2026-2027 ATI RN COMPREHENSIVE EXIT EXAM QUESTIONS AND
VERIFIED ANSWERS WITH RATIONALE
1. The nurse is concerned about the skin integrity of the patient in the intraoperative phase of surgery. Which
action will the nurse take to minimize skin breakdown?
a. Encouraging the patient to bathe before surgery
b. Securing attachments to the operating table with foam padding
c. Periodically adjusting the patient during the surgical procedure
d. Measuring the time a patient is in one position during surgery
ANS: B
Although it may be necessary to place a patient in an unusual position, try to maintain correct alignment and
protect the patient from pressure, abrasion, and other injuries. Special mattresses, use of foam padding, and
attachments to the operating suite table provide protection for the extremities and bony prominences. Bathing
before surgery helps to decrease the number of microbes on the skin. Periodically adjusting the patient during
the surgical procedure is impractical and can present a safety issue with regard to maintaining sterility of the
field and maintaining an airway. Measuring the time the patient is in one position may help with monitoring
the situation but does not prevent skin breakdown.
2. The nurse is assessing a postoperative patient with a history of obstructive sleep apnea for airway
obstruction. Which assessment finding will best alert the nurse to this complication?
a. Drop in pulse oximetry readings
b. Moaning with reports of pain
c. Shallow respirations
d. Disorientation
ANS: A
One of the greatest concerns after general anesthesia is airway obstruction, especially in patients with
obstructive sleep apnea. A drop in oxygen saturation by pulse oximetry is a sign of airway obstruction in
patients with obstructive sleep apnea. Weak pharyngeal/laryngeal muscle tone from anesthetics; secretions in
the pharynx, bronchial tree, or trachea; and laryngeal or subglottic edema also contribute to airway obstruction.
In the postanesthetic patient, the tongue is a major cause of airway obstruction. Shallow respirations are
indicative of respiratory depression. Moaning and reports of pain are common in all surgical patients and are
an expected event. Disorientation is common when first awakening from anesthesia but can be a sign of
hypoxia.
3. The nurse is caring for a patient in the operating suite who is experiencing hypercarbia, tachypnea,
tachycardia, premature ventricular contractions, and muscle rigidity. Which condition does the nurse
suspect the patient is experiencing?
a. Malignant hyperthermia
b. Fluid imbalance
c. Hemorrhage
d. Hypoxia
ANS: A
A life-threatening, rare complication of anesthesia is malignant hyperthermia. Malignant hyperthermia causes
hypercarbia, tachycardia, tachypnea, premature ventricular contractions, unstable blood pressure, cyanosis,
skin mottling, and muscular rigidity. It often occurs during anesthesia induction. Hypoxia would manifest with
decreased oxygen saturation as one of its signs and symptoms. Fluid imbalance would be assessed with intake
and output and can manifest with tachycardia and blood pressure fluctuations but does not have muscle
rigidity. Hemorrhage can manifest with tachycardia and decreased blood pressure, along with a thready pulse.
Usually some sign or symptom of blood loss is noted (e.g., drains, incision, orifice, and abdomen).
4. The nurse is caring for a postoperative patient who has had a minimally invasive carpel tunnel repair. The
patient has a temperature of 97° F and is shivering. Which reason will the nurse most likely consider as the
324
, primary cause when planning care?
325
VERIFIED ANSWERS WITH RATIONALE
1. The nurse is concerned about the skin integrity of the patient in the intraoperative phase of surgery. Which
action will the nurse take to minimize skin breakdown?
a. Encouraging the patient to bathe before surgery
b. Securing attachments to the operating table with foam padding
c. Periodically adjusting the patient during the surgical procedure
d. Measuring the time a patient is in one position during surgery
ANS: B
Although it may be necessary to place a patient in an unusual position, try to maintain correct alignment and
protect the patient from pressure, abrasion, and other injuries. Special mattresses, use of foam padding, and
attachments to the operating suite table provide protection for the extremities and bony prominences. Bathing
before surgery helps to decrease the number of microbes on the skin. Periodically adjusting the patient during
the surgical procedure is impractical and can present a safety issue with regard to maintaining sterility of the
field and maintaining an airway. Measuring the time the patient is in one position may help with monitoring
the situation but does not prevent skin breakdown.
2. The nurse is assessing a postoperative patient with a history of obstructive sleep apnea for airway
obstruction. Which assessment finding will best alert the nurse to this complication?
a. Drop in pulse oximetry readings
b. Moaning with reports of pain
c. Shallow respirations
d. Disorientation
ANS: A
One of the greatest concerns after general anesthesia is airway obstruction, especially in patients with
obstructive sleep apnea. A drop in oxygen saturation by pulse oximetry is a sign of airway obstruction in
patients with obstructive sleep apnea. Weak pharyngeal/laryngeal muscle tone from anesthetics; secretions in
the pharynx, bronchial tree, or trachea; and laryngeal or subglottic edema also contribute to airway obstruction.
In the postanesthetic patient, the tongue is a major cause of airway obstruction. Shallow respirations are
indicative of respiratory depression. Moaning and reports of pain are common in all surgical patients and are
an expected event. Disorientation is common when first awakening from anesthesia but can be a sign of
hypoxia.
3. The nurse is caring for a patient in the operating suite who is experiencing hypercarbia, tachypnea,
tachycardia, premature ventricular contractions, and muscle rigidity. Which condition does the nurse
suspect the patient is experiencing?
a. Malignant hyperthermia
b. Fluid imbalance
c. Hemorrhage
d. Hypoxia
ANS: A
A life-threatening, rare complication of anesthesia is malignant hyperthermia. Malignant hyperthermia causes
hypercarbia, tachycardia, tachypnea, premature ventricular contractions, unstable blood pressure, cyanosis,
skin mottling, and muscular rigidity. It often occurs during anesthesia induction. Hypoxia would manifest with
decreased oxygen saturation as one of its signs and symptoms. Fluid imbalance would be assessed with intake
and output and can manifest with tachycardia and blood pressure fluctuations but does not have muscle
rigidity. Hemorrhage can manifest with tachycardia and decreased blood pressure, along with a thready pulse.
Usually some sign or symptom of blood loss is noted (e.g., drains, incision, orifice, and abdomen).
4. The nurse is caring for a postoperative patient who has had a minimally invasive carpel tunnel repair. The
patient has a temperature of 97° F and is shivering. Which reason will the nurse most likely consider as the
324
, primary cause when planning care?
325
