VATI PN Comprehensive Predictor — NGN Questions
VATI PN Comprehensive Predictor Exam
NGN Questions & Case Scenarios
With Answers
Practical Nursing (PN) — NGN
Question 1. The PN is planning care for four clients at the start of the shift. Which
client should the PN assess first?
A. A client 2 days post-op appendectomy who rates incisional pain 4/10
B. A client with a new tracheostomy who is restless and has increased secretions
C. A client with heart failure who has 2+ pitting edema of the ankles
D. A client scheduled for discharge teaching on a new insulin regimen
Answer: B
Rationale: Restlessness and increased secretions in a new tracheostomy suggest airway
compromise/hypoxia, an immediate life-threatening (Airway) priority using the ABC
framework. The other clients have stable, expected findings that can wait.
NGN Multiple Response — Select all that apply
Question 2. The PN is delegating tasks to an unlicensed assistive personnel (UAP).
Which tasks are appropriate to delegate? Select all that apply.
A. Ambulating a stable client 1 day post-hip replacement
B. Reinforcing teaching about a low-sodium diet
C. Obtaining routine vital signs on a stable client
D. Feeding a client newly diagnosed with dysphagia
E. Emptying and recording a Foley catheter output
F. Assessing a new client's lung sounds on admission
Answer: A, C, E
Rationale: UAPs may perform tasks with predictable outcomes on stable clients:
ambulation, routine vitals, and measuring/recording I&O. Teaching (B) requires licensed
judgment, feeding a client with newly diagnosed dysphagia (D) requires assessment of
aspiration risk, and admission assessment (F) requires nursing judgment — all remain
the nurse's responsibility.
Page 1 of 37
, VATI PN Comprehensive Predictor — NGN Questions
Multiple Choice
Question 3. A client's call light is on. The PN enters the room and finds the client on
the floor next to the bed, awake and denying injury. What is the PN's first action?
A. Help the client back into bed immediately
B. Call for assistance and assess the client before moving them
C. Complete an incident report
D. Notify the client's family
Answer: B
Rationale: After a fall, the priority is to assess for injury before any movement to avoid
worsening a possible fracture or spinal injury. Additional help should be called to safely
assist. The incident report and family notification occur after the client is assessed and
stabilized.
Multiple Choice
Question 4. Which situation should the PN report to the RN or provider immediately
using SBAR?
A. A client's temperature is 99.2°F (37.3°C) 12 hours post-op
B. A client's oxygen saturation drops from 96% to 88% on room air
C. A client reports mild constipation on day 2 post-op
D. A client asks for clarification about discharge instructions
Answer: B
Rationale: An acute drop in SpO2 to 88% signals hypoxemia requiring immediate
intervention and provider notification. The other findings are expected/minor and can be
addressed through routine nursing care.
Multiple Choice
Question 5. The PN is using the nursing process. After implementing a plan of care for
a client with impaired skin integrity, what is the next step?
A. Diagnosis
B. Planning
C. Evaluation
D. Assessment
Answer: C
Rationale: The nursing process follows Assessment → Diagnosis → Planning →
Implementation → Evaluation. After implementation, the nurse evaluates whether the
interventions achieved the expected outcomes.
Page 2 of 37
, VATI PN Comprehensive Predictor — NGN Questions
Multiple Choice
Question 6. A client who is a Jehovah's Witness refuses a blood transfusion ordered
for symptomatic anemia. What is the PN's priority action?
A. Explain the risks of refusing to the client's family
B. Respect the client's right to refuse and document the refusal
C. Proceed with the transfusion since it is medically necessary
D. Ask the family to convince the client to accept
Answer: B
Rationale: Competent adults have the legal and ethical right to refuse treatment
(autonomy). The PN documents the refusal, notifies the provider, and ensures the client
understands alternatives — but does not coerce or override the decision.
NGN Multiple Response — Select all that apply
Question 7. Which findings indicate an actual or potential need to reprioritize care
during morning rounds? Select all that apply.
A. Client with new-onset chest pain radiating to the jaw
B. Client with a surgical dressing that is dry and intact
C. Client with slurred speech and facial droop that began 10 minutes ago
D. Client requesting pain medication for a 3/10 headache
E. Client with a blood glucose of 42 mg/dL and diaphoresis
Answer: A, C, E
Rationale: Chest pain radiating to the jaw suggests myocardial infarction, sudden
slurred speech/facial droop suggests stroke, and hypoglycemia with diaphoresis is an
emergent metabolic crisis — all require immediate action. A dry, intact dressing and mild
headache are stable/routine findings.
