ATI PN Comprehensive Predictor 2026
Advanced Prep: Master NCLEX-PN Next
Gen Nursing (NGN) Practice Questions &
Detailed Explanations
Subject: Medical-Surgical Nursing, Pharmacology, and Clinical Decision-
Making
Question 1: A nurse is caring for a client with heart failure who is receiving furosemide. The
client’s morning laboratory results are as follows: Potassium 2.9 mEq/L, Sodium 138 mEq/L,
and BUN 22 mg/dL. Which action should the nurse take first?
A) Administer the scheduled dose of furosemide.
B) Notify the provider regarding the potassium level.
C) Increase the client’s dietary intake of sodium.
D) Document the findings and reassess in 4 hours.
Correct Answer: B) Notify the provider regarding the potassium level.
Explanation: The client's potassium level is 2.9 mEq/L, which indicates significant hypokalemia
(normal range 3.5–5.0 mEq/L). Furosemide is a potassium-wasting diuretic that can exacerbate
this condition and lead to life-threatening cardiac arrhythmias. The nurse must hold the
medication and contact the provider before taking further action.
Question 2: A client is diagnosed with type 1 diabetes mellitus and is experiencing signs of
hypoglycemia. Which of the following findings should the nurse expect?
A) Kussmaul respirations.
B) Polyuria.
C) Diaphoresis.
D) Fruity breath odor.
Correct Answer: C) Diaphoresis.
Explanation: Hypoglycemia triggers the sympathetic nervous system, leading to classic
symptoms such as diaphoresis (sweating), tachycardia, tremors, and anxiety. Kussmaul
, respirations, polyuria, and fruity breath odor are classic signs of diabetic ketoacidosis
(hyperglycemia).
Question 3: A nurse is caring for a client who has a chest tube. The nurse notes continuous
bubbling in the water seal chamber. What does this finding indicate?
A) Normal lung re-expansion.
B) A persistent air leak in the system.
C) An obstruction in the chest tube.
D) Expected fluctuation with respiration.
Correct Answer: B) A persistent air leak in the system.
Explanation: * Continuous bubbling in the water seal chamber indicates that air is escaping into
the chamber from the pleural space or from a disconnection in the system. While occasional
bubbling might be expected during expiration shortly after insertion, continuous bubbling is a
clinical sign of an air leak that must be identified and corrected.*
Question 4: A nurse is preparing to administer digoxin to a client. Which of the following actions
should the nurse prioritize?
A) Assess the client’s blood pressure in the supine position.
B) Check the client’s apical pulse for a full minute.
C) Monitor the client for signs of hypokalemia.
D) Review the client's blood urea nitrogen (BUN) levels.
Correct Answer: B) Check the client’s apical pulse for a full minute.
Explanation: Digoxin is a cardiac glycoside that slows the heart rate. The nurse must assess the
apical pulse for one full minute and withhold the dose if the pulse is less than 60 beats per
minute (in an adult) to prevent severe bradycardia.
Question 5: A client is admitted with a suspected bowel obstruction. Which of the following
findings would be most consistent with a small bowel obstruction?
A) Ribbon-like stools.
B) Profuse, projectile vomiting.
C) Lower abdominal cramping.
Advanced Prep: Master NCLEX-PN Next
Gen Nursing (NGN) Practice Questions &
Detailed Explanations
Subject: Medical-Surgical Nursing, Pharmacology, and Clinical Decision-
Making
Question 1: A nurse is caring for a client with heart failure who is receiving furosemide. The
client’s morning laboratory results are as follows: Potassium 2.9 mEq/L, Sodium 138 mEq/L,
and BUN 22 mg/dL. Which action should the nurse take first?
A) Administer the scheduled dose of furosemide.
B) Notify the provider regarding the potassium level.
C) Increase the client’s dietary intake of sodium.
D) Document the findings and reassess in 4 hours.
Correct Answer: B) Notify the provider regarding the potassium level.
Explanation: The client's potassium level is 2.9 mEq/L, which indicates significant hypokalemia
(normal range 3.5–5.0 mEq/L). Furosemide is a potassium-wasting diuretic that can exacerbate
this condition and lead to life-threatening cardiac arrhythmias. The nurse must hold the
medication and contact the provider before taking further action.
Question 2: A client is diagnosed with type 1 diabetes mellitus and is experiencing signs of
hypoglycemia. Which of the following findings should the nurse expect?
A) Kussmaul respirations.
B) Polyuria.
C) Diaphoresis.
D) Fruity breath odor.
Correct Answer: C) Diaphoresis.
Explanation: Hypoglycemia triggers the sympathetic nervous system, leading to classic
symptoms such as diaphoresis (sweating), tachycardia, tremors, and anxiety. Kussmaul
, respirations, polyuria, and fruity breath odor are classic signs of diabetic ketoacidosis
(hyperglycemia).
Question 3: A nurse is caring for a client who has a chest tube. The nurse notes continuous
bubbling in the water seal chamber. What does this finding indicate?
A) Normal lung re-expansion.
B) A persistent air leak in the system.
C) An obstruction in the chest tube.
D) Expected fluctuation with respiration.
Correct Answer: B) A persistent air leak in the system.
Explanation: * Continuous bubbling in the water seal chamber indicates that air is escaping into
the chamber from the pleural space or from a disconnection in the system. While occasional
bubbling might be expected during expiration shortly after insertion, continuous bubbling is a
clinical sign of an air leak that must be identified and corrected.*
Question 4: A nurse is preparing to administer digoxin to a client. Which of the following actions
should the nurse prioritize?
A) Assess the client’s blood pressure in the supine position.
B) Check the client’s apical pulse for a full minute.
C) Monitor the client for signs of hypokalemia.
D) Review the client's blood urea nitrogen (BUN) levels.
Correct Answer: B) Check the client’s apical pulse for a full minute.
Explanation: Digoxin is a cardiac glycoside that slows the heart rate. The nurse must assess the
apical pulse for one full minute and withhold the dose if the pulse is less than 60 beats per
minute (in an adult) to prevent severe bradycardia.
Question 5: A client is admitted with a suspected bowel obstruction. Which of the following
findings would be most consistent with a small bowel obstruction?
A) Ribbon-like stools.
B) Profuse, projectile vomiting.
C) Lower abdominal cramping.
