ATI RN COMPREHENSIVE PREDICTOR NGN-STYLE SET 1
EXAM QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. During routine supportive care, a client is experiencing urinary incontinence. Which assessment finding
is most consistent with this care need?
A. frequent nighttime awakening related to noise, pain, and repeated interruptions
B. involuntary urine loss associated with urgency but no urinary retention
C. dry oral mucosa with inability to perform self-care
D. abdominal bloating, nausea, or repeated coughing during tube feeding
Correct Answer: B. involuntary urine loss associated with urgency but no urinary retention
Rationale: involuntary urine loss associated with urgency but no urinary retention is a common cue when caring
for urinary incontinence.
2. While preparing care for a high-risk client, a nurse sustains a needlestick from a used hollow-bore
needle. What should the nurse do first?
A. Squeeze the wound vigorously for several minutes
B. Wait for symptoms before reporting the exposure
C. Wash the site with soap and water and immediately report the exposure for post-exposure evaluation
D. Apply bleach to the puncture site
Correct Answer: C. Wash the site with soap and water and immediately report the exposure for post-exposure
evaluation
Rationale: Occupational exposure management starts with prompt cleansing and immediate reporting so source
testing and post-exposure prophylaxis can be evaluated without delay.
3. On a medical-surgical unit, a client with pneumonia has the expected presentation of fever, cough, focal
crackles, and infiltrate. Which worsening development should the nurse anticipate as a major
complication?
A. cerebral edema or osmotic demyelination from overcorrection
B. rebleeding and vasospasm
C. sepsis or respiratory failure
D. sepsis
Correct Answer: C. sepsis or respiratory failure
Rationale: A major complication of pneumonia is sepsis or respiratory failure.
4. During an urgent bedside reassessment, a client’s presentation is consistent with subarachnoid
hemorrhage. What is the nurse’s best next action?
A. correct cause and raise sodium carefully to avoid osmotic demyelination
B. obtain urine testing and start appropriate antibiotics
C. urgent CT/vascular evaluation and neurosurgical management
D. obtain cultures when indicated and begin timely antimicrobial/supportive care
Correct Answer: C. urgent CT/vascular evaluation and neurosurgical management
Rationale: For subarachnoid hemorrhage, the priority response is to urgent CT/vascular evaluation and
neurosurgical management.
5. During a pharmacist-nurse medication review, for which problem would the nurse most expect to see
valproate prescribed?
A. transplant immunosuppression
B. seizure disorders and bipolar disorder
C. hypertension, angina, and rate control
D. tick-borne disease, acne, and selected infections
Correct Answer: B. seizure disorders and bipolar disorder
Rationale: valproate, a antiseizure medication/mood stabilizer, is commonly used for seizure disorders and
bipolar disorder.
6. A client with asthma initially has loud wheezing. Thirty minutes later the client is exhausted, has
minimal air movement, and the wheezing is barely audible. How should the nurse interpret this change?
Diffuse wheezing; RR 30/min Earlier Exhausted; minimal air movement; faint wheeze Now
A. The asthma attack is resolving because wheezing is quieter
,B. The client may be developing severe airflow obstruction with impending respiratory failure
C. The client is ready for discharge
D. The client is experiencing only anxiety
Correct Answer: B. The client may be developing severe airflow obstruction with impending respiratory failure
Rationale: A “silent chest” with fatigue and poor air movement is an ominous sign of severe obstruction, not
improvement.
7. During a preventive-care visit, a parent asks when to introduce complementary foods to a healthy infant.
Which guidance is appropriate?
A. Introduce developmentally appropriate complementary foods around 6 months while continuing breast milk or
formula
B. Start solid foods routinely at 1 month
C. Replace all breast milk or formula at 4 months
D. Delay all textured foods until age 2 years
Correct Answer: A. Introduce developmentally appropriate complementary foods around 6 months while
continuing breast milk or formula
Rationale: Complementary foods are typically introduced around 6 months when developmental readiness is
present, while breast milk or formula remains important.
8. While assisting with activities of daily living, which client statement demonstrates correct teaching about
limited mobility?
A. maintain hearing aids and use visual cues in difficult listening environments
B. use a consistent sleep schedule and limit late caffeine when feasible
C. shift weight frequently and avoid prolonged pressure on vulnerable areas
D. participate in prescribed range-of-motion and mobility activities rather than remaining in bed continuously
Correct Answer: D. participate in prescribed range-of-motion and mobility activities rather than remaining in
bed continuously
Rationale: Progressive mobility preserves function and reduces complications such as deconditioning,
atelectasis, and pressure injury.
