ATI RN Comprehensive Exit Exam Review With
Complete Real Exam Questions And Correct Verified
Answers/ Already Graded A+ (Most Recent!!)| 2025–
2026 Edition
180 NGN Questions with Verified Answers & In-Depth
Rationales | Aligned with NCLEX-RN Standards | Graded A+
Introduction
This expertly crafted study resource contains 180 Next Generation NCLEX (NGN)-
formatted questions from the ATI RN Comprehensive Exit Exam, fully updated for the
2025–2026 testing cycle. Each question is verified for accuracy and clinical relevance,
with well-rationalized answers to promote deep understanding and real-world
application of nursing concepts essential for NCLEX success.
• Topics Covered:
o Clinical Judgment & Case Studies (NGN Format)
o Pharmacological & Parenteral Therapies
o Management of Care & Prioritization
o Safety & Infection Control
o Physiological Adaptation
o Psychosocial Integrity & Mental Health
o Health Promotion & Maintenance
o Basic Care & Comfort
Correct answers are marked in bold and green. Each is paired with a detailed rationale that
explains the reasoning behind the correct choice and why alternative answers are incorrect—
ideal for mastering NCLEX-style clinical judgment.
, Exam Questions and Answers
• Case Study 1: Acute Myocardial Infarction
o Scenario: A 55-year-old male presents to the ED with chest pain, diaphoresis, and
nausea for 1 hour. ECG shows ST elevation in leads V1–V4. BP is 140/90 mmHg,
HR 100 bpm, RR 20 breaths/min, SpO2 94%.
o Question 1 (Multiple Choice): What is the priority nursing action?
▪ A) Administer sublingual nitroglycerin
▪ B) Perform a 12-lead ECG and notify the physician
▪ C) Start an IV line with normal saline
▪ D) Administer morphine IV
▪ Rationale: ST elevation indicates an acute MI, requiring immediate ECG
confirmation and physician notification to initiate reperfusion therapy.
Nitroglycerin, IV fluids, and morphine are secondary actions after
physician consultation.
Question 2 (Select All That Apply): Which interventions should the nurse implement?
(Select all that apply)
o A) Administer oxygen at 2 L/min via nasal cannula
o B) Obtain cardiac biomarkers
o C) Prepare for possible catheterization
o D) Encourage ambulation to reduce anxiety
o E) Administer aspirin per protocol
o Rationale: Cardiac biomarkers confirm MI, catheterization may be needed for
reperfusion, and aspirin reduces clot progression. Oxygen is only needed if SpO2
< 90%. Ambulation is contraindicated in acute MI.
, Question 3 (Drag-and-Drop): Place the steps of MONA protocol in the correct order for
this patient.
o Options: Administer aspirin, Administer morphine, Administer oxygen,
Administer nitroglycerin
o Correct Order:
1. Administer oxygen
2. Administer aspirin
3. Administer nitroglycerin
4. Administer morphine
o Rationale: The MONA protocol prioritizes oxygen (if hypoxic), aspirin to prevent
clot growth, nitroglycerin for vasodilation, and morphine for pain relief, in that
order, per protocol.
• Mia D. just purchased a document 4 minutes ago
• B) Measuring vital signs
• C) Assessing pain levels
• D) Developing a care plan
• Rationale: Measuring vital signs is within the UAP’s scope, while the others require RN
licensure and judgment.
Case Study 2: Heart Failure Exacerbation
Scenario: A 78-year-old female with chronic heart failure presents with worsening dyspnea,
orthopnea, +3 pedal edema, and weight gain of 5 lbs in 3 days. BP 160/90, HR 110, RR 28, SpO2
88% on room air.
Question 4 (Multiple Choice): What is the priority nursing action?
A) Administer IV furosemide
B) Apply high-flow oxygen
C) Restrict oral fluids
D) Place in Trendelenburg position
Rationale: Hypoxia (SpO2 <90%) is the most immediate threat; oxygen should be applied first to
improve tissue oxygenation. Diuretics and fluid restriction are important but secondary.
, Question 5 (Select All That Apply): Which assessment findings support a diagnosis of fluid
overload? (Select all that apply)
A) Jugular venous distension
B) Crackles in lung bases
C) Decreased blood pressure
D) Hepatomegaly
E) Dry mucous membranes
Rationale: JVD, crackles, and hepatomegaly indicate fluid overload. Low BP can occur in
cardiogenic shock but is not specific to fluid overload; dry mucous membranes indicate
dehydration.
Question 6 (Drag-and-Drop): Place the steps for administering IV furosemide in correct order.
Options: Assess lung sounds, Dilute furosemide if needed, Administer slow IV push, Monitor
urine output
Correct Order:
1. Assess lung sounds
2. Dilute furosemide if needed
3. Administer slow IV push
4. Monitor urine output
Rationale: Baseline assessment ensures need for diuresis; dilution prevents irritation; slow push
prevents ototoxicity; monitoring output evaluates effectiveness.
Case Study 3: Postoperative Pneumonia Prevention
Scenario: A 68-year-old male is post-op day 1 after abdominal surgery. He is reluctant to deep
breathe or cough due to incisional pain.
Question 7 (Multiple Choice): What is the best initial intervention?
A) Notify the provider for stronger pain medication
B) Administer prescribed analgesia 30 minutes before breathing exercises
C) Encourage ambulation to improve lung expansion
D) Apply incentive spirometer every 4 hours
Rationale: Pain control before deep breathing/coughing improves compliance and
effectiveness. Ambulation is helpful but secondary to pain management.
