ATI PN Comprehensive Predictor 2026 – NGN
Questions
Practical Nursing Comprehensive Examination
- 150 Questions
1. A practical nurse is caring for a client who has a new prescription for furosemide. Which of the
following laboratory values should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to hypokalemia. This can
precipitate cardiac arrhythmias, especially in clients taking digoxin. Potassium monitoring is essential for
clients on loop diuretics. The nurse should monitor for signs of hypokalemia including muscle weakness,
cardiac arrhythmias, and fatigue.
2. A PN is providing care to a client with a nasogastric tube. Which of the following actions should the
nurse take to verify tube placement?
A) Auscultate for air bubbles after injecting 10 mL of air
B) Aspirate gastric contents and check the pH
C) Obtain a chest x-ray before each feeding
D) Measure the external tube length
Answer: B) Aspirate gastric contents and check the pH
Rationale: Aspirating gastric contents and checking pH is the most reliable bedside method to verify
feeding tube placement. Gastric pH is typically ≤ 5.0, while respiratory pH is > 6.0. Auscultation is no
longer recommended as a sole method. X-ray is the gold standard but is not done before each feeding.
3. A client with COPD has a prescription for oxygen at 2 L/min via nasal cannula. The PN observes the
client removing the oxygen. Which response is most appropriate?
A) "You need to keep the oxygen on to prevent hypoxia"
B) "Tell me why you are removing your oxygen"
,C) "I will notify the healthcare provider about your refusal"
D) "You will need to be restrained if you continue to remove the oxygen"
Answer: B) "Tell me why you are removing your oxygen"
Rationale: This therapeutic communication technique explores the client's reasons for removing the
oxygen without being confrontational. It validates the client's autonomy while addressing the underlying
issue. Threatening restraint is inappropriate; notifying the provider may be necessary but should not be
the first response.
4. The PN is preparing to administer an enteral feeding through a gastrostomy tube. Which action
should the nurse take first?
A) Flush the tube with 30 mL of water
B) Verify tube placement by aspirating gastric contents
C) Warm the formula to room temperature
D) Elevate the head of the bed to 30 degrees
Answer: B) Verify tube placement by aspirating gastric contents
Rationale: Before administering any enteral feeding, verifying tube placement is the priority to prevent
aspiration and ensure the tube is in the stomach. This is followed by checking residual volume, flushing,
warming formula, and positioning the client.
5. A client receiving heparin therapy has an aPTT of 120 seconds. The PN should anticipate which
prescription?
A) Increase the heparin infusion rate
B) Decrease the heparin infusion rate
C) Administer vitamin K
D) Administer protamine sulfate
Answer: D) Administer protamine sulfate
Rationale: Normal aPTT is 30-40 seconds; therapeutic range for heparin is typically 60-80 seconds. An
aPTT of 120 seconds indicates excessive anticoagulation. Protamine sulfate is the specific antidote for
heparin and should be administered to reverse the effects. Vitamin K reverses warfarin, not heparin.
6. A PN is providing discharge teaching to a client with a new colostomy. Which statement by the
client indicates a need for further teaching?
A) "I should avoid carbonated beverages to prevent gas"
B) "I will empty the pouch when it is one-third full"
C) "I can shower with my appliance on"
D) "I should change the pouch daily"
Answer: D) "I should change the pouch daily"
,Rationale: Ostomy pouches should be changed every 3-7 days or when leaking, not daily. Daily changes
can irritate the peristomal skin. The other statements are correct: avoiding carbonated beverages
reduces gas, emptying at one-third full prevents leakage, and showering with the appliance on is
acceptable.
7. A client with Alzheimer's disease is wandering and agitated. Which intervention should the PN
implement first?
A) Apply physical restraints
B) Administer a sedative medication
C) Redirect the client to a structured activity
D) Place the client in a quiet, darkened room
Answer: C) Redirect the client to a structured activity
Rationale: Redirection to a structured activity is the least restrictive intervention and should be
attempted first for wandering and agitation. Restraints are a last resort, sedatives may worsen
confusion, and isolation can increase agitation. Structured activities provide purposeful engagement.
8. A client with a UTI is prescribed ciprofloxacin. Which adverse effect should the PN teach the client
to report immediately?
A) Nausea and headache
B) Tendon pain or swelling
C) Diarrhea and abdominal cramping
D) Dizziness and drowsiness
Answer: B) Tendon pain or swelling
Rationale: Ciprofloxacin carries a black box warning for tendonitis and tendon rupture, particularly the
Achilles tendon. Clients should report any tendon pain, swelling, or inflammation immediately. Nausea,
diarrhea, and dizziness are common but less serious adverse effects.
9. The PN is caring for a client with a chest tube. Which finding indicates proper functioning of the
system?