9. Fifteen minutes after a packed RBC transfusion begins, the client develops chills, lumbar pain, and
dyspnea. What should the nurse do first? T 37.0 C; BP 126/72 Before transfusion T 38.3 C; chills, low-back
pain, dyspnea 15 min after start
A. Slow the transfusion and reassess in 30 minutes
B. Administer the next unit of blood
C. Remove the IV catheter immediately and provide no access
D. Stop the transfusion and keep the IV line open with normal saline using new tubing
Correct Answer: D. Stop the transfusion and keep the IV line open with normal saline using new tubing
Rationale: These findings may indicate an acute transfusion reaction; the transfusion must be stopped while
venous access is maintained with normal saline.
10. During morning coordination rounds, a client says a cultural practice is important during
hospitalization. What should the nurse do?
A. Assume all clients from that culture follow the same practice
B. Ask the client to explain the practice and incorporate it when it can be done safely
C. Refuse any practice not used by the nurse
D. Ask another client from the same culture to decide
Correct Answer: B. Ask the client to explain the practice and incorporate it when it can be done safely
Rationale: Culturally responsive care begins with individualized assessment rather than stereotypes and
accommodates preferences when safe.
11. During a focused safety round, a nurse is preparing an IM injection for an adult. Which safety principle
applies?
A. Select an appropriate site and needle based on medication volume, muscle mass, and client factors
B. Inject into any bruised area because it is already tender
C. Massage all vaccines vigorously after injection
D. Use the same needle for multiple clients if the medication is identical
Correct Answer: A. Select an appropriate site and needle based on medication volume, muscle mass, and client
factors
, Rationale: Safe IM injection requires correct site and equipment selection and single-use aseptic technique.
12. A postoperative client has increasing calf swelling and then develops sudden pleuritic chest pain and
tachycardia. Which diagnostic concern is highest? Unilateral calf swelling Earlier finding Sudden pleuritic
chest pain; HR 126/min New findings
A. Postoperative ileus
B. Pulmonary embolism
C. Urinary retention
D. Pressure injury
Correct Answer: B. Pulmonary embolism
Rationale: A new swollen calf followed by sudden pleuritic chest pain and tachycardia is highly concerning for
venous thromboembolism with pulmonary embolism.
13. During routine supportive care, a client is experiencing limited mobility. Which assessment finding is
most consistent with this care need?
A. difficulty locating objects and navigating an unfamiliar room
B. difficulty repositioning with intact cognition and stable cardiopulmonary status
C. nonblanchable erythema over a pressure point in an immobile client
D. difficulty understanding speech in background noise despite wearing hearing aids
Correct Answer: B. difficulty repositioning with intact cognition and stable cardiopulmonary status
Rationale: difficulty repositioning with intact cognition and stable cardiopulmonary status is a common cue
when caring for limited mobility.
14. While reconciling medications after a care transition, which pharmacologic action best explains the
therapeutic effect of cyclosporine?
A. inhibits calcineurin and T-cell activation
B. reduces beta1-mediated heart rate and contractility
C. inhibits bacterial 30S protein synthesis
D. blocks angiotensin II receptors
Correct Answer: A. inhibits calcineurin and T-cell activation
Rationale: cyclosporine works primarily because it inhibits calcineurin and T-cell activation.
15. A healthy 9-month-old has missed several routine immunizations because the family moved. Which
plan is most appropriate? 9 months Age Received some infant vaccines; records confirm valid prior doses
History None Current illness
A. Restart every vaccine series from the first dose
B. Wait until school entry to resume vaccines
C. Use the age-appropriate catch-up schedule without restarting prior valid vaccine series
D. Avoid all future vaccines because doses were late
Correct Answer: C. Use the age-appropriate catch-up schedule without restarting prior valid vaccine series
Rationale: Late doses generally do not require restarting valid vaccine series; catch-up schedules are used to
complete needed doses.
16. During emergency reassessment, the nurse is reviewing a client for possible atrial fibrillation. Which
assessment finding best supports this concern?
A. headache, confusion, seizures when severe
B. sudden severe thunderclap headache
C. irregularly irregular rhythm
D. fever, flank pain, and urinary symptoms
Correct Answer: C. irregularly irregular rhythm
Rationale: atrial fibrillation is classically associated with irregularly irregular rhythm.
17. During a therapeutic encounter, which assessment finding most strongly supports intimate partner
violence disclosure?
A. injuries with fearful behavior and a partner who controls the conversation or access to care
B. a specific suicide plan with access to the intended means
C. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe
D. acute fluctuating attention and cognition with altered level of consciousness
Correct Answer: A. injuries with fearful behavior and a partner who controls the conversation or access to care
EXAM QUESTIONS WITH ANSWERS AND EXPLANATIONS
1. During routine supportive care, a client is experiencing urinary incontinence. Which assessment finding
is most consistent with this care need?
