ATI RN COMPREHENSIVE
PREDICTOR NGN REVIEW--Full
Practice Test Pack (2026 Edition)|||
questions and answers with
rationales/graded A+/2026
update/100% correct /instant
download
Total Questions: 85 | Format: NGN Case Studies, Bow-Tie, Multiple Choice,
Select All That Apply
Part 1: NGN Unfolding Case Study – Heart Failure Exacerbation
Scenario (Questions 1–6)
A 72-year-old male with a history of HFpEF (preserved ejection fraction) presents
to the ED with worsening dyspnea on exertion, orthopnea, and 3+ pitting edema in
lower extremities. Vital signs: BP 168/94, HR 112, RR 28, SpO2 88% on room air,
afebrile. Lung auscultation reveals crackles bilaterally at bases.
Question 1 (Matrix / Select All That Apply)
Which assessment findings are consistent with acute decompensated heart failure?
Select all that apply.
A. Jugular venous distension
B. Paroxysmal nocturnal dyspnea
C. Decreased brain natriuretic peptide (BNP)
D. S3 gallop
E. Dry, nonproductive cough
, Correct Answers: A, B, D
Rationale: JVD, PND, and S3 gallop are classic signs of HF. BNP is increased, not
decreased, in HF exacerbation. Dry cough is not typical; moist crackles are
expected.
Question 2 (Bow-Tie Question)
Complete the bow-tie by selecting the priority assessment (left side) and
priority intervention (right side) for this patient’s immediate care.
Left (Assessment) Center (Priority Problem) Right (Intervention)
A. Respiratory rate Impaired gas exchange A. Administer IV furosemide
B. Urine output Fluid volume excess B. Place in high-Fowler’s position
C. Oxygen saturation Activity intolerance C. Start dopamine infusion
Correct Answer: Left = C (Oxygen saturation) → Center problem is impaired
gas exchange → Right = B (High-Fowler’s position)
Rationale: Low SpO2 indicates impaired gas exchange. High-Fowler’s improves
ventilation and reduces preload. Furosemide is important but not the immediate
positioning priority.
Question 3 (Multiple Response – Cloze)
The provider orders IV furosemide 40 mg. Which action(s) must the nurse take?
Select 3 that apply.
A. Assess for ototoxicity if given rapidly
B. Monitor urine output hourly
C. Give IV push at 20 mg/min
D. Keep patient supine for 2 hours after dose
E. Check potassium level before administration
Correct Answers: A, B, E
Rationale: Rapid furosemide can cause ototoxicity. Hourly urine output monitors
diuretic effect. Hypokalemia risk requires baseline K+ check.
Incorrect C: Max rate is 20 mg/min? No – ATI recommends 20-40 mg over 1-2
min, but ototoxicity risk if >4 mg/min. Slower is safer. Check facility policy. D is
not needed.
PREDICTOR NGN REVIEW--Full
Practice Test Pack (2026 Edition)|||
questions and answers with
rationales/graded A+/2026
update/100% correct /instant
download
Total Questions: 85 | Format: NGN Case Studies, Bow-Tie, Multiple Choice,
Select All That Apply
Part 1: NGN Unfolding Case Study – Heart Failure Exacerbation
Scenario (Questions 1–6)
A 72-year-old male with a history of HFpEF (preserved ejection fraction) presents
to the ED with worsening dyspnea on exertion, orthopnea, and 3+ pitting edema in
lower extremities. Vital signs: BP 168/94, HR 112, RR 28, SpO2 88% on room air,
afebrile. Lung auscultation reveals crackles bilaterally at bases.
Question 1 (Matrix / Select All That Apply)
Which assessment findings are consistent with acute decompensated heart failure?
Select all that apply.
A. Jugular venous distension
B. Paroxysmal nocturnal dyspnea
C. Decreased brain natriuretic peptide (BNP)
D. S3 gallop
E. Dry, nonproductive cough
, Correct Answers: A, B, D
Rationale: JVD, PND, and S3 gallop are classic signs of HF. BNP is increased, not
decreased, in HF exacerbation. Dry cough is not typical; moist crackles are
expected.
Question 2 (Bow-Tie Question)
Complete the bow-tie by selecting the priority assessment (left side) and
priority intervention (right side) for this patient’s immediate care.
Left (Assessment) Center (Priority Problem) Right (Intervention)
A. Respiratory rate Impaired gas exchange A. Administer IV furosemide
B. Urine output Fluid volume excess B. Place in high-Fowler’s position
C. Oxygen saturation Activity intolerance C. Start dopamine infusion
Correct Answer: Left = C (Oxygen saturation) → Center problem is impaired
gas exchange → Right = B (High-Fowler’s position)
Rationale: Low SpO2 indicates impaired gas exchange. High-Fowler’s improves
ventilation and reduces preload. Furosemide is important but not the immediate
positioning priority.
Question 3 (Multiple Response – Cloze)
The provider orders IV furosemide 40 mg. Which action(s) must the nurse take?
Select 3 that apply.
A. Assess for ototoxicity if given rapidly
B. Monitor urine output hourly
C. Give IV push at 20 mg/min
D. Keep patient supine for 2 hours after dose
E. Check potassium level before administration
Correct Answers: A, B, E
Rationale: Rapid furosemide can cause ototoxicity. Hourly urine output monitors
diuretic effect. Hypokalemia risk requires baseline K+ check.
Incorrect C: Max rate is 20 mg/min? No – ATI recommends 20-40 mg over 1-2
min, but ototoxicity risk if >4 mg/min. Slower is safer. Check facility policy. D is
not needed.
