ATI RN Comprehensive Exit Exam Prep 2026 | 180 NGN-Style
Questions with Answers & Rationales
SECTION A: FUNDAMENTALS OF NURSING & SAFETY
1. A nurse is preparing to insert a nasogastric tube for a client with a bowel obstruction. Which action
best verifies proper placement before initiating feeding?
A. Aspirate gastric contents and check pH
B. Auscultate over the epigastrium while injecting air
C. Obtain an abdominal X‑ray
D. Observe for coughing or cyanosis
Answer: C
Explanation: Abdominal X‑ray is the gold standard for confirming NG tube placement. pH testing is
reliable but X‑ray is definitive.
2. A client on fall precautions attempts to get out of bed unassisted. Which intervention should the nurse
implement first?
A. Apply a bed alarm
B. Place the client in a vest restraint
C. Answer the call light immediately and assist
D. Raise all four side rails
Answer: C
Explanation: The least restrictive intervention is to respond promptly. Bed alarms are preventive, but
immediate assistance prevents the fall.
3. A nurse is calculating intake for a client. The client drank 8 oz of water, 12 oz of juice, and received 500
mL of IV fluids. How many total mL should the nurse document?
A. 1,020 mL
B. 1,100 mL
C. 1,200 mL
D. 1,500 mL
,Answer: B
Explanation: 8 oz = 240 mL, 12 oz = 360 mL, total oral = 600 mL + 500 mL IV = 1,100 mL.
4. A nurse is providing discharge teaching to a client with a new colostomy. Which statement by the
client indicates a need for further teaching?
A. “I will empty my pouch when it is one‑third full.”
B. “I can take a bath with the pouch on.”
C. “I will change my pouch every day to prevent infection.”
D. “I should avoid carbonated beverages to reduce gas.”
Answer: C
Explanation: Ostomy pouches should be changed every 3–7 days or when leaking, not daily. Frequent
changes irritate the skin.
5. A client is receiving a blood transfusion and reports chills and low back pain. What is the nurse’s
priority action?
A. Slow the infusion rate
B. Stop the transfusion
C. Administer acetaminophen
D. Notify the provider
Answer: B
Explanation: Chills and back pain suggest acute hemolytic reaction. Stop the transfusion immediately,
then notify the provider and maintain IV line with saline.
6. A nurse is caring for a client with a stage 3 pressure injury on the sacrum. Which wound care product
is most appropriate?
A. Hydrocolloid dressing
B. Alginate dressing
C. Transparent film
D. Dry gauze
Answer: B
,Explanation: Stage 3 pressure injury has full‑thickness tissue loss with visible subcutaneous fat. Alginate
or foam dressings absorb exudate and maintain moisture.
7. A client on a clear liquid diet is allowed which of the following?
A. Milk
B. Orange juice with pulp
C. Chicken broth
D. Vanilla pudding
Answer: C
Explanation: Clear liquids include broth, clear juices (no pulp), gelatin, and water. Milk, pulp, and
pudding are not clear liquids.
8. A nurse is inserting an indwelling urinary catheter. After cleaning the meatus, the client inadvertently
touches the sterile catheter. What should the nurse do?
A. Continue with the procedure
B. Wipe the catheter with antiseptic
C. Discard the catheter and obtain a new one
D. Apply sterile gloves over the contaminated area
Answer: C
Explanation: Once sterility is broken, the catheter is contaminated and must be replaced to prevent
infection.
9. A client with a tracheostomy has thick, tenacious secretions. Which intervention should the nurse
perform first?
A. Instill normal saline into the tracheostomy
B. Suction the airway
C. Increase humidity via tracheostomy collar
D. Perform chest physiotherapy
Answer: C
Explanation: Increasing humidity loosens secretions; suctioning is done after humidification if needed.
Saline instillation is no longer routinely recommended.
, 10. A nurse is evaluating a client’s understanding of a low‑sodium diet. Which meal choice indicates
effective teaching?
A. Grilled chicken sandwich with pickles and fries
B. Baked salmon, steamed broccoli, and a baked potato
C. Ham and cheese omelet with bacon
D. Canned vegetable soup with saltine crackers
Answer: B
Explanation: Fresh salmon, broccoli, and potato are naturally low in sodium. Pickles, ham, bacon, canned
soup, and processed foods are high in sodium.
11. A nurse receives a verbal order for “morphine 4 mg IV push every 2 hours PRN pain.” Which action is
most appropriate?
A. Administer the medication as stated
B. Ask the provider to repeat the order for clarification
C. Write the order in the chart and sign it
D. Clarify the route and rate with the provider
Answer: D
Explanation: Verbal orders must be read back and clarified. IV push requires rate (e.g., over 2–5 minutes)
to prevent respiratory depression.
12. A client with an indwelling catheter has sediment in the tubing. Which nursing action is appropriate?
A. Irrigate the catheter with 30 mL sterile saline
B. Increase fluid intake to 2,500 mL/day
C. Replace the catheter immediately
D. Clamp the catheter for 2 hours
Answer: B
Explanation: Increasing fluids helps flush sediment. Irrigation is not routine and requires an order.
