NGN ATI RN COMPREHENSIVE PREDICTOR Q&A
2026/2027 300 Practice Questions with Detailed
Verified Answers & Rationales
1. A nurse is caring for a client who is 2 days postoperative following an abdominal hysterectomy.
The client reports sudden shortness of breath and chest pain. Vital signs: HR 118, BP 98/62, RR 28,
SpO₂ 89% on room air. Which action should the nurse take FIRST?
A) Administer prescribed morphine for pain
B) Apply oxygen at 2 L/min via nasal cannula and raise the head of the bed
C) Assist the client to ambulate to improve circulation
D) Obtain a 12-lead ECG before initiating any intervention
Answer: B
Rationale: The client's presentation is consistent with a pulmonary embolism (PE), a life-threatening
complication of surgery. The priority is airway, breathing, and circulation (ABC). Applying oxygen and
positioning the client upright improves oxygenation and reduces the work of breathing. Administering
morphine may mask symptoms and depress respirations. Ambulation could dislodge additional clot. An ECG
is important but does not take priority over oxygenation. The nurse should also notify the provider
immediately.
2. A nurse is reviewing laboratory results for a client receiving furosemide. Which finding requires
immediate intervention?
A) Potassium 3.1 mEq/L
B) Sodium 138 mEq/L
C) BUN 18 mg/dL
D) Creatinine 1.0 mg/dL
Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss (hypokalemia). A potassium level of 3.1
mEq/L is below the normal range (3.5–5.0 mEq/L) and places the client at risk for cardiac dysrhythmias,
muscle weakness, and digitalis toxicity. The nurse should notify the provider and anticipate potassium
supplementation. The other values are within normal limits.
,3. A nurse is teaching a client about warfarin therapy. Which statement by the client indicates
understanding?
A) "I should increase my intake of leafy green vegetables."
B) "I will use a soft toothbrush and electric razor."
C) "I can take aspirin for headaches without concern."
D) "I will stop taking the medication if I notice bruising."
Answer: B
Rationale: Warfarin increases bleeding risk. Using a soft toothbrush and electric razor reduces the risk of
bleeding from minor trauma. Leafy green vegetables are high in vitamin K, which antagonizes warfarin—
intake should be consistent, not increased. Aspirin increases bleeding risk and should be avoided unless
prescribed. Bruising is a common side effect and does not warrant stopping the medication without provider
guidance.
4. A nurse is caring for a client with a new colostomy. Which stoma assessment finding should the
nurse report to the provider?
A) Stoma is beefy red and moist
B) Stoma is pale and dusky
C) Stoma is raised above the skin surface
D) Stoma is circular in shape
Answer: B
Rationale: A healthy stoma is beefy red, moist, and raised. A pale or dusky stoma indicates inadequate blood
supply (ischemia) and requires immediate provider notification. This can progress to necrosis. The other
findings are normal characteristics of a healthy stoma.
5. A nurse is preparing to administer digoxin to a client. Which assessment finding should cause the
nurse to withhold the medication?
A) Heart rate 58 beats/min
B) Blood pressure 128/76 mm Hg
C) Respiratory rate 18 breaths/min
D) Temperature 98.6°F (37°C)
Answer: A
2
,Rationale: Digoxin slows the heart rate and is withheld if the adult heart rate is below 60 beats/min.
Administering digoxin at a rate of 58 could lead to symptomatic bradycardia or heart block. The nurse
should hold the dose, reassess, and notify the provider. The other vital signs are within normal limits and do
not contraindicate administration.
6. A nurse is assessing a client with heart failure. Which finding indicates worsening fluid retention?
A) Weight loss of 1 kg over 2 days
B) Bilateral crackles in the lung bases
C) Blood pressure 118/72 mm Hg
D) Urine output of 40 mL/hr
Answer: B
Rationale: Crackles in the lung bases indicate pulmonary congestion from fluid accumulation, a sign of
worsening heart failure. Weight gain, not loss, indicates fluid retention. A blood pressure of 118/72 is
acceptable. Urine output of 40 mL/hr is adequate. The nurse should also monitor for edema, jugular venous
distention, and dyspnea.
7. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A) Assessing a client's surgical incision
B) Administering oral pain medication
C) Measuring and recording a client's intake and output
D) Teaching a client about a new prescription
Answer: C
Rationale: Measuring and recording intake and output is a routine, non-invasive task within the UAP's scope
of practice. Assessment, medication administration, and client teaching require the clinical judgment and
licensure of a registered nurse and cannot be delegated to UAP. The nurse retains responsibility for ensuring
tasks are completed correctly.
