# ATI-RN COMPREHENSIVE PREDICTOR EXIT EXAM 2023–2024
WITH NGN
## 100 Questions with Rationales & Answers
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**1.** A nurse is assessing a client who is 6 hours post‑operative following a total hip arthroplasty.
Which finding requires immediate intervention?
A) Pain score 6/10 on a 0–10 scale
B) Temperature 99.2°F (37.3°C)
C) Oxygen saturation 89% on room air
D) Serosanguineous drainage on the dressing
💡 **RATIONALE** – Oxygen saturation <90% indicates hypoxemia, which may result from atelectasis,
pulmonary embolism, or fat embolism syndrome. Immediate action is required.
✔️ **ANSWER** – C) Oxygen saturation 89% on room air
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**2.** A client with chronic obstructive pulmonary disease (COPD) is prescribed home oxygen at 2
L/min via nasal cannula. Which statement by the client indicates a need for further teaching?
A) “I will check my oxygen saturation with a pulse oximeter daily.”
B) “I can increase the flow rate to 4 L/min if I feel more short of breath.”
C) “I will not smoke or allow anyone to smoke near my oxygen.”
D) “I will store my oxygen tanks upright and away from heat sources.”
,💡 **RATIONALE** – Oxygen flow rate should never be adjusted without provider order; increasing flow
can worsen CO2 retention in COPD clients with chronic hypercapnia.
✔️ **ANSWER** – B) “I can increase the flow rate to 4 L/min if I feel more short of breath.”
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**3.** A nurse is caring for a client with a chest tube to a closed drainage system after a thoracotomy.
The nurse notes gentle continuous bubbling in the suction control chamber. What action should the
nurse take?
A) Clamp the chest tube and notify the provider
B) Document this as an expected finding
C) Increase the suction pressure until bubbling stops
D) Assess the system for an air leak
💡 **RATIONALE** – Gentle continuous bubbling in the *suction control chamber* is expected when
suction is applied. Bubbling in the *water seal chamber* indicates an air leak.
✔️ **ANSWER** – B) Document this as an expected finding
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**4.** A client with type 2 diabetes mellitus has a blood glucose level of 52 mg/dL and is conscious and
able to swallow. What should the nurse administer first?
A) 4 oz of skim milk
B) 4 oz of orange juice
C) 2 tablespoons of honey
D) 6 oz of diet soda
💡 **RATIONALE** – For conscious hypoglycemia, 15 g of fast‑acting carbohydrate is given. 4 oz of
orange juice (≈15 g carbs) is appropriate. Diet soda has no sugar; honey is 17 g per tbsp but thicker; skim
milk works slower.
✔️ **ANSWER** – B) 4 oz of orange juice
,---
**5.** A nurse is providing discharge teaching to a client with a new colostomy. Which statement by the
client indicates understanding of stoma care?
A) “I will clean my stoma with alcohol wipes to prevent infection.”
B) “I will cut the wafer opening exactly the size of my stoma.”
C) “I will change my pouch every day to keep the skin clean.”
D) “I will expect my stoma to be moist and pink to red.”
💡 **RATIONALE** – A healthy stoma is moist, pink to red. The wafer should be cut 1/8 inch larger than
the stoma; alcohol is too harsh; pouches can stay 3‑7 days.
✔️ **ANSWER** – D) “I will expect my stoma to be moist and pink to red.”
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**6.** A client with heart failure is receiving IV furosemide. Which laboratory value requires the most
immediate action?
A) Serum potassium 3.2 mEq/L
B) Serum sodium 135 mEq/L
C) Serum magnesium 2.0 mg/dL
D) Serum glucose 110 mg/dL
💡 **RATIONALE** – Hypokalemia (K <3.5) from loop diuretics increases risk of digoxin toxicity and
cardiac dysrhythmias. This requires prompt intervention.
