VATI GREEN LIGHT PREDICTOR 180 QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
1. Prioritization
A nurse has four clients. Who should be seen first?
A. Post-op client with pain 6/10 and stable vitals
B. Client with chest pain and diaphoresis
C. Client requesting discharge teaching
D. Client with nausea after chemotherapy
Answer: B
Rationale: Chest pain with diaphoresis suggests possible myocardial ischemia —
airway/breathing/circulation and potential life threat take priority.
2. Pharmacology
Which medication requires INR monitoring?
A. Enoxaparin (Lovenox)
B. Warfarin (Coumadin)
C. Heparin (IV)
D. Aspirin
Answer: B
Rationale: Warfarin affects vitamin K–dependent clotting factors; INR/PT monitoring is
required. (Heparin uses aPTT.)
3. Safety
Which action best reduces risk of patient falls in the hospital?
A. Keep bed in high position
B. Place call light out of reach
C. Use non-skid footwear and hourly rounding
D. Remove ambulation assist devices
Answer: C
Rationale: Non-skid footwear and regular rounding address mobility and toileting needs,
reducing falls.
4. Med-Surg — Cardiac
A client with acute MI develops sudden dyspnea, hypotension, and JVD. The nurse
suspects:
A. Pulmonary embolism
B. Left-sided heart failure
C. Cardiac tamponade
D. Right-sided heart failure
Answer: C
Rationale: Beck’s triad (hypotension, muffled heart sounds, JVD) and acute
deterioration suggest tamponade.
5. Respiratory
A patient with COPD has an SaO₂ of 88% on room air and is short of breath. The nurse
, should:
A. Apply high-flow oxygen via nonrebreather at 15 L/min
B. Apply low-flow oxygen (1–2 L/min nasal cannula) and reassess
C. Withhold oxygen to prevent CO₂ retention
D. Begin chest physiotherapy immediately
Answer: B
Rationale: COPD patients often tolerate lower O₂; start low-flow O₂ to improve
saturation and reassess.
6. Pharmacology — Antibiotics
An infant on gentamicin should be monitored for:
A. Hepatotoxicity
B. Ototoxicity and nephrotoxicity
C. Thrombocytopenia
D. Hypoglycemia
Answer: B
Rationale: Aminoglycosides (gentamicin) risk hearing loss and kidney injury; monitor
levels and renal function.
7. Maternity
A woman at 38 weeks reports painless bright red vaginal bleeding and fetal heart rate of
170 bpm. The nurse’s priority:
A. Start oxytocin infusion
B. Assess for placental abruption and fetal distress
C. Encourage ambulation and observe
D. Offer a warm bath
Answer: B
Rationale: Bright red bleeding and fetal tachycardia call for immediate assessment for
abruption and fetal compromise.
8. Pediatrics
A toddler with dehydration shows dry mucous membranes, tachycardia, and decreased
urine output. Best initial action:
A. Give oral rehydration solution if tolerated
B. Start IV isotonic fluids (NS) bolus
C. Offer clear liquids only
D. Place on strict NPO
Answer: B
Rationale: Signs of moderate to severe dehydration require IV isotonic bolus to restore
perfusion quickly.
9. Psych-Mental Health
A client in acute manic episode is loud, disruptive, and acting impulsively. Priority
nursing intervention:
A. Encourage group therapy participation
B. Offer high-calorie finger foods and set limits
C. Suggest journaling during the shift
D. Arrange family conferencing at bedside
Answer: B
, Rationale: Safety and meeting basic needs (nutrition) plus consistent limits help reduce
escalation in mania.
10. Neurology
After a right-sided stroke, a client has left facial droop and left arm weakness. Which
action is appropriate?
A. Place objects on the left side of bedside
B. Encourage use of the left arm for grooming immediately
C. Place objects on the right side of bedside
D. Apply restraints to left arm to prevent injury
Answer: C
Rationale: Hemineglect/right-brain stroke — place items on the unaffected (right) side;
promote safe use of affected side with therapy, not forced immediate use.
11. Infection Control
Which is correct for airborne precautions?
A. Surgical mask and gloves
B. N95 respirator and negative-pressure room
C. Contact gown only
D. Eye protection only
Answer: B
Rationale: Airborne pathogens (e.g., TB, measles) require N95 respirator and negative
air pressure.
12. Endocrine
A client with DKA has blood glucose 520 mg/dL and is receiving IV insulin. Which
electrolyte must be monitored closely?
A. Calcium
B. Potassium
C. Sodium
D. Magnesium
Answer: B
Rationale: Insulin shifts potassium into cells; serum K⁺ can fall rapidly, risking
arrhythmias.