A) Continuous bubbling in the water seal chamber
B) Tidaling in the water seal chamber with respirations
C) Absence of drainage in the collection chamber
D) Suction pressure of -40 cm H₂O
Answer: B) Tidaling in the water seal chamber with respirations
Rationale: Tidaling (fluctuation of water level) in the water seal chamber with respirations indicates the
chest tube is patent and functioning properly. Continuous bubbling suggests an air leak. Absence of
drainage may indicate obstruction or successful drainage. Suction pressure typically is -20 cm H₂O.
, 10. A client with hypothyroidism is prescribed levothyroxine. Which instruction should the PN
include?
A) Take the medication with food to prevent GI upset
B) Take the medication on an empty stomach 30-60 minutes before breakfast
C) Take the medication at bedtime to promote sleep
D) Skip the dose if you experience palpitations
Answer: B) Take the medication on an empty stomach 30-60 minutes before breakfast
Rationale: Levothyroxine absorption is best when taken on an empty stomach, 30-60 minutes before
breakfast. Food, calcium, iron, and other medications can interfere with absorption. Palpitations should
be reported, not ignored.
11. The PN assesses a client with a hemoglobin of 7.5 g/dL. Which manifestation should the nurse
expect?
A) Polyuria and polydipsia
B) Fatigue and pallor
C) Hypertension and bradycardia
D) Jaundice and hepatomegaly
Answer: B) Fatigue and pallor
Rationale: A hemoglobin of 7.5 g/dL indicates anemia. Fatigue and pallor are classic symptoms due to
decreased oxygen-carrying capacity. Polyuria/polydipsia suggest diabetes; hypertension/bradycardia are
not typical; jaundice/hepatomegaly suggest liver disease or hemolysis.
12. A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is
most therapeutic?
A) Tell the client the voices are not real
B) Ask the client what the voices are saying
C) Ignore the hallucinations and redirect to reality
D) Administer a PRN antipsychotic immediately
Answer: B) Ask the client what the voices are saying
Rationale: Asking about the content of hallucinations is therapeutic as it helps the nurse assess safety
(command hallucinations) and validate the client's experience without endorsing the hallucinations.
Telling the client voices aren't real can increase anxiety and distrust.
13. A client is receiving IV potassium chloride. Which action by the PN is correct?
A) Administer IV push for rapid replacement
B) Infuse at a rate of 30 mEq/hour
Questions
Practical Nursing Comprehensive Examination
- 150 Questions
1. A practical nurse is caring for a client who has a new prescription for furosemide. Which of the
following laboratory values should the nurse monitor closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to hypokalemia. This can
precipitate cardiac arrhythmias, especially in clients taking digoxin. Potassium monitoring is essential for
clients on loop diuretics. The nurse should monitor for signs of hypokalemia including muscle weakness,
cardiac arrhythmias, and fatigue.
2. A PN is providing care to a client with a nasogastric tube. Which of the following actions should the
nurse take to verify tube placement?
A) Auscultate for air bubbles after injecting 10 mL of air
B) Aspirate gastric contents and check the pH
C) Obtain a chest x-ray before each feeding
D) Measure the external tube length
Answer: B) Aspirate gastric contents and check the pH
Rationale: Aspirating gastric contents and checking pH is the most reliable bedside method to verify
feeding tube placement. Gastric pH is typically ≤ 5.0, while respiratory pH is > 6.0. Auscultation is no
longer recommended as a sole method. X-ray is the gold standard but is not done before each feeding.
3. A client with COPD has a prescription for oxygen at 2 L/min via nasal cannula. The PN observes the
client removing the oxygen. Which response is most appropriate?
A) "You need to keep the oxygen on to prevent hypoxia"
B) "Tell me why you are removing your oxygen"
,C) "I will notify the healthcare provider about your refusal"
D) "You will need to be restrained if you continue to remove the oxygen"
Answer: B) "Tell me why you are removing your oxygen"
Rationale: This therapeutic communication technique explores the client's reasons for removing the
oxygen without being confrontational. It validates the client's autonomy while addressing the underlying
issue. Threatening restraint is inappropriate; notifying the provider may be necessary but should not be
the first response.
4. The PN is preparing to administer an enteral feeding through a gastrostomy tube. Which action
should the nurse take first?
A) Flush the tube with 30 mL of water
B) Verify tube placement by aspirating gastric contents
C) Warm the formula to room temperature
D) Elevate the head of the bed to 30 degrees
Answer: B) Verify tube placement by aspirating gastric contents
Rationale: Before administering any enteral feeding, verifying tube placement is the priority to prevent
aspiration and ensure the tube is in the stomach. This is followed by checking residual volume, flushing,
warming formula, and positioning the client.
5. A client receiving heparin therapy has an aPTT of 120 seconds. The PN should anticipate which
prescription?
