1
Next Gen NCLEX | ATI Med-Surg NGN Case
Study Pack (2025–2026) | Clinical Judgment Cases
1–10 with Rationales
ATI Med-Surg NGN Case Study Pack – Case 1
Case Study 1: Postoperative Patient with Complications
A 68-year-old female, Mrs. Thompson, is 2 days post-op from an
abdominal hysterectomy. She reports increasing pain at the
incision site, chills, and malaise. Her dressing appears saturated.
She is currently receiving IV fluids and is on a clear liquid diet.
, 2
Clinical Data Tabs
Nurse’s Notes
• Client reports 8/10 abdominal pain localized to incision site.
• Incision site red, warm to touch, and oozing purulent
drainage.
• Client verbalizes feeling 'shaky' and 'hot' since this morning.
• IV site patent. No N/V. Tolerating clear liquids.
Vital Signs
• Temp: 101.9°F
• HR: 110 bpm
• BP: 100/60 mmHg
• RR: 24
• O2 Sat: 95% on room air
Labs
• WBC: 16,500/mm³ (↑)
• Hemoglobin: 10.2 g/Dl
, 3
• Glucose: 108 mg/dL
• Sodium: 135 mEq/L
• CRP: Elevated
• Blood Cultures: Pending
NGN-Style Questions and Rationales
Question 1: Identify the client’s priority problem.
A. Postoperative pain
B. Risk for deficient fluid volume
C. Risk for delayed wound healing
D. Possible surgical site infection
✅ Correct Answer: D. Possible surgical site infection
Rationale: The client displays hallmark signs of a postoperative
infection: fever, elevated WBC, tachycardia, localized redness and
purulent drainage at the incision. Infection is the most urgent issue
requiring intervention.
, 4
Question 2: Which action should the nurse take FIRST?
A. Administer prescribed acetaminophen for fever
B. Notify the provider of the assessment findings
C. Replace the dressing with sterile gauze
D. Reassess temperature in one hour
✅ Correct Answer: B. Notify the provider of the assessment
findings
Rationale: Prompt reporting is essential when infection is
suspected. While dressing change and antipyretics are supportive,
reporting ensures cultures, antibiotics, and escalation of care can
begin.
Question 3: Drag & Drop – Place the nursing actions in order
of priority.
Actions:
• Administer antipyretic
Next Gen NCLEX | ATI Med-Surg NGN Case
Study Pack (2025–2026) | Clinical Judgment Cases
1–10 with Rationales
ATI Med-Surg NGN Case Study Pack – Case 1
Case Study 1: Postoperative Patient with Complications
A 68-year-old female, Mrs. Thompson, is 2 days post-op from an
abdominal hysterectomy. She reports increasing pain at the
incision site, chills, and malaise. Her dressing appears saturated.
She is currently receiving IV fluids and is on a clear liquid diet.
, 2
Clinical Data Tabs
Nurse’s Notes
• Client reports 8/10 abdominal pain localized to incision site.
• Incision site red, warm to touch, and oozing purulent
drainage.
• Client verbalizes feeling 'shaky' and 'hot' since this morning.
• IV site patent. No N/V. Tolerating clear liquids.
Vital Signs
• Temp: 101.9°F
• HR: 110 bpm
• BP: 100/60 mmHg
• RR: 24
• O2 Sat: 95% on room air
Labs
• WBC: 16,500/mm³ (↑)
• Hemoglobin: 10.2 g/Dl
, 3
• Glucose: 108 mg/dL
• Sodium: 135 mEq/L
• CRP: Elevated
• Blood Cultures: Pending
NGN-Style Questions and Rationales
Question 1: Identify the client’s priority problem.
A. Postoperative pain
B. Risk for deficient fluid volume
C. Risk for delayed wound healing
D. Possible surgical site infection
✅ Correct Answer: D. Possible surgical site infection
Rationale: The client displays hallmark signs of a postoperative
infection: fever, elevated WBC, tachycardia, localized redness and
purulent drainage at the incision. Infection is the most urgent issue
requiring intervention.
, 4
Question 2: Which action should the nurse take FIRST?
A. Administer prescribed acetaminophen for fever
B. Notify the provider of the assessment findings
C. Replace the dressing with sterile gauze
D. Reassess temperature in one hour
✅ Correct Answer: B. Notify the provider of the assessment
findings
Rationale: Prompt reporting is essential when infection is
suspected. While dressing change and antipyretics are supportive,
reporting ensures cultures, antibiotics, and escalation of care can
begin.
Question 3: Drag & Drop – Place the nursing actions in order
of priority.
Actions:
• Administer antipyretic
