ATI Next Gen PN Comprehensive Predictor
Exit Assessment for NUR 265 Level 3 Forms
A, B & C with Actual & Retake Real Questions
and Verified Solutions — Pass on First
Attempt
Question 1 of 180 (Form C)
A practical nurse (PN) is reviewing the vital signs of a 12-hour-old newborn.
Which of the following findings is the priority for the PN to report to the
healthcare provider?
1. Heart rate 180/min
2. Respiratory rate 65/min
3. Axillary temperature 36.8°C (98.2°F)
4. Nasal flaring
Verified Solution:
Correct answer: 4 – Nasal flaring is a sign of respiratory distress in a newborn.
• 1 HR 180 is upper normal (110–180).
• 2 RR 65 is tachypnea but flaring is more specific distress.
• 3 Normal temperature.
Question 2 of 180 (Form C)
A client with heart failure (HF) has been prescribed a new prescription for
metoprolol (Lopressor). Which of the following client statements indicates a
need for further teaching about this medication?
1. “I will call my provider if my heart rate goes below 60.”
2. “I should avoid taking OTC cold medications without asking.”
3. “I will stop taking this medication if I feel tired.”
4. “I need to change positions slowly.”
Verified Solution:
Correct answer: 3 – Abrupt beta-blocker withdrawal can worsen HF, cause
tachycardia, or hypertension.
• 1,2,4 are correct precautions.
P a g e 1 | 55
,Question 3 of 180 (Form C)
A PN is reviewing laboratory data for a client who has a prescription for lithium
(Eskalith). Which of the following laboratory values should the PN immediately
report to the healthcare provider?
1. Serum lithium 0.9 mEq/L
2. Hemoglobin 13.5 g/dL
3. Potassium 3.8 mEq/L
4. Creatinine 1.8 mg/dL
Verified Solution:
Correct answer: 4 – Creatinine 1.8 mg/dL indicates kidney impairment; lithium
is renally excreted.
• 1 Lithium is therapeutic (0.8–1.2).
• 2,3 normal.
Question 4 of 180 (Form C)
A PN is caring for a client with a new diagnosis of type 1 diabetes mellitus.
Which finding indicates the client may be experiencing diabetic ketoacidosis
(DKA)?
1. Blood glucose 180 mg/dL
2. Deep, rapid respirations (Kussmaul)
3. Bradycardia
4. Warm, dry skin
Verified Solution:
Correct answer: 2 – Kussmaul respirations are compensatory for metabolic
acidosis in DKA.
• 1 Glucose usually >250; 3 Tachycardia; 4 Skin is dry but not specific;
Kussmaul is key.
Question 5 of 180 (Form C)
A PN is reinforcing discharge instructions for a client with a new prescription for
enoxaparin (Lovenox). Which statement by the client indicates understanding?
1. “I will take this medication with food.”
2. “I will call my provider if I notice blood in my urine.”
3. “I can stop this medication when I feel better.”
4. “I will take ibuprofen for headache.”
Verified Solution:
Correct answer: 2 – Blood in urine indicates bleeding complication – must
report.
P a g e 2 | 55
, • 1 Enoxaparin is given subcut, not oral; 3 Never stop anticoagulants; 4
Avoid NSAIDs.
Question 6 of 180 (Form C)
A PN is caring for a client who is receiving a blood transfusion. Fifteen minutes
after starting, the client reports low back pain and chills. Which action should
the PN take first?
1. Slow the infusion rate.
2. Stop the transfusion.
3. Administer acetaminophen.
4. Notify the healthcare provider.
Verified Solution:
Correct answer: 2 – Back pain and chills suggest acute hemolytic reaction; stop
transfusion immediately.
• 1 Slowing is wrong; 3 Meds after stopping; 4 Notify after stopping.
Question 7 of 180 (Form C)
A PN is reinforcing teaching for a client with a new prescription for alendronate
(Fosamax) for osteoporosis. 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.
