ATI RN COMPREHENSIVE PREDICTOR NGN-STYLE SET 5
EXAM QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. A client with acute pancreatitis develops increasing tachycardia, hypotension, and rising hematocrit
despite ongoing pain control. What should the nurse suspect? 124/min HR 88/54 mm Hg BP Rising from
42% to 51% Hematocrit
A. Worsening intravascular volume depletion and severe pancreatitis
B. Simple anxiety only
C. Excess fluid volume
D. Resolution of inflammation
Correct Answer: A. Worsening intravascular volume depletion and severe pancreatitis
Rationale: Third spacing in severe pancreatitis can cause hemoconcentration and hypovolemic shock; rising
hematocrit with hypotension is concerning.
2. While preparing care for a high-risk client, a client with a tracheostomy has thick secretions and
suddenly becomes distressed with minimal airflow. What should the nurse do first?
A. Offer oral fluids before assessing the airway
B. Assess tracheostomy patency and suction the airway as indicated while providing oxygenation support
C. Remove the tracheostomy ties and leave the tube unsecured
D. Delay intervention until the respiratory therapist arrives
Correct Answer: B. Assess tracheostomy patency and suction the airway as indicated while providing
oxygenation support
Rationale: Acute distress with poor airflow suggests airway obstruction; immediate patency assessment and
suctioning may be lifesaving.
3. During focused reassessment, a client with wound dehiscence/evisceration presents with surgical wound
opens with visible tissue or organs. Which data should be trended most closely?
A. neurologic examination and ICP when monitored
B. CBC with differential and marrow evaluation
C. wound and vital assessment
D. cortisol testing and metabolic monitoring
Correct Answer: C. wound and vital assessment
Rationale: Priority monitoring for wound dehiscence/evisceration includes wound and vital assessment.
4. At a chronic-care clinic visit, which client factor creates the greatest concern before therapy with
hydrochlorothiazide?
A. Parkinson disease or severe QT risk caution
B. pregnancy
C. anuria
D. hypersensitivity to product components
Correct Answer: C. anuria
Rationale: hydrochlorothiazide requires particular caution or avoidance with anuria.
5. During a mental-health nursing interaction, which assessment finding most strongly supports panic
attack?
A. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe
B. a report that voices are telling the client to harm someone
C. injuries with fearful behavior and a partner who controls the conversation or access to care
D. tremor, autonomic hyperactivity, insomnia, agitation, hallucinations, or seizures after reducing heavy alcohol
use
Correct Answer: A. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending
catastrophe
Rationale: sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe is
characteristic of panic attack.
6. At a community health appointment, a pregnant client at 30 weeks asks how fetal movement should be
monitored. Which teaching is appropriate?
A. Fetal movement should stop during the third trimester
,B. Learn the fetus's usual movement pattern and report a marked decrease promptly
C. Count only movements that cause pain
D. Reduced movement is expected for several days at a time
Correct Answer: B. Learn the fetus's usual movement pattern and report a marked decrease promptly
Rationale: A significant decrease from the fetus's usual movement pattern can signal compromise and should be
evaluated.
7. While planning comfort-focused bedside care, a client is experiencing constipation prevention. Which
assessment finding is most consistent with this care need?
A. air hunger in a client receiving comfort-focused end-of-life care
B. dry oral mucosa with inability to perform self-care
C. difficulty repositioning with intact cognition and stable cardiopulmonary status
D. hard infrequent stools with straining and no signs of acute obstruction
Correct Answer: D. hard infrequent stools with straining and no signs of acute obstruction
Rationale: hard infrequent stools with straining and no signs of acute obstruction is a common cue when caring
for constipation prevention.
8. At shift change, a client with heart failure is readmitted twice because medications could not be
purchased. Which referral is most useful before discharge?
A. Radiology scheduling
B. Case management or social work for medication-access resources
C. Hospital security
D. Operating-room education
Correct Answer: B. Case management or social work for medication-access resources
Rationale: Care coordination should address the barrier causing readmission; case management/social work can
connect the client with financial and medication resources.
9. While assessing coping and safety, which nurse response is most therapeutic for a client experiencing
acute mania?
A. Use brief, calm, concrete statements and redirect without arguing about grandiose ideas
B. Say, "You do not deserve to be hurt. Help is available, and you can decide what feels safest."
C. After stabilization, use nonjudgmental language and offer overdose-prevention and treatment resources
D. Say, "Tell me what you miss most about your spouse," and allow silence
Correct Answer: A. Use brief, calm, concrete statements and redirect without arguing about grandiose ideas
Rationale: Mania impairs judgment and attention; structure, reduced stimulation, nutrition, and clear limits
support safety.
