ATI RN COMPREHENSIVE PREDICTOR NGN-STYLE SET 2
EXAM QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. A client with a chest tube for pneumothorax suddenly becomes dyspneic. The tubing is kinked under the
bedrail and there is no tidaling in the water-seal chamber. What should the nurse do first? Sudden dyspnea
New symptom Tubing kinked under bedrail; no tidaling Chest tube
A. Clamp the tube near the chest and leave it clamped
B. Raise the drainage system above chest level
C. Remove the kink and reassess breathing and the drainage system
D. Strip the tube vigorously
Correct Answer: C. Remove the kink and reassess breathing and the drainage system
Rationale: A kink can obstruct air evacuation and recreate pressure in the pleural space; restoring patency is
immediate.
2. During morning coordination rounds, during assignment planning, which activity can the RN safely
delegate for a long-term care resident with stable dysphagia who has an established feeding plan?
A. Position the resident upright and assist with the prescribed meal using the established plan
B. Perform the first swallowing assessment after a new stroke
C. Change the diet consistency after coughing
D. Teach the family new aspiration precautions
Correct Answer: A. Position the resident upright and assist with the prescribed meal using the established plan
Rationale: Routine assistance using an established plan can be delegated for a stable client; new assessment and
plan changes cannot.
3. During bedside safety checks, a nurse is preparing to insert an indwelling urinary catheter. Which action
reduces infection risk?
A. Use aseptic insertion technique and maintain a closed drainage system
B. Disconnect the drainage tubing routinely for urine collection
C. Place the drainage bag on the bed above the bladder
D. Irrigate the catheter daily without a prescription
Correct Answer: A. Use aseptic insertion technique and maintain a closed drainage system
Rationale: Aseptic insertion and a continuously closed drainage system reduce catheter-associated urinary
infection risk.
4. During an adult medical-surgical follow-up, which pharmacologic action best explains the therapeutic
effect of sertraline?
A. inhibits influenza neuraminidase
B. suppresses airway inflammation
C. inhibits serotonin reuptake
D. stimulates pancreatic insulin release
Correct Answer: C. inhibits serotonin reuptake
Rationale: sertraline works primarily because it inhibits serotonin reuptake.
5. During a comfort and mobility assessment, a client is experiencing end-of-life dyspnea. Which
assessment finding is most consistent with this care need?
A. air hunger in a client receiving comfort-focused end-of-life care
B. frequent loose stools with moist erythematous perineal skin
C. frequent nighttime awakening related to noise, pain, and repeated interruptions
D. queasiness and reduced oral intake without abdominal rigidity or hemodynamic instability
Correct Answer: A. air hunger in a client receiving comfort-focused end-of-life care
Rationale: air hunger in a client receiving comfort-focused end-of-life care is a common cue when caring for
end-of-life dyspnea.
6. During a preventive-care visit, a healthy 50-year-old asks about shingles prevention. Which vaccine
teaching is appropriate?
A. The live zoster vaccine is preferred during pregnancy
B. Shingles vaccination is never needed after prior chickenpox
C. Recombinant zoster vaccine is recommended beginning at age 50 for immunocompetent adults
,D. Vaccination is delayed until age 80 in all adults
Correct Answer: C. Recombinant zoster vaccine is recommended beginning at age 50 for immunocompetent
adults
Rationale: Recombinant zoster vaccine is routinely recommended for adults age 50 and older and for certain
immunocompromised adults.
7. During a mental-health nursing interaction, a client is experiencing obsessive-compulsive disorder.
Which nursing action is the priority?
A. avoid abruptly blocking rituals initially; support structured treatment such as exposure and response prevention
B. promote safety, identify triggers, and support evidence-based trauma-focused treatment
C. interview the client privately, assess immediate danger, document objectively, and connect with advocacy
resources according to law/policy
D. identify and treat the underlying cause while providing orientation, sensory aids, sleep support, and safety
measures
Correct Answer: A. avoid abruptly blocking rituals initially; support structured treatment such as exposure and
response prevention
Rationale: OCD symptoms are driven by anxiety; exposure and response prevention is evidence-based, and
arguing about the obsession is usually unhelpful.
8. In the emergency department, which intervention best addresses the acute priorities of a client with
tension pneumothorax?
A. support oxygenation and obtain urgent diagnostic/treatment evaluation
B. exercise, weight management, and analgesia as appropriate
C. NPO, IV fluids, gastric decompression when ordered, surgical evaluation
D. immediate decompression followed by chest tube
Correct Answer: D. immediate decompression followed by chest tube
Rationale: For tension pneumothorax, the priority response is to immediate decompression followed by chest
tube.
9. While reconciling medications after a care transition, before discharge, a client newly prescribed
atorvastatin asks what to remember at home. Which teaching is most important?
