**
A) Lactated Ringer's
,B) Dextrose 5% in water
C) 0.9% Normal Saline
D) Dextrose 5% in 0.45% Saline
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: 0.9% Normal Saline is the only compatible IV solution for blood transfusions.
Dextrose solutions can cause hemolysis due to changes in osmolarity and pH. Lactated Ringer's contains
calcium, which can cause clotting in the blood bag. This critical safety point is frequently tested on the
ATI RN Comprehensive Predictor. Proper IV selection is a cornerstone of nursing exam practice and
ensuring patient safety.
**3. A patient is admitted with a diagnosis of heart failure. The nurse hears an S3 heart sound during
auscultation. What is the best interpretation of this finding?**
A) Normal finding in young adults
B) Indication of ventricular hypertrophy
C) Sign of decreased cardiac output
D) Indicator of hypertension
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: An S3 heart sound, often called a ventricular gallop, is associated with increased fluid
volume and decreased cardiac output, commonly seen in heart failure. While it can be normal in
children and young adults, in older adults it is a pathological finding. Option B describes an S4 sound,
and D is unrelated. This is a key assessment finding for Med-Surg Nursing I exams and NCLEX readiness.
**4. A nurse is teaching a client about a low-sodium diet. Which statement indicates the client needs
further teaching?**
A) "I will avoid using soy sauce."
B) "I can have fresh fruits like apples and bananas."
C) "I will use garlic powder as a seasoning."
D) "I can eat canned soups as a quick meal."
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Canned soups are typically high in sodium, which is contraindicated for a low-sodium
diet. Fresh fruits and garlic powder (without salt) are safe. This teaching point is vital for patients with
hypertension or heart failure and is a common scenario in Fundamentals of Nursing. This question
provides excellent exam practice for students aiming for nursing success in their program.
,**5. A client is receiving an enteral feeding via a nasogastric tube. What is the priority intervention
before administering the feeding?**
A) Check for gastric residual volume
B) Flush the tube with 30 mL of air
C) Elevate the head of the bed to 45 degrees
D) Confirm tube placement
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: While all options are part of enteral feeding administration, confirming tube
placement is the priority to prevent accidental instillation into the lungs. Patient safety is the highest
priority, a concept heavily emphasized in all nursing curricula, including Walden University Nursing
Programs. This is a top-scoring topic on the HESI Exit Exam.
**6. A nurse is monitoring a client in active labor. The fetal heart rate (FHR) baseline is 140 bpm. Which
pattern should the nurse report to the provider immediately?**
A) Accelerations with fetal movement
B) Early decelerations
C) Variable decelerations
D) Late decelerations
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Late decelerations are a sign of uteroplacental insufficiency and fetal hypoxemia,
requiring immediate intervention. Accelerations and early decelerations are reassuring. Variable
decelerations can be associated with cord compression but are not always immediately emergent. Labor
and delivery topics are essential for the Maternal-Newborn Nursing Final Exam and the ATI Maternal
Newborn Proctored Exam.
**7. A client is prescribed digoxin. The nurse should monitor the client for signs of toxicity. Which
finding is a key indicator of digoxin toxicity?**
A) Tachycardia
B) Yellow vision
C) Weight gain
D) Hypertension
, 💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Visual disturbances, particularly yellow or green halos around lights, are classic signs
of digoxin toxicity. Other signs include bradycardia, not tachycardia, and GI symptoms. Monitoring
therapeutic levels is crucial for safe medication administration, a key topic on the Pharmacology Final
Exam. This is essential knowledge for any nursing exam guide.
**8. A nurse is preparing a client for surgery. Which intervention is most important to prevent a surgical
site infection?**
A) Administering prophylactic antibiotics 24 hours before surgery
B) Shaving the surgical site the evening before surgery
C) Ensuring the client has a bowel prep
D) Having the client shower with an antimicrobial soap before surgery
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Preoperative showering with an antimicrobial soap reduces skin flora. Prophylactic
antibiotics are given within 60 minutes of incision, not 24 hours prior. Shaving the site immediately
before (not the night before) is preferred to prevent micro-abrasions. This nursing intervention is vital
for patient safety and is a core part of the Med Surg Nursing I Final Exam.
**9. A client with a history of deep vein thrombosis (DVT) is prescribed warfarin. The nurse should
instruct the client to avoid foods high in which vitamin?**
A) Vitamin A
B) Vitamin C
C) Vitamin D
D) Vitamin K
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Warfarin is a Vitamin K antagonist. Foods high in Vitamin K (like leafy green
vegetables) interfere with the drug's anticoagulant effect. This is a frequent question on the ATI
Pharmacology Proctored Exam and NCLEX. Client education regarding dietary interactions is a standard
nursing exam practice.
**10. A nurse is using the SBAR communication tool to report a client's change in status to a provider.
What does the "R" in SBAR stand for?**
A) Recommendation
exam guide features over 60 high-yield practice questions with
detailed rationales, covering Medical-Surgical, Pharmacology,
Leadership, and Fundamentals for nursing students at Chamberlain,
Walden, and Grand Canyon.
---
## 🏆 2025/2026 | Ultimate Nursing Exam Prep Bundle | ATI, HESI &
NCLEX-RN Mastery | Complete NGN Questions & Rationales for BSN
Success (V1-V7)
---
**1. A client with chronic obstructive pulmonary disease (COPD) is prescribed theophylline. Which
assessment finding indicates a therapeutic response to the medication?**
A) Increased heart rate
B) Decreased shortness of breath
C) Productive cough with green sputum
D) Increased respiratory rate at rest
💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Theophylline is a bronchodilator that relaxes smooth muscles in the airways, leading
to decreased shortness of breath and improved ventilation. This is a key therapeutic goal for COPD
management, a common topic on the NCLEX and HESI exams. Options A and D indicate adverse effects
(tachycardia and tachypnea), while C suggests an infection, not a therapeutic response. For Chamberlain
BSN students, understanding bronchodilator therapy is fundamental to nursing exam guide success.
