Virtual ATI Next Gen PN Comprehensive
Predictor Exit Assessment for NUR 265 Level
3 Form B & C with Actual & Retake Real
Questions and Verified Solutions — Pass on
First Attempt
Question 1 of 180 (Form B)
A practical nurse (PN) is caring for a client with a new diagnosis of deep vein
thrombosis (DVT) who is receiving heparin infusion. Which of the following
findings indicates a therapeutic response?
1. aPTT 2.5 times the control value
2. INR 3.0
3. Platelet count 50,000/mm³
4. Fibrinogen level 400 mg/dL
Verified Solution:
Correct answer: 1 – Therapeutic aPTT for heparin is 1.5–2.5 times the control
value.
• 2 INR monitors warfarin, not heparin.
• 3 Platelet count 50,000 indicates thrombocytopenia (possible HIT), not
therapeutic effect.
• 4 Fibrinogen is an acute phase reactant; normal level does not indicate
heparin effectiveness.
Question 2 of 180 (Form B)
A PN is reinforcing discharge teaching for a client with a new prescription for
clopidogrel (Plavix). Which statement by the client indicates a need for further
teaching?
1. “I will avoid taking omeprazole (Prilosec).”
2. “I will report any black, tarry stools.”
3. “I can take ibuprofen if I have a headache.”
4. “I will stop this medication 5 days before surgery.”
Verified Solution:
Correct answer: 3 – Ibuprofen (NSAID) increases bleeding risk and should be
avoided with clopidogrel.
• 1 Omeprazole reduces clopidogrel effectiveness (correct to avoid).
• 2 Black/tarry stools indicate GI bleeding – correct to report.
Page 1 of 58
, • 4 Stopping 5 days before surgery is standard to reduce bleeding risk.
Question 3 of 180 (Form B)
A PN is caring for a client who is 2 hours post-mediastinoscopy. Which finding
should be reported immediately?
1. Subcutaneous emphysema around the neck
2. Pain rated 4/10
3. Small amount of serosanguineous drainage
4. Heart rate 88 bpm
Verified Solution:
Correct answer: 1 – Subcutaneous emphysema may indicate pneumothorax or
air leak from the procedure – report immediately.
• 2 Mild pain is expected.
• 3 Small amount of serosanguineous drainage is normal.
• 4 Heart rate 88 bpm is within normal range.
Question 4 of 180 (Form B)
A PN is reinforcing education for a client with a new ileostomy about skin care.
Which statement indicates understanding?
1. “I will use alcohol to clean around the stoma.”
2. “I will cut the wafer opening exactly the size of my stoma.”
3. “I will apply petroleum jelly to protect the skin.”
4. “I will change the pouch every day.”
Verified Solution:
Correct answer: 2 – Cutting the wafer opening to exactly fit the stoma prevents
leakage and skin breakdown.
• 1 Alcohol irritates peristomal skin.
• 3 Petroleum jelly prevents the pouch from adhering.
• 4 Pouches are typically changed every 3–7 days, not daily.
Question 5 of 180 (Form B)
A PN is reviewing laboratory data for a client taking lithium (Eskalith). Which
value requires immediate reporting?
1. Serum lithium 0.8 mEq/L
2. Serum sodium 125 mEq/L
3. Creatinine 0.9 mg/dL
4. Hemoglobin 13 g/dL
Verified Solution:
Correct answer: 2 – Hyponatremia (sodium 125 mEq/L) increases lithium
reabsorption in the kidneys, risking lithium toxicity.
Page 2 of 58
, • 1 Lithium 0.8 mEq/L is within therapeutic range (0.8–1.2).
• 3 Creatinine 0.9 mg/dL is normal.
• 4 Hemoglobin 13 g/dL is normal.
Question 6 of 180 (Form B)
A client with heart failure (HF) has a new prescription for carvedilol (Coreg).
Which assessment finding would cause the PN to hold the medication?
1. Heart rate 54 bpm
2. Blood pressure 118/76 mm Hg
3. Weight gain of 0.5 kg in 2 days
4. Complaints of mild fatigue
Verified Solution:
Correct answer: 1 – Beta-blockers like carvedilol are typically held if heart rate
is below 60 bpm (or per provider order).
• 2 Blood pressure is normal.
• 3 Weight gain of 0.5 kg in 2 days is minimal and not a reason to hold.
• 4 Mild fatigue is an expected early side effect.
Question 7 of 180 (Form B)
A PN is caring for a newborn who is 24 hours old. Which finding should be
reported to the provider?
1. Jaundice on the face only
2. Acrocyanosis of hands and feet
3. Irregular breathing with pauses <10 seconds
4. Grunting with nasal flaring
Verified Solution:
Correct answer: 4 – Grunting with nasal flaring indicates respiratory distress
(possible infection, retained fluid, or pneumothorax).