A) Increase the heparin infusion rate
B) Decrease the heparin infusion rate
C) Administer vitamin K
D) Administer protamine sulfate
Answer: D) Administer protamine sulfate
Rationale: Normal aPTT is 30-40 seconds; therapeutic range for heparin is typically 60-80 seconds. An
aPTT of 120 seconds indicates excessive anticoagulation. Protamine sulfate is the specific antidote for
heparin and should be administered to reverse the effects. Vitamin K reverses warfarin, not heparin.
6. A PN is providing discharge teaching to a client with a new colostomy. Which statement by the
client indicates a need for further teaching?
A) "I should avoid carbonated beverages to prevent gas"
B) "I will empty the pouch when it is one-third full"
C) "I can shower with my appliance on"
D) "I should change the pouch daily"
Answer: D) "I should change the pouch daily"
,Rationale: Ostomy pouches should be changed every 3-7 days or when leaking, not daily. Daily changes
can irritate the peristomal skin. The other statements are correct: avoiding carbonated beverages
reduces gas, emptying at one-third full prevents leakage, and showering with the appliance on is
acceptable.
7. A client with Alzheimer's disease is wandering and agitated. Which intervention should the PN
implement first?
A) Apply physical restraints
B) Administer a sedative medication
C) Redirect the client to a structured activity
D) Place the client in a quiet, darkened room
Answer: C) Redirect the client to a structured activity
Rationale: Redirection to a structured activity is the least restrictive intervention and should be
attempted first for wandering and agitation. Restraints are a last resort, sedatives may worsen
confusion, and isolation can increase agitation. Structured activities provide purposeful engagement.
8. A client with a UTI is prescribed ciprofloxacin. Which adverse effect should the PN teach the client
to report immediately?
A) Nausea and headache
B) Tendon pain or swelling
C) Diarrhea and abdominal cramping
D) Dizziness and drowsiness
Answer: B) Tendon pain or swelling
Rationale: Ciprofloxacin carries a black box warning for tendonitis and tendon rupture, particularly the
Achilles tendon. Clients should report any tendon pain, swelling, or inflammation immediately. Nausea,
diarrhea, and dizziness are common but less serious adverse effects.
9. The PN is caring for a client with a chest tube. Which finding indicates proper functioning of the
system?
A) Continuous bubbling in the water seal chamber
B) Tidaling in the water seal chamber with respirations
C) Absence of drainage in the collection chamber
D) Suction pressure of -40 cm H₂O
Answer: B) Tidaling in the water seal chamber with respirations
Rationale: Tidaling (fluctuation of water level) in the water seal chamber with respirations indicates the
chest tube is patent and functioning properly. Continuous bubbling suggests an air leak. Absence of
drainage may indicate obstruction or successful drainage. Suction pressure typically is -20 cm H₂O.
, 10. A client with hypothyroidism is prescribed levothyroxine. Which instruction should the PN
include?
A) Take the medication with food to prevent GI upset
B) Take the medication on an empty stomach 30-60 minutes before breakfast
C) Take the medication at bedtime to promote sleep
D) Skip the dose if you experience palpitations
Answer: B) Take the medication on an empty stomach 30-60 minutes before breakfast
Rationale: Levothyroxine absorption is best when taken on an empty stomach, 30-60 minutes before
breakfast. Food, calcium, iron, and other medications can interfere with absorption. Palpitations should
be reported, not ignored.
11. The PN assesses a client with a hemoglobin of 7.5 g/dL. Which manifestation should the nurse
expect?
A) Polyuria and polydipsia
B) Fatigue and pallor
C) Hypertension and bradycardia
D) Jaundice and hepatomegaly
Answer: B) Fatigue and pallor
Rationale: A hemoglobin of 7.5 g/dL indicates anemia. Fatigue and pallor are classic symptoms due to
decreased oxygen-carrying capacity. Polyuria/polydipsia suggest diabetes; hypertension/bradycardia are
not typical; jaundice/hepatomegaly suggest liver disease or hemolysis.
12. A client with schizophrenia is experiencing auditory hallucinations. Which nursing intervention is
most therapeutic?
A) Tell the client the voices are not real
B) Ask the client what the voices are saying
C) Ignore the hallucinations and redirect to reality
D) Administer a PRN antipsychotic immediately
Answer: B) Ask the client what the voices are saying
Rationale: Asking about the content of hallucinations is therapeutic as it helps the nurse assess safety
(command hallucinations) and validate the client's experience without endorsing the hallucinations.
Telling the client voices aren't real can increase anxiety and distrust.
13. A client is receiving IV potassium chloride. Which action by the PN is correct?
A) Administer IV push for rapid replacement
B) Infuse at a rate of 30 mEq/hour
