,ATI PN Comprehensive Online Practice A | NGN Questions &
Case Scenarios (Updated PDF)
1. A PN is caring for four clients. Which client should the PN assess first?
A) Client with a blood glucose of 180 mg/dL
B) Client with new-onset confusion and oxygen saturation 88% on room air
C) Client with a fractured leg requesting pain medication
D) Client with a urinary catheter needing output measurement
Answer: B
Rationale: Hypoxemia with confusion indicates an immediate airway/breathing threat; assess first.
2. A PN is preparing to insert a urinary catheter. Which action is most important to prevent
infection?
A) Use clean gloves for insertion
B) Use sterile technique throughout
C) Lubricate with petroleum jelly
D) Clean the meatus back-to-front
Answer: B
Rationale: Sterile technique prevents catheter-associated urinary tract infection (CAUTI).
3. A client with a new colostomy has a purple, dry stoma. What should the PN do first?
A) Document as expected
B) Notify the surgeon immediately
C) Apply a warm compress
D) Reassure the client
Answer: B
Rationale: Purple/black stoma indicates ischemia or necrosis; immediate evaluation needed.
2
,4. A PN is delegating to a UAP. Which task is appropriate?
A) Assess a client’s pain level
B) Measure and record intake and output
C) Administer a tube feeding
D) Change a sterile dressing
Answer: B
Rationale: I&O measurement is within UAP scope; assessment and sterile procedures are not.
5. A client with major depressive disorder says, “I’m worthless.” Which response is most
therapeutic?
A) “You shouldn’t feel that way.”
B) “It sounds like you’re feeling really down about yourself.”
C) “Let’s list your accomplishments.”
D) “Why do you feel worthless?”
Answer: B
Rationale: Reflection validates the feeling without arguing or false reassurance.
6. A client on lithium has a level of 1.8 mEq/L. Which finding does the PN expect?
A) Fine hand tremor
B) Coarse tremor, vomiting, and confusion
C) No symptoms
D) Weight gain
Answer: B
Rationale: Lithium 1.5–2.0 mEq/L indicates moderate toxicity.
7. A PN is caring for a client with preeclampsia receiving magnesium sulfate. Which finding
indicates toxicity?
A) Deep tendon reflexes 2+
3
, B) Respiratory rate 10 breaths/min
C) Urine output 40 mL/hr
D) Serum magnesium 4.5 mg/dL
Answer: B
Rationale: Respiratory depression is a sign of magnesium toxicity; calcium gluconate is antidote.
8. A postpartum client who delivered 2 hours ago has a boggy fundus displaced to the right. What
is the priority action?
A) Administer methylergonovine
B) Assist the client to void
C) Perform fundal massage
D) Increase oxytocin infusion
Answer: B
Rationale: A displaced fundus often indicates a distended bladder; voiding restores uterine tone.
9. A child with a peanut allergy develops stridor and hypotension after eating a cookie. What
should the PN do first?
A) Administer diphenhydramine IM
B) Administer epinephrine IM
C) Start an IV line
D) Apply oxygen via non-rebreather
Answer: B
Rationale: Anaphylaxis with stridor and hypotension requires immediate epinephrine.
10. A PN is preparing to administer digoxin. Which finding requires holding the dose?
A) Heart rate 68 bpm
B) Heart rate 52 bpm
C) Blood pressure 130/80 mmHg
4
Case Scenarios (Updated PDF)
1. A PN is caring for four clients. Which client should the PN assess first?
A) Client with a blood glucose of 180 mg/dL
B) Client with new-onset confusion and oxygen saturation 88% on room air
C) Client with a fractured leg requesting pain medication
D) Client with a urinary catheter needing output measurement
Answer: B
Rationale: Hypoxemia with confusion indicates an immediate airway/breathing threat; assess first.
2. A PN is preparing to insert a urinary catheter. Which action is most important to prevent
infection?
A) Use clean gloves for insertion
B) Use sterile technique throughout
C) Lubricate with petroleum jelly
D) Clean the meatus back-to-front
Answer: B
Rationale: Sterile technique prevents catheter-associated urinary tract infection (CAUTI).
3. A client with a new colostomy has a purple, dry stoma. What should the PN do first?
A) Document as expected
B) Notify the surgeon immediately
C) Apply a warm compress
D) Reassure the client
Answer: B
Rationale: Purple/black stoma indicates ischemia or necrosis; immediate evaluation needed.
2
,4. A PN is delegating to a UAP. Which task is appropriate?
A) Assess a client’s pain level
B) Measure and record intake and output
C) Administer a tube feeding
D) Change a sterile dressing
Answer: B
Rationale: I&O measurement is within UAP scope; assessment and sterile procedures are not.
5. A client with major depressive disorder says, “I’m worthless.” Which response is most
therapeutic?
A) “You shouldn’t feel that way.”
B) “It sounds like you’re feeling really down about yourself.”
C) “Let’s list your accomplishments.”
D) “Why do you feel worthless?”
Answer: B
Rationale: Reflection validates the feeling without arguing or false reassurance.
6. A client on lithium has a level of 1.8 mEq/L. Which finding does the PN expect?
A) Fine hand tremor
B) Coarse tremor, vomiting, and confusion
C) No symptoms
D) Weight gain
Answer: B
Rationale: Lithium 1.5–2.0 mEq/L indicates moderate toxicity.
7. A PN is caring for a client with preeclampsia receiving magnesium sulfate. Which finding
indicates toxicity?
A) Deep tendon reflexes 2+
3
, B) Respiratory rate 10 breaths/min
C) Urine output 40 mL/hr
D) Serum magnesium 4.5 mg/dL
Answer: B
Rationale: Respiratory depression is a sign of magnesium toxicity; calcium gluconate is antidote.
8. A postpartum client who delivered 2 hours ago has a boggy fundus displaced to the right. What
is the priority action?
A) Administer methylergonovine
B) Assist the client to void
C) Perform fundal massage
D) Increase oxytocin infusion
Answer: B
Rationale: A displaced fundus often indicates a distended bladder; voiding restores uterine tone.
9. A child with a peanut allergy develops stridor and hypotension after eating a cookie. What
should the PN do first?
A) Administer diphenhydramine IM
B) Administer epinephrine IM
C) Start an IV line
D) Apply oxygen via non-rebreather
Answer: B
Rationale: Anaphylaxis with stridor and hypotension requires immediate epinephrine.
10. A PN is preparing to administer digoxin. Which finding requires holding the dose?
A) Heart rate 68 bpm
B) Heart rate 52 bpm
C) Blood pressure 130/80 mmHg
4
