ATI PN COMPREHENSIVE
PREDICTOR 2026/2027 – LATEST
NGN PRACTICE EXAM||questions
and answers with rationales/graded
A+/2026 update/100% correct /instant
download
Total Questions: 85
Topics: Medical-Surgical, Pharmacology, Maternity, Pediatrics, Mental Health,
Fundamentals, Leadership, NGN Case Studies
Time Limit: 3 hours
SECTION A: NGN CASE STUDY (Questions 1–8)
Case Study: Postoperative Care
A 68-year-old male is 6 hours post–right total knee arthroplasty. He has a PCA
pump with morphine, IV fluids at 75 mL/hr, and a sequential compression device.
Vital signs: BP 142/88, HR 102, RR 10, O2 sat 90% on room air. He is lethargic
and difficult to arouse.
1. Which assessment finding requires immediate intervention?
A. BP 142/88
B. RR 10 and O2 sat 90%
C. HR 102
D. Lethargy
Rationale: A respiratory rate of 10 and O2 sat of 90% indicate hypoventilation and
hypoxemia, likely from opioid over-sedation. This is an emergency requiring
naloxone and airway support. Lethargy is a consequence but the ABCs take
priority.
,2. Select the 3 priority actions (SATA).
A. Administer naloxone as ordered
B. Apply oxygen at 2–4 L via nasal cannula
C. Increase IV fluid rate
D. Prepare for possible bag-valve-mask ventilation
E. Encourage deep breathing and coughing
F. Check pain level
Rationale: Narcan reverses opioid depression, oxygen treats hypoxemia, and
BVM may be needed if RR does not improve. Pain assessment is not urgent here.
3. Which medication order should the nurse question?
A. Morphine 1 mg IV push q2h PRN pain
B. Zolpidem 10 mg PO at bedtime
C. Enoxaparin 40 mg subcut daily
D. Ondansetron 4 mg IV q6h PRN nausea
Rationale: Zolpidem (Ambien) is a CNS depressant. Adding it to morphine
increases respiratory depression risk. The nurse should clarify this order.
4. The patient’s urine output over the last 2 hours is 40 mL total. What is the
priority action?
A. Increase IV fluids to 125 mL/hr
B. Assess bladder distention and check patency of Foley catheter
C. Notify the provider immediately
D. Administer furosemide 20 mg IV
Rationale: Low urine output post-op may be due to Foley obstruction or bladder
distention. Check mechanical causes before assuming renal issue or giving
diuretics.
5. Place the following actions in correct order for suspected opioid overdose.
1. Check responsiveness and respirations
2. Call for help and obtain naloxone
3. Administer naloxone
4. Provide bag-valve-mask ventilation if needed
Rationale: Assess first, then activate team, then give antidote, then support
breathing.
, 6. The patient becomes alert after naloxone. What should the nurse do next?
A. Discontinue the PCA pump
B. Monitor for recurrent respiratory depression every 15 min for 2 hours
C. Increase morphine dose due to pain
D. Discharge to home
Rationale: Naloxone has a shorter half-life than morphine; repeat sedation is
common. Close monitoring is essential.
7. Which pain management strategy is safest now?
A. Resume PCA morphine at same dose
B. Oral acetaminophen 650 mg q6h and ice packs
C. IV ketorolac 30 mg once
D. Fentanyl patch 25 mcg/hr
Rationale: After respiratory depression, use non-opioid or low-risk options.
Acetaminophen and ice are safest.
8. The patient asks, “Why do I have those leg squeezers on?” Best response:
A. “They prevent blood clots by keeping circulation moving.”
B. “They help reduce leg swelling after surgery.”
C. “They squeeze your legs to prevent deep vein thrombosis.”
D. “They are required after knee surgery.”
Rationale: Correct answer directly explains DVT prevention, which is primary
indication for SCDs post-op.
SECTION B: FUNDAMENTALS (Questions 9–22)
9. A nurse is preparing to insert a nasogastric tube. Which position is best for
the patient?
A. Supine with head flat
B. High-Fowler’s with head tilted forward
C. Left side-lying
D. Trendelenburg
Rationale: High-Fowler’s with chin down closes trachea and opens esophagus,
facilitating passage.
