Recommended PN ATI Comprehensive Predictor
2026 Exit Exam Level 3 with Forms A, B and C,
NGN 180 Questions and Answers for Final Exit
Preparation
1. A nurse is caring for a client who has heart failure and is prescribed
furosemide. Which of the following findings indicates a therapeutic effect of
the medication?
o A. Heart rate of 110/min
o B. Bilateral crackles in the lungs
o C. Weight loss of 1 kg (2.2 lb) in 24 hours
o D. Serum potassium level of 3.2 mEq/L
o Rationale: Furosemide is a loop diuretic used to treat fluid
overload in heart failure. A therapeutic effect is the excretion of
excess fluid, which is manifested by weight loss. Tachycardia, crackles,
and hypokalemia are signs of worsening heart failure or an adverse
effect of the medication.
2. A client is admitted with an acute myocardial infarction (MI). The nurse
should identify that which of the following is a priority nursing action?
o A. Obtain a 12-lead ECG
o B. Administer a PRN dose of morphine
o C. Assess the client's pain level and characteristics
o D. Prepare the client for a coronary artery bypass graft (CABG)
o Rationale: The priority action is always to assess the client first.
While obtaining an ECG and administering medication are critical, a
focused assessment of the client's pain (the hallmark symptom of an
, MI) provides immediate data to guide interventions. This assessment
is the first step in the nursing process.
3. A nurse is teaching a client who is scheduled for a cardiac catheterization.
Which of the following instructions should the nurse include?
o A. "You will need to be NPO for 24 hours before the procedure."
o B. "You will be awake and will feel a warm sensation when the dye is
injected."
o C. "You will need to keep your affected leg straight for several
hours after the procedure."
o D. "You can resume your normal activities immediately after the
procedure."
o Rationale: After a cardiac catheterization, the client must keep
the affected extremity straight to prevent bleeding from the arterial
puncture site. The NPO period is typically 6-8 hours, not 24. A warm
sensation is expected, but this is not a post-procedure instruction.
Activity is restricted for several hours.
4. A client with atrial fibrillation is prescribed warfarin. Which of the following
laboratory values should the nurse monitor to evaluate the effectiveness of
the therapy?
o A. aPTT
o B. Platelet count
o C. INR
o D. Hemoglobin
o Rationale: Warfarin is an anticoagulant that inhibits vitamin K-
dependent clotting factors. The International Normalized Ratio (INR)
is the standard laboratory test used to monitor its therapeutic effect
and adjust the dosage. aPTT is used to monitor heparin therapy.
,5. A nurse is assessing a client who has a new diagnosis of hypertension.
Which of the following findings should the nurse expect?
o A. Often asymptomatic
o B. Frequent headaches
o C. Peripheral edema
o D. Jugular vein distention
o Rationale: Hypertension is often called the "silent killer" because
it is frequently asymptomatic until it has caused significant damage to
target organs. While some clients may experience headaches, it is not
a consistent finding. Edema and JVD are signs of heart failure, which
can be a consequence of long-standing hypertension, but not the
primary finding of the diagnosis itself.
6. A nurse is caring for a client who has been prescribed atorvastatin. Which of
the following instructions should the nurse include in the teaching?
o A. "Take this medication in the morning with breakfast."
o B. "Report any unexplained muscle pain or weakness."
o C. "Avoid drinking grapefruit juice."
o D. "Increase your intake of green, leafy vegetables."
o Rationale: Atorvastatin is a statin used to lower cholesterol. A
rare but serious adverse effect is myopathy/rhabdomyolysis, which
presents as unexplained muscle pain, tenderness, or weakness. The
client should report this immediately. Grapefruit juice interacts with
certain statins but is a secondary concern. Taking it in the evening is
often recommended. Increasing leafy greens is important for clients
on warfarin, not statins.
7. A client is experiencing an acute episode of angina. Which of the following
actions should the nurse take first?
, o A. Administer sublingual nitroglycerin.
o B. Stop the client's activity and have them rest.
o C. Obtain a 12-lead ECG.
o D. Assess the client's blood pressure.
o Rationale: The first action for angina is to decrease myocardial
oxygen demand. Resting immediately decreases the heart's
workload. Administering nitroglycerin is the next step if rest does not
relieve the pain. Assessment (BP, ECG) follows.
8. A nurse is monitoring a client who is receiving a continuous IV infusion of
heparin. Which of the following findings indicates a potential complication
of the therapy?
o A. INR of 2.5
o B. Platelet count of 100,000/mm3
o C. aPTT of 60 seconds
o D. Hematocrit of 45%
o Rationale: Heparin-induced thrombocytopenia (HIT) is a serious
complication of heparin therapy. A falling platelet count (below
150,000/mm3) is a key indicator. The nurse should report this
immediately. An aPTT of 60 seconds may be within the therapeutic
range, depending on the facility's protocol. INR is not used to monitor
heparin.
9. A nurse is providing discharge teaching to a client who had a permanent
pacemaker inserted. Which of the following statements by the client
indicates an understanding of the teaching?
o A. "I should avoid using a microwave oven."
o B. "I will need to take a daily diuretic."
