ATI RN Comprehensive Predictor 2025 (Versions A & B) |
180 NGN Questions + Answers w/ Rationales | Graded A+
NCLEX Prep
QUESTION 1
A nurse is caring for a client who has heart failure and is receiving furosemide. The provider
adds digoxin to the client’s medication regimen. Which of the following findings should the
nurse report immediately as an indication of digoxin toxicity?
A. Serum potassium level of 4.0 mEq/L
B. Respiratory rate of 20/min
C. Yellow-tinged vision and nausea
D. Heart rate of 88/min
Correct Answer: _C. Yellow-tinged vision and nausea_
Rationale: Yellow-tinged vision (xanthopsia), nausea, and vomiting are classic early signs of
digoxin toxicity. Clients with heart failure on furosemide are at increased risk due to potassium
loss, which enhances digoxin's effects. The other findings are within expected ranges and not
specific to toxicity.
QUESTION 2
A nurse is providing discharge teaching to a client who has a new prescription for warfarin.
Which of the following statements by the client indicates a need for further teaching?
A. “I will use a soft-bristled toothbrush.”
B. “I can continue eating salads every day.”
C. “I will report any signs of bruising or bleeding.”
D. “I will take aspirin if I have a headache.”
Correct Answer: _D. “I will take aspirin if I have a headache.”_
Rationale: Aspirin increases the risk of bleeding in clients taking warfarin due to its antiplatelet
,properties. This statement indicates a lack of understanding and a need for further teaching. The
other statements reflect proper warfarin precautions.
QUESTION 3
A nurse in a pediatric clinic is assessing a toddler who has iron deficiency anemia. Which of the
following findings should the nurse expect?
A. Spoon-shaped nails and fatigue
B. Excessive weight gain
C. Jaundiced skin
D. Bradycardia and hypotension
Correct Answer: _A. Spoon-shaped nails and fatigue_
Rationale: Spoon-shaped nails (koilonychia) and fatigue are hallmark signs of iron deficiency
anemia in children. Iron deficiency impairs hemoglobin production, leading to decreased oxygen
delivery and resultant fatigue. Weight loss and pallor may also be seen. Jaundice suggests
hemolysis, not iron deficiency.
QUESTION 4
A nurse is reviewing the lab results of a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following lab values requires immediate intervention?
A. Hemoglobin 12.0 g/dL
B. White blood cell count 9,000/mm³
C. Potassium 5.1 mEq/L
D. Platelet count 90,000/mm³
Correct Answer: _D. Platelet count 90,000/mm³_
Rationale: A platelet count under 100,000/mm³ places the client at risk for bleeding. This is a
priority concern, especially postoperatively. Hemoglobin and potassium are borderline but not
critically abnormal. The WBC is normal.
QUESTION 5
A nurse is caring for a client receiving IV vancomycin. The client begins to report itching of the
face and neck and appears flushed. Which action should the nurse take first?
A. Check the client's temperature
B. Slow the infusion rate
C. Notify the provider
D. Stop the infusion immediately
,Correct Answer: _B. Slow the infusion rate_
Rationale: The client is likely experiencing "Red Man Syndrome," a histamine reaction caused
by rapid vancomycin infusion. Slowing the rate often resolves the symptoms. Stopping the
infusion may be necessary if symptoms worsen, but the first step is to reduce the rate.
QUESTION 6
A nurse is caring for a client with pneumonia who is receiving oxygen therapy at 2 L/min via
nasal cannula. The client suddenly reports shortness of breath, has a respiratory rate of 28/min,
and shows signs of restlessness. What is the nurse’s priority action?
A. Increase oxygen to 4 L/min
B. Administer a bronchodilator as prescribed
C. Place the client in high Fowler’s position
D. Notify the provider immediately
Correct Answer: _C. Place the client in high Fowler’s position_
Rationale: The priority action is to optimize lung expansion through positioning. High Fowler’s
position promotes maximal chest expansion and oxygenation. While increasing oxygen and
medications may be needed, positioning comes first in the ABCs.
QUESTION 7
A nurse is teaching a client who has type 1 diabetes about managing hypoglycemia. Which of the
following client statements indicates an understanding of the teaching?