A. start promptly when indicated
B. report unexplained muscle pain
C. rinse mouth after use
D. benefit may take several weeks
Correct Answer: B. report unexplained muscle pain
Rationale: Appropriate teaching for atorvastatin includes: report unexplained muscle pain.
10. During an acute-care handoff, a handoff report notes Guillain-Barre syndrome. Which monitoring
focus should the incoming nurse prioritize?
A. sudden dyspnea, pleuritic chest pain, tachycardia, and hypoxemia
B. ascending weakness and areflexia after infection
C. activity-related joint pain and brief morning stiffness
D. crampy pain, vomiting, distention, and high-pitched sounds early
Correct Answer: B. ascending weakness and areflexia after infection
Rationale: Guillain-Barre syndrome is classically associated with ascending weakness and areflexia after
infection.
11. At shift change, which task is best for unlicensed assistive personnel to perform for a client with
diabetes who needs a premeal capillary glucose check and the unit permits trained UAP testing?
A. Obtain the capillary glucose value and report it promptly
B. Select the correction-dose insulin based on the result
C. Teach sick-day rules before discharge
D. Evaluate recurrent morning hypoglycemia
Correct Answer: A. Obtain the capillary glucose value and report it promptly
Rationale: A trained UAP may collect a routine point-of-care measurement when permitted, but the RN
interprets the result and makes clinical decisions.
12. During a therapeutic encounter, which assessment finding most strongly supports opioid overdose?
A. a specific suicide plan with access to the intended means
, B. progressive memory impairment and functional decline without the acute fluctuating course of delirium
C. intense fear of abandonment, unstable relationships, affective instability, and recurrent self-harm behavior
D. marked respiratory depression with decreased consciousness and pinpoint pupils
Correct Answer: D. marked respiratory depression with decreased consciousness and pinpoint pupils
Rationale: marked respiratory depression with decreased consciousness and pinpoint pupils is characteristic of
opioid overdose.
13. At a chronic-care clinic visit, which data should the nurse review regularly to evaluate safe use of
enoxaparin?
A. clinical response
B. symptom control and oral mucosa
C. renal function and bleeding
D. mood, suicidality, and sodium in at-risk patients
Correct Answer: C. renal function and bleeding
Rationale: For enoxaparin, priority monitoring includes renal function and bleeding because it helps identify
therapeutic response or clinically important toxicity.
14. During a focused safety round, a nurse is entering a sterile field and notices the sterile glove touches the
bedrail. What should the nurse do?
A. Continue because only the fingertips matter
B. Replace the contaminated glove before continuing the sterile procedure
C. Wipe the glove with alcohol
D. Ask the client not to look at the glove
Correct Answer: B. Replace the contaminated glove before continuing the sterile procedure
Rationale: Contact with a nonsterile surface contaminates the glove; sterile technique requires replacement
before continuing.
15. During a comfort and mobility assessment, which nursing action best addresses postoperative pain?
A. use multimodal pain control, position for comfort, and reassess response after intervention
B. provide frequent oral care with suction available and position to reduce aspiration risk
C. keep the client upright, follow the prescribed texture/feeding plan, and use swallowing precautions
D. cleanse gently after stools, protect the skin with a moisture barrier, and monitor hydration
Correct Answer: A. use multimodal pain control, position for comfort, and reassess response after intervention
Rationale: Adequate multimodal pain control promotes ventilation, mobility, sleep, and recovery while limiting
unnecessary opioid exposure.
16. At a routine wellness encounter, which behavior is expected in many 9-month-old infants?
A. Reading simple words
B. Skipping on one foot
C. Sitting without support and showing stranger anxiety
D. Using a spoon without spilling consistently
Correct Answer: C. Sitting without support and showing stranger anxiety
Rationale: Independent sitting and stranger anxiety are common around 9 months.
17. During transfer from the emergency department, the nurse receives a client with manifestations of
osteoarthritis. Which management priority is correct?
A. support oxygenation and obtain urgent diagnostic/treatment evaluation
B. NPO, IV fluids, gastric decompression when ordered, surgical evaluation
C. support airway/ventilation and administer IV thyroid hormone as ordered
D. exercise, weight management, and analgesia as appropriate
Correct Answer: D. exercise, weight management, and analgesia as appropriate
Rationale: For osteoarthritis, the priority response is to exercise, weight management, and analgesia as
appropriate.
18. During an interprofessional safety huddle, which task is best for unlicensed assistive personnel to
perform for a client with dementia who eats independently but needs meal setup?
