ATI RN Comprehensive Predictor 2026
Proctored Exams NGN-Style Questions and Case Scenarios Verified
Exit Exam Pack
1. A nurse is assessing a client who has been admitted with an acute exacerbation of heart failure.
Which finding requires immediate intervention?
A) Weight gain of 2 lbs in 24 hours
B) Oxygen saturation of 92% on room air
C) Pink frothy sputum
D) Heart rate of 98 bpm
Correct Answer: C) Pink frothy sputum
Rationale: Pink frothy sputum indicates pulmonary edema, a life-threatening complication of
heart failure that requires immediate intervention. Weight gain of 2 lbs in 24 hours is
concerning but not immediately life-threatening. Oxygen saturation of 92% and heart rate of 98
bpm are not immediately dangerous.
2. A nurse is caring for a client who is receiving heparin therapy. Which laboratory value should the
nurse monitor?
A) PT/INR
B) aPTT
C) Platelet count
D) Hemoglobin
Correct Answer: B) aPTT
Rationale: aPTT is used to monitor heparin therapy. PT/INR is used to monitor warfarin therapy.
Platelet count is monitored for heparin-induced thrombocytopenia but aPTT is the primary
monitoring parameter. Hemoglobin is not specific to heparin therapy.
3. A nurse is teaching a client about a new prescription for warfarin. Which statement indicates
understanding?
A) "I will avoid foods high in vitamin K."
B) "I will increase my intake of green leafy vegetables."
C) "I will take aspirin for headaches."
D) "I will double my dose if I miss one."
Correct Answer: A) "I will avoid foods high in vitamin K."
,Rationale: Clients on warfarin should maintain consistent intake of vitamin K and avoid sudden
increases. Increasing green leafy vegetables can decrease warfarin effectiveness. Aspirin
increases bleeding risk. Doubling doses is unsafe.
4. A nurse is assessing a client who has a new onset of atrial fibrillation. Which medication should the
nurse anticipate administering?
A) Digoxin
B) Amiodarone
C) Lisinopril
D) Metoprolol
Correct Answer: B) Amiodarone
Rationale: Amiodarone is commonly used for rate and rhythm control in atrial fibrillation.
Digoxin can be used but is not first-line. Lisinopril is an ACE inhibitor for blood pressure.
Metoprolol is a beta-blocker used for rate control but amiodarone is preferred for rhythm
control.
5. A nurse is caring for a client who is post-operative day 1 following a total hip replacement. Which
finding should the nurse report immediately?
A) Pain at the surgical site
B) Temperature of 100.2°F
C) Shortness of breath and chest pain
D) Bloody drainage on the dressing
Correct Answer: C) Shortness of breath and chest pain
Rationale: Shortness of breath and chest pain after hip replacement are concerning for
pulmonary embolism, which requires immediate intervention. Pain at the surgical site, low-
grade fever, and bloody drainage are expected post-operative findings.
6. A nurse is assessing a client who is receiving furosemide. Which finding indicates a therapeutic
response?
A) Increased urine output
B) Decreased heart rate
C) Weight gain
D) Increased blood pressure
Correct Answer: A) Increased urine output
,Rationale: Furosemide is a loop diuretic that increases urine output to reduce fluid overload.
Decreased heart rate, weight gain, and increased blood pressure are not therapeutic responses.
7. A nurse is teaching a client about the use of insulin. Which statement indicates understanding?
A) "I will rotate injection sites."
B) "I will inject into the same site each time."
C) "I will store insulin in the freezer."
D) "I will skip doses when I don't eat."
Correct Answer: A) "I will rotate injection sites."
Rationale: Rotating injection sites prevents lipohypertrophy and ensures consistent insulin
absorption. Injecting into the same site can cause tissue damage. Insulin should not be frozen.
Skipping doses can cause hyperglycemia.
8. A nurse is caring for a client who has a new diagnosis of diabetes mellitus. Which finding indicates
hypoglycemia?
A) Blood glucose of 250 mg/dL
B) Blood glucose of 60 mg/dL
C) Blood glucose of 180 mg/dL
D) Blood glucose of 120 mg/dL
Correct Answer: B) Blood glucose of 60 mg/dL
Rationale: Hypoglycemia is defined as blood glucose below 70 mg/dL. A blood glucose of 60
mg/dL indicates hypoglycemia. Values of 120, 180, and 250 mg/dL are elevated or within
normal limits.
