ATI RN Comprehensive Predictor (NGN-STYLE QUESTIONS & CASE
SCENARIOS) Set 1 Exam
1. During morning rounds, a 74-year-old client has the following concern: staff member discussing a client in
a public elevator. Which assessment data should the nurse monitor most closely to evaluate safety and
response to care?
A. whether protected information was exposed and whether reporting is required by policy
B. airway patency, respiratory effort, oxygen saturation, and mental status
C. client status and escalation response
D. completion of pending actions and response to interventions
Correct Answer: A. whether protected information was exposed and whether reporting is required by policy
Rationale: The most relevant monitoring is whether protected information was exposed and whether reporting is
required by policy because it directly tracks the risks and expected response associated with privacy and minimum
necessary disclosure. Monitoring unrelated systems would not provide the same early warning value.
2. Jamie is a 34-year-old client and is being assessed by the nurse. Client newly taking an ace inhibitor
reports lip swelling. Which teaching point is most important for the nurse to reinforce?
A. HIT is an immune complication associated with thrombosis risk
B. angioedema can threaten the airway and requires urgent action
C. ethambutol can cause optic toxicity and several TB drugs can affect the liver
D. loss of reflexes and respiratory depression suggest magnesium toxicity
Correct Answer: B. angioedema can threaten the airway and requires urgent action
Rationale: The key teaching is that angioedema can threaten the airway and requires urgent action. This instruction
targets the preventable risk central to ACE inhibitor safety and supports safe self-management.
3. During a medication pass, a 55-year-old client has the following concern: change-of-shift report for a client
with a recent clinical deterioration. Which nursing action would require correction?
A. assess the client, obtain needed care, notify the provider as indicated, and complete the safety report per policy
B. stop the conversation and move any necessary discussion to a private location
C. assign the sterile dressing change and routine oral medications to the LPN/VN when permitted by jurisdiction and
policy
D. omitting a critical pending laboratory result because it is in the chart
Correct Answer: D. omitting a critical pending laboratory result because it is in the chart
Rationale: Omitting a critical pending laboratory result because it is in the chart would require correction because it
conflicts with continuity of care and could increase risk. The safer approach is to follow the evidence-based action
appropriate to the client's current status.
,4. During a postoperative assessment, the nurse is caring for a 55-year-old client. Client prescribed an maoi
asks about diet. Which teaching point is most important for the nurse to reinforce?
A. digoxin toxicity is more likely with renal impairment and electrolyte disturbance
B. prolonged corticosteroid therapy suppresses the hypothalamic-pituitary-adrenal axis
C. aminoglycosides can cause ototoxicity and nephrotoxicity
D. MAO inhibition can produce dangerous reactions with tyramine and interacting drugs
Correct Answer: D. MAO inhibition can produce dangerous reactions with tyramine and interacting drugs
Rationale: The key teaching is that MAO inhibition can produce dangerous reactions with tyramine and interacting
drugs. This instruction targets the preventable risk central to MAOI interactions and supports safe self-management.
5. The nurse reviews the situation of a 55-year-old client: unit identifies an increase in central-line infections.
Which nursing action would require correction?
A. disciplining individual staff before examining system factors
B. communicate current status, recent changes, pending tests, and time-sensitive concerns using a structured handoff
C. respect the refusal, assess understanding, notify the provider, and document the decision
D. withhold the unsafe action and use the chain of command to resolve the concern
Correct Answer: A. disciplining individual staff before examining system factors
Rationale: Disciplining individual staff before examining system factors would require correction because it conflicts
with systems thinking and outcome measurement and could increase risk. The safer approach is to follow the
evidence-based action appropriate to the client's current status.
6. During morning rounds, the nurse is caring for a 41-year-old client. Client receiving an aminoglycoside
reports tinnitus. Which finding best indicates that the plan of care is effective?
