ATI PN Comprehensive Predictor 2026
Exit Exam with NGN 350 Questions &
100% Correct Answers with rationales
A high-yield, 350-question clinical practice exam database developed explicitly
for Practical Nursing students preparing for their exit exams and NCLEX-PN
licensure. This dataset completes the testing engine, covering core topics
including psychopharmacology, emergency interventions, pediatric care,
maternal-newborn nursing, and fluid-electrolyte imbalances. Every entry features
the correct multiple-choice variant highlighted in bold paired with a detailed,
italicised nursing rationale to reinforce clinical judgment and critical thinking
concepts.
1. A nurse is reviewing the medical record of a client who has a prescription for digoxin.
Which of the following laboratory results should the nurse report to the provider prior to
administering the medication?
A) Serum potassium 4.2 mEq/L
B) Serum potassium 3.2 mEq/L
C) Serum digoxin level 1.1 ng/mL
D) Serum calcium 9.5 mg/dL
Rationale: Hypokalemia (serum potassium less than 3.5 mEq/L) significantly
increases the risk of digoxin toxicity because low potassium levels enhance the
binding of digoxin to myocardial cell receptors, potentially inducing lethal cardiac
arrhythmias.
2. A nurse is collecting data from a client who is 6 hr postoperative following a
cholecystectomy. Which of the following findings is the priority for the nurse to report to
the provider?
A) Pain rating of 6 on a scale of 0 to 10
B) Absent bowel sounds in all four quadrants with abdominal distension
C) Serosanguineous drainage on the surgical dressing
D) Urinary output of 100 mL over the past 4 hr
Rationale: While hypoactive bowel sounds are expected early postoperatively,
completely absent bowel sounds combined with progressive abdominal
distension can indicate a developing paralytic ileus or internal peritonitis,
requiring immediate diagnostic evaluation.
,3. A nurse is reinforcing teaching with a client who has a new prescription for ferrous
sulfate tablets. Which of the following instructions should the nurse include?
A) "Take the medication with an antacid to prevent gastric upset."
B) "Drink a glass of milk immediately after swallowing the tablet."
C) "Take the medication with a glass of orange juice."
D) "Crush the tablet and mix it with applesauce if it is difficult to swallow."
Rationale: Vitamin C (ascorbic acid) significantly enhances the absorption of non-
heme iron in the gastrointestinal tract. Taking ferrous sulfate with orange juice
optimizes the medication's therapeutic outcomes.
4. A nurse is caring for a client who is in droplet precautions. Which of the following
personal protective equipment (PPE) is required when entering the client's room?
A) N95 respirator mask
B) Gown and sterile gloves
C) Surgical mask
D) Protective goggles only
Rationale: Droplet precautions require a standard surgical mask when working
within close proximity (typically 3 feet) of the client to prevent the transmission of
large-particle droplets generated during coughing or sneezing.
5. A nurse is preparing to administer an intramuscular injection to an infant who is 6
months old. Which of the following sites should the nurse select?
A) Dorsogluteal
B) Deltoid
C) Ventrogluteal
D) Vastus lateralis
Rationale: The vastus lateralis is the preferred and safest site for intramuscular
injections in infants under 12 months of age because it contains the largest, most
developed muscle mass available at this developmental stage.
6. A nurse is reinforcing discharge teaching with a client who has a new prescription for
warfarin. Which of the following dietary instructions should the nurse reinforce?
A) "Eliminate all green leafy vegetables from your diet completely."
B) "Maintain a consistent intake of green leafy vegetables each day."
C) "Double your intake of red meat to boost vitamin K synthesis."
D) "Avoid drinking orange juice or eating citrus fruits while on this medication."
Rationale: Warfarin acts as a vitamin K antagonist. Abrupt increases or decreases
in dietary vitamin K (found in green leafy vegetables) can dramatically alter the
therapeutic International Normalized Ratio (INR), making consistency essential.
7. A nurse is collecting data from a client who has hypokalemia. Which of the following
electrocardiogram (ECG) findings should the nurse expect?
A) Tall, peaked T waves
B) Prominent U waves and ST depression
C) Widened QRS complex
D) Absent P waves
Rationale: Hypokalemia causes characteristic ECG changes due to delayed
ventricular repolarization, which manifests as flattening or inversion of the T
wave, ST-segment depression, and the appearance of a prominent U wave.
,8. A nurse is assisting with the care of a client who is experiencing a tonic-clonic seizure.
Which of the following actions should the nurse take first?
A) Insert a padded tongue blade into the client's mouth.
B) Restrict the client's limb movements to prevent fractures.
C) Turn the client onto their side.
D) Administer a PRN dose of intravenous diazepam.
Rationale: Using the airway, breathing, circulation (ABC) framework, the priority
action during an active seizure is to maintain a patent airway and prevent
aspiration by turning the client into a lateral position.
