ATI RN PREDICTOR EXAM
ULTIMATE REVIEW - NGN-
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2026 BSN/RN School Exam||Questions
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SECTION 1: Cardiovascular & Respiratory Disorders (Items 1–15)
1. A nurse assesses a client with heart failure who reports sudden onset of
dyspnea and cough producing pink, frothy sputum. Which action should the
nurse take first?
A. Administer furosemide IV push
B. Place the client in high-Fowler’s position
C. Apply a non-rebreather mask at 100% oxygen
D. Check oxygen saturation via pulse oximetry
Rationale: High-Fowler’s position reduces venous return (preload) and improves
lung expansion, offering immediate relief for pulmonary edema. Oxygen and
diuretics follow after positioning.
2. A client with atrial fibrillation is prescribed warfarin. Which laboratory
result indicates therapeutic effect?
A. INR 1.0
B. INR 2.5
C. aPTT 60 seconds
D. Platelets 150,000/mm³
Rationale: For atrial fibrillation, target INR is 2.0–3.0. INR 2.5 is therapeutic.
,3. (Select all that apply) A nurse is teaching a client about digoxin toxicity.
Which manifestations should be included?
☐ Bradycardia
☐ Nausea and vomiting
☐ Yellow-tinged vision
☐ Hyperglycemia
☐ Tachycardia
Rationale: Digoxin toxicity causes bradycardia, GI upset (nausea, vomiting,
anorexia), and visual disturbances (yellow/green halos).
4. A client post–myocardial infarction develops jugular vein distention,
muffled heart sounds, and hypotension. The nurse suspects:
A. Cardiogenic shock
B. Pericardial effusion with cardiac tamponade
C. Left-sided heart failure
D. Pulmonary embolism
Rationale: Beck’s triad (hypotension, muffled heart sounds, JVD) indicates
cardiac tamponade requiring emergency pericardiocentesis.
5. A client with pneumonia has an SpO₂ of 88% on room air. The nurse applies
oxygen at 2 L/min via nasal cannula. What is the priority reassessment after 5
minutes?
A. Lung sounds
B. Respiratory rate and SpO₂
C. Level of consciousness
D. Sputum color
Rationale: After oxygen therapy, reassess oxygenation (SpO₂) and respiratory
effort to determine effectiveness.
,6. A nurse is caring for a client with a chest tube to water seal drainage for a
pneumothorax. Which finding requires immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Tidaling with respiration
C. Drainage of 50 mL in the first hour
D. Pain at insertion site rated 3/10
Rationale: Continuous bubbling indicates an air leak (e.g., loose connection or
chest wall defect). Tidaling is normal; drainage <100 mL/hr expected.
7. (Bowtie question) A client with chronic obstructive pulmonary disease
(COPD) has an SpO₂ of 86% and is drowsy. The nurse should place the
highest priority on which condition and which action?
Condition (Center) Action (Right side)
Hypoventilation with CO₂ retention Prepare for noninvasive ventilation (BiPAP)
Rationale: COPD clients on high oxygen can lose hypoxic drive, leading to CO₂
narcosis. BiPAP supports ventilation.
8. A client with deep vein thrombosis (DVT) is on heparin infusion. The nurse
notes a sudden onset of chest pain, dyspnea, and hemoptysis. What is the
priority nursing action?
A. Stop the heparin drip
B. Elevate the head of bed and apply oxygen
C. Administer protamine sulfate
D. Obtain a stat ECG
Rationale: These symptoms suggest pulmonary embolism. Oxygen and
positioning (HOB up) improve oxygenation first, then notify provider for
thrombolytics/embolectomy.
9. (Select all that apply) A nurse is providing discharge teaching to a client
with heart failure. Which statements indicate understanding?
, ☐ “I will weigh myself every morning after voiding.”
☐ “I should limit my fluid intake to 3 liters per day.”
☐ “I will report a weight gain of 2–3 pounds in a day.”
☐ “I will avoid adding salt to my food while cooking.”
☐ “I can take ibuprofen for joint pain if needed.”
Rationale: Daily weight (same scale, same time) and sodium restriction are key.
Rapid weight gain indicates fluid retention. NSAIDs (ibuprofen) worsen HF.
10. A client with hypertension is prescribed lisinopril. Which adverse effect
requires the nurse to question the prescription?
A. Dry cough
B. Serum potassium 5.3 mEq/L
C. Angioedema of the lips and tongue
D. Dizziness when standing up
Rationale: Angioedema is a life-threatening ACE inhibitor reaction requiring
immediate discontinuation and epinephrine. Dry cough is common but not
emergent.
11. A nurse auscultates an S3 heart sound in a 70-year-old client. What does
this finding suggest?
A. Normal aging change
B. Heart failure or volume overload
C. Aortic stenosis
D. Pericarditis
Rationale: S3 (gallop) in older adults indicates decreased left ventricular
compliance, often from HF or fluid overload.