A. "If I feel shaky, I will inject regular insulin."
B. "I’ll eat a snack that contains protein but no sugar."
C. "If I feel dizzy, I’ll drink 4 oz of orange juice."
D. "If I skip a meal, I’ll double my insulin dose."
Correct Answer: _C. "If I feel dizzy, I’ll drink 4 oz of orange juice."_
Rationale: Orange juice provides fast-acting carbohydrates to raise blood glucose during
hypoglycemia. Administering insulin or skipping meals worsens hypoglycemia. Protein-only
snacks are not fast enough to reverse symptoms.
QUESTION 8
A nurse is planning care for a client who is in Buck’s traction for a left femoral fracture. Which
of the following actions should the nurse include in the plan of care?
A. Remove the traction every 8 hr to inspect the skin
B. Elevate the foot of the bed to reduce hip contractures
, C. Ensure the weights hang freely at all times
D. Place a pillow under the affected leg for comfort
Correct Answer: _C. Ensure the weights hang freely at all times_
Rationale: Buck's traction must maintain continuous, free-hanging weights to ensure proper
alignment and reduce muscle spasms. Weights must never rest on the bed or floor. Removing
traction or placing pillows disrupts alignment.
QUESTION 9
A nurse is reviewing the preoperative checklist of a client scheduled for surgery under general
anesthesia. Which of the following findings requires the nurse to notify the provider
immediately?
A. Potassium 3.5 mEq/L
B. INR 4.2
C. Hemoglobin 14.2 g/dL
D. Temperature 37.4°C (99.3°F)
Correct Answer: _B. INR 4.2_
Rationale: An INR of 4.2 is critically high and indicates an increased risk for bleeding during
surgery. The provider must be notified to delay surgery or reverse anticoagulation. The other
findings are within normal or acceptable ranges.
QUESTION 10
A nurse is performing a fundal assessment on a postpartum client 12 hours after delivery. The
fundus is midline and palpated 1 cm above the umbilicus. Which of the following actions should
the nurse take?
A. Document the findings as expected
B. Notify the provider of uterine atony
C. Massage the fundus until it becomes firm
D. Instruct the client to void and reassess
Correct Answer: _A. Document the findings as expected_
Rationale: At 12 hours postpartum, the fundus is normally 1 cm above the umbilicus and should
be firm and midline. No further intervention is needed unless it is boggy or displaced, which
suggests atony or a full bladder.
QUESTION 11
180 NGN Questions + Answers w/ Rationales | Graded A+
NCLEX Prep
QUESTION 1
A nurse is caring for a client who has heart failure and is receiving furosemide. The provider
adds digoxin to the client’s medication regimen. Which of the following findings should the
nurse report immediately as an indication of digoxin toxicity?
A. Serum potassium level of 4.0 mEq/L
B. Respiratory rate of 20/min
C. Yellow-tinged vision and nausea
D. Heart rate of 88/min
Correct Answer: _C. Yellow-tinged vision and nausea_
Rationale: Yellow-tinged vision (xanthopsia), nausea, and vomiting are classic early signs of
digoxin toxicity. Clients with heart failure on furosemide are at increased risk due to potassium
loss, which enhances digoxin's effects. The other findings are within expected ranges and not
specific to toxicity.
QUESTION 2
A nurse is providing discharge teaching to a client who has a new prescription for warfarin.
Which of the following statements by the client indicates a need for further teaching?
A. “I will use a soft-bristled toothbrush.”
B. “I can continue eating salads every day.”
C. “I will report any signs of bruising or bleeding.”
D. “I will take aspirin if I have a headache.”
Correct Answer: _D. “I will take aspirin if I have a headache.”_
Rationale: Aspirin increases the risk of bleeding in clients taking warfarin due to its antiplatelet
,properties. This statement indicates a lack of understanding and a need for further teaching. The
other statements reflect proper warfarin precautions.
QUESTION 3
A nurse in a pediatric clinic is assessing a toddler who has iron deficiency anemia. Which of the
following findings should the nurse expect?
A. Spoon-shaped nails and fatigue
B. Excessive weight gain
C. Jaundiced skin
D. Bradycardia and hypotension
Correct Answer: _A. Spoon-shaped nails and fatigue_
Rationale: Spoon-shaped nails (koilonychia) and fatigue are hallmark signs of iron deficiency
anemia in children. Iron deficiency impairs hemoglobin production, leading to decreased oxygen
delivery and resultant fatigue. Weight loss and pallor may also be seen. Jaundice suggests
hemolysis, not iron deficiency.