8. A nurse is caring for a client with diabetic ketoacidosis (DKA). Which laboratory finding is
expected?
A) pH 7.48, PaCO₂ 48 mm Hg
B) Blood glucose 480 mg/dL, pH 7.25, bicarbonate 14 mEq/L
C) Blood glucose 60 mg/dL, pH 7.35
3
, D) Serum potassium 5.8 mEq/L, pH 7.40
Answer: B
Rationale: DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.35), low
bicarbonate (<18 mEq/L), and ketonuria. Option B reflects these findings. Option A suggests respiratory
alkalosis. Option C indicates hypoglycemia. Option D shows normal pH with hyperkalemia, not DKA.
Treatment includes IV fluids, insulin, and electrolyte replacement.
9. A nurse is administering IV potassium chloride. Which action is essential?
A) Administer as a rapid IV push
B) Dilute and administer via IV pump at a rate not exceeding 10–20 mEq/hr
C) Administer undiluted via central line
D) Give IM instead of IV
Answer: B
Rationale: IV potassium must always be diluted and infused via an infusion pump at a controlled rate
(usually ≤10–20 mEq/hr) to prevent cardiac arrest. It is never given IV push or IM. Rapid infusion can cause
fatal dysrhythmias. The nurse should also verify adequate urine output before administration.
10. A nurse is assessing a client with increased intracranial pressure (ICP). Which finding is an early
sign of increased ICP?
A) Decreased level of consciousness
B) Decerebrate posturing
C) Fixed and dilated pupils
D) Cushing's triad
Answer: A
Rationale: A decreased level of consciousness is the earliest and most sensitive indicator of increased ICP.
Decerebrate posturing, fixed dilated pupils, and Cushing's triad (bradycardia, hypertension, irregular
respirations) are late signs. Early recognition and intervention are critical to prevent herniation.
11. A nurse is caring for a client receiving heparin infusion. Which laboratory value should the nurse
monitor?
A) PT/INR
B) aPTT
C) Platelet count only
4
2026/2027 300 Practice Questions with Detailed
Verified Answers & Rationales
1. A nurse is caring for a client who is 2 days postoperative following an abdominal hysterectomy.
The client reports sudden shortness of breath and chest pain. Vital signs: HR 118, BP 98/62, RR 28,
SpO₂ 89% on room air. Which action should the nurse take FIRST?
A) Administer prescribed morphine for pain
B) Apply oxygen at 2 L/min via nasal cannula and raise the head of the bed
C) Assist the client to ambulate to improve circulation
D) Obtain a 12-lead ECG before initiating any intervention
Answer: B
Rationale: The client's presentation is consistent with a pulmonary embolism (PE), a life-threatening
complication of surgery. The priority is airway, breathing, and circulation (ABC). Applying oxygen and
positioning the client upright improves oxygenation and reduces the work of breathing. Administering
morphine may mask symptoms and depress respirations. Ambulation could dislodge additional clot. An ECG
is important but does not take priority over oxygenation. The nurse should also notify the provider
immediately.
2. A nurse is reviewing laboratory results for a client receiving furosemide. Which finding requires
immediate intervention?
A) Potassium 3.1 mEq/L
B) Sodium 138 mEq/L
C) BUN 18 mg/dL
D) Creatinine 1.0 mg/dL
Answer: A
Rationale: Furosemide is a loop diuretic that causes potassium loss (hypokalemia). A potassium level of 3.1
mEq/L is below the normal range (3.5–5.0 mEq/L) and places the client at risk for cardiac dysrhythmias,
muscle weakness, and digitalis toxicity. The nurse should notify the provider and anticipate potassium
supplementation. The other values are within normal limits.
,3. A nurse is teaching a client about warfarin therapy. Which statement by the client indicates
understanding?
A) "I should increase my intake of leafy green vegetables."
B) "I will use a soft toothbrush and electric razor."
C) "I can take aspirin for headaches without concern."
D) "I will stop taking the medication if I notice bruising."
Answer: B
Rationale: Warfarin increases bleeding risk. Using a soft toothbrush and electric razor reduces the risk of
bleeding from minor trauma. Leafy green vegetables are high in vitamin K, which antagonizes warfarin—
intake should be consistent, not increased. Aspirin increases bleeding risk and should be avoided unless
prescribed. Bruising is a common side effect and does not warrant stopping the medication without provider
guidance.