A. drug-related toxicity is recognized early
B. exposure stops and the reaction is treated promptly
C. toxicity is reversed before respiratory arrest
D. serotonergic toxicity is treated promptly
Correct Answer: A. drug-related toxicity is recognized early
Rationale: An effective plan should produce this result: drug-related toxicity is recognized early. That outcome directly
demonstrates improvement in the problem targeted by aminoglycoside safety.
,7. In an urgent care area, a 48-year-old client has the following concern: disaster triage with limited
resources and multiple victims. Which principle best explains the nurse's clinical decision-making in this
situation?
A. scope of practice and client stability
B. continuity of care
C. occupational safety and assignment
D. disaster ethics and triage
Correct Answer: D. disaster ethics and triage
Rationale: The central principle is disaster ethics and triage. It links the client cues to the safest nursing response and
helps distinguish the best option from alternatives that may be reasonable in other contexts.
8. Casey is a 74-year-old client and is being assessed by the nurse. Client starting levothyroxine asks when to
take it. Which finding best indicates that the plan of care is effective?
A. toxicity is recognized before serious dysrhythmia occurs
B. ventilation improves and sedation decreases
C. eligible clients receive therapy with bleeding risk minimized
D. thyroid replacement reaches a stable therapeutic effect
Correct Answer: D. thyroid replacement reaches a stable therapeutic effect
Rationale: An effective plan should produce this result: thyroid replacement reaches a stable therapeutic effect. That
outcome directly demonstrates improvement in the problem targeted by thyroid replacement.
9. During an interdisciplinary care conference, the nurse is caring for a 48-year-old client. Multiple clients
requiring attention, including one with new inspiratory stridor. Which principle best explains the nurse's
clinical decision-making in this situation?
A. disaster ethics and triage
B. legal documentation
C. occupational safety and assignment
D. ABCs and acute change
Correct Answer: D. ABCs and acute change
Rationale: The central principle is ABCs and acute change. It links the client cues to the safest nursing response and
helps distinguish the best option from alternatives that may be reasonable in other contexts.
, 10. The nurse reviews the situation of a 68-year-old client: client with type 1 diabetes has glucose 520 mg/dL,
dehydration, abdominal pain, and deep rapid respirations. Which assessment data should the nurse monitor
most closely to evaluate safety and response to care?
A. work of breathing, oxygenation, mental status, and response to therapy
B. glucose, potassium, anion gap, hydration, and neurologic status
C. osmolality, sodium, glucose, potassium, hemodynamics, and mental status
D. airway, blood pressure, oxygenation, and recurrence
Correct Answer: B. glucose, potassium, anion gap, hydration, and neurologic status
Rationale: The most relevant monitoring is glucose, potassium, anion gap, hydration, and neurologic status because it
directly tracks the risks and expected response associated with diabetic ketoacidosis. Monitoring unrelated systems would
not provide the same early warning value.
11. During a telephone triage call, a 24-year-old client has the following concern: staff member discussing a
client in a public elevator. What should the nurse do next?
A. follow facility radiation-safety policy and avoid assignments that exceed permitted exposure
B. assess and intervene for the client with stridor first
C. stop the conversation and move any necessary discussion to a private location
D. use a structured quality-improvement process to review adherence, identify causes, implement changes, and track
outcomes
Correct Answer: C. stop the conversation and move any necessary discussion to a private location
Rationale: The next step is to stop the conversation and move any necessary discussion to a private location. This action
follows the priorities implied by privacy and minimum necessary disclosure and addresses the most time-sensitive risk
before lower-priority interventions.
12. The nurse reviews the situation of a 62-year-old client: provider prescribes IV potassium for severe
hypokalemia. Which principle best explains the nurse's clinical decision-making in this situation?
A. transfusion reaction
B. electrolyte replacement
C. heparin complications
D. serotonin syndrome
Correct Answer: B. electrolyte replacement
Rationale: The central principle is electrolyte replacement. It links the client cues to the safest nursing response and
helps distinguish the best option from alternatives that may be reasonable in other contexts.