10. During rapid-response evaluation, a client’s presentation is consistent with Cushing syndrome. What is
the nurse’s best next action?
A. cover with sterile saline-moistened dressings and notify surgeon; do not reinsert organs
B. identify source and reduce excess glucocorticoid exposure safely
C. maintain oxygenation and head alignment/elevation while treating cause
D. protect from bleeding/infection and treat cause
Correct Answer: B. identify source and reduce excess glucocorticoid exposure safely
Rationale: For Cushing syndrome, the priority response is to identify source and reduce excess glucocorticoid
exposure safely.
11. While reviewing infection-prevention practices, a nurse is preparing a medication labeled 1 mg/mL for
a prescribed dose of 0.1 mg. Which action best prevents a decimal error?
A. Write the dose as .1 mg
B. Write the dose as 0.10 mg
C. Write the dose as 1.0 mg
D. Write and verify the dose as 0.1 mg with a leading zero and no trailing zero
Correct Answer: D. Write and verify the dose as 0.1 mg with a leading zero and no trailing zero
Rationale: A leading zero is used for doses less than one; trailing zeros are avoided because both practices reduce
tenfold medication errors.
12. On a medical-surgical unit, a client with Crohn disease flare has the expected presentation of
abdominal pain, diarrhea, weight loss, and transmural inflammation. Which worsening development
should the nurse anticipate as a major complication?
, A. infection and organ injury
B. herniation
C. fistula, stricture, abscess
D. sepsis or hemorrhage
Correct Answer: C. fistula, stricture, abscess
Rationale: A major complication of Crohn disease flare is fistula, stricture, abscess.
13. While reconciling medications after a care transition, a client asks how epoetin alfa works. Which
explanation by the nurse is most accurate?
A. blocks dopamine D2 receptors
B. reduces angiotensin II formation
C. stimulates neutrophil production
D. stimulates erythroid progenitor cells
Correct Answer: D. stimulates erythroid progenitor cells
Rationale: epoetin alfa works primarily because it stimulates erythroid progenitor cells.
14. A client 2 days after total hip arthroplasty develops sudden dyspnea, HR 128/min, and pleuritic chest
pain. Which complication should the nurse suspect? 2 Post-op day Sudden dyspnea; HR 128/min; pleuritic
chest pain New findings
A. Postoperative constipation
B. Pulmonary embolism
C. Urinary retention
D. Incisional infection only
Correct Answer: B. Pulmonary embolism
Rationale: Sudden dyspnea, tachycardia, and pleuritic pain after major orthopedic surgery strongly suggest
pulmonary embolism.
15. During anticipatory-guidance teaching, a 42-year-old average-risk client asks about breast cancer
screening. Which guidance reflects current U.S. preventive recommendations?
A. Wait until age 50 for all clients
B. Obtain annual breast MRI instead of mammography
C. Stop all screening after age 45
D. Begin screening mammography every 2 years from age 40 through 74
Correct Answer: D. Begin screening mammography every 2 years from age 40 through 74
Rationale: Current USPSTF guidance recommends biennial mammography for average-risk women ages 40
through
74.
16. While supporting the client’s psychosocial needs, which nurse response is most therapeutic for a client
experiencing panic attack?
A. Say, "Tell me what you miss most about your spouse," and allow silence
B. Say, "You do not deserve to be hurt. Help is available, and you can decide what feels safest."
C. Say, "I will stay with you. Focus on one slow breath at a time."
D. Ask directly about suicidal thoughts, plan, intent, and access to means without judgment
Correct Answer: C. Say, "I will stay with you. Focus on one slow breath at a time."
Rationale: During panic, the client may be unable to process complex information; calm presence and simple
guidance reduce escalation.
17. While managing care on a busy unit, a nurse is coordinating care for a client with recurrent asthma
exacerbations caused by inability to obtain inhalers. Which action is most useful?
A. Repeat inhaler teaching without addressing access
B. Tell the client to use a family member's inhaler
C. Connect the client with medication-assistance, insurance, pharmacy, or community resources and confirm
access before discharge
D. Remove controller therapy from the plan
Correct Answer: C. Connect the client with medication-assistance, insurance, pharmacy, or community
resources and confirm access before discharge
Rationale: Addressing medication access is essential for effective chronic-disease management and prevention of
avoidable readmission.
