ATI PN Comprehensive Predictor 2026 –
Version 2 Practice Exam | NGN Clinical
Judgment Case Studies, Verified Answers,
& Comprehensive Rationales
Question 1
A nurse is caring for a client who has chronic kidney disease.
Which laboratory finding should the nurse report to the
provider immediately?
A. Hemoglobin 10 g/dL
B. Creatinine 2.4 mg/dL
C. Potassium 6.2 mEq/L
D. Calcium 8.1 mg/dL
Answer: C. Potassium 6.2 mEq/L
Rationale: Hyperkalemia is a life-threatening complication of
chronic kidney disease because it can cause fatal cardiac
dysrhythmias. A potassium level of 6.2 mEq/L requires
immediate intervention. The other findings are expected or
less urgent manifestations of chronic kidney disease.
Question 2
A nurse is assessing a client 12 hr after a thyroidectomy.
Which finding requires immediate intervention?
,A. Hoarse voice
B. Temperature 37.6°C (99.7°F)
C. Frequent swallowing
D. Pain rating of 4 on a scale of 0 to 10
Answer: C. Frequent swallowing
Rationale: Frequent swallowing may indicate hemorrhage at
the surgical site. Internal bleeding can rapidly compromise
the airway and requires immediate assessment. Mild
hoarseness and moderate pain are common after thyroid
surgery.
Question 3
A nurse is reinforcing teaching with a client prescribed
warfarin. Which statement indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will take aspirin for headaches."
C. "I will notify my provider if my urine appears pink."
D. "I should stop taking warfarin if bruising occurs."
Answer: C. "I will notify my provider if my urine appears
pink."
Rationale: Pink urine may indicate bleeding, a serious adverse
effect of warfarin. Green leafy vegetables contain vitamin K
and can reduce effectiveness. Aspirin increases bleeding risk.
The client should never discontinue anticoagulants without
provider guidance.
,Question 4
A nurse is caring for a client experiencing hypoglycemia.
Which manifestation should the nurse expect?
A. Warm, dry skin
B. Bradycardia
C. Confusion and diaphoresis
D. Deep respirations
Answer: C. Confusion and diaphoresis
Rationale: Hypoglycemia activates the sympathetic nervous
system, causing sweating, tremors, tachycardia, hunger, and
confusion. Warm, dry skin and deep respirations are more
consistent with hyperglycemia.
Question 5
A nurse is assisting with the care of a client who has a chest
tube. Which finding indicates the system is functioning
properly?
A. Continuous bubbling in the water-seal chamber
B. Fluctuation of water in the water-seal chamber
C. No drainage in the collection chamber
D. Clamped tubing during transport
Answer: B. Fluctuation of water in the water-seal chamber
Rationale: Tidaling or fluctuation reflects pressure changes
during breathing and indicates patency of the drainage
system. Continuous bubbling may indicate an air leak. Chest
tubes should not be routinely clamped.
, Question 6
A nurse is caring for a client who has bacterial meningitis.
Which action is the priority?
A. Encourage oral fluids
B. Institute droplet precautions
C. Provide passive range-of-motion exercises
D. Reduce environmental stimuli
Answer: B. Institute droplet precautions
Rationale: Preventing transmission of meningitis to others is
the immediate priority. Droplet precautions should be
implemented promptly. Although reducing stimuli is
important, infection control takes precedence.
Question 7
A nurse is reviewing laboratory results for a client with heart
failure. Which finding indicates effectiveness of diuretic
therapy?
A. Weight gain of 1 kg
B. Increased jugular vein distention
C. Urine output 2,000 mL/day
D. Crackles throughout both lungs
Answer: C. Urine output 2,000 mL/day
Version 2 Practice Exam | NGN Clinical
Judgment Case Studies, Verified Answers,
& Comprehensive Rationales
Question 1
A nurse is caring for a client who has chronic kidney disease.
Which laboratory finding should the nurse report to the
provider immediately?
A. Hemoglobin 10 g/dL
B. Creatinine 2.4 mg/dL
C. Potassium 6.2 mEq/L
D. Calcium 8.1 mg/dL
Answer: C. Potassium 6.2 mEq/L
Rationale: Hyperkalemia is a life-threatening complication of
chronic kidney disease because it can cause fatal cardiac
dysrhythmias. A potassium level of 6.2 mEq/L requires
immediate intervention. The other findings are expected or
less urgent manifestations of chronic kidney disease.
Question 2
A nurse is assessing a client 12 hr after a thyroidectomy.
Which finding requires immediate intervention?
,A. Hoarse voice
B. Temperature 37.6°C (99.7°F)
C. Frequent swallowing
D. Pain rating of 4 on a scale of 0 to 10
Answer: C. Frequent swallowing
Rationale: Frequent swallowing may indicate hemorrhage at
the surgical site. Internal bleeding can rapidly compromise
the airway and requires immediate assessment. Mild
hoarseness and moderate pain are common after thyroid
surgery.
Question 3
A nurse is reinforcing teaching with a client prescribed
warfarin. Which statement indicates understanding?
A. "I will increase my intake of green leafy vegetables."
B. "I will take aspirin for headaches."
C. "I will notify my provider if my urine appears pink."
D. "I should stop taking warfarin if bruising occurs."
Answer: C. "I will notify my provider if my urine appears
pink."
Rationale: Pink urine may indicate bleeding, a serious adverse
effect of warfarin. Green leafy vegetables contain vitamin K
and can reduce effectiveness. Aspirin increases bleeding risk.
The client should never discontinue anticoagulants without
provider guidance.
,Question 4
A nurse is caring for a client experiencing hypoglycemia.
Which manifestation should the nurse expect?
A. Warm, dry skin
B. Bradycardia
C. Confusion and diaphoresis
D. Deep respirations
Answer: C. Confusion and diaphoresis
Rationale: Hypoglycemia activates the sympathetic nervous
system, causing sweating, tremors, tachycardia, hunger, and
confusion. Warm, dry skin and deep respirations are more
consistent with hyperglycemia.
Question 5
A nurse is assisting with the care of a client who has a chest
tube. Which finding indicates the system is functioning
properly?
A. Continuous bubbling in the water-seal chamber
B. Fluctuation of water in the water-seal chamber
C. No drainage in the collection chamber
D. Clamped tubing during transport
Answer: B. Fluctuation of water in the water-seal chamber
Rationale: Tidaling or fluctuation reflects pressure changes
during breathing and indicates patency of the drainage
system. Continuous bubbling may indicate an air leak. Chest
tubes should not be routinely clamped.
, Question 6
A nurse is caring for a client who has bacterial meningitis.
Which action is the priority?
A. Encourage oral fluids
B. Institute droplet precautions
C. Provide passive range-of-motion exercises
D. Reduce environmental stimuli
Answer: B. Institute droplet precautions
Rationale: Preventing transmission of meningitis to others is
the immediate priority. Droplet precautions should be
implemented promptly. Although reducing stimuli is
important, infection control takes precedence.
Question 7
A nurse is reviewing laboratory results for a client with heart
failure. Which finding indicates effectiveness of diuretic
therapy?
A. Weight gain of 1 kg
B. Increased jugular vein distention
C. Urine output 2,000 mL/day
D. Crackles throughout both lungs
Answer: C. Urine output 2,000 mL/day
