NGN ATI RN COMPREHENSIVE PREDICTOR
2026 RETAKE EXAM 350 UNIQUE MULTIPLE-
CHOICE QUESTIONS WITH DETAILED
RATIONALES
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SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-50)
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Question 1
A nurse is caring for a client with heart failure who reports dyspnea, crackles in the
lung bases, and 2+ pitting edema. Which intervention should the nurse implement
first?
A) Administer furosemide as prescribed
B) Place the client in High-Fowler's position
C) Check oxygen saturation
D) Restrict oral fluid intake
Correct Answer: B
Rationale: The priority is to relieve dyspnea. High-Fowler's position maximizes lung
expansion and improves ventilation. While oxygen and diuretics are important,
,positioning is the immediate nursing intervention that can be implemented without
waiting for prescriptions or additional assessments.
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Question 2
A client with diabetes mellitus is scheduled for a fasting blood glucose test. The
nurse should instruct the client to:
A) Eat a light breakfast before the test
B) Drink only water for 8 hours before the test
C) Take the morning dose of insulin as usual
D) Avoid all food and fluids for 12 hours
Correct Answer: B
Rationale: Fasting means no caloric intake for 8-12 hours. Water is permitted to
prevent dehydration. Insulin should be withheld until after the test to prevent
hypoglycemia during the fasting period.
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Question 3
A nurse is assessing a client with pneumonia. Which finding requires immediate
intervention?
A) Temperature of 38.3°C (101°F)
B) Productive cough with green sputum
,C) Respiratory rate of 28/min with SpO₂ of 88%
D) Chest discomfort with deep breathing
Correct Answer: C
Rationale: An SpO₂ of 88% indicates significant hypoxemia requiring immediate
oxygen therapy. The ABC framework (Airway, Breathing, Circulation) prioritizes
respiratory compromise. While the other findings are concerning, they do not
represent immediate life-threatening conditions.
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Question 4
A nurse is caring for a client with an arteriovenous fistula for hemodialysis. Which
finding should the nurse report to the provider?
A) Thrill upon palpation
B) Absence of a bruit
C) Warmth over the fistula site
D) Slight edema around the site
Correct Answer: B
Rationale: Absence of a bruit indicates possible thrombosis or occlusion of the
fistula, which requires immediate intervention. A thrill and bruit are expected
findings indicating patency. Warmth and slight edema may be expected post-
creation but should be monitored.
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, Question 5
A client is receiving a blood transfusion and develops chills, fever, and lower back
pain. What is the nurse's priority action?
A) Slow the transfusion rate
B) Administer acetaminophen
C) Stop the transfusion immediately
D) Notify the provider
Correct Answer: C
Rationale: These findings suggest a hemolytic transfusion reaction. The priority
action is to stop the transfusion immediately to prevent further complications. After
stopping the transfusion, the nurse should maintain IV access with normal saline,
notify the provider, and send the blood bag and tubing to the blood bank for
analysis.
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Question 6
A nurse is preparing to insert a nasogastric tube. After inserting the tube, which
method is the most reliable to confirm placement?
A) Auscultating for air over the epigastric area
B) Measuring the pH of gastric aspirate
C) X-ray confirmation
D) Observing for coughing or gagging
2026 RETAKE EXAM 350 UNIQUE MULTIPLE-
CHOICE QUESTIONS WITH DETAILED
RATIONALES
---
SECTION 1: MEDICAL-SURGICAL NURSING (Questions 1-50)
---
Question 1
A nurse is caring for a client with heart failure who reports dyspnea, crackles in the
lung bases, and 2+ pitting edema. Which intervention should the nurse implement
first?
A) Administer furosemide as prescribed
B) Place the client in High-Fowler's position
C) Check oxygen saturation
D) Restrict oral fluid intake
Correct Answer: B
Rationale: The priority is to relieve dyspnea. High-Fowler's position maximizes lung
expansion and improves ventilation. While oxygen and diuretics are important,
,positioning is the immediate nursing intervention that can be implemented without
waiting for prescriptions or additional assessments.
---
Question 2
A client with diabetes mellitus is scheduled for a fasting blood glucose test. The
nurse should instruct the client to:
A) Eat a light breakfast before the test
B) Drink only water for 8 hours before the test
C) Take the morning dose of insulin as usual
D) Avoid all food and fluids for 12 hours
Correct Answer: B
Rationale: Fasting means no caloric intake for 8-12 hours. Water is permitted to
prevent dehydration. Insulin should be withheld until after the test to prevent
hypoglycemia during the fasting period.
---
Question 3
A nurse is assessing a client with pneumonia. Which finding requires immediate
intervention?
A) Temperature of 38.3°C (101°F)
B) Productive cough with green sputum
,C) Respiratory rate of 28/min with SpO₂ of 88%
D) Chest discomfort with deep breathing
Correct Answer: C
Rationale: An SpO₂ of 88% indicates significant hypoxemia requiring immediate
oxygen therapy. The ABC framework (Airway, Breathing, Circulation) prioritizes
respiratory compromise. While the other findings are concerning, they do not
represent immediate life-threatening conditions.
---
Question 4
A nurse is caring for a client with an arteriovenous fistula for hemodialysis. Which
finding should the nurse report to the provider?
A) Thrill upon palpation
B) Absence of a bruit
C) Warmth over the fistula site
D) Slight edema around the site
Correct Answer: B
Rationale: Absence of a bruit indicates possible thrombosis or occlusion of the
fistula, which requires immediate intervention. A thrill and bruit are expected
findings indicating patency. Warmth and slight edema may be expected post-
creation but should be monitored.
---
, Question 5
A client is receiving a blood transfusion and develops chills, fever, and lower back
pain. What is the nurse's priority action?
A) Slow the transfusion rate
B) Administer acetaminophen
C) Stop the transfusion immediately
D) Notify the provider
Correct Answer: C
Rationale: These findings suggest a hemolytic transfusion reaction. The priority
action is to stop the transfusion immediately to prevent further complications. After
stopping the transfusion, the nurse should maintain IV access with normal saline,
notify the provider, and send the blood bag and tubing to the blood bank for
analysis.
---
Question 6
A nurse is preparing to insert a nasogastric tube. After inserting the tube, which
method is the most reliable to confirm placement?
A) Auscultating for air over the epigastric area
B) Measuring the pH of gastric aspirate
C) X-ray confirmation
D) Observing for coughing or gagging
