ATI Exit Exam 2025 | Comprehensive Study Guide,
Key Nursing Concepts, Practice Questions, and
Exam Preparation Resources
These are written at the highest ATI difficulty level and integrate priority, delegation, safety,
pharmacology, medical-surgical, maternal, mental health, and leadership—exactly how the
ATI Exit Exam tests.
ATI RN COMPREHENSIVE EXIT EXAM
10 LONGEST & MOST DIFFICULT – MOST TESTED QUESTIONS
1. PRIORITY + ABCs + MULTIPLE PATIENTS
The nurse receives report on four clients at the beginning of the shift:
• Client A: A 68-year-old with heart failure reporting shortness of breath when lying flat;
SpO₂ 90% on room air.
• Client B: A 55-year-old with type 1 diabetes, blood glucose 54 mg/dL, diaphoretic but
alert.
• Client C: A 72-year-old postoperative abdominal surgery client with BP 88/52 mmHg,
HR 118 bpm, urine output 15 mL/hr.
• Client D: A 40-year-old with pneumonia receiving IV antibiotics, temperature 101.8°F
(38.8°C).
Which client should the nurse assess FIRST?
A. Client A
B. Client B
C. Client C
D. Client D
,✅ Correct Answer: C
Rationale:
Hypotension, tachycardia, and low urine output indicate possible shock, which is an
immediate threat to life. Circulation compromise overrides hypoglycemia and hypoxia when
not severe.
2. DELEGATION + SCOPE OF PRACTICE (ATI FAVORITE)
Which task should the RN delegate to an unlicensed assistive personnel (UAP)?
A. Reinforce teaching about incentive spirometer use
B. Assist a stable client to the bathroom
C. Assess a surgical incision for infection
D. Evaluate effectiveness of pain medication
✅ Correct Answer: B
Rationale:
UAPs may perform routine, non-assessment tasks. Teaching, assessment, and evaluation
require RN judgment.
3. PHARMACOLOGY + SAFETY
A nurse is administering IV potassium chloride to a client with hypokalemia.
Which action by the nurse is MOST appropriate?
A. Administer the medication IV push
B. Dilute the medication and infuse via IV pump
C. Administer with dextrose only
D. Hold the medication if urine output is 20 mL/hr
✅ Correct Answer: B
Rationale:
Potassium is a high-alert medication and must be diluted and infused via pump. IV push
potassium is fatal.
4. RESPIRATORY + OXYGEN THERAPY
A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The client becomes
drowsy and difficult to arouse.
, Which action should the nurse take FIRST?
A. Increase oxygen flow
B. Notify the provider
C. Lower oxygen flow and assess respiratory status
D. Prepare for intubation
✅ Correct Answer: C
Rationale:
Clients with COPD rely on hypoxic drive. Excess oxygen can cause CO₂ retention and
respiratory depression.
5. MATERNAL-NEWBORN (VERY TESTED)
A postpartum client reports heavy vaginal bleeding and uterine bogginess.
What is the nurse’s PRIORITY intervention?
A. Notify the provider
B. Massage the uterine fundus
C. Administer oxytocin
D. Obtain vital signs
✅ Correct Answer: B
Rationale:
Uterine atony causes postpartum hemorrhage. Fundal massage is the first action before
medications.
6. MENTAL HEALTH + SAFETY
A client with major depressive disorder states, “I won’t be a problem much longer.”
What is the nurse’s BEST response?
A. “You shouldn’t feel that way.”
B. “Are you thinking about harming yourself?”
C. “Everything will be okay.”
D. “Let’s talk about coping skills.”
✅ Correct Answer: B
Rationale:
Direct questioning about suicide does not increase risk and is required for safety assessment.
Key Nursing Concepts, Practice Questions, and
Exam Preparation Resources
These are written at the highest ATI difficulty level and integrate priority, delegation, safety,
pharmacology, medical-surgical, maternal, mental health, and leadership—exactly how the
ATI Exit Exam tests.
ATI RN COMPREHENSIVE EXIT EXAM
10 LONGEST & MOST DIFFICULT – MOST TESTED QUESTIONS
1. PRIORITY + ABCs + MULTIPLE PATIENTS
The nurse receives report on four clients at the beginning of the shift:
• Client A: A 68-year-old with heart failure reporting shortness of breath when lying flat;
SpO₂ 90% on room air.
• Client B: A 55-year-old with type 1 diabetes, blood glucose 54 mg/dL, diaphoretic but
alert.
• Client C: A 72-year-old postoperative abdominal surgery client with BP 88/52 mmHg,
HR 118 bpm, urine output 15 mL/hr.
• Client D: A 40-year-old with pneumonia receiving IV antibiotics, temperature 101.8°F
(38.8°C).
Which client should the nurse assess FIRST?
A. Client A
B. Client B
C. Client C
D. Client D
,✅ Correct Answer: C
Rationale:
Hypotension, tachycardia, and low urine output indicate possible shock, which is an
immediate threat to life. Circulation compromise overrides hypoglycemia and hypoxia when
not severe.
2. DELEGATION + SCOPE OF PRACTICE (ATI FAVORITE)
Which task should the RN delegate to an unlicensed assistive personnel (UAP)?
A. Reinforce teaching about incentive spirometer use
B. Assist a stable client to the bathroom
C. Assess a surgical incision for infection
D. Evaluate effectiveness of pain medication
✅ Correct Answer: B
Rationale:
UAPs may perform routine, non-assessment tasks. Teaching, assessment, and evaluation
require RN judgment.
3. PHARMACOLOGY + SAFETY
A nurse is administering IV potassium chloride to a client with hypokalemia.
Which action by the nurse is MOST appropriate?
A. Administer the medication IV push
B. Dilute the medication and infuse via IV pump
C. Administer with dextrose only
D. Hold the medication if urine output is 20 mL/hr
✅ Correct Answer: B
Rationale:
Potassium is a high-alert medication and must be diluted and infused via pump. IV push
potassium is fatal.
4. RESPIRATORY + OXYGEN THERAPY
A client with COPD is receiving oxygen at 4 L/min via nasal cannula. The client becomes
drowsy and difficult to arouse.
, Which action should the nurse take FIRST?
A. Increase oxygen flow
B. Notify the provider
C. Lower oxygen flow and assess respiratory status
D. Prepare for intubation
✅ Correct Answer: C
Rationale:
Clients with COPD rely on hypoxic drive. Excess oxygen can cause CO₂ retention and
respiratory depression.
5. MATERNAL-NEWBORN (VERY TESTED)
A postpartum client reports heavy vaginal bleeding and uterine bogginess.
What is the nurse’s PRIORITY intervention?
A. Notify the provider
B. Massage the uterine fundus
C. Administer oxytocin
D. Obtain vital signs
✅ Correct Answer: B
Rationale:
Uterine atony causes postpartum hemorrhage. Fundal massage is the first action before
medications.
6. MENTAL HEALTH + SAFETY
A client with major depressive disorder states, “I won’t be a problem much longer.”
What is the nurse’s BEST response?
A. “You shouldn’t feel that way.”
B. “Are you thinking about harming yourself?”
C. “Everything will be okay.”
D. “Let’s talk about coping skills.”
✅ Correct Answer: B
Rationale:
Direct questioning about suicide does not increase risk and is required for safety assessment.
