ATI RN Comprehensive Predictor 2025:
180 NGN-Style Questions with Answers
& Detailed Rationales
Question 1
A nurse is caring for a client who is 2 hours postoperative following a thyroidectomy. Which of
the following findings should the nurse report immediately?
A. Hoarseness when speaking
B. Difficulty swallowing water
C. Respiratory stridor
D. Pain at the incision site
Correct Answer: C. Respiratory stridor
Rationale: Stridor is a high-pitched sound indicating airway obstruction, a potential post-
thyroidectomy emergency from laryngeal nerve damage or hematoma. Immediate action is
required.
Question 2
The nurse is planning care for a client with a Stage 3 pressure ulcer on the coccyx. Which
intervention is most appropriate to promote healing?
,A. Apply a dry gauze dressing
B. Turn the client every 4 hours
C. Use a hydrocolloid dressing
D. Massage the reddened area around the ulcer
Correct Answer: C. Use a hydrocolloid dressing
Rationale: Hydrocolloid dressings promote a moist wound environment which aids in healing.
Massaging is contraindicated and turning should occur every 2 hours, not 4.
Question 3
A nurse is performing a focused assessment for a client with a chest tube. Which of the
following findings requires immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Fluctuation of fluid level with respiration
C. 50 mL of drainage in 1 hour
D. Drainage system secured below chest level
Correct Answer: A. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling suggests an air leak, which must be corrected to prevent lung
collapse or pneumothorax.
Question 4
A nurse is administering haloperidol to a client with schizophrenia. The client suddenly
develops a high fever, muscle rigidity, and altered mental status. What is the priority nursing
action?
A. Administer acetaminophen
B. Place the client on seizure precautions
C. Discontinue the medication and notify the provider
D. Reorient the client to reality
Correct Answer: C. Discontinue the medication and notify the provider
Rationale: These are signs of neuroleptic malignant syndrome (NMS), a life-threatening
reaction. The antipsychotic must be stopped immediately.
Question 5
,A nurse in a pediatric clinic is assessing a 4-month-old infant. Which finding should be reported
to the provider?
A. Rolls from back to side
B. Grasps a rattle
C. No head control
D. Smiles spontaneously
Correct Answer: C. No head control
Rationale: By 4 months, infants should have some head control. Lack of it suggests
developmental delay or neuromuscular issues.
Question 6
A nurse is providing teaching to a client prescribed warfarin. Which of the following statements
by the client indicates the need for further teaching?
A. "I will use a soft toothbrush."
B. "I will avoid foods high in vitamin K."
C. "I can take aspirin if I have a headache."
D. "I will notify my provider about any bleeding."
Correct Answer: C. "I can take aspirin if I have a headache."
Rationale: Aspirin increases bleeding risk when taken with warfarin. This statement requires
correction.
Question 7
A nurse is assessing a client receiving TPN (Total Parenteral Nutrition). Which of the following
findings requires immediate action?
A. Capillary blood glucose of 210 mg/dL
B. Weight gain of 1.2 kg in 2 days
C. Temperature of 38.5°C (101.3°F)
D. Complaints of hunger between infusions
Correct Answer: C. Temperature of 38.5°C (101.3°F)
Rationale: Fever indicates possible infection, including central line-associated bloodstream
infection (CLABSI), a serious TPN complication.
, Question 8
A client is 6 hours post laparoscopic cholecystectomy. Which of the following findings is most
concerning?
A. Pain rated 5/10 at incision site
B. Reports shoulder pain
C. No bowel sounds
D. Respiratory rate of 26/min with shallow breaths
Correct Answer: D. Respiratory rate of 26/min with shallow breaths
Rationale: This suggests inadequate pain control or respiratory compromise, possibly due to
CO₂ insufflation or atelectasis.
Question 9
A nurse is caring for a client with acute pancreatitis. Which of the following interventions
should the nurse implement?
A. Encourage intake of clear liquids
B. Monitor blood glucose levels
C. Place in supine position
D. Administer morphine IM q4h
Correct Answer: B. Monitor blood glucose levels
Rationale: Pancreatitis impairs insulin production, placing the client at risk for hyperglycemia.
Blood glucose must be monitored.
Question 10
Which lab result requires intervention in a client receiving furosemide?
A. Sodium 136 mEq/L
B. Potassium 2.9 mEq/L
C. Chloride 100 mEq/L
D. BUN 16 mg/dL
Correct Answer: B. Potassium 2.9 mEq/L
Rationale: Hypokalemia (< 3.5 mEq/L) is a common side effect of loop diuretics like
furosemide and increases risk of arrhythmias.
