,
, NGN ATI RN Comprehensive Predictor 2026 Exit Assessment Level 3 Forms A, B & C with 150 Next Gen NCLEX
(NGN) style questions, multiple-choice answers, verified correct answers (✅), and rationales in italic — designed
for pass on first attempt.
FORM A — Questions 1–50
A nurse in an emergency department is assessing a client who reports chest pain, shortness of
breath, and diaphoresis. The client’s blood pressure is 88/54 mm Hg, HR 120 bpm, RR 28/min,
SpO2 89% on room air. Which of the following is the priority action?
A. Obtain a 12-lead ECG
B. Administer oxygen at 2 L/min via nasal cannula
C. Start a peripheral IV line
D. Administer aspirin 324 mg PO
✅
Rationale: Oxygenation is the priority (ABC framework). Hypoxia (SpO2 <90%) must be corrected first to
prevent tissue damage. ECG and aspirin follow, but oxygen comes first.
A nurse is caring for a client with major depressive disorder who was prescribed phenelzine.
Which of the following client statements indicates a need for further teaching?
A. “I will avoid eating aged cheese and red wine.”
B. “I can take over-the-counter cold medicine for my runny nose.”
C. “I need to monitor my blood pressure regularly.”
D. “I will inform my dentist about this medication.”
✅
Rationale: Phenelzine is an MAOI. Decongestants and cold medicines containing sympathomimetics can
cause hypertensive crisis. All other options are correct safety measures.
A nurse is assessing a client who has heart failure and is receiving digoxin. Which of the
following findings indicates digoxin toxicity? (Select all that apply)
A. Anorexia
, B. Visual yellow halos
C. Heart rate of 54 bpm
D. Serum digoxin level 1.2 ng/mL
E. Nausea and vomiting
✅
✅
✅
✅
*Rationale: Digoxin toxicity causes GI symptoms (anorexia, nausea, vomiting), visual disturbances
(halos, blurring), and bradycardia. Therapeutic digoxin level is 0.8–2.0 ng/mL (1.2 is normal).*
A nurse is preparing to administer packed RBCs to a client. Which of the following actions
should the nurse take?
A. Infuse the blood over 10 minutes
B. Use a 22-gauge IV catheter
C. Administer the blood with dextrose 5% in water
D. Stay with the client for the first 15 minutes of infusion
✅
Rationale: Most transfusion reactions occur within the first 15 minutes. The nurse must remain with the
client to monitor for fever, chills, or hemolysis. Infusion should be over 2–4 hours; use 18–20 gauge; never
mix with dextrose (causes hemolysis).
A nurse in a mental health unit is caring for a client with bipolar disorder who is experiencing
acute mania. Which of the following interventions should the nurse include? (Select all that apply)
A. Provide high-calorie finger foods
B. Assign a private room near the nurses’ station
C. Encourage group competitive activities
D. Allow the client to set own limits on behavior
E. Reduce environmental stimuli
✅
, NGN ATI RN Comprehensive Predictor 2026 Exit Assessment Level 3 Forms A, B & C with 150 Next Gen NCLEX
(NGN) style questions, multiple-choice answers, verified correct answers (✅), and rationales in italic — designed
for pass on first attempt.
FORM A — Questions 1–50
A nurse in an emergency department is assessing a client who reports chest pain, shortness of
breath, and diaphoresis. The client’s blood pressure is 88/54 mm Hg, HR 120 bpm, RR 28/min,
SpO2 89% on room air. Which of the following is the priority action?
A. Obtain a 12-lead ECG
B. Administer oxygen at 2 L/min via nasal cannula
C. Start a peripheral IV line
D. Administer aspirin 324 mg PO
✅
Rationale: Oxygenation is the priority (ABC framework). Hypoxia (SpO2 <90%) must be corrected first to
prevent tissue damage. ECG and aspirin follow, but oxygen comes first.
A nurse is caring for a client with major depressive disorder who was prescribed phenelzine.
Which of the following client statements indicates a need for further teaching?
A. “I will avoid eating aged cheese and red wine.”
B. “I can take over-the-counter cold medicine for my runny nose.”
C. “I need to monitor my blood pressure regularly.”
D. “I will inform my dentist about this medication.”
✅
Rationale: Phenelzine is an MAOI. Decongestants and cold medicines containing sympathomimetics can
cause hypertensive crisis. All other options are correct safety measures.
A nurse is assessing a client who has heart failure and is receiving digoxin. Which of the
following findings indicates digoxin toxicity? (Select all that apply)
A. Anorexia
, B. Visual yellow halos
C. Heart rate of 54 bpm
D. Serum digoxin level 1.2 ng/mL
E. Nausea and vomiting
✅
✅
✅
✅
*Rationale: Digoxin toxicity causes GI symptoms (anorexia, nausea, vomiting), visual disturbances
(halos, blurring), and bradycardia. Therapeutic digoxin level is 0.8–2.0 ng/mL (1.2 is normal).*
A nurse is preparing to administer packed RBCs to a client. Which of the following actions
should the nurse take?
A. Infuse the blood over 10 minutes
B. Use a 22-gauge IV catheter
C. Administer the blood with dextrose 5% in water
D. Stay with the client for the first 15 minutes of infusion
✅
Rationale: Most transfusion reactions occur within the first 15 minutes. The nurse must remain with the
client to monitor for fever, chills, or hemolysis. Infusion should be over 2–4 hours; use 18–20 gauge; never
mix with dextrose (causes hemolysis).
A nurse in a mental health unit is caring for a client with bipolar disorder who is experiencing
acute mania. Which of the following interventions should the nurse include? (Select all that apply)
A. Provide high-calorie finger foods
B. Assign a private room near the nurses’ station
C. Encourage group competitive activities
D. Allow the client to set own limits on behavior
E. Reduce environmental stimuli
✅
