1
NEXT GEN ATI RN Comprehensive Predictor Exit Exam Level 3
2026 Proctored Exit Exam | Real Screenshot-Based Questions and
Correct Answers
Section 1: Fundamentals of Nursing / Prioritization
1. A nurse is caring for a client who is receiving a continuous IV infusion of normal
saline at 125 mL/hr. The nurse notes that the client's urine output has been 50 mL
over the last 4 hours. What action should the nurse take first?
• A. Notify the healthcare provider immediately.
• B. Assess the IV site for infiltration and patency.
• C. Continue to monitor as this is within normal limits.
• D. Increase the IV rate to 150 mL/hr.
Correct Answer: B
Rationale: Oliguria (50 mL/4 hrs = 12.5 mL/hr, normal is 30 mL/hr) may indicate
decreased perfusion. Before notifying the provider, assess for a kinked, infiltrated, or
disconnected IV line .
2. A nurse is caring for a client with heart failure who has been prescribed
furosemide 40 mg IV twice daily. Which laboratory value requires immediate
notification of the provider?
• A. Serum sodium 135 mEq/L
• B. Serum potassium 2.8 mEq/L
• C. Serum creatinine 1.0 mg/dL
• D. Blood glucose 110 mg/dL
Correct Answer: B
,2
Rationale: Furosemide is a loop diuretic that causes potassium wasting. A potassium of
2.8 mEq/L indicates severe hypokalemia, increasing the risk of cardiac dysrhythmias .
Section 2: Pharmacological and Parenteral Therapies
6. A nurse is preparing to administer digoxin to a client with heart failure. Which
finding should prompt the nurse to withhold the medication?
• A. Heart rate 58 bpm
• B. Blood pressure 118/76 mm Hg
• C. Potassium 4.0 mEq/L
• D. Respiratory rate 18/min
Correct Answer: A
Rationale: Digoxin should be withheld if the apical pulse is below 60 bpm (adults) due
to risk of bradycardia and heart block. Potassium 4.0 is normal; BP and RR are normal .
7. A nurse is preparing to administer vancomycin IV to a client. Which laboratory
value should be reported to the provider before administering?
• A. Serum sodium 138 mEq/L
• B. BUN 18 mg/dL
• C. Creatinine 2.5 mg/dL
• D. WBC count 11,000/mm³
Correct Answer: C
Rationale: Vancomycin is nephrotoxic. Creatinine of 2.5 mg/dL (normal 0.6–1.2)
indicates significant renal impairment. The dose should be held and the provider
notified .
,3
8. A nurse is preparing to administer packed RBCs to a client. Which IV solution is
compatible for priming the tubing?
• A. Lactated Ringer's
• B. 5% Dextrose in water
• C. 0.9% Sodium chloride
• D. 0.45% Sodium chloride
Correct Answer: C
Rationale: 0.9% sodium chloride (normal saline) is the only compatible solution for
priming blood administration tubing. Dextrose solutions cause RBC hemolysis;
hypotonic solutions can cause RBC lysis .
9. A client with major depressive disorder started taking phenelzine. Which food
item on the client's tray should the nurse remove?
• A. Grilled chicken
• B. Cheddar cheese
• C. White rice
• D. Apple juice
Correct Answer: B
Rationale: Phenelzine is an MAOI. Aged cheese (cheddar) is high in tyramine and can
cause hypertensive crisis. Grilled chicken, white rice, and apple juice are low in tyramine
and safe .
10. A nurse is caring for a client with a new diagnosis of diabetes mellitus type 1.
Which statement indicates a need for further teaching?
• A. "I will rotate my insulin injection sites."
• B. "I can store my unopened insulin vials in the freezer."
• C. "I need to check my blood glucose before each meal."
, 4
• D. "I should wear a medical alert bracelet."
Correct Answer: B
Rationale: Insulin should never be frozen. Unopened vials should be refrigerated.
Freezing destroys insulin's effectiveness. Rotation of sites, pre-meal glucose checks, and
medical alert bracelets are correct .
11. A nurse is preparing to administer furosemide to a client with heart failure.
Which finding indicates the medication is effective?
• A. Jugular vein distention
• B. Weight loss of 2 kg in 24 hours
• C. Blood pressure 150/90 mm Hg
• D. Crackles in lung bases
Correct Answer: B
Rationale: Furosemide is a diuretic. Weight loss of 2 kg in 24 hours indicates a
reduction in fluid volume, demonstrating the medication is effective. Jugular vein
distention, hypertension, and crackles indicate fluid overload .
12. A nurse is caring for a client who received the first dose of lisinopril. Which is
an appropriate nursing intervention?
• A. Place cardiac monitoring
• B. Monitor the client's oxygen saturation level
• C. Provide standby assist when the client gets out of bed
• D. Encourage foods high in potassium
Correct Answer: C
Rationale: Lisinopril, an ACE inhibitor, can cause hypotension, especially after the first
dose, increasing fall risk. Standby assistance ensures safety .