9. A nurse is reviewing laboratory results for a client who is receiving a heparin infusion for
a deep vein thrombosis. Which of the following laboratory values indicates that the
therapy is effective?
A) INR of 2.5
B) aPTT of 65 seconds
C) Platelet count of 95,000/mm³
D) Prothrombin time (PT) of 12 seconds
Rationale: Continuous intravenous heparin infusions are monitored using the
activated partial thromboplastin time (aPTT). A therapeutic level is typically 1.5 to
2.5 times the normal baseline value, aligning with 65 seconds.
10. A nurse is assisting with the admission of an older adult client who has acute confusion
and a suspected urinary tract infection (UTI). Which of the following findings represents
a typical age-related variation in this population?
A) High spiking fever above 39°C
B) Severe dysuria and hematuria
C) Change in mental status without a significant febrile response
D) Marked costovertebral angle tenderness
Rationale: Older adult clients frequently do not present with classic signs of
infection like fever or dysuria; instead, a sudden onset of acute confusion or
delirium is often the primary manifestation of a UTI.
11. A nurse is monitoring a client who is receiving blood transfusion therapy. Which of the
following signs indicates an acute hemolytic transfusion reaction?
A) Low back pain, fever, and tachycardia
B) Generalized pruritus and urticaria
C) Distended neck veins and bilateral crackles
D) Sudden hypotension and bradycardia
Rationale: An acute hemolytic reaction involves an incompatible antigen-antibody
reaction that lyses red blood cells, manifesting rapidly with low back pain, chills,
fever, dyspnea, chest tightness, and tachycardia.
12. A nurse is evaluating a client's understanding of nitroglycerin sublingual tablet
administration for angina. Which of the following statements indicates that the client
understands the instructions?
A) "I should swallow the tablet immediately with a full glass of water."
B) "I can take up to three tablets, spaced 5 minutes apart, if chest pain persists."
C) "I must store the tablets in a clear, plastic container on the windowsill."
D) "I should chew the tablet thoroughly before swallowing to speed up absorption."
Rationale: The standard protocol for acute angina is to place one sublingual
, tablet under the tongue at the onset of pain. If pain continues, the client can
repeat the dose every 5 minutes for a maximum of 3 doses before seeking
emergency care.
13. A nurse is reinforcing teaching regarding clean intermittent self-catheterization for a
client at home. Which of the following statements should the nurse include?
A) "You must use sterile gloves every time you perform the procedure at home."
B) "Wash the catheter thoroughly with soap and water after each use."
C) "Soak the catheter in a bleach solution for 30 minutes daily."
D) "Discard the catheter after a single use and never reuse it."
Rationale: In the home setting, clean technique (rather than sterile technique) is
acceptable for intermittent self-catheterization. Washing the catheter thoroughly
with soap and water minimizes bacterial colonization safely.
14. A nurse is collecting data from a client who is taking a loop diuretic for heart failure.
Which of the following findings should the nurse identify as an adverse effect of the
medication?
A) Hypernatremia
B) Muscle weakness and cramping
C) Bradycardia
D) Weight gain of 2 lb in 24 hr
Rationale: Loop diuretics (such as furosemide) inhibit sodium and water
reabsorption while accelerating potassium excretion, which frequently causes
hypokalemia, presenting as muscle weakness or cramps.
15. A nurse is caring for a client who is 24 hr postoperative following an abdominal
hysterectomy. Which of the following nursing interventions is the priority to prevent deep
vein thrombosis (DVT)?
A) Perform passive range-of-motion exercises of the upper extremities.
B) Assist the client with early and frequent ambulation.
C) Apply a warm heating pad to the client's lower calves.
D) Administer an oral analgesic 30 minutes prior to repositioning.
Rationale: Early, frequent ambulation is the most effective intervention to
promote venous return, eliminate circulatory stasis, and minimize the risk of
thromboembolism following major pelvic surgeries.
16. A nurse is assisting with the care of a client who has a chest tube connected to a water-
seal drainage system. The nurse notes continuous, rapid bubbling in the water-seal
chamber. How should the nurse interpret this finding?
A) The system is functioning normally and air is exiting the pleural space.
B) There is an air leak present somewhere within the system or connections.
C) The suction control regulator is set to a pressure that is too low.
D) The drainage collection bottle has reached maximum volume capacity.
Rationale: Intermittent bubbling in the water-seal chamber is normal during
expiration or coughing, but continuous bubbling indicates an air leak in the
system or at the insertion site that requires immediate troubleshooting.
17. A nurse is preparing to administer an enteral feeding via a gastrostomy tube. Which of
the following actions should the nurse perform first?
A) Flush the tube with 30 mL of warm sterile water.
B) Warm the formula to body temperature in a microwave.