SCENARIOS) Set 1 Exam
1. During morning rounds, a 74-year-old client has the following concern: staff member discussing a client in
a public elevator. Which assessment data should the nurse monitor most closely to evaluate safety and
response to care?
A. whether protected information was exposed and whether reporting is required by policy
B. airway patency, respiratory effort, oxygen saturation, and mental status
C. client status and escalation response
D. completion of pending actions and response to interventions
Correct Answer: A. whether protected information was exposed and whether reporting is required by policy
Rationale: The most relevant monitoring is whether protected information was exposed and whether reporting is
required by policy because it directly tracks the risks and expected response associated with privacy and minimum
necessary disclosure. Monitoring unrelated systems would not provide the same early warning value.
2. Jamie is a 34-year-old client and is being assessed by the nurse. Client newly taking an ace inhibitor
reports lip swelling. Which teaching point is most important for the nurse to reinforce?
A. HIT is an immune complication associated with thrombosis risk
B. angioedema can threaten the airway and requires urgent action
C. ethambutol can cause optic toxicity and several TB drugs can affect the liver
D. loss of reflexes and respiratory depression suggest magnesium toxicity
Correct Answer: B. angioedema can threaten the airway and requires urgent action
Rationale: The key teaching is that angioedema can threaten the airway and requires urgent action. This instruction
targets the preventable risk central to ACE inhibitor safety and supports safe self-management.
3. During a medication pass, a 55-year-old client has the following concern: change-of-shift report for a client
with a recent clinical deterioration. Which nursing action would require correction?
A. assess the client, obtain needed care, notify the provider as indicated, and complete the safety report per policy
B. stop the conversation and move any necessary discussion to a private location
C. assign the sterile dressing change and routine oral medications to the LPN/VN when permitted by jurisdiction and
policy
D. omitting a critical pending laboratory result because it is in the chart
Correct Answer: D. omitting a critical pending laboratory result because it is in the chart
Rationale: Omitting a critical pending laboratory result because it is in the chart would require correction because it
conflicts with continuity of care and could increase risk. The safer approach is to follow the evidence-based action
appropriate to the client's current status.
,4. During a postoperative assessment, the nurse is caring for a 55-year-old client. Client prescribed an maoi
asks about diet. Which teaching point is most important for the nurse to reinforce?
A. digoxin toxicity is more likely with renal impairment and electrolyte disturbance
B. prolonged corticosteroid therapy suppresses the hypothalamic-pituitary-adrenal axis
C. aminoglycosides can cause ototoxicity and nephrotoxicity
D. MAO inhibition can produce dangerous reactions with tyramine and interacting drugs
Correct Answer: D. MAO inhibition can produce dangerous reactions with tyramine and interacting drugs
Rationale: The key teaching is that MAO inhibition can produce dangerous reactions with tyramine and interacting
drugs. This instruction targets the preventable risk central to MAOI interactions and supports safe self-management.
5. The nurse reviews the situation of a 55-year-old client: unit identifies an increase in central-line infections.
Which nursing action would require correction?
A. disciplining individual staff before examining system factors
B. communicate current status, recent changes, pending tests, and time-sensitive concerns using a structured handoff
C. respect the refusal, assess understanding, notify the provider, and document the decision
D. withhold the unsafe action and use the chain of command to resolve the concern
Correct Answer: A. disciplining individual staff before examining system factors
Rationale: Disciplining individual staff before examining system factors would require correction because it conflicts
with systems thinking and outcome measurement and could increase risk. The safer approach is to follow the
evidence-based action appropriate to the client's current status.
6. During morning rounds, the nurse is caring for a 41-year-old client. Client receiving an aminoglycoside
reports tinnitus. Which finding best indicates that the plan of care is effective?