EXAM QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. A client with acute pancreatitis develops increasing tachycardia, hypotension, and rising hematocrit
despite ongoing pain control. What should the nurse suspect? 124/min HR 88/54 mm Hg BP Rising from
42% to 51% Hematocrit
A. Worsening intravascular volume depletion and severe pancreatitis
B. Simple anxiety only
C. Excess fluid volume
D. Resolution of inflammation
Correct Answer: A. Worsening intravascular volume depletion and severe pancreatitis
Rationale: Third spacing in severe pancreatitis can cause hemoconcentration and hypovolemic shock; rising
hematocrit with hypotension is concerning.
2. While preparing care for a high-risk client, a client with a tracheostomy has thick secretions and
suddenly becomes distressed with minimal airflow. What should the nurse do first?
A. Offer oral fluids before assessing the airway
B. Assess tracheostomy patency and suction the airway as indicated while providing oxygenation support
C. Remove the tracheostomy ties and leave the tube unsecured
D. Delay intervention until the respiratory therapist arrives
Correct Answer: B. Assess tracheostomy patency and suction the airway as indicated while providing
oxygenation support
Rationale: Acute distress with poor airflow suggests airway obstruction; immediate patency assessment and
suctioning may be lifesaving.
3. During focused reassessment, a client with wound dehiscence/evisceration presents with surgical wound
opens with visible tissue or organs. Which data should be trended most closely?
A. neurologic examination and ICP when monitored
B. CBC with differential and marrow evaluation
C. wound and vital assessment
D. cortisol testing and metabolic monitoring
Correct Answer: C. wound and vital assessment
Rationale: Priority monitoring for wound dehiscence/evisceration includes wound and vital assessment.
4. At a chronic-care clinic visit, which client factor creates the greatest concern before therapy with
hydrochlorothiazide?
A. Parkinson disease or severe QT risk caution
B. pregnancy
C. anuria
D. hypersensitivity to product components
Correct Answer: C. anuria
Rationale: hydrochlorothiazide requires particular caution or avoidance with anuria.
5. During a mental-health nursing interaction, which assessment finding most strongly supports panic
attack?
A. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe
B. a report that voices are telling the client to harm someone
C. injuries with fearful behavior and a partner who controls the conversation or access to care
D. tremor, autonomic hyperactivity, insomnia, agitation, hallucinations, or seizures after reducing heavy alcohol
use
Correct Answer: A. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending
catastrophe
Rationale: sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe is
characteristic of panic attack.
6. At a community health appointment, a pregnant client at 30 weeks asks how fetal movement should be
monitored. Which teaching is appropriate?
A. Fetal movement should stop during the third trimester
,B. Learn the fetus's usual movement pattern and report a marked decrease promptly
C. Count only movements that cause pain
D. Reduced movement is expected for several days at a time
Correct Answer: B. Learn the fetus's usual movement pattern and report a marked decrease promptly
Rationale: A significant decrease from the fetus's usual movement pattern can signal compromise and should be
evaluated.
7. While planning comfort-focused bedside care, a client is experiencing constipation prevention. Which
assessment finding is most consistent with this care need?
A. air hunger in a client receiving comfort-focused end-of-life care
B. dry oral mucosa with inability to perform self-care
C. difficulty repositioning with intact cognition and stable cardiopulmonary status
D. hard infrequent stools with straining and no signs of acute obstruction
Correct Answer: D. hard infrequent stools with straining and no signs of acute obstruction
Rationale: hard infrequent stools with straining and no signs of acute obstruction is a common cue when caring
for constipation prevention.
8. At shift change, a client with heart failure is readmitted twice because medications could not be
purchased. Which referral is most useful before discharge?
A. Radiology scheduling
B. Case management or social work for medication-access resources
C. Hospital security
D. Operating-room education
Correct Answer: B. Case management or social work for medication-access resources
Rationale: Care coordination should address the barrier causing readmission; case management/social work can
connect the client with financial and medication resources.
9. While assessing coping and safety, which nurse response is most therapeutic for a client experiencing
acute mania?
A. Use brief, calm, concrete statements and redirect without arguing about grandiose ideas
B. Say, "You do not deserve to be hurt. Help is available, and you can decide what feels safest."
C. After stabilization, use nonjudgmental language and offer overdose-prevention and treatment resources
D. Say, "Tell me what you miss most about your spouse," and allow silence
Correct Answer: A. Use brief, calm, concrete statements and redirect without arguing about grandiose ideas
Rationale: Mania impairs judgment and attention; structure, reduced stimulation, nutrition, and clear limits
support safety.