180 NGN-Style Questions with Answers
& Detailed Rationales
Question 1
A nurse is caring for a client who is 2 hours postoperative following a thyroidectomy. Which of
the following findings should the nurse report immediately?
A. Hoarseness when speaking
B. Difficulty swallowing water
C. Respiratory stridor
D. Pain at the incision site
Correct Answer: C. Respiratory stridor
Rationale: Stridor is a high-pitched sound indicating airway obstruction, a potential post-
thyroidectomy emergency from laryngeal nerve damage or hematoma. Immediate action is
required.
Question 2
The nurse is planning care for a client with a Stage 3 pressure ulcer on the coccyx. Which
intervention is most appropriate to promote healing?
,A. Apply a dry gauze dressing
B. Turn the client every 4 hours
C. Use a hydrocolloid dressing
D. Massage the reddened area around the ulcer
Correct Answer: C. Use a hydrocolloid dressing
Rationale: Hydrocolloid dressings promote a moist wound environment which aids in healing.
Massaging is contraindicated and turning should occur every 2 hours, not 4.
Question 3
A nurse is performing a focused assessment for a client with a chest tube. Which of the
following findings requires immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Fluctuation of fluid level with respiration
C. 50 mL of drainage in 1 hour
D. Drainage system secured below chest level
Correct Answer: A. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling suggests an air leak, which must be corrected to prevent lung
collapse or pneumothorax.
Question 4
A nurse is administering haloperidol to a client with schizophrenia. The client suddenly
develops a high fever, muscle rigidity, and altered mental status. What is the priority nursing
action?
A. Administer acetaminophen
B. Place the client on seizure precautions
C. Discontinue the medication and notify the provider
D. Reorient the client to reality
Correct Answer: C. Discontinue the medication and notify the provider
Rationale: These are signs of neuroleptic malignant syndrome (NMS), a life-threatening
reaction. The antipsychotic must be stopped immediately.
Question 5
,A nurse in a pediatric clinic is assessing a 4-month-old infant. Which finding should be reported
to the provider?
A. Rolls from back to side
B. Grasps a rattle
C. No head control
D. Smiles spontaneously
Correct Answer: C. No head control
Rationale: By 4 months, infants should have some head control. Lack of it suggests
developmental delay or neuromuscular issues.
Question 6
A nurse is providing teaching to a client prescribed warfarin. Which of the following statements
by the client indicates the need for further teaching?
A. "I will use a soft toothbrush."
B. "I will avoid foods high in vitamin K."
C. "I can take aspirin if I have a headache."
D. "I will notify my provider about any bleeding."
Correct Answer: C. "I can take aspirin if I have a headache."
Rationale: Aspirin increases bleeding risk when taken with warfarin. This statement requires
correction.
Question 7
A nurse is assessing a client receiving TPN (Total Parenteral Nutrition). Which of the following
findings requires immediate action?
A. Capillary blood glucose of 210 mg/dL
B. Weight gain of 1.2 kg in 2 days
C. Temperature of 38.5°C (101.3°F)
D. Complaints of hunger between infusions
Correct Answer: C. Temperature of 38.5°C (101.3°F)
Rationale: Fever indicates possible infection, including central line-associated bloodstream
infection (CLABSI), a serious TPN complication.
, Question 8
A client is 6 hours post laparoscopic cholecystectomy. Which of the following findings is most
concerning?
A. Pain rated 5/10 at incision site
B. Reports shoulder pain
C. No bowel sounds
D. Respiratory rate of 26/min with shallow breaths
Correct Answer: D. Respiratory rate of 26/min with shallow breaths
Rationale: This suggests inadequate pain control or respiratory compromise, possibly due to
CO₂ insufflation or atelectasis.
Question 9
A nurse is caring for a client with acute pancreatitis. Which of the following interventions
should the nurse implement?
A. Encourage intake of clear liquids
B. Monitor blood glucose levels
C. Place in supine position
D. Administer morphine IM q4h
Correct Answer: B. Monitor blood glucose levels
Rationale: Pancreatitis impairs insulin production, placing the client at risk for hyperglycemia.
Blood glucose must be monitored.
Question 10
Which lab result requires intervention in a client receiving furosemide?
A. Sodium 136 mEq/L
B. Potassium 2.9 mEq/L
C. Chloride 100 mEq/L
D. BUN 16 mg/dL
Correct Answer: B. Potassium 2.9 mEq/L
Rationale: Hypokalemia (< 3.5 mEq/L) is a common side effect of loop diuretics like
furosemide and increases risk of arrhythmias.