NEXT GEN ATI RN Comprehensive Predictor Exit Exam Level 3
2026 Proctored Exit Exam | Real Screenshot-Based Questions and
Correct Answers
Section 1: Fundamentals of Nursing / Prioritization
1. A nurse is caring for a client who is receiving a continuous IV infusion of normal
saline at 125 mL/hr. The nurse notes that the client's urine output has been 50 mL
over the last 4 hours. What action should the nurse take first?
• A. Notify the healthcare provider immediately.
• B. Assess the IV site for infiltration and patency.
• C. Continue to monitor as this is within normal limits.
• D. Increase the IV rate to 150 mL/hr.
Correct Answer: B
Rationale: Oliguria (50 mL/4 hrs = 12.5 mL/hr, normal is 30 mL/hr) may indicate
decreased perfusion. Before notifying the provider, assess for a kinked, infiltrated, or
disconnected IV line .
2. A nurse is caring for a client with heart failure who has been prescribed
furosemide 40 mg IV twice daily. Which laboratory value requires immediate
notification of the provider?
• A. Serum sodium 135 mEq/L
• B. Serum potassium 2.8 mEq/L
• C. Serum creatinine 1.0 mg/dL
• D. Blood glucose 110 mg/dL
Correct Answer: B
,2
Rationale: Furosemide is a loop diuretic that causes potassium wasting. A potassium of
2.8 mEq/L indicates severe hypokalemia, increasing the risk of cardiac dysrhythmias .
Section 2: Pharmacological and Parenteral Therapies
6. A nurse is preparing to administer digoxin to a client with heart failure. Which
finding should prompt the nurse to withhold the medication?
• A. Heart rate 58 bpm
• B. Blood pressure 118/76 mm Hg
• C. Potassium 4.0 mEq/L
• D. Respiratory rate 18/min
Correct Answer: A
Rationale: Digoxin should be withheld if the apical pulse is below 60 bpm (adults) due
to risk of bradycardia and heart block. Potassium 4.0 is normal; BP and RR are normal .
7. A nurse is preparing to administer vancomycin IV to a client. Which laboratory
value should be reported to the provider before administering?
• A. Serum sodium 138 mEq/L
• B. BUN 18 mg/dL
• C. Creatinine 2.5 mg/dL
• D. WBC count 11,000/mm³
Correct Answer: C
Rationale: Vancomycin is nephrotoxic. Creatinine of 2.5 mg/dL (normal 0.6–1.2)
indicates significant renal impairment. The dose should be held and the provider
notified .
,3
8. A nurse is preparing to administer packed RBCs to a client. Which IV solution is
compatible for priming the tubing?
• A. Lactated Ringer's
• B. 5% Dextrose in water
• C. 0.9% Sodium chloride
• D. 0.45% Sodium chloride
Correct Answer: C
Rationale: 0.9% sodium chloride (normal saline) is the only compatible solution for
priming blood administration tubing. Dextrose solutions cause RBC hemolysis;
hypotonic solutions can cause RBC lysis .
9. A client with major depressive disorder started taking phenelzine. Which food
item on the client's tray should the nurse remove?
• A. Grilled chicken
• B. Cheddar cheese
• C. White rice
• D. Apple juice
Correct Answer: B
Rationale: Phenelzine is an MAOI. Aged cheese (cheddar) is high in tyramine and can
cause hypertensive crisis. Grilled chicken, white rice, and apple juice are low in tyramine
and safe .
10. A nurse is caring for a client with a new diagnosis of diabetes mellitus type 1.
Which statement indicates a need for further teaching?
• A. "I will rotate my insulin injection sites."
• B. "I can store my unopened insulin vials in the freezer."
• C. "I need to check my blood glucose before each meal."
, 4
• D. "I should wear a medical alert bracelet."
Correct Answer: B
Rationale: Insulin should never be frozen. Unopened vials should be refrigerated.
Freezing destroys insulin's effectiveness. Rotation of sites, pre-meal glucose checks, and
medical alert bracelets are correct .
11. A nurse is preparing to administer furosemide to a client with heart failure.
Which finding indicates the medication is effective?
• A. Jugular vein distention
• B. Weight loss of 2 kg in 24 hours
• C. Blood pressure 150/90 mm Hg
• D. Crackles in lung bases
Correct Answer: B
Rationale: Furosemide is a diuretic. Weight loss of 2 kg in 24 hours indicates a
reduction in fluid volume, demonstrating the medication is effective. Jugular vein
distention, hypertension, and crackles indicate fluid overload .
12. A nurse is caring for a client who received the first dose of lisinopril. Which is
an appropriate nursing intervention?
• A. Place cardiac monitoring
• B. Monitor the client's oxygen saturation level
• C. Provide standby assist when the client gets out of bed
• D. Encourage foods high in potassium
Correct Answer: C
Rationale: Lisinopril, an ACE inhibitor, can cause hypotension, especially after the first
dose, increasing fall risk. Standby assistance ensures safety .