12. A client with asthma uses an albuterol rescue inhaler. The nurse evaluates
that the medication is effective when the client reports:
A. Decreased respiratory rate from 28 to 16
B. Increased peak expiratory flow from 200 to 350 L/min
ULTIMATE REVIEW - NGN-
Question Comprehensive Test | Latest
2026 BSN/RN School Exam||Questions
And Answers With Rationales/Graded
A+/2026 Update/100% Correct
/Instant Download
SECTION 1: Cardiovascular & Respiratory Disorders (Items 1–15)
1. A nurse assesses a client with heart failure who reports sudden onset of
dyspnea and cough producing pink, frothy sputum. Which action should the
nurse take first?
A. Administer furosemide IV push
B. Place the client in high-Fowler’s position
C. Apply a non-rebreather mask at 100% oxygen
D. Check oxygen saturation via pulse oximetry
Rationale: High-Fowler’s position reduces venous return (preload) and improves
lung expansion, offering immediate relief for pulmonary edema. Oxygen and
diuretics follow after positioning.
2. A client with atrial fibrillation is prescribed warfarin. Which laboratory
result indicates therapeutic effect?
A. INR 1.0
B. INR 2.5
C. aPTT 60 seconds
D. Platelets 150,000/mm³
Rationale: For atrial fibrillation, target INR is 2.0–3.0. INR 2.5 is therapeutic.
,3. (Select all that apply) A nurse is teaching a client about digoxin toxicity.
Which manifestations should be included?
☐ Bradycardia
☐ Nausea and vomiting
☐ Yellow-tinged vision
☐ Hyperglycemia
☐ Tachycardia
Rationale: Digoxin toxicity causes bradycardia, GI upset (nausea, vomiting,
anorexia), and visual disturbances (yellow/green halos).
4. A client post–myocardial infarction develops jugular vein distention,
muffled heart sounds, and hypotension. The nurse suspects:
A. Cardiogenic shock
B. Pericardial effusion with cardiac tamponade
C. Left-sided heart failure
D. Pulmonary embolism
Rationale: Beck’s triad (hypotension, muffled heart sounds, JVD) indicates
cardiac tamponade requiring emergency pericardiocentesis.
5. A client with pneumonia has an SpO₂ of 88% on room air. The nurse applies
oxygen at 2 L/min via nasal cannula. What is the priority reassessment after 5
minutes?
A. Lung sounds
B. Respiratory rate and SpO₂
C. Level of consciousness
D. Sputum color
Rationale: After oxygen therapy, reassess oxygenation (SpO₂) and respiratory
effort to determine effectiveness.
,6. A nurse is caring for a client with a chest tube to water seal drainage for a
pneumothorax. Which finding requires immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Tidaling with respiration
C. Drainage of 50 mL in the first hour
D. Pain at insertion site rated 3/10
Rationale: Continuous bubbling indicates an air leak (e.g., loose connection or
chest wall defect). Tidaling is normal; drainage <100 mL/hr expected.
7. (Bowtie question) A client with chronic obstructive pulmonary disease
(COPD) has an SpO₂ of 86% and is drowsy. The nurse should place the
highest priority on which condition and which action?
Condition (Center) Action (Right side)
Hypoventilation with CO₂ retention Prepare for noninvasive ventilation (BiPAP)
Rationale: COPD clients on high oxygen can lose hypoxic drive, leading to CO₂
narcosis. BiPAP supports ventilation.
8. A client with deep vein thrombosis (DVT) is on heparin infusion. The nurse
notes a sudden onset of chest pain, dyspnea, and hemoptysis. What is the
priority nursing action?
A. Stop the heparin drip
B. Elevate the head of bed and apply oxygen
C. Administer protamine sulfate
D. Obtain a stat ECG
Rationale: These symptoms suggest pulmonary embolism. Oxygen and
positioning (HOB up) improve oxygenation first, then notify provider for
thrombolytics/embolectomy.
9. (Select all that apply) A nurse is providing discharge teaching to a client
with heart failure. Which statements indicate understanding?
, ☐ “I will weigh myself every morning after voiding.”
☐ “I should limit my fluid intake to 3 liters per day.”
☐ “I will report a weight gain of 2–3 pounds in a day.”
☐ “I will avoid adding salt to my food while cooking.”
☐ “I can take ibuprofen for joint pain if needed.”
Rationale: Daily weight (same scale, same time) and sodium restriction are key.
Rapid weight gain indicates fluid retention. NSAIDs (ibuprofen) worsen HF.
10. A client with hypertension is prescribed lisinopril. Which adverse effect
requires the nurse to question the prescription?
A. Dry cough
B. Serum potassium 5.3 mEq/L
C. Angioedema of the lips and tongue
D. Dizziness when standing up
Rationale: Angioedema is a life-threatening ACE inhibitor reaction requiring
immediate discontinuation and epinephrine. Dry cough is common but not
emergent.
11. A nurse auscultates an S3 heart sound in a 70-year-old client. What does
this finding suggest?
A. Normal aging change
B. Heart failure or volume overload
C. Aortic stenosis
D. Pericarditis
Rationale: S3 (gallop) in older adults indicates decreased left ventricular
compliance, often from HF or fluid overload.
12. A client with asthma uses an albuterol rescue inhaler. The nurse evaluates
that the medication is effective when the client reports:
A. Decreased respiratory rate from 28 to 16
B. Increased peak expiratory flow from 200 to 350 L/min