• 1 Facial jaundice at 24 hours is common but may be physiologic; priority
is respiratory.
• 2 Acrocyanosis (blue hands/feet) is normal in newborns.
• 3 Periodic breathing with pauses <10 seconds is normal.
Question 8 of 180 (Form B)
A PN is reinforcing teaching for a client with a new prescription for alendronate
(Fosamax). Which instruction is most important?
1. Take with a full glass of water after waking.
2. Remain upright for 30 minutes after taking.
3. Take with food to prevent GI upset.
4. Both 1 and 2.
Page 3 of 58
, Verified Solution:
Correct answer: 4 – Both 1 and 2 are essential to prevent esophageal irritation
and ulceration.
• 3 Alendronate must be taken on an empty stomach, not with food.
Question 9 of 180 (Form B)
A PN is caring for a client with a chest tube to water seal. Which finding requires
immediate action?
1. Intermittent bubbling in the water seal chamber
2. Fluctuation (tidaling) with respirations
3. Continuous bubbling in the water seal chamber
4. Drainage of 50 mL in 4 hours
Verified Solution:
Correct answer: 3 – Continuous bubbling in the water seal chamber indicates
an air leak that must be located and sealed.
• 1 Intermittent bubbling is expected as air is evacuated from the pleural
space.
• 2 Tidaling is normal.
• 4 Drainage of 50 mL in 4 hours is within expected range.
Question 10 of 180 (Form B)
A client with type 2 diabetes is prescribed metformin (Glucophage). Which
statement by the client requires further teaching?
1. “I should take this medication with meals.”
2. “I will stop it before a CT scan with contrast.”
3. “I can drink alcohol in moderation.”
4. “I may have a metallic taste in my mouth.”
Verified Solution:
Correct answer: 3 – Alcohol increases the risk of lactic acidosis with metformin;
even moderate intake should be avoided or severely limited.
• 1 Taking with meals reduces GI upset – correct.
• 2 Holding metformin before contrast dye prevents lactic acidosis –
correct.
• 4 Metallic taste is a common side effect – correct.
Question 11 of 180 (Form B)
A PN is monitoring a client receiving IV vancomycin. The client reports flushing
and itching of the neck and face. What is the priority action?
1. Stop the infusion immediately.
2. Slow the infusion rate.
Page 4 of 58
Predictor Exit Assessment for NUR 265 Level
3 Form B & C with Actual & Retake Real
Questions and Verified Solutions — Pass on
First Attempt
Question 1 of 180 (Form B)
A practical nurse (PN) is caring for a client with a new diagnosis of deep vein
thrombosis (DVT) who is receiving heparin infusion. Which of the following
findings indicates a therapeutic response?
1. aPTT 2.5 times the control value
2. INR 3.0
3. Platelet count 50,000/mm³
4. Fibrinogen level 400 mg/dL
Verified Solution:
Correct answer: 1 – Therapeutic aPTT for heparin is 1.5–2.5 times the control
value.
• 2 INR monitors warfarin, not heparin.
• 3 Platelet count 50,000 indicates thrombocytopenia (possible HIT), not
therapeutic effect.
• 4 Fibrinogen is an acute phase reactant; normal level does not indicate
heparin effectiveness.
Question 2 of 180 (Form B)
A PN is reinforcing discharge teaching for a client with a new prescription for
clopidogrel (Plavix). Which statement by the client indicates a need for further
teaching?
1. “I will avoid taking omeprazole (Prilosec).”
2. “I will report any black, tarry stools.”
3. “I can take ibuprofen if I have a headache.”
4. “I will stop this medication 5 days before surgery.”
Verified Solution:
Correct answer: 3 – Ibuprofen (NSAID) increases bleeding risk and should be
avoided with clopidogrel.
• 1 Omeprazole reduces clopidogrel effectiveness (correct to avoid).
• 2 Black/tarry stools indicate GI bleeding – correct to report.
Page 1 of 58
, • 4 Stopping 5 days before surgery is standard to reduce bleeding risk.
Question 3 of 180 (Form B)
A PN is caring for a client who is 2 hours post-mediastinoscopy. Which finding
should be reported immediately?
1. Subcutaneous emphysema around the neck
2. Pain rated 4/10
3. Small amount of serosanguineous drainage
4. Heart rate 88 bpm
Verified Solution:
Correct answer: 1 – Subcutaneous emphysema may indicate pneumothorax or
air leak from the procedure – report immediately.
• 2 Mild pain is expected.
• 3 Small amount of serosanguineous drainage is normal.
• 4 Heart rate 88 bpm is within normal range.
Question 4 of 180 (Form B)
A PN is reinforcing education for a client with a new ileostomy about skin care.
