ATI Comprehensive Exit Exam (NGN) – ATI RN
Comprehensive Predictor Study Guide,
Original NGN-Style Practice Questions &
Answers, Comprehensive Nursing Exit Exam
Preparation, Next Generation NCLEX Clinical
Judgment, Fundamentals, Adult Medical-
Surgical Nursing, Pharmacology, Maternal-
Newborn, Pediatrics, Mental Health,
Leadership, Prioritization, Delegation, Patient
Safety & NCLEX Readiness Review
Question 1: A nurse is preparing to administer a scheduled dose of enoxaparin
subcutaneously to a client. The client's platelet count is 85,000/mm³. Which of
the following actions should the nurse take?
A. Administer the medication as prescribed.
B. Hold the medication and notify the healthcare provider.
C. Ask the client if they have any signs of bleeding.
D. Administer the medication and monitor for bruising.
CORRECT ANSWER: B. Hold the medication and notify the healthcare
provider.
Rationale: Enoxaparin, a low-molecular-weight heparin, is contraindicated in clients with
active bleeding or a history of heparin-induced thrombocytopenia (HIT). A platelet
count of less than 100,000/mm³ is a significant finding that requires holding the
medication and notifying the provider for further evaluation and potential alternative
therapy . Administering the medication could increase the risk of bleeding
complications.
Question 2: A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following statements by the client
indicates a need for further teaching?
A. "I will use an electric razor to shave."
B. "I will avoid eating large amounts of leafy green vegetables."
C. "I will take ibuprofen for my occasional headaches."
D. "I will get my blood drawn as scheduled."
CORRECT ANSWER: C. "I will take ibuprofen for my occasional headaches."
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Nonsteroidal anti-
inflammatory drugs (NSAIDs) like ibuprofen also increase bleeding risk and should be
avoided while taking warfarin. The client should be taught to use acetaminophen for
pain or headache, as it does not affect bleeding risk .
,Question 3: A nurse is caring for a client who has a prescription for
gentamicin. The client reports new-onset dizziness and tinnitus. Which of the
following actions should the nurse take first?
A. Reassure the client these are expected side effects.
B. Administer the prescribed dose of gentamicin.
C. Encourage the client to increase oral fluid intake.
D. Hold the medication and notify the healthcare provider.
CORRECT ANSWER: D. Hold the medication and notify the healthcare
provider.
Rationale: Gentamicin is an aminoglycoside antibiotic with a known adverse effect of
ototoxicity, which can be irreversible. Signs of ototoxicity include tinnitus and dizziness .
The nurse should hold the medication and notify the provider to prevent further damage
and discuss an alternative antibiotic.
Question 4: A nurse is performing a focused assessment on 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 for the past 4 hours has been 100 mL.
Which of the following actions should the nurse take first?
A. Notify the healthcare provider immediately.
B. Assess the client's IV site for patency and infiltration.
C. Continue to monitor the client's urinary output.
D. Increase the IV infusion rate to 150 mL/hr.
CORRECT ANSWER: B. Assess the client's IV site for patency and infiltration.
Rationale: Urine output of less than 30 mL/hour indicates oliguria and requires prompt
action . However, before notifying the provider, the nurse must first assess for
correctable causes, such as a non-functioning IV line. Assessing the IV site is the priority
to determine if the client is receiving the prescribed fluids.
Question 5: A nurse is receiving change-of-shift report on four clients. Which
of the following clients should the nurse assess first?
A. A client with diabetes mellitus who has a blood glucose level of 185 mg/dL.
B. A client with a hip fracture who has a new onset of tachypnea.
C. A client who is 12 hours post-appendectomy and has a temperature of 38°C
(100.4°F).
D. A client with chronic kidney disease who has a hemoglobin level of 10.2 g/dL.
CORRECT ANSWER: B. A client with a hip fracture who has a new onset of
tachypnea.
Rationale: A new onset of tachypnea in a client with a hip fracture is a significant finding
that could indicate a pulmonary embolism, which is a life-threatening complication .
This client requires immediate assessment and intervention.
,Question 6: A nurse is caring for a client who is 2 hours post-operative
following a bronchoscopy. Which of the following actions by the assistive
personnel (AP) requires the nurse to intervene?
A. Assisting the client to a semi-Fowler's position.
B. Encouraging the client to use the incentive spirometer.
C. Offering the client a glass of water.
D. Checking the client's pulse oximetry reading.
CORRECT ANSWER: C. Offering the client a glass of water.
Rationale: Following a bronchoscopy, the client's gag reflex is impaired due to topical
anesthesia. Offering fluids before the gag reflex returns places the client at significant
risk for aspiration . The nurse must assess the gag reflex before allowing the client to
take anything by mouth.
Question 7: A nurse is preparing to administer a client's morning medications.
Which of the following actions should the nurse take to verify the client's
identity?
A. Ask the client to state their room number.
B. Verify the client's identity with a family member.
C. Check the name on the client's door.
D. Scan the facility identification band and compare to the MAR.
CORRECT ANSWER: D. Scan the facility identification band and compare to
the MAR.
Rationale: Verifying client identity using at least two unique identifiers (e.g., name and
date of birth) is essential for safety . Scanning the facility identification band and
comparing it to the Medication Administration Record (MAR) is the most reliable
method, ensuring the right medication is given to the right client.
