, NGN ATI RN COMPREHENSIVE EXIT RETAKE EXAM –
ADVANCED SET WITH COMPLETE QUESTIONS AND
ANSWERS |<2026 UPDATE ENHANCED WITH USEFUL
RATIONALES>|
1. (Clinical Judgment – Prioritize Hypotheses)
A nurse is caring for a 72-year-old client admitted with pneumonia. The client becomes increasingly
restless, with oxygen saturation dropping from 94% to 88% on 2L nasal cannula. Which action should the
nurse take first?
A. Notify the provider of the client’s deterioration
B. Increase oxygen flow rate and reassess respiratory status
C. Administer prescribed antipyretics
D. Encourage fluid intake
Correct Answer: B
Rationale:
Using the ABC priority framework, airway and breathing take precedence. The nurse must immediately
correct hypoxia by increasing oxygen and reassessing before notifying the provider.
• A is appropriate but not first
• C and D do not address immediate hypoxia
2. (Cue Recognition)
A client with heart failure presents with the following findings: weight gain of 2 kg in 2 days, bilateral
crackles, and dyspnea at rest. Which interpretation is most accurate?
A. The client is improving with treatment
B. The client is experiencing fluid overload and worsening heart failure
C. The client has dehydration
D. The findings are expected in stable heart failure
Correct Answer: B
Rationale:
Rapid weight gain, crackles, and dyspnea indicate fluid retention and pulmonary congestion,
suggesting worsening heart failure.
3. (Select All That Apply – Safety)
,A nurse is administering morphine IV. Which findings require immediate intervention?
A. Respiratory rate of 8/min
B. Oxygen saturation 90%
C. Sedation score indicating difficult arousal
D. Pain rating 7/10
E. Blood pressure 140/88 mmHg
Correct Answers: A, B, C
Rationale:
Morphine can cause respiratory depression and sedation.
• RR <12, low SpO₂, and decreased responsiveness are critical
• Pain and BP are less urgent
4. (Prioritization)
Which client should the nurse assess first?
A. Client with COPD reporting mild dyspnea
B. Client with diabetes and blood glucose of 250 mg/dL
C. Postoperative client with sudden chest pain and shortness of breath
D. Client requesting pain medication
Correct Answer: C
Rationale:
Sudden chest pain and dyspnea may indicate pulmonary embolism, a life-threatening emergency.
5. (Case Study – Hypothesis Evaluation)
A client with sepsis has the following findings: BP 86/50 mmHg, lactate 4 mmol/L, HR 120 bpm. What is
the priority intervention?
A. Administer IV fluids rapidly
B. Provide oral fluids
C. Administer antihypertensives
D. Encourage rest
Correct Answer: A
Rationale:
Sepsis causes hypoperfusion and shock. Rapid IV fluids restore circulation and perfusion.
6. (Pharmacology Judgment)
A client taking warfarin has an INR of 5.0. What action should the nurse anticipate?
, A. Continue medication
B. Administer vitamin K
C. Increase dose
D. Administer heparin
Correct Answer: B
Rationale:
High INR indicates bleeding risk. Vitamin K reverses warfarin effects.
7. (Delegation)
Which task is appropriate to delegate to an assistive personnel (AP)?
A. Assess pain level
B. Provide client education
C. Measure and record vital signs
D. Evaluate response to medication
Correct Answer: C
Rationale:
AP can perform routine, non-assessment tasks like vital signs.
8. (Infection Control)
A client with suspected tuberculosis is admitted. Which precaution is required?
A. Contact
B. Droplet
C. Airborne
D. Standard only
Correct Answer: C
Rationale:
TB spreads via airborne particles, requiring N95 mask and negative-pressure room.
9. (Clinical Judgment – Action)
A client develops hyperkalemia (K⁺ = 6.5 mEq/L). Which medication should the nurse expect?