Which statement indicates understanding?
1. “I will use alcohol to clean around the stoma.”
2. “I will cut the wafer opening exactly the size of my stoma.”
3. “I will apply petroleum jelly to protect the skin.”
4. “I will change the pouch every day.”
Verified Solution:
Correct answer: 2 – Cutting the wafer opening to exactly fit the stoma prevents
leakage and skin breakdown.
• 1 Alcohol irritates peristomal skin.
• 3 Petroleum jelly prevents the pouch from adhering.
• 4 Pouches are typically changed every 3–7 days, not daily.
Question 5 of 180 (Form B)
A PN is reviewing laboratory data for a client taking lithium (Eskalith). Which
value requires immediate reporting?
1. Serum lithium 0.8 mEq/L
2. Serum sodium 125 mEq/L
3. Creatinine 0.9 mg/dL
4. Hemoglobin 13 g/dL
Verified Solution:
Correct answer: 2 – Hyponatremia (sodium 125 mEq/L) increases lithium
reabsorption in the kidneys, risking lithium toxicity.
Page 2 of 58
, • 1 Lithium 0.8 mEq/L is within therapeutic range (0.8–1.2).
• 3 Creatinine 0.9 mg/dL is normal.
• 4 Hemoglobin 13 g/dL is normal.
Question 6 of 180 (Form B)
A client with heart failure (HF) has a new prescription for carvedilol (Coreg).
Which assessment finding would cause the PN to hold the medication?
1. Heart rate 54 bpm
2. Blood pressure 118/76 mm Hg
3. Weight gain of 0.5 kg in 2 days
4. Complaints of mild fatigue
Verified Solution:
Correct answer: 1 – Beta-blockers like carvedilol are typically held if heart rate
is below 60 bpm (or per provider order).
• 2 Blood pressure is normal.
• 3 Weight gain of 0.5 kg in 2 days is minimal and not a reason to hold.
• 4 Mild fatigue is an expected early side effect.
Question 7 of 180 (Form B)
A PN is caring for a newborn who is 24 hours old. Which finding should be
reported to the provider?
1. Jaundice on the face only
2. Acrocyanosis of hands and feet
3. Irregular breathing with pauses <10 seconds
4. Grunting with nasal flaring
Verified Solution:
Correct answer: 4 – Grunting with nasal flaring indicates respiratory distress
(possible infection, retained fluid, or pneumothorax).
• 1 Facial jaundice at 24 hours is common but may be physiologic; priority
is respiratory.
• 2 Acrocyanosis (blue hands/feet) is normal in newborns.
• 3 Periodic breathing with pauses <10 seconds is normal.
Question 8 of 180 (Form B)
A PN is reinforcing teaching for a client with a new prescription for alendronate
(Fosamax). Which instruction is most important?
1. Take with a full glass of water after waking.
2. Remain upright for 30 minutes after taking.
3. Take with food to prevent GI upset.
4. Both 1 and 2.
Page 3 of 58
, Verified Solution:
Correct answer: 4 – Both 1 and 2 are essential to prevent esophageal irritation
and ulceration.
• 3 Alendronate must be taken on an empty stomach, not with food.
Question 9 of 180 (Form B)
A PN is caring for a client with a chest tube to water seal. Which finding requires
immediate action?
1. Intermittent bubbling in the water seal chamber
2. Fluctuation (tidaling) with respirations
3. Continuous bubbling in the water seal chamber
4. Drainage of 50 mL in 4 hours
Verified Solution:
Correct answer: 3 – Continuous bubbling in the water seal chamber indicates
an air leak that must be located and sealed.
• 1 Intermittent bubbling is expected as air is evacuated from the pleural
space.
• 2 Tidaling is normal.
• 4 Drainage of 50 mL in 4 hours is within expected range.
Question 10 of 180 (Form B)
A client with type 2 diabetes is prescribed metformin (Glucophage). Which
statement by the client requires further teaching?
1. “I should take this medication with meals.”
2. “I will stop it before a CT scan with contrast.”
3. “I can drink alcohol in moderation.”
4. “I may have a metallic taste in my mouth.”
Verified Solution:
Correct answer: 3 – Alcohol increases the risk of lactic acidosis with metformin;
even moderate intake should be avoided or severely limited.
• 1 Taking with meals reduces GI upset – correct.
• 2 Holding metformin before contrast dye prevents lactic acidosis –
correct.
• 4 Metallic taste is a common side effect – correct.
Question 11 of 180 (Form B)
A PN is monitoring a client receiving IV vancomycin. The client reports flushing
and itching of the neck and face. What is the priority action?
1. Stop the infusion immediately.
2. Slow the infusion rate.
Page 4 of 58