10. During rapid-response evaluation, a client’s presentation is consistent with Cushing syndrome. What is
the nurse’s best next action?
A. cover with sterile saline-moistened dressings and notify surgeon; do not reinsert organs
B. identify source and reduce excess glucocorticoid exposure safely
C. maintain oxygenation and head alignment/elevation while treating cause
D. protect from bleeding/infection and treat cause
Correct Answer: B. identify source and reduce excess glucocorticoid exposure safely
Rationale: For Cushing syndrome, the priority response is to identify source and reduce excess glucocorticoid
exposure safely.
11. While reviewing infection-prevention practices, a nurse is preparing a medication labeled 1 mg/mL for
a prescribed dose of 0.1 mg. Which action best prevents a decimal error?
A. Write the dose as .1 mg
B. Write the dose as 0.10 mg
C. Write the dose as 1.0 mg
D. Write and verify the dose as 0.1 mg with a leading zero and no trailing zero
Correct Answer: D. Write and verify the dose as 0.1 mg with a leading zero and no trailing zero
Rationale: A leading zero is used for doses less than one; trailing zeros are avoided because both practices reduce
tenfold medication errors.
12. On a medical-surgical unit, a client with Crohn disease flare has the expected presentation of
abdominal pain, diarrhea, weight loss, and transmural inflammation. Which worsening development
should the nurse anticipate as a major complication?
, A. infection and organ injury
B. herniation
C. fistula, stricture, abscess
D. sepsis or hemorrhage
Correct Answer: C. fistula, stricture, abscess
Rationale: A major complication of Crohn disease flare is fistula, stricture, abscess.
13. While reconciling medications after a care transition, a client asks how epoetin alfa works. Which
explanation by the nurse is most accurate?
A. blocks dopamine D2 receptors
B. reduces angiotensin II formation
C. stimulates neutrophil production
D. stimulates erythroid progenitor cells
Correct Answer: D. stimulates erythroid progenitor cells
Rationale: epoetin alfa works primarily because it stimulates erythroid progenitor cells.
14. A client 2 days after total hip arthroplasty develops sudden dyspnea, HR 128/min, and pleuritic chest
pain. Which complication should the nurse suspect? 2 Post-op day Sudden dyspnea; HR 128/min; pleuritic
chest pain New findings
A. Postoperative constipation
B. Pulmonary embolism
C. Urinary retention
D. Incisional infection only
Correct Answer: B. Pulmonary embolism
Rationale: Sudden dyspnea, tachycardia, and pleuritic pain after major orthopedic surgery strongly suggest
pulmonary embolism.
15. During anticipatory-guidance teaching, a 42-year-old average-risk client asks about breast cancer
screening. Which guidance reflects current U.S. preventive recommendations?
A. Wait until age 50 for all clients
B. Obtain annual breast MRI instead of mammography
C. Stop all screening after age 45
D. Begin screening mammography every 2 years from age 40 through 74
Correct Answer: D. Begin screening mammography every 2 years from age 40 through 74
Rationale: Current USPSTF guidance recommends biennial mammography for average-risk women ages 40
through
74.
16. While supporting the client’s psychosocial needs, which nurse response is most therapeutic for a client
experiencing panic attack?
A. Say, "Tell me what you miss most about your spouse," and allow silence
B. Say, "You do not deserve to be hurt. Help is available, and you can decide what feels safest."
C. Say, "I will stay with you. Focus on one slow breath at a time."
D. Ask directly about suicidal thoughts, plan, intent, and access to means without judgment
Correct Answer: C. Say, "I will stay with you. Focus on one slow breath at a time."
Rationale: During panic, the client may be unable to process complex information; calm presence and simple
guidance reduce escalation.
17. While managing care on a busy unit, a nurse is coordinating care for a client with recurrent asthma
exacerbations caused by inability to obtain inhalers. Which action is most useful?
A. Repeat inhaler teaching without addressing access
B. Tell the client to use a family member's inhaler
C. Connect the client with medication-assistance, insurance, pharmacy, or community resources and confirm
access before discharge
D. Remove controller therapy from the plan
Correct Answer: C. Connect the client with medication-assistance, insurance, pharmacy, or community
resources and confirm access before discharge
Rationale: Addressing medication access is essential for effective chronic-disease management and prevention of
avoidable readmission.
