ATI RN NGN CASE STUDIES EXAM NEWEST
EVALUATED PRACTICE EXAM 100 QUESTIONS
2026-2027|ORIGINAL QUESTIONS & ANSWERS
|DETAILED RATIONALES |HINTED COMPLETE
EXAM PREP GRADED A+*INSTANT DOWNLOAD
PDF*
Case Study 1: Acute Heart Failure
A 72-year-old client with a history of hypertension and heart failure
reports worsening shortness of breath and a 3-kg (6.6-lb) weight gain
over 4 days. The client is sitting upright, anxious, and using accessory
muscles.
Assessment:
BP 168/94 mm Hg
HR 112/min
RR 30/min
SpO₂ 86% on room air
Bilateral crackles
3+ bilateral lower-extremity edema
1. Which finding requires the nurse's immediate attention?
A. 3+ lower-extremity edema
B. Weight gain
C. SpO₂ 86%
D. BP 168/94 mm Hg
Answer: C. SpO₂ 86%
,Rationale: The client's oxygen saturation indicates significant
hypoxemia. Airway and breathing take priority over fluid-volume
findings and hypertension.
2. Which position should the nurse place the client in?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone
Answer: B. High-Fowler's
Rationale: High-Fowler's promotes lung expansion and decreases
venous return, which can reduce pulmonary congestion and improve
breathing.
3. Which prescription should the nurse implement first?
A. Administer IV furosemide
B. Obtain a daily weight
C. Restrict sodium
D. Measure abdominal girth
Answer: A. Administer IV furosemide
Rationale: IV loop diuretics rapidly reduce fluid overload and
pulmonary congestion in acute decompensated heart failure.
4. Which medication should the nurse anticipate administering to
reduce pulmonary congestion?
A. Furosemide
B. Ferrous sulfate
C. Lactulose
D. Levothyroxine
,Answer: A. Furosemide
Rationale: Furosemide promotes diuresis, decreasing circulating
volume and pulmonary fluid accumulation.
5. Which finding indicates improvement?
A. RR 34/min
B. SpO₂ 94% with oxygen
C. Increasing crackles
D. Urine output 15 mL/hr
Answer: B. SpO₂ 94% with oxygen
Rationale: Improved oxygen saturation indicates better gas exchange
and response to treatment.
6. Which laboratory value is most important to monitor after
administering furosemide?
A. Potassium
B. Hemoglobin
C. Platelets
D. Amylase
Answer: A. Potassium
Rationale: Loop diuretics can cause potassium loss, increasing the risk
for dysrhythmias.
7. Which finding should the nurse report immediately after diuretic
therapy?
A. Urine output 800 mL in 4 hr
B. Potassium 2.8 mEq/L
C. Reduced ankle edema
D. Respiratory rate 20/min
, Answer: B. Potassium 2.8 mEq/L
Rationale: Severe hypokalemia can cause life-threatening cardiac
dysrhythmias and requires prompt intervention.
8. Which statement indicates correct understanding of daily weights?
A. "I will weigh myself at different times each day."
B. "I will weigh myself every morning after urinating."
C. "I only need to weigh myself when my ankles swell."
D. "I will weigh myself once a week."
Answer: B. "I will weigh myself every morning after urinating."
Rationale: Consistent daily weights provide an early indicator of fluid
retention.
9. Which foods should the nurse recommend limiting? Select all that
apply.
A. Canned soup
B. Fresh apples
C. Processed meats
D. Salted chips
E. Fresh unsalted vegetables
Answers: A, C, D
Rationale: Canned soups, processed meats, and salted snacks
commonly contain large amounts of sodium and can worsen fluid
retention.
10. Which client statement requires further teaching?
A. "I will take my medications as prescribed."
B. "I will report rapid weight gain."
EVALUATED PRACTICE EXAM 100 QUESTIONS
2026-2027|ORIGINAL QUESTIONS & ANSWERS
|DETAILED RATIONALES |HINTED COMPLETE
EXAM PREP GRADED A+*INSTANT DOWNLOAD
PDF*
Case Study 1: Acute Heart Failure
A 72-year-old client with a history of hypertension and heart failure
reports worsening shortness of breath and a 3-kg (6.6-lb) weight gain
over 4 days. The client is sitting upright, anxious, and using accessory
muscles.
Assessment:
BP 168/94 mm Hg
HR 112/min
RR 30/min
SpO₂ 86% on room air
Bilateral crackles
3+ bilateral lower-extremity edema
1. Which finding requires the nurse's immediate attention?
A. 3+ lower-extremity edema
B. Weight gain
C. SpO₂ 86%
D. BP 168/94 mm Hg
Answer: C. SpO₂ 86%
,Rationale: The client's oxygen saturation indicates significant
hypoxemia. Airway and breathing take priority over fluid-volume
findings and hypertension.
2. Which position should the nurse place the client in?
A. Supine
B. High-Fowler's
C. Trendelenburg
D. Prone
Answer: B. High-Fowler's
Rationale: High-Fowler's promotes lung expansion and decreases
venous return, which can reduce pulmonary congestion and improve
breathing.
3. Which prescription should the nurse implement first?
A. Administer IV furosemide
B. Obtain a daily weight
C. Restrict sodium
D. Measure abdominal girth
Answer: A. Administer IV furosemide
Rationale: IV loop diuretics rapidly reduce fluid overload and
pulmonary congestion in acute decompensated heart failure.
4. Which medication should the nurse anticipate administering to
reduce pulmonary congestion?
A. Furosemide
B. Ferrous sulfate
C. Lactulose
D. Levothyroxine
,Answer: A. Furosemide
Rationale: Furosemide promotes diuresis, decreasing circulating
volume and pulmonary fluid accumulation.
5. Which finding indicates improvement?
A. RR 34/min
B. SpO₂ 94% with oxygen
C. Increasing crackles
D. Urine output 15 mL/hr
Answer: B. SpO₂ 94% with oxygen
Rationale: Improved oxygen saturation indicates better gas exchange
and response to treatment.
6. Which laboratory value is most important to monitor after
administering furosemide?
A. Potassium
B. Hemoglobin
C. Platelets
D. Amylase
Answer: A. Potassium
Rationale: Loop diuretics can cause potassium loss, increasing the risk
for dysrhythmias.
7. Which finding should the nurse report immediately after diuretic
therapy?
A. Urine output 800 mL in 4 hr
B. Potassium 2.8 mEq/L
C. Reduced ankle edema
D. Respiratory rate 20/min
, Answer: B. Potassium 2.8 mEq/L
Rationale: Severe hypokalemia can cause life-threatening cardiac
dysrhythmias and requires prompt intervention.
8. Which statement indicates correct understanding of daily weights?
A. "I will weigh myself at different times each day."
B. "I will weigh myself every morning after urinating."
C. "I only need to weigh myself when my ankles swell."
D. "I will weigh myself once a week."
Answer: B. "I will weigh myself every morning after urinating."
Rationale: Consistent daily weights provide an early indicator of fluid
retention.
9. Which foods should the nurse recommend limiting? Select all that
apply.
A. Canned soup
B. Fresh apples
C. Processed meats
D. Salted chips
E. Fresh unsalted vegetables
Answers: A, C, D
Rationale: Canned soups, processed meats, and salted snacks
commonly contain large amounts of sodium and can worsen fluid
retention.
10. Which client statement requires further teaching?
A. "I will take my medications as prescribed."
B. "I will report rapid weight gain."