A. Assess a sudden new swallowing difficulty
B. Open containers and arrange the tray according to the care plan
C. Decide whether a speech-language referral is needed
D. Teach the caregiver how to recognize aspiration
EXAM QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. A client with a chest tube for pneumothorax suddenly becomes dyspneic. The tubing is kinked under the
bedrail and there is no tidaling in the water-seal chamber. What should the nurse do first? Sudden dyspnea
New symptom Tubing kinked under bedrail; no tidaling Chest tube
A. Clamp the tube near the chest and leave it clamped
B. Raise the drainage system above chest level
C. Remove the kink and reassess breathing and the drainage system
D. Strip the tube vigorously
Correct Answer: C. Remove the kink and reassess breathing and the drainage system
Rationale: A kink can obstruct air evacuation and recreate pressure in the pleural space; restoring patency is
immediate.
2. During morning coordination rounds, during assignment planning, which activity can the RN safely
delegate for a long-term care resident with stable dysphagia who has an established feeding plan?
A. Position the resident upright and assist with the prescribed meal using the established plan
B. Perform the first swallowing assessment after a new stroke
C. Change the diet consistency after coughing
D. Teach the family new aspiration precautions
Correct Answer: A. Position the resident upright and assist with the prescribed meal using the established plan
Rationale: Routine assistance using an established plan can be delegated for a stable client; new assessment and
plan changes cannot.
3. During bedside safety checks, a nurse is preparing to insert an indwelling urinary catheter. Which action
reduces infection risk?
A. Use aseptic insertion technique and maintain a closed drainage system
B. Disconnect the drainage tubing routinely for urine collection
C. Place the drainage bag on the bed above the bladder
D. Irrigate the catheter daily without a prescription
Correct Answer: A. Use aseptic insertion technique and maintain a closed drainage system
Rationale: Aseptic insertion and a continuously closed drainage system reduce catheter-associated urinary
infection risk.
4. During an adult medical-surgical follow-up, which pharmacologic action best explains the therapeutic
effect of sertraline?
A. inhibits influenza neuraminidase
B. suppresses airway inflammation
C. inhibits serotonin reuptake
D. stimulates pancreatic insulin release
Correct Answer: C. inhibits serotonin reuptake
Rationale: sertraline works primarily because it inhibits serotonin reuptake.
5. During a comfort and mobility assessment, a client is experiencing end-of-life dyspnea. Which
assessment finding is most consistent with this care need?
A. air hunger in a client receiving comfort-focused end-of-life care
B. frequent loose stools with moist erythematous perineal skin
C. frequent nighttime awakening related to noise, pain, and repeated interruptions
D. queasiness and reduced oral intake without abdominal rigidity or hemodynamic instability
Correct Answer: A. air hunger in a client receiving comfort-focused end-of-life care
Rationale: air hunger in a client receiving comfort-focused end-of-life care is a common cue when caring for
end-of-life dyspnea.
6. During a preventive-care visit, a healthy 50-year-old asks about shingles prevention. Which vaccine
teaching is appropriate?
A. The live zoster vaccine is preferred during pregnancy
B. Shingles vaccination is never needed after prior chickenpox
C. Recombinant zoster vaccine is recommended beginning at age 50 for immunocompetent adults
,D. Vaccination is delayed until age 80 in all adults
Correct Answer: C. Recombinant zoster vaccine is recommended beginning at age 50 for immunocompetent
adults
Rationale: Recombinant zoster vaccine is routinely recommended for adults age 50 and older and for certain
immunocompromised adults.
7. During a mental-health nursing interaction, a client is experiencing obsessive-compulsive disorder.
Which nursing action is the priority?
A. avoid abruptly blocking rituals initially; support structured treatment such as exposure and response prevention
B. promote safety, identify triggers, and support evidence-based trauma-focused treatment
C. interview the client privately, assess immediate danger, document objectively, and connect with advocacy
resources according to law/policy
D. identify and treat the underlying cause while providing orientation, sensory aids, sleep support, and safety
measures
Correct Answer: A. avoid abruptly blocking rituals initially; support structured treatment such as exposure and
response prevention
Rationale: OCD symptoms are driven by anxiety; exposure and response prevention is evidence-based, and
arguing about the obsession is usually unhelpful.
8. In the emergency department, which intervention best addresses the acute priorities of a client with
tension pneumothorax?
A. support oxygenation and obtain urgent diagnostic/treatment evaluation
B. exercise, weight management, and analgesia as appropriate
C. NPO, IV fluids, gastric decompression when ordered, surgical evaluation
D. immediate decompression followed by chest tube
Correct Answer: D. immediate decompression followed by chest tube
Rationale: For tension pneumothorax, the priority response is to immediate decompression followed by chest
tube.
9. While reconciling medications after a care transition, before discharge, a client newly prescribed
atorvastatin asks what to remember at home. Which teaching is most important?