Verified Solution:
Correct answer: 4 – Both 1 and 2 are essential to prevent esophageal irritation
and ulceration.
• 3 Take on empty stomach, not with food.
Question 8 of 180 (Form C)
A client with chronic kidney disease (CKD) has a serum potassium of 6.5 mEq/L.
Which finding should the PN report immediately?
1. Blood pressure 140/90 mm Hg
2. Muscle weakness and ECG changes
3. Fatigue and pallor
4. Nausea and vomiting
Verified Solution:
Correct answer: 2 – Hyperkalemia can cause cardiac dysrhythmias; muscle
weakness and ECG changes (peaked T waves) are critical.
• 1,3,4 are less specific.
P a g e 3 | 55
, Question 9 of 180 (Form C)
A PN is caring for a client with a chest tube to water seal. The PN notes
continuous bubbling in the water seal chamber. What is the priority action?
1. Document the finding.
2. Notify the healthcare provider.
3. Check for an air leak.
4. Increase suction pressure.
Verified Solution:
Correct answer: 3 – Continuous bubbling indicates an air leak; the PN should
first check the system for loose connections.
• 2 Notify after checking; 4 Not appropriate.
Question 10 of 180 (Form C)
A client with major depressive disorder is started on phenelzine (Nardil). Which
over-the-counter product should the PN instruct the client to avoid?
1. Acetaminophen
2. Diphenhydramine
3. Pseudoephedrine
4. Ibuprofen
Verified Solution:
Correct answer: 3 – Pseudoephedrine (sympathomimetic) can cause
hypertensive crisis with MAOIs.
• 1,2,4 are safer but still check with provider.
Question 11 of 180 (Form C)
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 – Exact fit prevents leakage and skin breakdown.
• 1 Alcohol irritates; 3 Petroleum jelly prevents adhesion; 4 Change q3–7
days.
Question 12 of 180 (Form C)
A PN is caring for a client who is 2 hours post-thyroidectomy. Which finding
requires immediate reporting?
P a g e 4 | 55
Exit Assessment for NUR 265 Level 3 Forms
A, B & C with Actual & Retake Real Questions
and Verified Solutions — Pass on First
Attempt
Question 1 of 180 (Form C)
A practical nurse (PN) is reviewing the vital signs of a 12-hour-old newborn.
Which of the following findings is the priority for the PN to report to the
healthcare provider?
1. Heart rate 180/min
2. Respiratory rate 65/min
3. Axillary temperature 36.8°C (98.2°F)
4. Nasal flaring
Verified Solution:
Correct answer: 4 – Nasal flaring is a sign of respiratory distress in a newborn.
• 1 HR 180 is upper normal (110–180).
• 2 RR 65 is tachypnea but flaring is more specific distress.
• 3 Normal temperature.
Question 2 of 180 (Form C)
A client with heart failure (HF) has been prescribed a new prescription for
metoprolol (Lopressor). Which of the following client statements indicates a
need for further teaching about this medication?
1. “I will call my provider if my heart rate goes below 60.”
2. “I should avoid taking OTC cold medications without asking.”
3. “I will stop taking this medication if I feel tired.”
4. “I need to change positions slowly.”
Verified Solution:
Correct answer: 3 – Abrupt beta-blocker withdrawal can worsen HF, cause
tachycardia, or hypertension.
• 1,2,4 are correct precautions.
P a g e 1 | 55
,Question 3 of 180 (Form C)
A PN is reviewing laboratory data for a client who has a prescription for lithium
(Eskalith). Which of the following laboratory values should the PN immediately
report to the healthcare provider?
1. Serum lithium 0.9 mEq/L
2. Hemoglobin 13.5 g/dL
3. Potassium 3.8 mEq/L
4. Creatinine 1.8 mg/dL
Verified Solution:
Correct answer: 4 – Creatinine 1.8 mg/dL indicates kidney impairment; lithium
is renally excreted.
• 1 Lithium is therapeutic (0.8–1.2).