2026 Exit Exam Level 3 with Forms A, B and C,
NGN 180 Questions and Answers for Final Exit
Preparation
1. A nurse is caring for a client who has heart failure and is prescribed
furosemide. Which of the following findings indicates a therapeutic effect of
the medication?
o A. Heart rate of 110/min
o B. Bilateral crackles in the lungs
o C. Weight loss of 1 kg (2.2 lb) in 24 hours
o D. Serum potassium level of 3.2 mEq/L
o Rationale: Furosemide is a loop diuretic used to treat fluid
overload in heart failure. A therapeutic effect is the excretion of
excess fluid, which is manifested by weight loss. Tachycardia, crackles,
and hypokalemia are signs of worsening heart failure or an adverse
effect of the medication.
2. A client is admitted with an acute myocardial infarction (MI). The nurse
should identify that which of the following is a priority nursing action?
o A. Obtain a 12-lead ECG
o B. Administer a PRN dose of morphine
o C. Assess the client's pain level and characteristics
o D. Prepare the client for a coronary artery bypass graft (CABG)
o Rationale: The priority action is always to assess the client first.
While obtaining an ECG and administering medication are critical, a
focused assessment of the client's pain (the hallmark symptom of an
, MI) provides immediate data to guide interventions. This assessment
is the first step in the nursing process.
3. A nurse is teaching a client who is scheduled for a cardiac catheterization.
Which of the following instructions should the nurse include?
o A. "You will need to be NPO for 24 hours before the procedure."
o B. "You will be awake and will feel a warm sensation when the dye is
injected."
o C. "You will need to keep your affected leg straight for several
hours after the procedure."
o D. "You can resume your normal activities immediately after the
procedure."
o Rationale: After a cardiac catheterization, the client must keep
the affected extremity straight to prevent bleeding from the arterial
puncture site. The NPO period is typically 6-8 hours, not 24. A warm
sensation is expected, but this is not a post-procedure instruction.
Activity is restricted for several hours.
4. A client with atrial fibrillation is prescribed warfarin. Which of the following
laboratory values should the nurse monitor to evaluate the effectiveness of
the therapy?
o A. aPTT
o B. Platelet count
o C. INR
o D. Hemoglobin
o Rationale: Warfarin is an anticoagulant that inhibits vitamin K-
dependent clotting factors. The International Normalized Ratio (INR)
is the standard laboratory test used to monitor its therapeutic effect
and adjust the dosage. aPTT is used to monitor heparin therapy.
,5. A nurse is assessing a client who has a new diagnosis of hypertension.
Which of the following findings should the nurse expect?
o A. Often asymptomatic
o B. Frequent headaches
o C. Peripheral edema
o D. Jugular vein distention
o Rationale: Hypertension is often called the "silent killer" because
it is frequently asymptomatic until it has caused significant damage to
target organs. While some clients may experience headaches, it is not
a consistent finding. Edema and JVD are signs of heart failure, which
can be a consequence of long-standing hypertension, but not the
primary finding of the diagnosis itself.
6. A nurse is caring for a client who has been prescribed atorvastatin. Which of
the following instructions should the nurse include in the teaching?
o A. "Take this medication in the morning with breakfast."
o B. "Report any unexplained muscle pain or weakness."
o C. "Avoid drinking grapefruit juice."
o D. "Increase your intake of green, leafy vegetables."
o Rationale: Atorvastatin is a statin used to lower cholesterol. A
rare but serious adverse effect is myopathy/rhabdomyolysis, which
presents as unexplained muscle pain, tenderness, or weakness. The
client should report this immediately. Grapefruit juice interacts with
certain statins but is a secondary concern. Taking it in the evening is
often recommended. Increasing leafy greens is important for clients
on warfarin, not statins.
7. A client is experiencing an acute episode of angina. Which of the following
actions should the nurse take first?
, o A. Administer sublingual nitroglycerin.
o B. Stop the client's activity and have them rest.
o C. Obtain a 12-lead ECG.
o D. Assess the client's blood pressure.
o Rationale: The first action for angina is to decrease myocardial
oxygen demand. Resting immediately decreases the heart's
workload. Administering nitroglycerin is the next step if rest does not
relieve the pain. Assessment (BP, ECG) follows.
8. A nurse is monitoring a client who is receiving a continuous IV infusion of
heparin. Which of the following findings indicates a potential complication
of the therapy?
o A. INR of 2.5
o B. Platelet count of 100,000/mm3
o C. aPTT of 60 seconds
o D. Hematocrit of 45%
o Rationale: Heparin-induced thrombocytopenia (HIT) is a serious
complication of heparin therapy. A falling platelet count (below
150,000/mm3) is a key indicator. The nurse should report this
immediately. An aPTT of 60 seconds may be within the therapeutic
range, depending on the facility's protocol. INR is not used to monitor
heparin.
9. A nurse is providing discharge teaching to a client who had a permanent
pacemaker inserted. Which of the following statements by the client
indicates an understanding of the teaching?
o A. "I should avoid using a microwave oven."
o B. "I will need to take a daily diuretic."
