1
ATI Comprehensive Predictor 2025 | 180 Verified NGN
Questions + A+ Rationales | Med-Surg, OB, Pharm, Peds,
Mental Health
1.
A nurse is caring for a client 2 hours post-op after a cholecystectomy. The client
reports severe shoulder pain. Which action should the nurse take first?
A. Administer prescribed analgesic
B. Encourage ambulation
C. Apply a warm compress to the shoulder
D. Reposition the client
Answer: B. Encourage ambulation
Rationale: Shoulder pain post-laparoscopic surgery is often caused by retained
carbon dioxide gas irritating the phrenic nerve. Ambulation promotes gas
, 2
expulsion, relieving pain faster than medication alone. Warm compresses or
repositioning can help, but mobility addresses the underlying cause.
2.
A nurse is caring for a client with heart failure who reports new onset shortness of
breath while lying flat. Which action should the nurse take first?
A. Assess lung sounds
B. Administer oxygen
C. Elevate the head of the bed
D. Notify the provider
Answer: C. Elevate the head of the bed
Rationale: The client is experiencing orthopnea due to fluid accumulation in
the lungs. Immediate airway support comes first, so raising the head of the bed
improves ventilation. Oxygen and provider notification follow initial airway
positioning per the ABC priority framework.
3.
, 3
A nurse is providing discharge teaching to a client prescribed warfarin. Which
statement by the client indicates a need for further teaching?
A. “I will have my INR checked regularly.”
B. “I can eat spinach as long as I’m consistent.”
C. “I will use an electric razor to shave.”
D. “I can take ibuprofen for headaches.”
Answer: D. I can take ibuprofen for headaches
Rationale: Ibuprofen and other NSAIDs increase bleeding risk when combined
with warfarin. The client should use acetaminophen for mild pain instead.
Consistent vitamin K intake, regular INR checks, and using safety measures are
correct actions.
4.
A nurse is preparing to administer digoxin to a client with heart failure. Which
finding requires the nurse to hold the medication?
A. Heart rate 58/min
B. Blood pressure 110/70 mm Hg
C. Serum potassium 4.2 mEq/L
D. Respiratory rate 18/min
, 4
Answer: A. Heart rate 58/min
Rationale: Digoxin slows AV conduction, and bradycardia is a sign of potential
toxicity. The medication should be withheld if apical pulse <60 bpm and the
provider should be notified. Potassium and other vitals are within normal limits.
5.
A nurse is caring for a client who has a new tracheostomy. The cuff is inflated.
Which assessment finding requires immediate intervention?
A. Small amount of blood-tinged secretions
B. Difficulty passing a suction catheter
C. Subcutaneous emphysema at the site
D. Clear lung sounds bilaterally
Answer: C. Subcutaneous emphysema at the site
Rationale: Subcutaneous emphysema indicates air is leaking from the trachea
into subcutaneous tissue, a sign of tracheal or cuff damage. This is a priority as
it may indicate airway compromise. Minor secretions are expected post-insertion.
6.
ATI Comprehensive Predictor 2025 | 180 Verified NGN
Questions + A+ Rationales | Med-Surg, OB, Pharm, Peds,
Mental Health
1.
A nurse is caring for a client 2 hours post-op after a cholecystectomy. The client
reports severe shoulder pain. Which action should the nurse take first?
A. Administer prescribed analgesic
B. Encourage ambulation
C. Apply a warm compress to the shoulder
D. Reposition the client
Answer: B. Encourage ambulation
Rationale: Shoulder pain post-laparoscopic surgery is often caused by retained
carbon dioxide gas irritating the phrenic nerve. Ambulation promotes gas
, 2
expulsion, relieving pain faster than medication alone. Warm compresses or
repositioning can help, but mobility addresses the underlying cause.
2.
A nurse is caring for a client with heart failure who reports new onset shortness of
breath while lying flat. Which action should the nurse take first?
A. Assess lung sounds
B. Administer oxygen
C. Elevate the head of the bed
D. Notify the provider
Answer: C. Elevate the head of the bed
Rationale: The client is experiencing orthopnea due to fluid accumulation in
the lungs. Immediate airway support comes first, so raising the head of the bed
improves ventilation. Oxygen and provider notification follow initial airway
positioning per the ABC priority framework.
3.
, 3
A nurse is providing discharge teaching to a client prescribed warfarin. Which
statement by the client indicates a need for further teaching?
A. “I will have my INR checked regularly.”
B. “I can eat spinach as long as I’m consistent.”
C. “I will use an electric razor to shave.”
D. “I can take ibuprofen for headaches.”
Answer: D. I can take ibuprofen for headaches
Rationale: Ibuprofen and other NSAIDs increase bleeding risk when combined
with warfarin. The client should use acetaminophen for mild pain instead.
Consistent vitamin K intake, regular INR checks, and using safety measures are
correct actions.
4.
A nurse is preparing to administer digoxin to a client with heart failure. Which
finding requires the nurse to hold the medication?
A. Heart rate 58/min
B. Blood pressure 110/70 mm Hg
C. Serum potassium 4.2 mEq/L
D. Respiratory rate 18/min
, 4
Answer: A. Heart rate 58/min
Rationale: Digoxin slows AV conduction, and bradycardia is a sign of potential
toxicity. The medication should be withheld if apical pulse <60 bpm and the
provider should be notified. Potassium and other vitals are within normal limits.
5.
A nurse is caring for a client who has a new tracheostomy. The cuff is inflated.
Which assessment finding requires immediate intervention?
A. Small amount of blood-tinged secretions
B. Difficulty passing a suction catheter
C. Subcutaneous emphysema at the site
D. Clear lung sounds bilaterally
Answer: C. Subcutaneous emphysema at the site
Rationale: Subcutaneous emphysema indicates air is leaking from the trachea
into subcutaneous tissue, a sign of tracheal or cuff damage. This is a priority as
it may indicate airway compromise. Minor secretions are expected post-insertion.
6.