• 2,3 normal.
Question 4 of 180 (Form C)
A PN is caring for a client with a new diagnosis of type 1 diabetes mellitus.
Which finding indicates the client may be experiencing diabetic ketoacidosis
(DKA)?
1. Blood glucose 180 mg/dL
2. Deep, rapid respirations (Kussmaul)
3. Bradycardia
4. Warm, dry skin
Verified Solution:
Correct answer: 2 – Kussmaul respirations are compensatory for metabolic
acidosis in DKA.
• 1 Glucose usually >250; 3 Tachycardia; 4 Skin is dry but not specific;
Kussmaul is key.
Question 5 of 180 (Form C)
A PN is reinforcing discharge instructions for a client with a new prescription for
enoxaparin (Lovenox). Which statement by the client indicates understanding?
1. “I will take this medication with food.”
2. “I will call my provider if I notice blood in my urine.”
3. “I can stop this medication when I feel better.”
4. “I will take ibuprofen for headache.”
Verified Solution:
Correct answer: 2 – Blood in urine indicates bleeding complication – must
report.
P a g e 2 | 55
, • 1 Enoxaparin is given subcut, not oral; 3 Never stop anticoagulants; 4
Avoid NSAIDs.
Question 6 of 180 (Form C)
A PN is caring for a client who is receiving a blood transfusion. Fifteen minutes
after starting, the client reports low back pain and chills. Which action should
the PN take first?
1. Slow the infusion rate.
2. Stop the transfusion.
3. Administer acetaminophen.
4. Notify the healthcare provider.
Verified Solution:
Correct answer: 2 – Back pain and chills suggest acute hemolytic reaction; stop
transfusion immediately.
• 1 Slowing is wrong; 3 Meds after stopping; 4 Notify after stopping.
Question 7 of 180 (Form C)
A PN is reinforcing teaching for a client with a new prescription for alendronate
(Fosamax) for osteoporosis. 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.
Verified Solution:
Correct answer: 4 – Both 1 and 2 are essential to prevent esophageal irritation
and ulceration.
• 3 Take on empty stomach, not with food.
Question 8 of 180 (Form C)
A client with chronic kidney disease (CKD) has a serum potassium of 6.5 mEq/L.
Which finding should the PN report immediately?
1. Blood pressure 140/90 mm Hg
2. Muscle weakness and ECG changes
3. Fatigue and pallor
4. Nausea and vomiting
Verified Solution:
Correct answer: 2 – Hyperkalemia can cause cardiac dysrhythmias; muscle
weakness and ECG changes (peaked T waves) are critical.
• 1,3,4 are less specific.
P a g e 3 | 55
, Question 9 of 180 (Form C)
A PN is caring for a client with a chest tube to water seal. The PN notes
continuous bubbling in the water seal chamber. What is the priority action?
1. Document the finding.
2. Notify the healthcare provider.
3. Check for an air leak.
4. Increase suction pressure.
Verified Solution:
Correct answer: 3 – Continuous bubbling indicates an air leak; the PN should
first check the system for loose connections.
• 2 Notify after checking; 4 Not appropriate.
Question 10 of 180 (Form C)
A client with major depressive disorder is started on phenelzine (Nardil). Which
over-the-counter product should the PN instruct the client to avoid?
1. Acetaminophen
2. Diphenhydramine
3. Pseudoephedrine
4. Ibuprofen
Verified Solution:
Correct answer: 3 – Pseudoephedrine (sympathomimetic) can cause
hypertensive crisis with MAOIs.
• 1,2,4 are safer but still check with provider.
Question 11 of 180 (Form C)
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 – Exact fit prevents leakage and skin breakdown.
• 1 Alcohol irritates; 3 Petroleum jelly prevents adhesion; 4 Change q3–7
days.
Question 12 of 180 (Form C)
A PN is caring for a client who is 2 hours post-thyroidectomy. Which finding
requires immediate reporting?
P a g e 4 | 55