Catheter change is not needed unless obstructed.
Questions with Answers & Rationales
SECTION A: FUNDAMENTALS OF NURSING & SAFETY
1. A nurse is preparing to insert a nasogastric tube for a client with a bowel obstruction. Which action
best verifies proper placement before initiating feeding?
A. Aspirate gastric contents and check pH
B. Auscultate over the epigastrium while injecting air
C. Obtain an abdominal X‑ray
D. Observe for coughing or cyanosis
Answer: C
Explanation: Abdominal X‑ray is the gold standard for confirming NG tube placement. pH testing is
reliable but X‑ray is definitive.
2. A client on fall precautions attempts to get out of bed unassisted. Which intervention should the nurse
implement first?
A. Apply a bed alarm
B. Place the client in a vest restraint
C. Answer the call light immediately and assist
D. Raise all four side rails
Answer: C
Explanation: The least restrictive intervention is to respond promptly. Bed alarms are preventive, but
immediate assistance prevents the fall.
3. A nurse is calculating intake for a client. The client drank 8 oz of water, 12 oz of juice, and received 500
mL of IV fluids. How many total mL should the nurse document?
A. 1,020 mL
B. 1,100 mL
C. 1,200 mL
D. 1,500 mL
,Answer: B
Explanation: 8 oz = 240 mL, 12 oz = 360 mL, total oral = 600 mL + 500 mL IV = 1,100 mL.
4. A nurse is providing discharge teaching to a client with a new colostomy. Which statement by the
client indicates a need for further teaching?
A. “I will empty my pouch when it is one‑third full.”
B. “I can take a bath with the pouch on.”
C. “I will change my pouch every day to prevent infection.”
D. “I should avoid carbonated beverages to reduce gas.”
Answer: C
Explanation: Ostomy pouches should be changed every 3–7 days or when leaking, not daily. Frequent
changes irritate the skin.
5. A client is receiving a blood transfusion and reports chills and low back pain. What is the nurse’s
priority action?
A. Slow the infusion rate
B. Stop the transfusion
C. Administer acetaminophen
D. Notify the provider
Answer: B
Explanation: Chills and back pain suggest acute hemolytic reaction. Stop the transfusion immediately,
then notify the provider and maintain IV line with saline.
6. A nurse is caring for a client with a stage 3 pressure injury on the sacrum. Which wound care product
is most appropriate?
A. Hydrocolloid dressing
B. Alginate dressing
C. Transparent film
D. Dry gauze
Answer: B
,Explanation: Stage 3 pressure injury has full‑thickness tissue loss with visible subcutaneous fat. Alginate
or foam dressings absorb exudate and maintain moisture.
7. A client on a clear liquid diet is allowed which of the following?
A. Milk
B. Orange juice with pulp
C. Chicken broth
D. Vanilla pudding
Answer: C
Explanation: Clear liquids include broth, clear juices (no pulp), gelatin, and water. Milk, pulp, and
pudding are not clear liquids.
8. A nurse is inserting an indwelling urinary catheter. After cleaning the meatus, the client inadvertently
touches the sterile catheter. What should the nurse do?
A. Continue with the procedure
B. Wipe the catheter with antiseptic
C. Discard the catheter and obtain a new one
D. Apply sterile gloves over the contaminated area
Answer: C
Explanation: Once sterility is broken, the catheter is contaminated and must be replaced to prevent
infection.
9. A client with a tracheostomy has thick, tenacious secretions. Which intervention should the nurse
perform first?
A. Instill normal saline into the tracheostomy
B. Suction the airway
C. Increase humidity via tracheostomy collar
D. Perform chest physiotherapy
Answer: C
Explanation: Increasing humidity loosens secretions; suctioning is done after humidification if needed.
Saline instillation is no longer routinely recommended.
, 10. A nurse is evaluating a client’s understanding of a low‑sodium diet. Which meal choice indicates
effective teaching?
A. Grilled chicken sandwich with pickles and fries
B. Baked salmon, steamed broccoli, and a baked potato
C. Ham and cheese omelet with bacon
D. Canned vegetable soup with saltine crackers
Answer: B
Explanation: Fresh salmon, broccoli, and potato are naturally low in sodium. Pickles, ham, bacon, canned
soup, and processed foods are high in sodium.
11. A nurse receives a verbal order for “morphine 4 mg IV push every 2 hours PRN pain.” Which action is
most appropriate?
A. Administer the medication as stated
B. Ask the provider to repeat the order for clarification
C. Write the order in the chart and sign it
D. Clarify the route and rate with the provider
Answer: D
Explanation: Verbal orders must be read back and clarified. IV push requires rate (e.g., over 2–5 minutes)
to prevent respiratory depression.
12. A client with an indwelling catheter has sediment in the tubing. Which nursing action is appropriate?
A. Irrigate the catheter with 30 mL sterile saline
B. Increase fluid intake to 2,500 mL/day
C. Replace the catheter immediately
D. Clamp the catheter for 2 hours
Answer: B
Explanation: Increasing fluids helps flush sediment. Irrigation is not routine and requires an order.
Catheter change is not needed unless obstructed.