A. frequent nighttime awakening related to noise, pain, and repeated interruptions
B. involuntary urine loss associated with urgency but no urinary retention
C. dry oral mucosa with inability to perform self-care
D. abdominal bloating, nausea, or repeated coughing during tube feeding
Correct Answer: B. involuntary urine loss associated with urgency but no urinary retention
Rationale: involuntary urine loss associated with urgency but no urinary retention is a common cue when caring
for urinary incontinence.
2. While preparing care for a high-risk client, a nurse sustains a needlestick from a used hollow-bore
needle. What should the nurse do first?
A. Squeeze the wound vigorously for several minutes
B. Wait for symptoms before reporting the exposure
C. Wash the site with soap and water and immediately report the exposure for post-exposure evaluation
D. Apply bleach to the puncture site
Correct Answer: C. Wash the site with soap and water and immediately report the exposure for post-exposure
evaluation
Rationale: Occupational exposure management starts with prompt cleansing and immediate reporting so source
testing and post-exposure prophylaxis can be evaluated without delay.
3. On a medical-surgical unit, a client with pneumonia has the expected presentation of fever, cough, focal
crackles, and infiltrate. Which worsening development should the nurse anticipate as a major
complication?
A. cerebral edema or osmotic demyelination from overcorrection
B. rebleeding and vasospasm
C. sepsis or respiratory failure
D. sepsis
Correct Answer: C. sepsis or respiratory failure
Rationale: A major complication of pneumonia is sepsis or respiratory failure.
4. During an urgent bedside reassessment, a client’s presentation is consistent with subarachnoid
hemorrhage. What is the nurse’s best next action?
A. correct cause and raise sodium carefully to avoid osmotic demyelination
B. obtain urine testing and start appropriate antibiotics
C. urgent CT/vascular evaluation and neurosurgical management
D. obtain cultures when indicated and begin timely antimicrobial/supportive care
Correct Answer: C. urgent CT/vascular evaluation and neurosurgical management
Rationale: For subarachnoid hemorrhage, the priority response is to urgent CT/vascular evaluation and
neurosurgical management.
5. During a pharmacist-nurse medication review, for which problem would the nurse most expect to see
valproate prescribed?
A. transplant immunosuppression
B. seizure disorders and bipolar disorder
C. hypertension, angina, and rate control
D. tick-borne disease, acne, and selected infections
Correct Answer: B. seizure disorders and bipolar disorder
Rationale: valproate, a antiseizure medication/mood stabilizer, is commonly used for seizure disorders and
bipolar disorder.
6. A client with asthma initially has loud wheezing. Thirty minutes later the client is exhausted, has
minimal air movement, and the wheezing is barely audible. How should the nurse interpret this change?
Diffuse wheezing; RR 30/min Earlier Exhausted; minimal air movement; faint wheeze Now
A. The asthma attack is resolving because wheezing is quieter
,B. The client may be developing severe airflow obstruction with impending respiratory failure
C. The client is ready for discharge
D. The client is experiencing only anxiety
Correct Answer: B. The client may be developing severe airflow obstruction with impending respiratory failure
Rationale: A “silent chest” with fatigue and poor air movement is an ominous sign of severe obstruction, not
improvement.
7. During a preventive-care visit, a parent asks when to introduce complementary foods to a healthy infant.
Which guidance is appropriate?
A. Introduce developmentally appropriate complementary foods around 6 months while continuing breast milk or
formula
B. Start solid foods routinely at 1 month
C. Replace all breast milk or formula at 4 months
D. Delay all textured foods until age 2 years
Correct Answer: A. Introduce developmentally appropriate complementary foods around 6 months while
continuing breast milk or formula
Rationale: Complementary foods are typically introduced around 6 months when developmental readiness is
present, while breast milk or formula remains important.
8. While assisting with activities of daily living, which client statement demonstrates correct teaching about
limited mobility?
A. maintain hearing aids and use visual cues in difficult listening environments
B. use a consistent sleep schedule and limit late caffeine when feasible
C. shift weight frequently and avoid prolonged pressure on vulnerable areas
D. participate in prescribed range-of-motion and mobility activities rather than remaining in bed continuously
Correct Answer: D. participate in prescribed range-of-motion and mobility activities rather than remaining in
bed continuously
Rationale: Progressive mobility preserves function and reduces complications such as deconditioning,
atelectasis, and pressure injury.