✔️ **ANSWER** – A) Serum potassium 3.2 mEq/L
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, **7.** A nurse is caring for a client with a traumatic brain injury. The client’s Glasgow Coma Scale score
is 10. Which finding is consistent with this score?
A) Eye opening to pain, incomprehensible sounds, abnormal flexion
B) Eye opening to speech, confused speech, localizes pain
C) Spontaneous eye opening, oriented, obeys commands
D) No eye opening, no verbal response, no motor response
💡 **RATIONALE** – GCS 10 = eye to speech (3) + confused speech (4) + localizes pain (5) = 12? Wait
recalc: eye to speech = 3, confused = 4, localizes = 5 → total 12. For 10: eye to pain (2) + inappropriate
words (3) + abnormal flexion (3) = 8; eye to speech (3) + confused (4) + withdrawal (4) = 11. Common
GCS 10 example: eye to pain (2) + inappropriate (3) + withdrawal (4) = 9; eye to speech (3) + confused
(4) + abnormal flexion (3) = 10. So option B with eye to speech (3), confused (4), localizes (5) is 12, not
10. Let me correct: The best match for 10 is not listed exactly. I will adjust the option. For exam integrity,
I'll write a new option:
B) Eye opening to speech, confused speech, abnormal flexion → 3+4+3=10.
I'll modify accordingly in the final Answer.
I will rewrite #7 properly:
**7.** A nurse is caring for a client with a traumatic brain injury. The client’s Glasgow Coma Scale score
is 10. Which finding is consistent with this score?
A) Eye opening to pain, incomprehensible sounds, abnormal flexion (2+2+2=6)
B) Eye opening to speech, confused speech, abnormal flexion (3+4+3=10)
C) Spontaneous eye opening, oriented, obeys commands (4+5+6=15)
D) No eye opening, no verbal response, no motor response (1+1+1=3)
💡 **RATIONALE** – GCS 10 indicates moderate brain injury. Eye opening to speech (3), confused
speech (4), and abnormal flexion (3) total 10.
✔️ **ANSWER** – B) Eye opening to speech, confused speech, abnormal flexion
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WITH NGN
## 100 Questions with Rationales & Answers
---
**1.** A nurse is assessing a client who is 6 hours post‑operative following a total hip arthroplasty.
Which finding requires immediate intervention?
A) Pain score 6/10 on a 0–10 scale
B) Temperature 99.2°F (37.3°C)
C) Oxygen saturation 89% on room air
D) Serosanguineous drainage on the dressing
💡 **RATIONALE** – Oxygen saturation <90% indicates hypoxemia, which may result from atelectasis,
pulmonary embolism, or fat embolism syndrome. Immediate action is required.
✔️ **ANSWER** – C) Oxygen saturation 89% on room air
---
**2.** A client with chronic obstructive pulmonary disease (COPD) is prescribed home oxygen at 2
L/min via nasal cannula. Which statement by the client indicates a need for further teaching?
A) “I will check my oxygen saturation with a pulse oximeter daily.”
B) “I can increase the flow rate to 4 L/min if I feel more short of breath.”
C) “I will not smoke or allow anyone to smoke near my oxygen.”
D) “I will store my oxygen tanks upright and away from heat sources.”
,💡 **RATIONALE** – Oxygen flow rate should never be adjusted without provider order; increasing flow
can worsen CO2 retention in COPD clients with chronic hypercapnia.
✔️ **ANSWER** – B) “I can increase the flow rate to 4 L/min if I feel more short of breath.”
---
**3.** A nurse is caring for a client with a chest tube to a closed drainage system after a thoracotomy.
The nurse notes gentle continuous bubbling in the suction control chamber. What action should the
nurse take?
A) Clamp the chest tube and notify the provider
B) Document this as an expected finding
C) Increase the suction pressure until bubbling stops
D) Assess the system for an air leak
💡 **RATIONALE** – Gentle continuous bubbling in the *suction control chamber* is expected when
suction is applied. Bubbling in the *water seal chamber* indicates an air leak.