Exit Exam with NGN 350 Questions &
100% Correct Answers with rationales
A high-yield, 350-question clinical practice exam database developed explicitly
for Practical Nursing students preparing for their exit exams and NCLEX-PN
licensure. This dataset completes the testing engine, covering core topics
including psychopharmacology, emergency interventions, pediatric care,
maternal-newborn nursing, and fluid-electrolyte imbalances. Every entry features
the correct multiple-choice variant highlighted in bold paired with a detailed,
italicised nursing rationale to reinforce clinical judgment and critical thinking
concepts.
1. A nurse is reviewing the medical record of a client who has a prescription for digoxin.
Which of the following laboratory results should the nurse report to the provider prior to
administering the medication?
A) Serum potassium 4.2 mEq/L
B) Serum potassium 3.2 mEq/L
C) Serum digoxin level 1.1 ng/mL
D) Serum calcium 9.5 mg/dL
Rationale: Hypokalemia (serum potassium less than 3.5 mEq/L) significantly
increases the risk of digoxin toxicity because low potassium levels enhance the
binding of digoxin to myocardial cell receptors, potentially inducing lethal cardiac
arrhythmias.
2. A nurse is collecting data from a client who is 6 hr postoperative following a
cholecystectomy. Which of the following findings is the priority for the nurse to report to
the provider?
A) Pain rating of 6 on a scale of 0 to 10
B) Absent bowel sounds in all four quadrants with abdominal distension
C) Serosanguineous drainage on the surgical dressing
D) Urinary output of 100 mL over the past 4 hr
Rationale: While hypoactive bowel sounds are expected early postoperatively,
completely absent bowel sounds combined with progressive abdominal
distension can indicate a developing paralytic ileus or internal peritonitis,
requiring immediate diagnostic evaluation.
,3. A nurse is reinforcing teaching with a client who has a new prescription for ferrous
sulfate tablets. Which of the following instructions should the nurse include?
A) "Take the medication with an antacid to prevent gastric upset."
B) "Drink a glass of milk immediately after swallowing the tablet."
C) "Take the medication with a glass of orange juice."
D) "Crush the tablet and mix it with applesauce if it is difficult to swallow."
Rationale: Vitamin C (ascorbic acid) significantly enhances the absorption of non-
heme iron in the gastrointestinal tract. Taking ferrous sulfate with orange juice
optimizes the medication's therapeutic outcomes.
4. A nurse is caring for a client who is in droplet precautions. Which of the following
personal protective equipment (PPE) is required when entering the client's room?
A) N95 respirator mask
B) Gown and sterile gloves
C) Surgical mask
D) Protective goggles only
Rationale: Droplet precautions require a standard surgical mask when working
within close proximity (typically 3 feet) of the client to prevent the transmission of
large-particle droplets generated during coughing or sneezing.
5. A nurse is preparing to administer an intramuscular injection to an infant who is 6
months old. Which of the following sites should the nurse select?
A) Dorsogluteal
B) Deltoid
C) Ventrogluteal
D) Vastus lateralis
Rationale: The vastus lateralis is the preferred and safest site for intramuscular
injections in infants under 12 months of age because it contains the largest, most
developed muscle mass available at this developmental stage.
6. A nurse is reinforcing discharge teaching with a client who has a new prescription for
warfarin. Which of the following dietary instructions should the nurse reinforce?
A) "Eliminate all green leafy vegetables from your diet completely."
B) "Maintain a consistent intake of green leafy vegetables each day."
C) "Double your intake of red meat to boost vitamin K synthesis."
D) "Avoid drinking orange juice or eating citrus fruits while on this medication."
Rationale: Warfarin acts as a vitamin K antagonist. Abrupt increases or decreases
in dietary vitamin K (found in green leafy vegetables) can dramatically alter the
therapeutic International Normalized Ratio (INR), making consistency essential.
7. A nurse is collecting data from a client who has hypokalemia. Which of the following
electrocardiogram (ECG) findings should the nurse expect?
A) Tall, peaked T waves
B) Prominent U waves and ST depression
C) Widened QRS complex
D) Absent P waves
Rationale: Hypokalemia causes characteristic ECG changes due to delayed
ventricular repolarization, which manifests as flattening or inversion of the T
wave, ST-segment depression, and the appearance of a prominent U wave.
,8. A nurse is assisting with the care of a client who is experiencing a tonic-clonic seizure.
Which of the following actions should the nurse take first?
A) Insert a padded tongue blade into the client's mouth.
B) Restrict the client's limb movements to prevent fractures.
C) Turn the client onto their side.
D) Administer a PRN dose of intravenous diazepam.
Rationale: Using the airway, breathing, circulation (ABC) framework, the priority
action during an active seizure is to maintain a patent airway and prevent
aspiration by turning the client into a lateral position.