**2. A nurse is preparing to administer a blood transfusion to a client. Which IV solution is compatible
with the blood product?**
A) Lactated Ringer's
,B) Dextrose 5% in water
C) 0.9% Normal Saline
D) Dextrose 5% in 0.45% Saline
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: 0.9% Normal Saline is the only compatible IV solution for blood transfusions.
Dextrose solutions can cause hemolysis due to changes in osmolarity and pH. Lactated Ringer's contains
calcium, which can cause clotting in the blood bag. This critical safety point is frequently tested on the
ATI RN Comprehensive Predictor. Proper IV selection is a cornerstone of nursing exam practice and
ensuring patient safety.
**3. A patient is admitted with a diagnosis of heart failure. The nurse hears an S3 heart sound during
auscultation. What is the best interpretation of this finding?**
A) Normal finding in young adults
B) Indication of ventricular hypertrophy
C) Sign of decreased cardiac output
D) Indicator of hypertension
💫ANSWER✔️✔️: C
💫RATIONALE✔️✔️: An S3 heart sound, often called a ventricular gallop, is associated with increased fluid
volume and decreased cardiac output, commonly seen in heart failure. While it can be normal in
children and young adults, in older adults it is a pathological finding. Option B describes an S4 sound,
and D is unrelated. This is a key assessment finding for Med-Surg Nursing I exams and NCLEX readiness.
**4. A nurse is teaching a client about a low-sodium diet. Which statement indicates the client needs
further teaching?**
A) "I will avoid using soy sauce."
B) "I can have fresh fruits like apples and bananas."
C) "I will use garlic powder as a seasoning."
D) "I can eat canned soups as a quick meal."
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Canned soups are typically high in sodium, which is contraindicated for a low-sodium
diet. Fresh fruits and garlic powder (without salt) are safe. This teaching point is vital for patients with
hypertension or heart failure and is a common scenario in Fundamentals of Nursing. This question
provides excellent exam practice for students aiming for nursing success in their program.
,**5. A client is receiving an enteral feeding via a nasogastric tube. What is the priority intervention
before administering the feeding?**
A) Check for gastric residual volume
B) Flush the tube with 30 mL of air
C) Elevate the head of the bed to 45 degrees
D) Confirm tube placement
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: While all options are part of enteral feeding administration, confirming tube
placement is the priority to prevent accidental instillation into the lungs. Patient safety is the highest
priority, a concept heavily emphasized in all nursing curricula, including Walden University Nursing
Programs. This is a top-scoring topic on the HESI Exit Exam.
**6. A nurse is monitoring a client in active labor. The fetal heart rate (FHR) baseline is 140 bpm. Which
pattern should the nurse report to the provider immediately?**
A) Accelerations with fetal movement
B) Early decelerations
C) Variable decelerations
D) Late decelerations
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Late decelerations are a sign of uteroplacental insufficiency and fetal hypoxemia,
requiring immediate intervention. Accelerations and early decelerations are reassuring. Variable
decelerations can be associated with cord compression but are not always immediately emergent. Labor
and delivery topics are essential for the Maternal-Newborn Nursing Final Exam and the ATI Maternal
Newborn Proctored Exam.
**7. A client is prescribed digoxin. The nurse should monitor the client for signs of toxicity. Which
finding is a key indicator of digoxin toxicity?**
A) Tachycardia
B) Yellow vision
C) Weight gain
D) Hypertension
, 💫ANSWER✔️✔️: B
💫RATIONALE✔️✔️: Visual disturbances, particularly yellow or green halos around lights, are classic signs
of digoxin toxicity. Other signs include bradycardia, not tachycardia, and GI symptoms. Monitoring
therapeutic levels is crucial for safe medication administration, a key topic on the Pharmacology Final
Exam. This is essential knowledge for any nursing exam guide.
**8. A nurse is preparing a client for surgery. Which intervention is most important to prevent a surgical
site infection?**
A) Administering prophylactic antibiotics 24 hours before surgery
B) Shaving the surgical site the evening before surgery
C) Ensuring the client has a bowel prep
D) Having the client shower with an antimicrobial soap before surgery
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Preoperative showering with an antimicrobial soap reduces skin flora. Prophylactic
antibiotics are given within 60 minutes of incision, not 24 hours prior. Shaving the site immediately
before (not the night before) is preferred to prevent micro-abrasions. This nursing intervention is vital
for patient safety and is a core part of the Med Surg Nursing I Final Exam.
**9. A client with a history of deep vein thrombosis (DVT) is prescribed warfarin. The nurse should
instruct the client to avoid foods high in which vitamin?**
A) Vitamin A
B) Vitamin C
C) Vitamin D
D) Vitamin K
💫ANSWER✔️✔️: D
💫RATIONALE✔️✔️: Warfarin is a Vitamin K antagonist. Foods high in Vitamin K (like leafy green
vegetables) interfere with the drug's anticoagulant effect. This is a frequent question on the ATI
Pharmacology Proctored Exam and NCLEX. Client education regarding dietary interactions is a standard
nursing exam practice.
**10. A nurse is using the SBAR communication tool to report a client's change in status to a provider.
What does the "R" in SBAR stand for?**
A) Recommendation