A. start promptly when indicated
B. report unexplained muscle pain
C. rinse mouth after use
D. benefit may take several weeks
Correct Answer: B. report unexplained muscle pain
Rationale: Appropriate teaching for atorvastatin includes: report unexplained muscle pain.
10. During an acute-care handoff, a handoff report notes Guillain-Barre syndrome. Which monitoring
focus should the incoming nurse prioritize?
A. sudden dyspnea, pleuritic chest pain, tachycardia, and hypoxemia
B. ascending weakness and areflexia after infection
C. activity-related joint pain and brief morning stiffness
D. crampy pain, vomiting, distention, and high-pitched sounds early
Correct Answer: B. ascending weakness and areflexia after infection
Rationale: Guillain-Barre syndrome is classically associated with ascending weakness and areflexia after
infection.
11. At shift change, which task is best for unlicensed assistive personnel to perform for a client with
diabetes who needs a premeal capillary glucose check and the unit permits trained UAP testing?
A. Obtain the capillary glucose value and report it promptly
B. Select the correction-dose insulin based on the result
C. Teach sick-day rules before discharge
D. Evaluate recurrent morning hypoglycemia
Correct Answer: A. Obtain the capillary glucose value and report it promptly
Rationale: A trained UAP may collect a routine point-of-care measurement when permitted, but the RN
interprets the result and makes clinical decisions.
12. During a therapeutic encounter, which assessment finding most strongly supports opioid overdose?
A. a specific suicide plan with access to the intended means
, B. progressive memory impairment and functional decline without the acute fluctuating course of delirium
C. intense fear of abandonment, unstable relationships, affective instability, and recurrent self-harm behavior
D. marked respiratory depression with decreased consciousness and pinpoint pupils
Correct Answer: D. marked respiratory depression with decreased consciousness and pinpoint pupils
Rationale: marked respiratory depression with decreased consciousness and pinpoint pupils is characteristic of
opioid overdose.
13. At a chronic-care clinic visit, which data should the nurse review regularly to evaluate safe use of
enoxaparin?
A. clinical response
B. symptom control and oral mucosa
C. renal function and bleeding
D. mood, suicidality, and sodium in at-risk patients
Correct Answer: C. renal function and bleeding
Rationale: For enoxaparin, priority monitoring includes renal function and bleeding because it helps identify
therapeutic response or clinically important toxicity.
14. During a focused safety round, a nurse is entering a sterile field and notices the sterile glove touches the
bedrail. What should the nurse do?
A. Continue because only the fingertips matter
B. Replace the contaminated glove before continuing the sterile procedure
C. Wipe the glove with alcohol
D. Ask the client not to look at the glove
Correct Answer: B. Replace the contaminated glove before continuing the sterile procedure
Rationale: Contact with a nonsterile surface contaminates the glove; sterile technique requires replacement
before continuing.
15. During a comfort and mobility assessment, which nursing action best addresses postoperative pain?
A. use multimodal pain control, position for comfort, and reassess response after intervention
B. provide frequent oral care with suction available and position to reduce aspiration risk
C. keep the client upright, follow the prescribed texture/feeding plan, and use swallowing precautions
D. cleanse gently after stools, protect the skin with a moisture barrier, and monitor hydration
Correct Answer: A. use multimodal pain control, position for comfort, and reassess response after intervention
Rationale: Adequate multimodal pain control promotes ventilation, mobility, sleep, and recovery while limiting
unnecessary opioid exposure.
16. At a routine wellness encounter, which behavior is expected in many 9-month-old infants?
A. Reading simple words
B. Skipping on one foot
C. Sitting without support and showing stranger anxiety
D. Using a spoon without spilling consistently
Correct Answer: C. Sitting without support and showing stranger anxiety
Rationale: Independent sitting and stranger anxiety are common around 9 months.
17. During transfer from the emergency department, the nurse receives a client with manifestations of
osteoarthritis. Which management priority is correct?
A. support oxygenation and obtain urgent diagnostic/treatment evaluation
B. NPO, IV fluids, gastric decompression when ordered, surgical evaluation
C. support airway/ventilation and administer IV thyroid hormone as ordered
D. exercise, weight management, and analgesia as appropriate
Correct Answer: D. exercise, weight management, and analgesia as appropriate
Rationale: For osteoarthritis, the priority response is to exercise, weight management, and analgesia as
appropriate.
18. During an interprofessional safety huddle, which task is best for unlicensed assistive personnel to
perform for a client with dementia who eats independently but needs meal setup?
A. Assess a sudden new swallowing difficulty
B. Open containers and arrange the tray according to the care plan
C. Decide whether a speech-language referral is needed
D. Teach the caregiver how to recognize aspiration
