NGN ATI RN VATI COMPREHENSIVE PREDICTOR 2024 FORM
A VATI RN COMPREHENSIVE, (LATEST
UPDATE), ACTUAL EXAM/TEST QUESTIONS AND 100%
VERIFIED ANSWERS| A+ GRADE.
Item Type: Bowtie
Client Scenario:
A 68-year-old male with a history of COPD, HTN, and 40 pack-year smoking presents to
the ED with increasing dyspnea, productive cough with yellow-green sputum, and
fatigue for 3 days.
Vital Signs: BP 158/90, HR 118, RR 28, SpO₂ 84% on RA, T 38.2°C.
ABG: pH 7.28, PaCO₂ 68, PaO₂ 52, HCO₃⁻ 32.
Nurse Notes: Patient appears anxious, using accessory muscles, and unable to speak in
full sentences.
Chest X-ray: Right lower lobe infiltrate.
Current meds: Lisinopril 10 mg daily, albuterol MDI PRN.
NGN Bowtie Task:
,Identify the cues, analyze the hypothesis, and select the priority nursing actions.
Cues (Select 3):
A. Productive cough with purulent sputum
B. SpO₂ 84% on room air
C. Temperature 38.2°C
D. HR 118
E. HCO₃⁻ 32 mEq/L
Analysis (Select 1):
F. Acute respiratory failure secondary to COPD exacerbation and pneumonia
Actions (Select 3):
G. Administer oxygen via Venturi mask to achieve SpO₂ 88–92%
H. Obtain sputum culture before initiating antibiotics
I. Initiate IV corticosteroids as ordered
J. Place patient in high-Fowler’s position
, K. Prepare for immediate intubation
Correct Responses:
Cues: A, B, C
Analysis: F
Actions: G, H, J
Rationale:
The patient presents with classic signs of acute COPD exacerbation triggered by
bacterial pneumonia. Purulent sputum and fever (A, C) indicate infection, while SpO₂
84% (B) reflects acute hypoxemia. The ABG shows acute-on-chronic respiratory
acidosis, but the priority is correcting hypoxemia and infection. Administering controlled
oxygen (G) prevents CO₂ narcosis while improving oxygenation. Sputum culture (H)
guides antibiotic therapy, and positioning (J) reduces dyspnea. Steroids (I) are
appropriate but not first-line in the bowtie priority sequence. Intubation (K) is not yet
indicated.
Item Type: Extended Multiple Response (Select All That Apply)
Client Scenario:
A 55-year-old female post-op day 2 after abdominal hysterectomy reports sudden
shortness of breath and chest pain.
A VATI RN COMPREHENSIVE, (LATEST
UPDATE), ACTUAL EXAM/TEST QUESTIONS AND 100%
VERIFIED ANSWERS| A+ GRADE.
Item Type: Bowtie
Client Scenario:
A 68-year-old male with a history of COPD, HTN, and 40 pack-year smoking presents to
the ED with increasing dyspnea, productive cough with yellow-green sputum, and
fatigue for 3 days.
Vital Signs: BP 158/90, HR 118, RR 28, SpO₂ 84% on RA, T 38.2°C.
ABG: pH 7.28, PaCO₂ 68, PaO₂ 52, HCO₃⁻ 32.
Nurse Notes: Patient appears anxious, using accessory muscles, and unable to speak in
full sentences.
Chest X-ray: Right lower lobe infiltrate.
Current meds: Lisinopril 10 mg daily, albuterol MDI PRN.
NGN Bowtie Task:
,Identify the cues, analyze the hypothesis, and select the priority nursing actions.
Cues (Select 3):
A. Productive cough with purulent sputum
B. SpO₂ 84% on room air
C. Temperature 38.2°C
D. HR 118
E. HCO₃⁻ 32 mEq/L
Analysis (Select 1):
F. Acute respiratory failure secondary to COPD exacerbation and pneumonia
Actions (Select 3):
G. Administer oxygen via Venturi mask to achieve SpO₂ 88–92%
H. Obtain sputum culture before initiating antibiotics
I. Initiate IV corticosteroids as ordered
J. Place patient in high-Fowler’s position
, K. Prepare for immediate intubation
Correct Responses:
Cues: A, B, C
Analysis: F
Actions: G, H, J
Rationale:
The patient presents with classic signs of acute COPD exacerbation triggered by
bacterial pneumonia. Purulent sputum and fever (A, C) indicate infection, while SpO₂
84% (B) reflects acute hypoxemia. The ABG shows acute-on-chronic respiratory
acidosis, but the priority is correcting hypoxemia and infection. Administering controlled
oxygen (G) prevents CO₂ narcosis while improving oxygenation. Sputum culture (H)
guides antibiotic therapy, and positioning (J) reduces dyspnea. Steroids (I) are
appropriate but not first-line in the bowtie priority sequence. Intubation (K) is not yet
indicated.
Item Type: Extended Multiple Response (Select All That Apply)
Client Scenario:
A 55-year-old female post-op day 2 after abdominal hysterectomy reports sudden
shortness of breath and chest pain.