13. Pharmacology — Opioids
Which drug is an opioid antagonist used to reverse respiratory depression?
A. Naloxone (Narcan)
B. Flumazenil
C. Naltrexone
D. Buprenorphine
Answer: A
Rationale: Naloxone rapidly reverses opioid effects; flumazenil reverses
benzodiazepines.
14. Renal
A client on hemodialysis reports new weakness and peaked T waves on ECG. The nurse
suspects:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
, D. Hyponatremia
Answer: B
Rationale: Peaked T waves indicate hyperkalemia, which causes muscle weakness and
cardiac changes.
15. Surgical
A post-op patient develops sudden shortness of breath and pleuritic chest pain. The nurse
should:
A. Encourage coughing and deep breathing
B. Apply topical heat to the chest
C. Notify provider and prepare for possible pulmonary embolism interventions
D. Give analgesic and observe
Answer: C
Rationale: Sudden pleuritic pain and dyspnea post-op raises suspicion for PE; prompt
evaluation and treatment are needed.
16. Gastrointestinal
A client with cirrhosis develops confusion and asterixis. Which treatment is indicated?
A. Lactulose to reduce ammonia levels
B. IV antibiotics only
C. Blood transfusion
D. Sodium restriction only
Answer: A
Rationale: Lactulose reduces ammonia absorption and is first-line for hepatic
encephalopathy symptoms.
17. Obstetrics — Newborn
An infant with respiratory distress shows nasal flaring, grunting, and retractions. First
action:
A. Suction mouth and nose, provide warmth, and give O₂ as needed
B. Start oral feedings immediately
C. Place infant prone to improve ventilation
D. Give antibiotics routinely
Answer: A
Rationale: Support airway and breathing; suction and O₂ as needed; assessment before
other interventions.
18. Pain Management
Which intervention is best for chronic neuropathic pain?
A. High-dose opioid monotherapy
B. Tricyclic antidepressants or anticonvulsants as adjuvant therapy
C. Only NSAIDs PRN
D. Heat and massage only
Answer: B
Rationale: Neuropathic pain often responds to TCAs or anticonvulsants (gabapentin)
rather than opioids alone.
19. Laboratory Interpretation
A client’s ABG: pH 7.30, PaCO₂ 50 mmHg, HCO₃⁻ 22 mEq/L. Interpretation:
A. Metabolic acidosis
B. Respiratory acidosis
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
1. Prioritization
A nurse has four clients. Who should be seen first?
A. Post-op client with pain 6/10 and stable vitals
B. Client with chest pain and diaphoresis
C. Client requesting discharge teaching
D. Client with nausea after chemotherapy
Answer: B
Rationale: Chest pain with diaphoresis suggests possible myocardial ischemia —
airway/breathing/circulation and potential life threat take priority.
2. Pharmacology
Which medication requires INR monitoring?
A. Enoxaparin (Lovenox)
B. Warfarin (Coumadin)
C. Heparin (IV)
D. Aspirin
Answer: B
Rationale: Warfarin affects vitamin K–dependent clotting factors; INR/PT monitoring is
required. (Heparin uses aPTT.)
3. Safety
Which action best reduces risk of patient falls in the hospital?
A. Keep bed in high position
B. Place call light out of reach
C. Use non-skid footwear and hourly rounding
D. Remove ambulation assist devices
Answer: C
Rationale: Non-skid footwear and regular rounding address mobility and toileting needs,
reducing falls.
4. Med-Surg — Cardiac
A client with acute MI develops sudden dyspnea, hypotension, and JVD. The nurse
suspects:
A. Pulmonary embolism
B. Left-sided heart failure
C. Cardiac tamponade
D. Right-sided heart failure
Answer: C
Rationale: Beck’s triad (hypotension, muffled heart sounds, JVD) and acute
deterioration suggest tamponade.
5. Respiratory
A patient with COPD has an SaO₂ of 88% on room air and is short of breath. The nurse
, should:
A. Apply high-flow oxygen via nonrebreather at 15 L/min
B. Apply low-flow oxygen (1–2 L/min nasal cannula) and reassess
C. Withhold oxygen to prevent CO₂ retention
D. Begin chest physiotherapy immediately
Answer: B
Rationale: COPD patients often tolerate lower O₂; start low-flow O₂ to improve
saturation and reassess.
6. Pharmacology — Antibiotics
An infant on gentamicin should be monitored for:
A. Hepatotoxicity
B. Ototoxicity and nephrotoxicity
C. Thrombocytopenia
D. Hypoglycemia
Answer: B
Rationale: Aminoglycosides (gentamicin) risk hearing loss and kidney injury; monitor
levels and renal function.