Multiple Choice
Question 8. The PN observes a coworker documenting vital signs on a client before
actually entering the room to obtain them. What is the PN's best initial action?
A. Report the coworker to the board of nursing immediately
B. Say nothing since it is not the PN's responsibility
C. Speak privately with the coworker about the observation
D. Document the incident in the client's chart
Answer: C
Page 3 of 37
, VATI PN Comprehensive Predictor — NGN Questions
Rationale: Falsifying documentation is a serious safety and legal issue, but the
appropriate first step is direct, professional communication with the coworker, followed
by reporting through the chain of command if the behavior continues or is unsafe.
Multiple Choice
Question 9. Using Maslow's hierarchy of needs, which client need should be met first?
A. A client expressing fear about an upcoming surgery
B. A client asking for a visitor pass for a family member
C. A client who has not voided in 8 hours and has a distended bladder
D. A client requesting a chaplain visit
Answer: C
Rationale: Physiological needs (elimination) take priority over safety/emotional or
psychosocial needs (fear, social contact, spiritual support) in Maslow's hierarchy. Urinary
retention can lead to complications and must be addressed first.
Multiple Choice
Question 10. A client scheduled for surgery in 2 hours tells the PN, 'I'm not sure I really
need this operation.' What is the PN's priority action?
A. Proceed with pre-op preparation as ordered
B. Notify the surgeon and hold further pre-op preparation
C. Reassure the client that the surgeon knows best
D. Ask the family to talk with the client
Answer: B
Rationale: Statements of doubt about a procedure suggest the client may not have
adequate informed consent understanding. The PN must stop preparation and notify the
surgeon so consent can be clarified before proceeding — the PN does not obtain
informed consent.
Pharmacology
Multiple Choice
Question 11. A client is prescribed digoxin 0.25 mg PO daily for heart failure. Before
administering, the PN should prioritize checking which value?
A. Blood glucose
B. Apical pulse rate
C. Respiratory rate
Page 4 of 37
VATI PN Comprehensive Predictor Exam
NGN Questions & Case Scenarios
With Answers
Practical Nursing (PN) — NGN
Question 1. The PN is planning care for four clients at the start of the shift. Which
client should the PN assess first?
A. A client 2 days post-op appendectomy who rates incisional pain 4/10
B. A client with a new tracheostomy who is restless and has increased secretions
C. A client with heart failure who has 2+ pitting edema of the ankles
D. A client scheduled for discharge teaching on a new insulin regimen
Answer: B
Rationale: Restlessness and increased secretions in a new tracheostomy suggest airway
compromise/hypoxia, an immediate life-threatening (Airway) priority using the ABC
framework. The other clients have stable, expected findings that can wait.
NGN Multiple Response — Select all that apply
Question 2. The PN is delegating tasks to an unlicensed assistive personnel (UAP).
Which tasks are appropriate to delegate? Select all that apply.
A. Ambulating a stable client 1 day post-hip replacement
B. Reinforcing teaching about a low-sodium diet
C. Obtaining routine vital signs on a stable client
D. Feeding a client newly diagnosed with dysphagia
E. Emptying and recording a Foley catheter output
F. Assessing a new client's lung sounds on admission
Answer: A, C, E
Rationale: UAPs may perform tasks with predictable outcomes on stable clients:
ambulation, routine vitals, and measuring/recording I&O. Teaching (B) requires licensed
judgment, feeding a client with newly diagnosed dysphagia (D) requires assessment of
aspiration risk, and admission assessment (F) requires nursing judgment — all remain
the nurse's responsibility.
Page 1 of 37
, VATI PN Comprehensive Predictor — NGN Questions
Multiple Choice
Question 3. A client's call light is on. The PN enters the room and finds the client on
the floor next to the bed, awake and denying injury. What is the PN's first action?
A. Help the client back into bed immediately
B. Call for assistance and assess the client before moving them
C. Complete an incident report
D. Notify the client's family
Answer: B
Rationale: After a fall, the priority is to assess for injury before any movement to avoid
worsening a possible fracture or spinal injury. Additional help should be called to safely
assist. The incident report and family notification occur after the client is assessed and
stabilized.
