ATI RN Comprehensive Exit Exam 2026–2027
Complete Study Guide with Practice
Questions, Rationales and Comprehensive
NCLEX Preparation Review
SAFETY & INFECTION CONTROL
Question 1:
A nurse is caring for a client with a urinary tract infection who has been
prescribed ciprofloxacin. The client also takes warfarin for atrial fibrillation.
Which of the following laboratory values should the nurse monitor most
closely?
A) Serum creatinine
B) International Normalized Ratio (INR)
C) White blood cell count
D) Serum potassium
Answer: B) International Normalized Ratio (INR)
Rationale: Ciprofloxacin inhibits the metabolism of warfarin, significantly
increasing the INR and risk of bleeding. The nurse should monitor INR
frequently and assess for signs of bleeding. This is a critical drug interaction
that requires dose adjustment.
Question 2:
A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions should the nurse take first?
A) Obtain the client's vital signs
B) Verify the client's identity using two identifiers
C) Prime the blood tubing with normal saline
D) Obtain consent for the transfusion
Answer: B) Verify the client's identity using two identifiers
,Rationale: The priority action before any blood transfusion is to verify the
client's identity using two unique identifiers (e.g., name and date of birth) to
prevent transfusion errors. This must be done before initiating the
transfusion.
Question 3:
A nurse is caring for a client who has a prescription for contact precautions.
Which of the following personal protective equipment (PPE) should the nurse
wear when entering the client's room?
A) Surgical mask and gloves
B) Gloves and gown
C) N95 respirator and gloves
D) Gown and face shield
Answer: B) Gloves and gown
Rationale: Contact precautions require the use of gloves and a gown. These
are used for clients with infections transmitted by direct contact (e.g., MRSA,
VRE, C. difficile). A mask is not required unless there is a risk of splash.
Question 4:
A nurse is assessing a client who has a new diagnosis of tuberculosis. Which of
the following isolation precautions should the nurse implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions
Answer: C) Airborne precautions
Rationale: Tuberculosis is transmitted via airborne particles and requires
airborne precautions, including a negative pressure room and N95 respirator.
Droplet precautions are for infections transmitted by large droplets (e.g.,
influenza, meningitis).
,Question 5:
A nurse is preparing to insert an indwelling urinary catheter. Which of the
following actions should the nurse take to maintain sterility?
A) Place the sterile field at waist level
B) Open the sterile kit toward the body
C) Use clean gloves for the procedure
D) Pour sterile solution into the sterile field from a height of 12 inches
Answer: A) Place the sterile field at waist level
Rationale: The sterile field should be placed at or above waist level to
maintain sterility. Opening the kit toward the body would contaminate the
field. Sterile gloves, not clean gloves, must be used. Solutions should be
poured from a height of 4-6 inches.
Question 6:
A client is prescribed enoxaparin for deep vein thrombosis prophylaxis. The
nurse should administer this medication via which of the following routes?
A) Intramuscular
B) Intravenous
C) Subcutaneous
D) Oral
Answer: C) Subcutaneous
Rationale: Enoxaparin is a low molecular weight heparin administered
subcutaneously in the abdomen. It should not be given IM or IV. The site
should not be rubbed after injection to prevent bruising.
Question 7:
A nurse is caring for a client who has a prescription for restraints. Which of
the following actions should the nurse take?
A) Document the client's behavior that necessitated restraints
B) Apply restraints for 24 hours before reassessment
C) Tie restraints to the bed frame
D) Remove restraints every 4 hours only
, Answer: A) Document the client's behavior that necessitated restraints
Rationale: Documentation of the client's behavior and the need for restraints
is essential. Restraints require frequent reassessment (every 2 hours for
children, every 1-2 hours for adults). Restraints should be tied to the bed
frame, not the side rails, to prevent injury.
Question 8:
A nurse is caring for a client who has a central venous catheter. Which of the
following actions should the nurse take to prevent catheter-related
bloodstream infection?
A) Use sterile technique when changing the dressing
B) Change the catheter dressing every 7 days
C) Use alcohol swabs only to clean the site
D) Place the client in contact isolation
Answer: A) Use sterile technique when changing the dressing
Rationale: Sterile technique must be used for central line dressing changes to
prevent infection. Dressing changes are typically every 24-48 hours for
transparent dressings and every 48 hours for gauze. Chlorhexidine is
preferred for site cleansing.
MEDICAL-SURGICAL NURSING
Question 9:
A nurse is caring for a client who is 24 hours post-operative following a
colectomy. Which of the following findings should the nurse report to the
healthcare provider?