9. A nurse is assessing a client who is receiving morphine for pain. Which finding indicates respiratory
depression?
A) Respiratory rate of 16/min
B) Respiratory rate of 8/min
C) Oxygen saturation of 95%
D) Pain relief
Correct Answer: B) Respiratory rate of 8/min
Rationale: Respiratory rate below 12/min indicates respiratory depression, a serious adverse
effect of morphine. Respiratory rate of 16/min and oxygen saturation of 95% are normal. Pain
relief is a therapeutic response.
, 10. A nurse is teaching a client about a low-sodium diet. Which food should the client avoid?
A) Fresh fruits
B) Canned vegetables
C) Fresh vegetables
D) Plain rice
Correct Answer: B) Canned vegetables
Rationale: Canned vegetables are high in sodium. Fresh fruits, vegetables, and plain rice are low
in sodium and appropriate for a low-sodium diet.
11. A nurse is caring for a client who is receiving a blood transfusion. Which finding indicates a
hemolytic reaction?
A) Urticaria
B) Fever and chills
C) Flank pain and dark urine
D) Mild itching
Correct Answer: C) Flank pain and dark urine
Rationale: Flank pain and dark urine indicate a hemolytic transfusion reaction, which is life-
threatening. Urticaria and itching indicate an allergic reaction. Fever and chills can indicate a
febrile reaction.
12. A nurse is assessing a client who has been admitted with a diagnosis of pneumonia. Which finding
requires immediate intervention?
A) Productive cough
B) Temperature of 101°F
C) Respiratory rate of 32/min
D) Oxygen saturation of 94%
Correct Answer: C) Respiratory rate of 32/min
Rationale: Respiratory rate of 32/min indicates respiratory distress and requires immediate
intervention. Productive cough and low-grade fever are expected with pneumonia. Oxygen
saturation of 94% is acceptable.
13. A nurse is teaching a client about the use of a metered-dose inhaler. Which instruction should the
nurse include?
Proctored Exams NGN-Style Questions and Case Scenarios Verified
Exit Exam Pack
1. A nurse is assessing a client who has been admitted with an acute exacerbation of heart failure.
Which finding requires immediate intervention?
A) Weight gain of 2 lbs in 24 hours
B) Oxygen saturation of 92% on room air
C) Pink frothy sputum
D) Heart rate of 98 bpm
Correct Answer: C) Pink frothy sputum
Rationale: Pink frothy sputum indicates pulmonary edema, a life-threatening complication of
heart failure that requires immediate intervention. Weight gain of 2 lbs in 24 hours is
concerning but not immediately life-threatening. Oxygen saturation of 92% and heart rate of 98
bpm are not immediately dangerous.
2. A nurse is caring for a client who is receiving heparin therapy. Which laboratory value should the
nurse monitor?
A) PT/INR
B) aPTT
C) Platelet count
D) Hemoglobin
Correct Answer: B) aPTT
Rationale: aPTT is used to monitor heparin therapy. PT/INR is used to monitor warfarin therapy.
Platelet count is monitored for heparin-induced thrombocytopenia but aPTT is the primary
monitoring parameter. Hemoglobin is not specific to heparin therapy.
3. A nurse is teaching a client about a new prescription for warfarin. Which statement indicates
understanding?
A) "I will avoid foods high in vitamin K."
B) "I will increase my intake of green leafy vegetables."
C) "I will take aspirin for headaches."
D) "I will double my dose if I miss one."
Correct Answer: A) "I will avoid foods high in vitamin K."
,Rationale: Clients on warfarin should maintain consistent intake of vitamin K and avoid sudden
increases. Increasing green leafy vegetables can decrease warfarin effectiveness. Aspirin
increases bleeding risk. Doubling doses is unsafe.
4. A nurse is assessing a client who has a new onset of atrial fibrillation. Which medication should the
nurse anticipate administering?
A) Digoxin
B) Amiodarone
C) Lisinopril
D) Metoprolol
Correct Answer: B) Amiodarone
Rationale: Amiodarone is commonly used for rate and rhythm control in atrial fibrillation.