4. A nurse is caring for a client with a new colostomy. Which stoma assessment finding should the
nurse report to the provider?
A) Stoma is beefy red and moist
B) Stoma is pale and dusky
C) Stoma is raised above the skin surface
D) Stoma is circular in shape
Answer: B
Rationale: A healthy stoma is beefy red, moist, and raised. A pale or dusky stoma indicates inadequate blood
supply (ischemia) and requires immediate provider notification. This can progress to necrosis. The other
findings are normal characteristics of a healthy stoma.
5. A nurse is preparing to administer digoxin to a client. Which assessment finding should cause the
nurse to withhold the medication?
A) Heart rate 58 beats/min
B) Blood pressure 128/76 mm Hg
C) Respiratory rate 18 breaths/min
D) Temperature 98.6°F (37°C)
Answer: A
2
,Rationale: Digoxin slows the heart rate and is withheld if the adult heart rate is below 60 beats/min.
Administering digoxin at a rate of 58 could lead to symptomatic bradycardia or heart block. The nurse
should hold the dose, reassess, and notify the provider. The other vital signs are within normal limits and do
not contraindicate administration.
6. A nurse is assessing a client with heart failure. Which finding indicates worsening fluid retention?
A) Weight loss of 1 kg over 2 days
B) Bilateral crackles in the lung bases
C) Blood pressure 118/72 mm Hg
D) Urine output of 40 mL/hr
Answer: B
Rationale: Crackles in the lung bases indicate pulmonary congestion from fluid accumulation, a sign of
worsening heart failure. Weight gain, not loss, indicates fluid retention. A blood pressure of 118/72 is
acceptable. Urine output of 40 mL/hr is adequate. The nurse should also monitor for edema, jugular venous
distention, and dyspnea.
7. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is appropriate to
delegate?
A) Assessing a client's surgical incision
B) Administering oral pain medication
C) Measuring and recording a client's intake and output
D) Teaching a client about a new prescription
Answer: C
Rationale: Measuring and recording intake and output is a routine, non-invasive task within the UAP's scope
of practice. Assessment, medication administration, and client teaching require the clinical judgment and
licensure of a registered nurse and cannot be delegated to UAP. The nurse retains responsibility for ensuring
tasks are completed correctly.
8. A nurse is caring for a client with diabetic ketoacidosis (DKA). Which laboratory finding is
expected?
A) pH 7.48, PaCO₂ 48 mm Hg
B) Blood glucose 480 mg/dL, pH 7.25, bicarbonate 14 mEq/L
C) Blood glucose 60 mg/dL, pH 7.35
3
, D) Serum potassium 5.8 mEq/L, pH 7.40
Answer: B
Rationale: DKA is characterized by hyperglycemia (>250 mg/dL), metabolic acidosis (pH <7.35), low
bicarbonate (<18 mEq/L), and ketonuria. Option B reflects these findings. Option A suggests respiratory
alkalosis. Option C indicates hypoglycemia. Option D shows normal pH with hyperkalemia, not DKA.
Treatment includes IV fluids, insulin, and electrolyte replacement.
9. A nurse is administering IV potassium chloride. Which action is essential?
A) Administer as a rapid IV push
B) Dilute and administer via IV pump at a rate not exceeding 10–20 mEq/hr
C) Administer undiluted via central line
D) Give IM instead of IV
Answer: B
Rationale: IV potassium must always be diluted and infused via an infusion pump at a controlled rate
(usually ≤10–20 mEq/hr) to prevent cardiac arrest. It is never given IV push or IM. Rapid infusion can cause
fatal dysrhythmias. The nurse should also verify adequate urine output before administration.
10. A nurse is assessing a client with increased intracranial pressure (ICP). Which finding is an early
sign of increased ICP?
A) Decreased level of consciousness
B) Decerebrate posturing
C) Fixed and dilated pupils
D) Cushing's triad
Answer: A
Rationale: A decreased level of consciousness is the earliest and most sensitive indicator of increased ICP.
Decerebrate posturing, fixed dilated pupils, and Cushing's triad (bradycardia, hypertension, irregular
respirations) are late signs. Early recognition and intervention are critical to prevent herniation.
11. A nurse is caring for a client receiving heparin infusion. Which laboratory value should the nurse
monitor?
A) PT/INR
B) aPTT
C) Platelet count only
4