Multiple Choice
Question 4. Which situation should the PN report to the RN or provider immediately
using SBAR?
A. A client's temperature is 99.2°F (37.3°C) 12 hours post-op
B. A client's oxygen saturation drops from 96% to 88% on room air
C. A client reports mild constipation on day 2 post-op
D. A client asks for clarification about discharge instructions
Answer: B
Rationale: An acute drop in SpO2 to 88% signals hypoxemia requiring immediate
intervention and provider notification. The other findings are expected/minor and can be
addressed through routine nursing care.
Multiple Choice
Question 5. The PN is using the nursing process. After implementing a plan of care for
a client with impaired skin integrity, what is the next step?
A. Diagnosis
B. Planning
C. Evaluation
D. Assessment
Answer: C
Rationale: The nursing process follows Assessment → Diagnosis → Planning →
Implementation → Evaluation. After implementation, the nurse evaluates whether the
interventions achieved the expected outcomes.
Page 2 of 37
, VATI PN Comprehensive Predictor — NGN Questions
Multiple Choice
Question 6. A client who is a Jehovah's Witness refuses a blood transfusion ordered
for symptomatic anemia. What is the PN's priority action?
A. Explain the risks of refusing to the client's family
B. Respect the client's right to refuse and document the refusal
C. Proceed with the transfusion since it is medically necessary
D. Ask the family to convince the client to accept
Answer: B
Rationale: Competent adults have the legal and ethical right to refuse treatment
(autonomy). The PN documents the refusal, notifies the provider, and ensures the client
understands alternatives — but does not coerce or override the decision.
NGN Multiple Response — Select all that apply
Question 7. Which findings indicate an actual or potential need to reprioritize care
during morning rounds? Select all that apply.
A. Client with new-onset chest pain radiating to the jaw
B. Client with a surgical dressing that is dry and intact
C. Client with slurred speech and facial droop that began 10 minutes ago
D. Client requesting pain medication for a 3/10 headache
E. Client with a blood glucose of 42 mg/dL and diaphoresis
Answer: A, C, E
Rationale: Chest pain radiating to the jaw suggests myocardial infarction, sudden
slurred speech/facial droop suggests stroke, and hypoglycemia with diaphoresis is an
emergent metabolic crisis — all require immediate action. A dry, intact dressing and mild
headache are stable/routine findings.
Multiple Choice
Question 8. The PN observes a coworker documenting vital signs on a client before
actually entering the room to obtain them. What is the PN's best initial action?
A. Report the coworker to the board of nursing immediately
B. Say nothing since it is not the PN's responsibility
C. Speak privately with the coworker about the observation
D. Document the incident in the client's chart
Answer: C
Page 3 of 37
, VATI PN Comprehensive Predictor — NGN Questions
Rationale: Falsifying documentation is a serious safety and legal issue, but the
appropriate first step is direct, professional communication with the coworker, followed
by reporting through the chain of command if the behavior continues or is unsafe.
Multiple Choice
Question 9. Using Maslow's hierarchy of needs, which client need should be met first?
A. A client expressing fear about an upcoming surgery
B. A client asking for a visitor pass for a family member
C. A client who has not voided in 8 hours and has a distended bladder
D. A client requesting a chaplain visit
Answer: C
Rationale: Physiological needs (elimination) take priority over safety/emotional or
psychosocial needs (fear, social contact, spiritual support) in Maslow's hierarchy. Urinary
retention can lead to complications and must be addressed first.
Multiple Choice
Question 10. A client scheduled for surgery in 2 hours tells the PN, 'I'm not sure I really
need this operation.' What is the PN's priority action?
A. Proceed with pre-op preparation as ordered
B. Notify the surgeon and hold further pre-op preparation
C. Reassure the client that the surgeon knows best
D. Ask the family to talk with the client
Answer: B
Rationale: Statements of doubt about a procedure suggest the client may not have
adequate informed consent understanding. The PN must stop preparation and notify the
surgeon so consent can be clarified before proceeding — the PN does not obtain
informed consent.
Pharmacology
Multiple Choice
Question 11. A client is prescribed digoxin 0.25 mg PO daily for heart failure. Before
administering, the PN should prioritize checking which value?
A. Blood glucose
B. Apical pulse rate
C. Respiratory rate
Page 4 of 37