7. Maternity
A woman at 38 weeks reports painless bright red vaginal bleeding and fetal heart rate of
170 bpm. The nurse’s priority:
A. Start oxytocin infusion
B. Assess for placental abruption and fetal distress
C. Encourage ambulation and observe
D. Offer a warm bath
Answer: B
Rationale: Bright red bleeding and fetal tachycardia call for immediate assessment for
abruption and fetal compromise.
8. Pediatrics
A toddler with dehydration shows dry mucous membranes, tachycardia, and decreased
urine output. Best initial action:
A. Give oral rehydration solution if tolerated
B. Start IV isotonic fluids (NS) bolus
C. Offer clear liquids only
D. Place on strict NPO
Answer: B
Rationale: Signs of moderate to severe dehydration require IV isotonic bolus to restore
perfusion quickly.
9. Psych-Mental Health
A client in acute manic episode is loud, disruptive, and acting impulsively. Priority
nursing intervention:
A. Encourage group therapy participation
B. Offer high-calorie finger foods and set limits
C. Suggest journaling during the shift
D. Arrange family conferencing at bedside
Answer: B
, Rationale: Safety and meeting basic needs (nutrition) plus consistent limits help reduce
escalation in mania.
10. Neurology
After a right-sided stroke, a client has left facial droop and left arm weakness. Which
action is appropriate?
A. Place objects on the left side of bedside
B. Encourage use of the left arm for grooming immediately
C. Place objects on the right side of bedside
D. Apply restraints to left arm to prevent injury
Answer: C
Rationale: Hemineglect/right-brain stroke — place items on the unaffected (right) side;
promote safe use of affected side with therapy, not forced immediate use.
11. Infection Control
Which is correct for airborne precautions?
A. Surgical mask and gloves
B. N95 respirator and negative-pressure room
C. Contact gown only
D. Eye protection only
Answer: B
Rationale: Airborne pathogens (e.g., TB, measles) require N95 respirator and negative
air pressure.
12. Endocrine
A client with DKA has blood glucose 520 mg/dL and is receiving IV insulin. Which
electrolyte must be monitored closely?
A. Calcium
B. Potassium
C. Sodium
D. Magnesium
Answer: B
Rationale: Insulin shifts potassium into cells; serum K⁺ can fall rapidly, risking
arrhythmias.
13. Pharmacology — Opioids
Which drug is an opioid antagonist used to reverse respiratory depression?
A. Naloxone (Narcan)
B. Flumazenil
C. Naltrexone
D. Buprenorphine
Answer: A
Rationale: Naloxone rapidly reverses opioid effects; flumazenil reverses
benzodiazepines.
14. Renal
A client on hemodialysis reports new weakness and peaked T waves on ECG. The nurse
suspects:
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
, D. Hyponatremia
Answer: B
Rationale: Peaked T waves indicate hyperkalemia, which causes muscle weakness and
cardiac changes.
15. Surgical
A post-op patient develops sudden shortness of breath and pleuritic chest pain. The nurse
should:
A. Encourage coughing and deep breathing
B. Apply topical heat to the chest
C. Notify provider and prepare for possible pulmonary embolism interventions
D. Give analgesic and observe
Answer: C
Rationale: Sudden pleuritic pain and dyspnea post-op raises suspicion for PE; prompt
evaluation and treatment are needed.
16. Gastrointestinal
A client with cirrhosis develops confusion and asterixis. Which treatment is indicated?
A. Lactulose to reduce ammonia levels
B. IV antibiotics only
C. Blood transfusion
D. Sodium restriction only
Answer: A
Rationale: Lactulose reduces ammonia absorption and is first-line for hepatic
encephalopathy symptoms.
17. Obstetrics — Newborn
An infant with respiratory distress shows nasal flaring, grunting, and retractions. First
action:
A. Suction mouth and nose, provide warmth, and give O₂ as needed
B. Start oral feedings immediately
C. Place infant prone to improve ventilation
D. Give antibiotics routinely
Answer: A
Rationale: Support airway and breathing; suction and O₂ as needed; assessment before
other interventions.
18. Pain Management
Which intervention is best for chronic neuropathic pain?
A. High-dose opioid monotherapy
B. Tricyclic antidepressants or anticonvulsants as adjuvant therapy
C. Only NSAIDs PRN
D. Heat and massage only
Answer: B
Rationale: Neuropathic pain often responds to TCAs or anticonvulsants (gabapentin)
rather than opioids alone.
19. Laboratory Interpretation
A client’s ABG: pH 7.30, PaCO₂ 50 mmHg, HCO₃⁻ 22 mEq/L. Interpretation:
A. Metabolic acidosis
B. Respiratory acidosis