Digoxin can be used but is not first-line. Lisinopril is an ACE inhibitor for blood pressure.
Metoprolol is a beta-blocker used for rate control but amiodarone is preferred for rhythm
control.
5. A nurse is caring for a client who is post-operative day 1 following a total hip replacement. Which
finding should the nurse report immediately?
A) Pain at the surgical site
B) Temperature of 100.2°F
C) Shortness of breath and chest pain
D) Bloody drainage on the dressing
Correct Answer: C) Shortness of breath and chest pain
Rationale: Shortness of breath and chest pain after hip replacement are concerning for
pulmonary embolism, which requires immediate intervention. Pain at the surgical site, low-
grade fever, and bloody drainage are expected post-operative findings.
6. A nurse is assessing a client who is receiving furosemide. Which finding indicates a therapeutic
response?
A) Increased urine output
B) Decreased heart rate
C) Weight gain
D) Increased blood pressure
Correct Answer: A) Increased urine output
,Rationale: Furosemide is a loop diuretic that increases urine output to reduce fluid overload.
Decreased heart rate, weight gain, and increased blood pressure are not therapeutic responses.
7. A nurse is teaching a client about the use of insulin. Which statement indicates understanding?
A) "I will rotate injection sites."
B) "I will inject into the same site each time."
C) "I will store insulin in the freezer."
D) "I will skip doses when I don't eat."
Correct Answer: A) "I will rotate injection sites."
Rationale: Rotating injection sites prevents lipohypertrophy and ensures consistent insulin
absorption. Injecting into the same site can cause tissue damage. Insulin should not be frozen.
Skipping doses can cause hyperglycemia.
8. A nurse is caring for a client who has a new diagnosis of diabetes mellitus. Which finding indicates
hypoglycemia?
A) Blood glucose of 250 mg/dL
B) Blood glucose of 60 mg/dL
C) Blood glucose of 180 mg/dL
D) Blood glucose of 120 mg/dL
Correct Answer: B) Blood glucose of 60 mg/dL
Rationale: Hypoglycemia is defined as blood glucose below 70 mg/dL. A blood glucose of 60
mg/dL indicates hypoglycemia. Values of 120, 180, and 250 mg/dL are elevated or within
normal limits.
9. A nurse is assessing a client who is receiving morphine for pain. Which finding indicates respiratory
depression?
A) Respiratory rate of 16/min
B) Respiratory rate of 8/min
C) Oxygen saturation of 95%
D) Pain relief
Correct Answer: B) Respiratory rate of 8/min
Rationale: Respiratory rate below 12/min indicates respiratory depression, a serious adverse
effect of morphine. Respiratory rate of 16/min and oxygen saturation of 95% are normal. Pain
relief is a therapeutic response.
, 10. A nurse is teaching a client about a low-sodium diet. Which food should the client avoid?
A) Fresh fruits
B) Canned vegetables
C) Fresh vegetables
D) Plain rice
Correct Answer: B) Canned vegetables
Rationale: Canned vegetables are high in sodium. Fresh fruits, vegetables, and plain rice are low
in sodium and appropriate for a low-sodium diet.
11. A nurse is caring for a client who is receiving a blood transfusion. Which finding indicates a
hemolytic reaction?
A) Urticaria
B) Fever and chills
C) Flank pain and dark urine
D) Mild itching
Correct Answer: C) Flank pain and dark urine
Rationale: Flank pain and dark urine indicate a hemolytic transfusion reaction, which is life-
threatening. Urticaria and itching indicate an allergic reaction. Fever and chills can indicate a
febrile reaction.
12. A nurse is assessing a client who has been admitted with a diagnosis of pneumonia. Which finding
requires immediate intervention?
A) Productive cough
B) Temperature of 101°F
C) Respiratory rate of 32/min
D) Oxygen saturation of 94%
Correct Answer: C) Respiratory rate of 32/min
Rationale: Respiratory rate of 32/min indicates respiratory distress and requires immediate
intervention. Productive cough and low-grade fever are expected with pneumonia. Oxygen
saturation of 94% is acceptable.
13. A nurse is teaching a client about the use of a metered-dose inhaler. Which instruction should the
nurse include?