QUESTION 4
A nurse is reviewing the lab results of a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following lab values requires immediate intervention?
A. Hemoglobin 12.0 g/dL
B. White blood cell count 9,000/mm³
C. Potassium 5.1 mEq/L
D. Platelet count 90,000/mm³
Correct Answer: _D. Platelet count 90,000/mm³_
Rationale: A platelet count under 100,000/mm³ places the client at risk for bleeding. This is a
priority concern, especially postoperatively. Hemoglobin and potassium are borderline but not
critically abnormal. The WBC is normal.
QUESTION 5
A nurse is caring for a client receiving IV vancomycin. The client begins to report itching of the
face and neck and appears flushed. Which action should the nurse take first?
A. Check the client's temperature
B. Slow the infusion rate
C. Notify the provider
D. Stop the infusion immediately
,Correct Answer: _B. Slow the infusion rate_
Rationale: The client is likely experiencing "Red Man Syndrome," a histamine reaction caused
by rapid vancomycin infusion. Slowing the rate often resolves the symptoms. Stopping the
infusion may be necessary if symptoms worsen, but the first step is to reduce the rate.
QUESTION 6
A nurse is caring for a client with pneumonia who is receiving oxygen therapy at 2 L/min via
nasal cannula. The client suddenly reports shortness of breath, has a respiratory rate of 28/min,
and shows signs of restlessness. What is the nurse’s priority action?
A. Increase oxygen to 4 L/min
B. Administer a bronchodilator as prescribed
C. Place the client in high Fowler’s position
D. Notify the provider immediately
Correct Answer: _C. Place the client in high Fowler’s position_
Rationale: The priority action is to optimize lung expansion through positioning. High Fowler’s
position promotes maximal chest expansion and oxygenation. While increasing oxygen and
medications may be needed, positioning comes first in the ABCs.
QUESTION 7
A nurse is teaching a client who has type 1 diabetes about managing hypoglycemia. Which of the
following client statements indicates an understanding of the teaching?
A. "If I feel shaky, I will inject regular insulin."
B. "I’ll eat a snack that contains protein but no sugar."
C. "If I feel dizzy, I’ll drink 4 oz of orange juice."
D. "If I skip a meal, I’ll double my insulin dose."
Correct Answer: _C. "If I feel dizzy, I’ll drink 4 oz of orange juice."_
Rationale: Orange juice provides fast-acting carbohydrates to raise blood glucose during
hypoglycemia. Administering insulin or skipping meals worsens hypoglycemia. Protein-only
snacks are not fast enough to reverse symptoms.
QUESTION 8
A nurse is planning care for a client who is in Buck’s traction for a left femoral fracture. Which
of the following actions should the nurse include in the plan of care?
A. Remove the traction every 8 hr to inspect the skin
B. Elevate the foot of the bed to reduce hip contractures
, C. Ensure the weights hang freely at all times
D. Place a pillow under the affected leg for comfort
Correct Answer: _C. Ensure the weights hang freely at all times_
Rationale: Buck's traction must maintain continuous, free-hanging weights to ensure proper
alignment and reduce muscle spasms. Weights must never rest on the bed or floor. Removing
traction or placing pillows disrupts alignment.
QUESTION 9
A nurse is reviewing the preoperative checklist of a client scheduled for surgery under general
anesthesia. Which of the following findings requires the nurse to notify the provider
immediately?
A. Potassium 3.5 mEq/L
B. INR 4.2
C. Hemoglobin 14.2 g/dL
D. Temperature 37.4°C (99.3°F)
Correct Answer: _B. INR 4.2_
Rationale: An INR of 4.2 is critically high and indicates an increased risk for bleeding during
surgery. The provider must be notified to delay surgery or reverse anticoagulation. The other
findings are within normal or acceptable ranges.
QUESTION 10
A nurse is performing a fundal assessment on a postpartum client 12 hours after delivery. The
fundus is midline and palpated 1 cm above the umbilicus. Which of the following actions should
the nurse take?
A. Document the findings as expected
B. Notify the provider of uterine atony
C. Massage the fundus until it becomes firm
D. Instruct the client to void and reassess
Correct Answer: _A. Document the findings as expected_
Rationale: At 12 hours postpartum, the fundus is normally 1 cm above the umbilicus and should
be firm and midline. No further intervention is needed unless it is boggy or displaced, which
suggests atony or a full bladder.
QUESTION 11