PREDICTOR 2026/2027 – LATEST
NGN PRACTICE EXAM||questions
and answers with rationales/graded
A+/2026 update/100% correct /instant
download
Total Questions: 85
Topics: Medical-Surgical, Pharmacology, Maternity, Pediatrics, Mental Health,
Fundamentals, Leadership, NGN Case Studies
Time Limit: 3 hours
SECTION A: NGN CASE STUDY (Questions 1–8)
Case Study: Postoperative Care
A 68-year-old male is 6 hours post–right total knee arthroplasty. He has a PCA
pump with morphine, IV fluids at 75 mL/hr, and a sequential compression device.
Vital signs: BP 142/88, HR 102, RR 10, O2 sat 90% on room air. He is lethargic
and difficult to arouse.
1. Which assessment finding requires immediate intervention?
A. BP 142/88
B. RR 10 and O2 sat 90%
C. HR 102
D. Lethargy
Rationale: A respiratory rate of 10 and O2 sat of 90% indicate hypoventilation and
hypoxemia, likely from opioid over-sedation. This is an emergency requiring
naloxone and airway support. Lethargy is a consequence but the ABCs take
priority.
,2. Select the 3 priority actions (SATA).
A. Administer naloxone as ordered
B. Apply oxygen at 2–4 L via nasal cannula
C. Increase IV fluid rate
D. Prepare for possible bag-valve-mask ventilation
E. Encourage deep breathing and coughing
F. Check pain level
Rationale: Narcan reverses opioid depression, oxygen treats hypoxemia, and
BVM may be needed if RR does not improve. Pain assessment is not urgent here.
3. Which medication order should the nurse question?
A. Morphine 1 mg IV push q2h PRN pain
B. Zolpidem 10 mg PO at bedtime
C. Enoxaparin 40 mg subcut daily
D. Ondansetron 4 mg IV q6h PRN nausea
Rationale: Zolpidem (Ambien) is a CNS depressant. Adding it to morphine
increases respiratory depression risk. The nurse should clarify this order.
4. The patient’s urine output over the last 2 hours is 40 mL total. What is the
priority action?
A. Increase IV fluids to 125 mL/hr
B. Assess bladder distention and check patency of Foley catheter
C. Notify the provider immediately
D. Administer furosemide 20 mg IV
Rationale: Low urine output post-op may be due to Foley obstruction or bladder
distention. Check mechanical causes before assuming renal issue or giving
diuretics.
5. Place the following actions in correct order for suspected opioid overdose.
1. Check responsiveness and respirations
2. Call for help and obtain naloxone
3. Administer naloxone
4. Provide bag-valve-mask ventilation if needed
Rationale: Assess first, then activate team, then give antidote, then support
breathing.
, 6. The patient becomes alert after naloxone. What should the nurse do next?
A. Discontinue the PCA pump
B. Monitor for recurrent respiratory depression every 15 min for 2 hours
C. Increase morphine dose due to pain
D. Discharge to home
Rationale: Naloxone has a shorter half-life than morphine; repeat sedation is
common. Close monitoring is essential.
7. Which pain management strategy is safest now?
A. Resume PCA morphine at same dose
B. Oral acetaminophen 650 mg q6h and ice packs
C. IV ketorolac 30 mg once
D. Fentanyl patch 25 mcg/hr
Rationale: After respiratory depression, use non-opioid or low-risk options.
Acetaminophen and ice are safest.
8. The patient asks, “Why do I have those leg squeezers on?” Best response:
A. “They prevent blood clots by keeping circulation moving.”
B. “They help reduce leg swelling after surgery.”
C. “They squeeze your legs to prevent deep vein thrombosis.”
D. “They are required after knee surgery.”
Rationale: Correct answer directly explains DVT prevention, which is primary
indication for SCDs post-op.
SECTION B: FUNDAMENTALS (Questions 9–22)
9. A nurse is preparing to insert a nasogastric tube. Which position is best for
the patient?
A. Supine with head flat
B. High-Fowler’s with head tilted forward
C. Left side-lying
D. Trendelenburg
Rationale: High-Fowler’s with chin down closes trachea and opens esophagus,
facilitating passage.