A. drug-related toxicity is recognized early
B. exposure stops and the reaction is treated promptly
C. toxicity is reversed before respiratory arrest
D. serotonergic toxicity is treated promptly
Correct Answer: A. drug-related toxicity is recognized early
Rationale: An effective plan should produce this result: drug-related toxicity is recognized early. That outcome directly
demonstrates improvement in the problem targeted by aminoglycoside safety.
,7. In an urgent care area, a 48-year-old client has the following concern: disaster triage with limited
resources and multiple victims. Which principle best explains the nurse's clinical decision-making in this
situation?
A. scope of practice and client stability
B. continuity of care
C. occupational safety and assignment
D. disaster ethics and triage
Correct Answer: D. disaster ethics and triage
Rationale: The central principle is disaster ethics and triage. It links the client cues to the safest nursing response and
helps distinguish the best option from alternatives that may be reasonable in other contexts.
8. Casey is a 74-year-old client and is being assessed by the nurse. Client starting levothyroxine asks when to
take it. Which finding best indicates that the plan of care is effective?
A. toxicity is recognized before serious dysrhythmia occurs
B. ventilation improves and sedation decreases
C. eligible clients receive therapy with bleeding risk minimized
D. thyroid replacement reaches a stable therapeutic effect
Correct Answer: D. thyroid replacement reaches a stable therapeutic effect
Rationale: An effective plan should produce this result: thyroid replacement reaches a stable therapeutic effect. That
outcome directly demonstrates improvement in the problem targeted by thyroid replacement.
9. During an interdisciplinary care conference, the nurse is caring for a 48-year-old client. Multiple clients
requiring attention, including one with new inspiratory stridor. Which principle best explains the nurse's
clinical decision-making in this situation?
A. disaster ethics and triage
B. legal documentation
C. occupational safety and assignment
D. ABCs and acute change
Correct Answer: D. ABCs and acute change
Rationale: The central principle is ABCs and acute change. It links the client cues to the safest nursing response and
helps distinguish the best option from alternatives that may be reasonable in other contexts.
, 10. The nurse reviews the situation of a 68-year-old client: client with type 1 diabetes has glucose 520 mg/dL,
dehydration, abdominal pain, and deep rapid respirations. Which assessment data should the nurse monitor
most closely to evaluate safety and response to care?
A. work of breathing, oxygenation, mental status, and response to therapy
B. glucose, potassium, anion gap, hydration, and neurologic status
C. osmolality, sodium, glucose, potassium, hemodynamics, and mental status
D. airway, blood pressure, oxygenation, and recurrence
Correct Answer: B. glucose, potassium, anion gap, hydration, and neurologic status
Rationale: The most relevant monitoring is glucose, potassium, anion gap, hydration, and neurologic status because it
directly tracks the risks and expected response associated with diabetic ketoacidosis. Monitoring unrelated systems would
not provide the same early warning value.
11. During a telephone triage call, a 24-year-old client has the following concern: staff member discussing a
client in a public elevator. What should the nurse do next?
A. follow facility radiation-safety policy and avoid assignments that exceed permitted exposure
B. assess and intervene for the client with stridor first
C. stop the conversation and move any necessary discussion to a private location
D. use a structured quality-improvement process to review adherence, identify causes, implement changes, and track
outcomes
Correct Answer: C. stop the conversation and move any necessary discussion to a private location
Rationale: The next step is to stop the conversation and move any necessary discussion to a private location. This action
follows the priorities implied by privacy and minimum necessary disclosure and addresses the most time-sensitive risk
before lower-priority interventions.
12. The nurse reviews the situation of a 62-year-old client: provider prescribes IV potassium for severe
hypokalemia. Which principle best explains the nurse's clinical decision-making in this situation?
A. transfusion reaction
B. electrolyte replacement
C. heparin complications
D. serotonin syndrome
Correct Answer: B. electrolyte replacement
Rationale: The central principle is electrolyte replacement. It links the client cues to the safest nursing response and
helps distinguish the best option from alternatives that may be reasonable in other contexts.