Complete Real Exam Questions And Correct Verified
Answers/ Already Graded A+ (Most Recent!!)| 2025–
2026 Edition
180 NGN Questions with Verified Answers & In-Depth
Rationales | Aligned with NCLEX-RN Standards | Graded A+
Introduction
This expertly crafted study resource contains 180 Next Generation NCLEX (NGN)-
formatted questions from the ATI RN Comprehensive Exit Exam, fully updated for the
2025–2026 testing cycle. Each question is verified for accuracy and clinical relevance,
with well-rationalized answers to promote deep understanding and real-world
application of nursing concepts essential for NCLEX success.
• Topics Covered:
o Clinical Judgment & Case Studies (NGN Format)
o Pharmacological & Parenteral Therapies
o Management of Care & Prioritization
o Safety & Infection Control
o Physiological Adaptation
o Psychosocial Integrity & Mental Health
o Health Promotion & Maintenance
o Basic Care & Comfort
Correct answers are marked in bold and green. Each is paired with a detailed rationale that
explains the reasoning behind the correct choice and why alternative answers are incorrect—
ideal for mastering NCLEX-style clinical judgment.
, Exam Questions and Answers
• Case Study 1: Acute Myocardial Infarction
o Scenario: A 55-year-old male presents to the ED with chest pain, diaphoresis, and
nausea for 1 hour. ECG shows ST elevation in leads V1–V4. BP is 140/90 mmHg,
HR 100 bpm, RR 20 breaths/min, SpO2 94%.
o Question 1 (Multiple Choice): What is the priority nursing action?
▪ A) Administer sublingual nitroglycerin
▪ B) Perform a 12-lead ECG and notify the physician
▪ C) Start an IV line with normal saline
▪ D) Administer morphine IV
▪ Rationale: ST elevation indicates an acute MI, requiring immediate ECG
confirmation and physician notification to initiate reperfusion therapy.
Nitroglycerin, IV fluids, and morphine are secondary actions after
physician consultation.
Question 2 (Select All That Apply): Which interventions should the nurse implement?
(Select all that apply)
o A) Administer oxygen at 2 L/min via nasal cannula
o B) Obtain cardiac biomarkers
o C) Prepare for possible catheterization
o D) Encourage ambulation to reduce anxiety
o E) Administer aspirin per protocol
o Rationale: Cardiac biomarkers confirm MI, catheterization may be needed for
reperfusion, and aspirin reduces clot progression. Oxygen is only needed if SpO2
< 90%. Ambulation is contraindicated in acute MI.
, Question 3 (Drag-and-Drop): Place the steps of MONA protocol in the correct order for
this patient.
o Options: Administer aspirin, Administer morphine, Administer oxygen,
Administer nitroglycerin
o Correct Order:
1. Administer oxygen
2. Administer aspirin
3. Administer nitroglycerin
4. Administer morphine
o Rationale: The MONA protocol prioritizes oxygen (if hypoxic), aspirin to prevent
clot growth, nitroglycerin for vasodilation, and morphine for pain relief, in that
order, per protocol.
• Mia D. just purchased a document 4 minutes ago
• B) Measuring vital signs
• C) Assessing pain levels
• D) Developing a care plan
• Rationale: Measuring vital signs is within the UAP’s scope, while the others require RN
licensure and judgment.
Case Study 2: Heart Failure Exacerbation
Scenario: A 78-year-old female with chronic heart failure presents with worsening dyspnea,
orthopnea, +3 pedal edema, and weight gain of 5 lbs in 3 days. BP 160/90, HR 110, RR 28, SpO2
88% on room air.
Question 4 (Multiple Choice): What is the priority nursing action?
A) Administer IV furosemide
B) Apply high-flow oxygen
C) Restrict oral fluids
D) Place in Trendelenburg position
Rationale: Hypoxia (SpO2 <90%) is the most immediate threat; oxygen should be applied first to
improve tissue oxygenation. Diuretics and fluid restriction are important but secondary.
, Question 5 (Select All That Apply): Which assessment findings support a diagnosis of fluid
overload? (Select all that apply)
A) Jugular venous distension
B) Crackles in lung bases
C) Decreased blood pressure
D) Hepatomegaly
E) Dry mucous membranes
Rationale: JVD, crackles, and hepatomegaly indicate fluid overload. Low BP can occur in
cardiogenic shock but is not specific to fluid overload; dry mucous membranes indicate
dehydration.
Question 6 (Drag-and-Drop): Place the steps for administering IV furosemide in correct order.
Options: Assess lung sounds, Dilute furosemide if needed, Administer slow IV push, Monitor
urine output
Correct Order:
1. Assess lung sounds
2. Dilute furosemide if needed
3. Administer slow IV push
4. Monitor urine output
Rationale: Baseline assessment ensures need for diuresis; dilution prevents irritation; slow push
prevents ototoxicity; monitoring output evaluates effectiveness.
Case Study 3: Postoperative Pneumonia Prevention
Scenario: A 68-year-old male is post-op day 1 after abdominal surgery. He is reluctant to deep
breathe or cough due to incisional pain.
Question 7 (Multiple Choice): What is the best initial intervention?
A) Notify the provider for stronger pain medication
B) Administer prescribed analgesia 30 minutes before breathing exercises
C) Encourage ambulation to improve lung expansion
D) Apply incentive spirometer every 4 hours
Rationale: Pain control before deep breathing/coughing improves compliance and
effectiveness. Ambulation is helpful but secondary to pain management.