A. Insulin with glucose
B. Potassium supplement
C. Sodium chloride
D. Diuretics only
Correct Answer: A
ADVANCED SET WITH COMPLETE QUESTIONS AND
ANSWERS |<2026 UPDATE ENHANCED WITH USEFUL
RATIONALES>|
1. (Clinical Judgment – Prioritize Hypotheses)
A nurse is caring for a 72-year-old client admitted with pneumonia. The client becomes increasingly
restless, with oxygen saturation dropping from 94% to 88% on 2L nasal cannula. Which action should the
nurse take first?
A. Notify the provider of the client’s deterioration
B. Increase oxygen flow rate and reassess respiratory status
C. Administer prescribed antipyretics
D. Encourage fluid intake
Correct Answer: B
Rationale:
Using the ABC priority framework, airway and breathing take precedence. The nurse must immediately
correct hypoxia by increasing oxygen and reassessing before notifying the provider.
• A is appropriate but not first
• C and D do not address immediate hypoxia
2. (Cue Recognition)
A client with heart failure presents with the following findings: weight gain of 2 kg in 2 days, bilateral
crackles, and dyspnea at rest. Which interpretation is most accurate?
A. The client is improving with treatment
B. The client is experiencing fluid overload and worsening heart failure
C. The client has dehydration
D. The findings are expected in stable heart failure
Correct Answer: B
Rationale:
Rapid weight gain, crackles, and dyspnea indicate fluid retention and pulmonary congestion,
suggesting worsening heart failure.
3. (Select All That Apply – Safety)
,A nurse is administering morphine IV. Which findings require immediate intervention?
A. Respiratory rate of 8/min
B. Oxygen saturation 90%
C. Sedation score indicating difficult arousal
D. Pain rating 7/10
E. Blood pressure 140/88 mmHg
Correct Answers: A, B, C
Rationale:
Morphine can cause respiratory depression and sedation.
• RR <12, low SpO₂, and decreased responsiveness are critical
• Pain and BP are less urgent
4. (Prioritization)
Which client should the nurse assess first?
A. Client with COPD reporting mild dyspnea
B. Client with diabetes and blood glucose of 250 mg/dL
C. Postoperative client with sudden chest pain and shortness of breath
D. Client requesting pain medication
Correct Answer: C
Rationale:
Sudden chest pain and dyspnea may indicate pulmonary embolism, a life-threatening emergency.
5. (Case Study – Hypothesis Evaluation)
A client with sepsis has the following findings: BP 86/50 mmHg, lactate 4 mmol/L, HR 120 bpm. What is
the priority intervention?
A. Administer IV fluids rapidly
B. Provide oral fluids
C. Administer antihypertensives
D. Encourage rest
Correct Answer: A
Rationale:
Sepsis causes hypoperfusion and shock. Rapid IV fluids restore circulation and perfusion.
6. (Pharmacology Judgment)
A client taking warfarin has an INR of 5.0. What action should the nurse anticipate?
, A. Continue medication
B. Administer vitamin K
C. Increase dose
D. Administer heparin
Correct Answer: B
Rationale:
High INR indicates bleeding risk. Vitamin K reverses warfarin effects.
7. (Delegation)
Which task is appropriate to delegate to an assistive personnel (AP)?
A. Assess pain level
B. Provide client education
C. Measure and record vital signs
D. Evaluate response to medication
Correct Answer: C
Rationale:
AP can perform routine, non-assessment tasks like vital signs.
8. (Infection Control)
A client with suspected tuberculosis is admitted. Which precaution is required?
A. Contact
B. Droplet
C. Airborne
D. Standard only
Correct Answer: C
Rationale:
TB spreads via airborne particles, requiring N95 mask and negative-pressure room.
9. (Clinical Judgment – Action)
A client develops hyperkalemia (K⁺ = 6.5 mEq/L). Which medication should the nurse expect?
A. Insulin with glucose
B. Potassium supplement
C. Sodium chloride
D. Diuretics only
Correct Answer: A
