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, RN ATI Comprehensive Proctored Exit Retake Exam
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2025/2026 | 180+ NGN Questions with Real Verified
Answers & Rationales | HealthStudyPro
Case Study 1: Heart Failure (Adult Med-Surg)
Patient Background: A 72-year-old male with a history of chronic heart failure
(CHF) presents to the emergency department with dyspnea on exertion, a
productive cough, and swelling in both lower extremities. The patient is on
furosemide and lisinopril.
Question 1
Select three clinical findings that indicate a worsening of the patient’s heart
failure status.
A. Heart rate of 78 bpm
B. Weight gain of 4.5 pounds over the past 2 days
C. Bilateral crackles auscultated in lower lung fields
D. Reports of orthopnea (needs 3 pillows to sleep)
E. Urine output of 50 mL/hour
Correct Answers:
B. Weight gain of 4.5 pounds over 2 days
C. Bilateral crackles in lungs
D. Orthopnea
Rationale:
A sudden weight gain of more than 2 pounds in 24 hours or more than 5 pounds in
a week is a strong indicator of fluid retention and worsening CHF. Crackles in the
lungs suggest pulmonary congestion due to left-sided heart failure. Orthopnea
(difficulty breathing when lying flat) is a classic symptom of fluid overload. A
, heart rate of 78 bpm and urine output of 50 mL/hour are within normal limits and
not indicative of worsening symptoms.
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Question 2
Drag and drop the following nursing interventions in the correct order of
priority for managing this patient’s symptoms.
1. Elevate the head of the bed
2. Administer oxygen via nasal cannula
3. Monitor blood pressure and oxygen saturation
4. Administer IV furosemide
5. Notify the healthcare provider
Correct Order:
Elevate the head of the bed
→ Administer oxygen
→ Monitor vital signs
→ Administer IV furosemide
→ Notify the healthcare provider
Rationale:
Elevating the HOB improves oxygenation by reducing preload and facilitating lung
expansion. Oxygen should be administered next to treat hypoxia. Vital signs must
be assessed to determine hemodynamic status before administering medications.
Furosemide, a loop diuretic, reduces fluid overload. The provider is notified after
the patient is stabilized and immediate nursing interventions are performed.
Question 3
Which laboratory value is most indicative of fluid overload related to
worsening heart failure?
, A. Hemoglobin 13.5 g/dL
B. B-type Natriuretic Peptide (BNP) 780 pg/mL
C. Serum Sodium 138 mEq/L
D. Serum Potassium 4.2 mEq/L
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Correct Answer:
B. BNP 780 pg/mL
Rationale:
BNP is secreted by the ventricles in response to excessive stretching from fluid
overload. A BNP level >100 pg/mL suggests heart failure, and values above 500–
700 are associated with moderate to severe exacerbation. Hemoglobin, sodium, and
potassium levels are within normal range and not diagnostic of worsening CHF.
🧠 Case Study 2: Preeclampsia (Maternity)
Patient Background: A 28-year-old woman at 34 weeks’ gestation presents to the
antenatal unit with complaints of severe headache, blurred vision, and swelling in
her hands and face. Her blood pressure is 160/100 mmHg, and her urine test shows
proteinuria.
Question 4
Which assessment finding requires immediate intervention?
A. Blood pressure of 142/88 mmHg
B. 3+ deep tendon reflexes with sustained clonus
C. Trace proteinuria on dipstick
D. Reports of mild frontal headache
Correct Answer:
B. 3+ deep tendon reflexes with sustained clonus
Rationale:
Hyperreflexia and clonus indicate increasing neuromuscular irritability, a sign of
worsening preeclampsia and potential onset of eclampsia (seizure activity).
, RN ATI Comprehensive Proctored Exit Retake Exam
Page | 2
2025/2026 | 180+ NGN Questions with Real Verified
Answers & Rationales | HealthStudyPro
Case Study 1: Heart Failure (Adult Med-Surg)
Patient Background: A 72-year-old male with a history of chronic heart failure
(CHF) presents to the emergency department with dyspnea on exertion, a
productive cough, and swelling in both lower extremities. The patient is on
furosemide and lisinopril.
Question 1
Select three clinical findings that indicate a worsening of the patient’s heart
failure status.
A. Heart rate of 78 bpm
B. Weight gain of 4.5 pounds over the past 2 days
C. Bilateral crackles auscultated in lower lung fields
D. Reports of orthopnea (needs 3 pillows to sleep)
E. Urine output of 50 mL/hour
Correct Answers:
B. Weight gain of 4.5 pounds over 2 days
C. Bilateral crackles in lungs
D. Orthopnea
Rationale:
A sudden weight gain of more than 2 pounds in 24 hours or more than 5 pounds in
a week is a strong indicator of fluid retention and worsening CHF. Crackles in the
lungs suggest pulmonary congestion due to left-sided heart failure. Orthopnea
(difficulty breathing when lying flat) is a classic symptom of fluid overload. A
, heart rate of 78 bpm and urine output of 50 mL/hour are within normal limits and
not indicative of worsening symptoms.
Page | 3
Question 2
Drag and drop the following nursing interventions in the correct order of
priority for managing this patient’s symptoms.
1. Elevate the head of the bed
2. Administer oxygen via nasal cannula
3. Monitor blood pressure and oxygen saturation
4. Administer IV furosemide
5. Notify the healthcare provider
Correct Order:
Elevate the head of the bed
→ Administer oxygen
→ Monitor vital signs
→ Administer IV furosemide
→ Notify the healthcare provider
Rationale:
Elevating the HOB improves oxygenation by reducing preload and facilitating lung
expansion. Oxygen should be administered next to treat hypoxia. Vital signs must
be assessed to determine hemodynamic status before administering medications.
Furosemide, a loop diuretic, reduces fluid overload. The provider is notified after
the patient is stabilized and immediate nursing interventions are performed.
Question 3
Which laboratory value is most indicative of fluid overload related to
worsening heart failure?
, A. Hemoglobin 13.5 g/dL
B. B-type Natriuretic Peptide (BNP) 780 pg/mL
C. Serum Sodium 138 mEq/L
D. Serum Potassium 4.2 mEq/L
Page | 4
Correct Answer:
B. BNP 780 pg/mL
Rationale:
BNP is secreted by the ventricles in response to excessive stretching from fluid
overload. A BNP level >100 pg/mL suggests heart failure, and values above 500–
700 are associated with moderate to severe exacerbation. Hemoglobin, sodium, and
potassium levels are within normal range and not diagnostic of worsening CHF.
🧠 Case Study 2: Preeclampsia (Maternity)
Patient Background: A 28-year-old woman at 34 weeks’ gestation presents to the
antenatal unit with complaints of severe headache, blurred vision, and swelling in
her hands and face. Her blood pressure is 160/100 mmHg, and her urine test shows
proteinuria.
Question 4
Which assessment finding requires immediate intervention?
A. Blood pressure of 142/88 mmHg
B. 3+ deep tendon reflexes with sustained clonus
C. Trace proteinuria on dipstick
D. Reports of mild frontal headache
Correct Answer:
B. 3+ deep tendon reflexes with sustained clonus
Rationale:
Hyperreflexia and clonus indicate increasing neuromuscular irritability, a sign of
worsening preeclampsia and potential onset of eclampsia (seizure activity).