A) Temperature of 37.5°C (99.5°F)
B) Wound edges that are separated and draining purulent fluid
C) Heart rate of 88 beats/minute
D) Blood pressure of 128/76 mmHg
Answer: B) Wound edges that are separated and draining purulent fluid
Complete Study Guide with Practice
Questions, Rationales and Comprehensive
NCLEX Preparation Review
SAFETY & INFECTION CONTROL
Question 1:
A nurse is caring for a client with a urinary tract infection who has been
prescribed ciprofloxacin. The client also takes warfarin for atrial fibrillation.
Which of the following laboratory values should the nurse monitor most
closely?
A) Serum creatinine
B) International Normalized Ratio (INR)
C) White blood cell count
D) Serum potassium
Answer: B) International Normalized Ratio (INR)
Rationale: Ciprofloxacin inhibits the metabolism of warfarin, significantly
increasing the INR and risk of bleeding. The nurse should monitor INR
frequently and assess for signs of bleeding. This is a critical drug interaction
that requires dose adjustment.
Question 2:
A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions should the nurse take first?
A) Obtain the client's vital signs
B) Verify the client's identity using two identifiers
C) Prime the blood tubing with normal saline
D) Obtain consent for the transfusion
Answer: B) Verify the client's identity using two identifiers
,Rationale: The priority action before any blood transfusion is to verify the
client's identity using two unique identifiers (e.g., name and date of birth) to
prevent transfusion errors. This must be done before initiating the
transfusion.
Question 3:
A nurse is caring for a client who has a prescription for contact precautions.
Which of the following personal protective equipment (PPE) should the nurse
wear when entering the client's room?
A) Surgical mask and gloves
B) Gloves and gown
C) N95 respirator and gloves
D) Gown and face shield
Answer: B) Gloves and gown
Rationale: Contact precautions require the use of gloves and a gown. These
are used for clients with infections transmitted by direct contact (e.g., MRSA,
VRE, C. difficile). A mask is not required unless there is a risk of splash.
Question 4:
A nurse is assessing a client who has a new diagnosis of tuberculosis. Which of
the following isolation precautions should the nurse implement?
A) Contact precautions
B) Droplet precautions
C) Airborne precautions
D) Standard precautions
Answer: C) Airborne precautions
Rationale: Tuberculosis is transmitted via airborne particles and requires
airborne precautions, including a negative pressure room and N95 respirator.
Droplet precautions are for infections transmitted by large droplets (e.g.,
influenza, meningitis).
,Question 5:
A nurse is preparing to insert an indwelling urinary catheter. Which of the
following actions should the nurse take to maintain sterility?
A) Place the sterile field at waist level
B) Open the sterile kit toward the body
C) Use clean gloves for the procedure
D) Pour sterile solution into the sterile field from a height of 12 inches
Answer: A) Place the sterile field at waist level
Rationale: The sterile field should be placed at or above waist level to
maintain sterility. Opening the kit toward the body would contaminate the
field. Sterile gloves, not clean gloves, must be used. Solutions should be
poured from a height of 4-6 inches.
Question 6:
A client is prescribed enoxaparin for deep vein thrombosis prophylaxis. The
nurse should administer this medication via which of the following routes?
A) Intramuscular
B) Intravenous
C) Subcutaneous
D) Oral
Answer: C) Subcutaneous
Rationale: Enoxaparin is a low molecular weight heparin administered
subcutaneously in the abdomen. It should not be given IM or IV. The site
should not be rubbed after injection to prevent bruising.
Question 7:
A nurse is caring for a client who has a prescription for restraints. Which of
the following actions should the nurse take?
A) Document the client's behavior that necessitated restraints
B) Apply restraints for 24 hours before reassessment
C) Tie restraints to the bed frame
D) Remove restraints every 4 hours only
, Answer: A) Document the client's behavior that necessitated restraints
Rationale: Documentation of the client's behavior and the need for restraints
is essential. Restraints require frequent reassessment (every 2 hours for
children, every 1-2 hours for adults). Restraints should be tied to the bed
frame, not the side rails, to prevent injury.
Question 8:
A nurse is caring for a client who has a central venous catheter. Which of the
following actions should the nurse take to prevent catheter-related
bloodstream infection?
A) Use sterile technique when changing the dressing
B) Change the catheter dressing every 7 days
C) Use alcohol swabs only to clean the site
D) Place the client in contact isolation
Answer: A) Use sterile technique when changing the dressing
Rationale: Sterile technique must be used for central line dressing changes to
prevent infection. Dressing changes are typically every 24-48 hours for
transparent dressings and every 48 hours for gauze. Chlorhexidine is
preferred for site cleansing.
MEDICAL-SURGICAL NURSING
Question 9:
A nurse is caring for a client who is 24 hours post-operative following a
colectomy. Which of the following findings should the nurse report to the
healthcare provider?
A) Temperature of 37.5°C (99.5°F)
B) Wound edges that are separated and draining purulent fluid
C) Heart rate of 88 beats/minute
D) Blood pressure of 128/76 mmHg
Answer: B) Wound edges that are separated and draining purulent fluid