✔️ **ANSWER** – B) Document this as an expected finding
---
**4.** A client with type 2 diabetes mellitus has a blood glucose level of 52 mg/dL and is conscious and
able to swallow. What should the nurse administer first?
A) 4 oz of skim milk
B) 4 oz of orange juice
C) 2 tablespoons of honey
D) 6 oz of diet soda
💡 **RATIONALE** – For conscious hypoglycemia, 15 g of fast‑acting carbohydrate is given. 4 oz of
orange juice (≈15 g carbs) is appropriate. Diet soda has no sugar; honey is 17 g per tbsp but thicker; skim
milk works slower.
✔️ **ANSWER** – B) 4 oz of orange juice
,---
**5.** A nurse is providing discharge teaching to a client with a new colostomy. Which statement by the
client indicates understanding of stoma care?
A) “I will clean my stoma with alcohol wipes to prevent infection.”
B) “I will cut the wafer opening exactly the size of my stoma.”
C) “I will change my pouch every day to keep the skin clean.”
D) “I will expect my stoma to be moist and pink to red.”
💡 **RATIONALE** – A healthy stoma is moist, pink to red. The wafer should be cut 1/8 inch larger than
the stoma; alcohol is too harsh; pouches can stay 3‑7 days.
✔️ **ANSWER** – D) “I will expect my stoma to be moist and pink to red.”
---
**6.** A client with heart failure is receiving IV furosemide. Which laboratory value requires the most
immediate action?
A) Serum potassium 3.2 mEq/L
B) Serum sodium 135 mEq/L
C) Serum magnesium 2.0 mg/dL
D) Serum glucose 110 mg/dL
💡 **RATIONALE** – Hypokalemia (K <3.5) from loop diuretics increases risk of digoxin toxicity and
cardiac dysrhythmias. This requires prompt intervention.
✔️ **ANSWER** – A) Serum potassium 3.2 mEq/L
---
, **7.** A nurse is caring for a client with a traumatic brain injury. The client’s Glasgow Coma Scale score
is 10. Which finding is consistent with this score?
A) Eye opening to pain, incomprehensible sounds, abnormal flexion
B) Eye opening to speech, confused speech, localizes pain
C) Spontaneous eye opening, oriented, obeys commands
D) No eye opening, no verbal response, no motor response
💡 **RATIONALE** – GCS 10 = eye to speech (3) + confused speech (4) + localizes pain (5) = 12? Wait
recalc: eye to speech = 3, confused = 4, localizes = 5 → total 12. For 10: eye to pain (2) + inappropriate
words (3) + abnormal flexion (3) = 8; eye to speech (3) + confused (4) + withdrawal (4) = 11. Common
GCS 10 example: eye to pain (2) + inappropriate (3) + withdrawal (4) = 9; eye to speech (3) + confused
(4) + abnormal flexion (3) = 10. So option B with eye to speech (3), confused (4), localizes (5) is 12, not
10. Let me correct: The best match for 10 is not listed exactly. I will adjust the option. For exam integrity,
I'll write a new option:
B) Eye opening to speech, confused speech, abnormal flexion → 3+4+3=10.
I'll modify accordingly in the final Answer.
I will rewrite #7 properly:
**7.** A nurse is caring for a client with a traumatic brain injury. The client’s Glasgow Coma Scale score
is 10. Which finding is consistent with this score?
A) Eye opening to pain, incomprehensible sounds, abnormal flexion (2+2+2=6)
B) Eye opening to speech, confused speech, abnormal flexion (3+4+3=10)
C) Spontaneous eye opening, oriented, obeys commands (4+5+6=15)
D) No eye opening, no verbal response, no motor response (1+1+1=3)
💡 **RATIONALE** – GCS 10 indicates moderate brain injury. Eye opening to speech (3), confused
speech (4), and abnormal flexion (3) total 10.
✔️ **ANSWER** – B) Eye opening to speech, confused speech, abnormal flexion
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