9. A nurse is reviewing laboratory results for a client who is receiving a heparin infusion for
a deep vein thrombosis. Which of the following laboratory values indicates that the
therapy is effective?
A) INR of 2.5
B) aPTT of 65 seconds
C) Platelet count of 95,000/mm³
D) Prothrombin time (PT) of 12 seconds
Rationale: Continuous intravenous heparin infusions are monitored using the
activated partial thromboplastin time (aPTT). A therapeutic level is typically 1.5 to
2.5 times the normal baseline value, aligning with 65 seconds.
10. A nurse is assisting with the admission of an older adult client who has acute confusion
and a suspected urinary tract infection (UTI). Which of the following findings represents
a typical age-related variation in this population?
A) High spiking fever above 39°C
B) Severe dysuria and hematuria
C) Change in mental status without a significant febrile response
D) Marked costovertebral angle tenderness
Rationale: Older adult clients frequently do not present with classic signs of
infection like fever or dysuria; instead, a sudden onset of acute confusion or
delirium is often the primary manifestation of a UTI.
11. A nurse is monitoring a client who is receiving blood transfusion therapy. Which of the
following signs indicates an acute hemolytic transfusion reaction?
A) Low back pain, fever, and tachycardia
B) Generalized pruritus and urticaria
C) Distended neck veins and bilateral crackles
D) Sudden hypotension and bradycardia
Rationale: An acute hemolytic reaction involves an incompatible antigen-antibody
reaction that lyses red blood cells, manifesting rapidly with low back pain, chills,
fever, dyspnea, chest tightness, and tachycardia.
12. A nurse is evaluating a client's understanding of nitroglycerin sublingual tablet
administration for angina. Which of the following statements indicates that the client
understands the instructions?
A) "I should swallow the tablet immediately with a full glass of water."
B) "I can take up to three tablets, spaced 5 minutes apart, if chest pain persists."
C) "I must store the tablets in a clear, plastic container on the windowsill."
D) "I should chew the tablet thoroughly before swallowing to speed up absorption."
Rationale: The standard protocol for acute angina is to place one sublingual
, tablet under the tongue at the onset of pain. If pain continues, the client can
repeat the dose every 5 minutes for a maximum of 3 doses before seeking
emergency care.
13. A nurse is reinforcing teaching regarding clean intermittent self-catheterization for a
client at home. Which of the following statements should the nurse include?
A) "You must use sterile gloves every time you perform the procedure at home."
B) "Wash the catheter thoroughly with soap and water after each use."
C) "Soak the catheter in a bleach solution for 30 minutes daily."
D) "Discard the catheter after a single use and never reuse it."
Rationale: In the home setting, clean technique (rather than sterile technique) is
acceptable for intermittent self-catheterization. Washing the catheter thoroughly
with soap and water minimizes bacterial colonization safely.
14. A nurse is collecting data from a client who is taking a loop diuretic for heart failure.
Which of the following findings should the nurse identify as an adverse effect of the
medication?
A) Hypernatremia
B) Muscle weakness and cramping
C) Bradycardia
D) Weight gain of 2 lb in 24 hr
Rationale: Loop diuretics (such as furosemide) inhibit sodium and water
reabsorption while accelerating potassium excretion, which frequently causes
hypokalemia, presenting as muscle weakness or cramps.
15. A nurse is caring for a client who is 24 hr postoperative following an abdominal
hysterectomy. Which of the following nursing interventions is the priority to prevent deep
vein thrombosis (DVT)?
A) Perform passive range-of-motion exercises of the upper extremities.
B) Assist the client with early and frequent ambulation.
C) Apply a warm heating pad to the client's lower calves.
D) Administer an oral analgesic 30 minutes prior to repositioning.
Rationale: Early, frequent ambulation is the most effective intervention to
promote venous return, eliminate circulatory stasis, and minimize the risk of
thromboembolism following major pelvic surgeries.
16. A nurse is assisting with the care of a client who has a chest tube connected to a water-
seal drainage system. The nurse notes continuous, rapid bubbling in the water-seal
chamber. How should the nurse interpret this finding?
A) The system is functioning normally and air is exiting the pleural space.
B) There is an air leak present somewhere within the system or connections.
C) The suction control regulator is set to a pressure that is too low.
D) The drainage collection bottle has reached maximum volume capacity.
Rationale: Intermittent bubbling in the water-seal chamber is normal during
expiration or coughing, but continuous bubbling indicates an air leak in the
system or at the insertion site that requires immediate troubleshooting.
17. A nurse is preparing to administer an enteral feeding via a gastrostomy tube. Which of
the following actions should the nurse perform first?
A) Flush the tube with 30 mL of warm sterile water.
B) Warm the formula to body temperature in a microwave.