9. Fifteen minutes after a packed RBC transfusion begins, the client develops chills, lumbar pain, and
dyspnea. What should the nurse do first? T 37.0 C; BP 126/72 Before transfusion T 38.3 C; chills, low-back
pain, dyspnea 15 min after start
A. Slow the transfusion and reassess in 30 minutes
B. Administer the next unit of blood
C. Remove the IV catheter immediately and provide no access
D. Stop the transfusion and keep the IV line open with normal saline using new tubing
Correct Answer: D. Stop the transfusion and keep the IV line open with normal saline using new tubing
Rationale: These findings may indicate an acute transfusion reaction; the transfusion must be stopped while
venous access is maintained with normal saline.
10. During morning coordination rounds, a client says a cultural practice is important during
hospitalization. What should the nurse do?
A. Assume all clients from that culture follow the same practice
B. Ask the client to explain the practice and incorporate it when it can be done safely
C. Refuse any practice not used by the nurse
D. Ask another client from the same culture to decide
Correct Answer: B. Ask the client to explain the practice and incorporate it when it can be done safely
Rationale: Culturally responsive care begins with individualized assessment rather than stereotypes and
accommodates preferences when safe.
11. During a focused safety round, a nurse is preparing an IM injection for an adult. Which safety principle
applies?
A. Select an appropriate site and needle based on medication volume, muscle mass, and client factors
B. Inject into any bruised area because it is already tender
C. Massage all vaccines vigorously after injection
D. Use the same needle for multiple clients if the medication is identical
Correct Answer: A. Select an appropriate site and needle based on medication volume, muscle mass, and client
factors
, Rationale: Safe IM injection requires correct site and equipment selection and single-use aseptic technique.
12. A postoperative client has increasing calf swelling and then develops sudden pleuritic chest pain and
tachycardia. Which diagnostic concern is highest? Unilateral calf swelling Earlier finding Sudden pleuritic
chest pain; HR 126/min New findings
A. Postoperative ileus
B. Pulmonary embolism
C. Urinary retention
D. Pressure injury
Correct Answer: B. Pulmonary embolism
Rationale: A new swollen calf followed by sudden pleuritic chest pain and tachycardia is highly concerning for
venous thromboembolism with pulmonary embolism.
13. During routine supportive care, a client is experiencing limited mobility. Which assessment finding is
most consistent with this care need?
A. difficulty locating objects and navigating an unfamiliar room
B. difficulty repositioning with intact cognition and stable cardiopulmonary status
C. nonblanchable erythema over a pressure point in an immobile client
D. difficulty understanding speech in background noise despite wearing hearing aids
Correct Answer: B. difficulty repositioning with intact cognition and stable cardiopulmonary status
Rationale: difficulty repositioning with intact cognition and stable cardiopulmonary status is a common cue
when caring for limited mobility.
14. While reconciling medications after a care transition, which pharmacologic action best explains the
therapeutic effect of cyclosporine?
A. inhibits calcineurin and T-cell activation
B. reduces beta1-mediated heart rate and contractility
C. inhibits bacterial 30S protein synthesis
D. blocks angiotensin II receptors
Correct Answer: A. inhibits calcineurin and T-cell activation
Rationale: cyclosporine works primarily because it inhibits calcineurin and T-cell activation.
15. A healthy 9-month-old has missed several routine immunizations because the family moved. Which
plan is most appropriate? 9 months Age Received some infant vaccines; records confirm valid prior doses
History None Current illness
A. Restart every vaccine series from the first dose
B. Wait until school entry to resume vaccines
C. Use the age-appropriate catch-up schedule without restarting prior valid vaccine series
D. Avoid all future vaccines because doses were late
Correct Answer: C. Use the age-appropriate catch-up schedule without restarting prior valid vaccine series
Rationale: Late doses generally do not require restarting valid vaccine series; catch-up schedules are used to
complete needed doses.
16. During emergency reassessment, the nurse is reviewing a client for possible atrial fibrillation. Which
assessment finding best supports this concern?
A. headache, confusion, seizures when severe
B. sudden severe thunderclap headache
C. irregularly irregular rhythm
D. fever, flank pain, and urinary symptoms
Correct Answer: C. irregularly irregular rhythm
Rationale: atrial fibrillation is classically associated with irregularly irregular rhythm.
17. During a therapeutic encounter, which assessment finding most strongly supports intimate partner
violence disclosure?
A. injuries with fearful behavior and a partner who controls the conversation or access to care
B. a specific suicide plan with access to the intended means
C. sudden intense fear with palpitations, dyspnea, trembling, and a sense of impending catastrophe
D. acute fluctuating attention and cognition with altered level of consciousness
Correct Answer: A. injuries with fearful behavior and a partner who controls the conversation or access to care