Question 8: A nurse is providing discharge instructions to a client with a new
prescription for a metered-dose inhaler (MDI). Which of the following
statements by the client indicates a correct understanding of the teaching?
A. "I should hold the medication in my mouth for 5 seconds after inhaling."
B. "I should shake the inhaler well before each use."
C. "I should exhale forcefully after inhaling the medication."
D. "I will rinse my mouth after every third dose."
CORRECT ANSWER: B. "I should shake the inhaler well before each use."
Rationale: Proper MDI technique includes shaking the inhaler well before each use,
holding the inhaler upright, and exhaling completely before placing the mouthpiece in
the mouth. The client should then inhale deeply and hold their breath for 5-10 seconds
to allow for medication deposition.
, Question 9: A nurse is assessing a client who has a new diagnosis of
schizophrenia and is prescribed risperidone. Which of the following findings
should the nurse document as a common side effect of this medication?
A. Orthostatic hypotension.
B. Weight loss.
C. Hyperglycemia.
D. Tachycardia.
CORRECT ANSWER: A. Orthostatic hypotension.
Rationale: Risperidone, an atypical antipsychotic, commonly causes orthostatic
hypotension due to its alpha-1 adrenergic receptor antagonism . The nurse should
educate the client to rise slowly from a sitting or lying position to prevent falls. Other
common side effects include weight gain, sedation, and extrapyramidal symptoms.
Question 10: A nurse is providing education to the parents of a newborn about
why their baby is receiving a Vitamin K injection. Which of the following
explanations should the nurse provide?
A. To prevent infection.
B. To prevent bleeding.
C. To promote healthy skin.
D. To promote bone growth.
CORRECT ANSWER: B. To prevent bleeding.
Rationale: Newborns have low levels of Vitamin K because it is not readily transferred
across the placenta and is not synthesized in the gut until normal flora are established .
Vitamin K is essential for the synthesis of clotting factors in the liver. The injection
prevents Vitamin K deficiency bleeding (VKDB), a serious hemorrhagic condition.
Question 11: A nurse is planning care for a client who is on fall precautions.
Which of the following interventions should the nurse include in the plan of
care?
A. Keep the bed in the highest position for easy access.
B. Place all four side rails in the up position at all times.
C. Keep the call light within the client's reach.
D. Encourage the client to use the bathroom without assistance to maintain
independence.
CORRECT ANSWER: C. Keep the call light within the client's reach.
Rationale: Keeping the call light within reach is a standard fall prevention intervention,
allowing the client to call for assistance before getting out of bed. Side rails should be
used with caution as they can be a restraint; the bed should be in its lowest position.
Encouraging independence without ensuring safety is inappropriate.
Comprehensive Predictor Study Guide,
Original NGN-Style Practice Questions &
Answers, Comprehensive Nursing Exit Exam
Preparation, Next Generation NCLEX Clinical
Judgment, Fundamentals, Adult Medical-
Surgical Nursing, Pharmacology, Maternal-
Newborn, Pediatrics, Mental Health,
Leadership, Prioritization, Delegation, Patient
Safety & NCLEX Readiness Review
Question 1: A nurse is preparing to administer a scheduled dose of enoxaparin
subcutaneously to a client. The client's platelet count is 85,000/mm³. Which of
the following actions should the nurse take?
A. Administer the medication as prescribed.
B. Hold the medication and notify the healthcare provider.
C. Ask the client if they have any signs of bleeding.
D. Administer the medication and monitor for bruising.
CORRECT ANSWER: B. Hold the medication and notify the healthcare
provider.
Rationale: Enoxaparin, a low-molecular-weight heparin, is contraindicated in clients with
active bleeding or a history of heparin-induced thrombocytopenia (HIT). A platelet
count of less than 100,000/mm³ is a significant finding that requires holding the
medication and notifying the provider for further evaluation and potential alternative
therapy . Administering the medication could increase the risk of bleeding
complications.
Question 2: A nurse is providing discharge teaching to a client who has a new
prescription for warfarin. Which of the following statements by the client
indicates a need for further teaching?
A. "I will use an electric razor to shave."
B. "I will avoid eating large amounts of leafy green vegetables."
C. "I will take ibuprofen for my occasional headaches."
D. "I will get my blood drawn as scheduled."
CORRECT ANSWER: C. "I will take ibuprofen for my occasional headaches."
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Nonsteroidal anti-
inflammatory drugs (NSAIDs) like ibuprofen also increase bleeding risk and should be
avoided while taking warfarin. The client should be taught to use acetaminophen for
pain or headache, as it does not affect bleeding risk .
,Question 3: A nurse is caring for a client who has a prescription for
gentamicin. The client reports new-onset dizziness and tinnitus. Which of the
following actions should the nurse take first?
A. Reassure the client these are expected side effects.
B. Administer the prescribed dose of gentamicin.
C. Encourage the client to increase oral fluid intake.
D. Hold the medication and notify the healthcare provider.
CORRECT ANSWER: D. Hold the medication and notify the healthcare
provider.
Rationale: Gentamicin is an aminoglycoside antibiotic with a known adverse effect of
ototoxicity, which can be irreversible. Signs of ototoxicity include tinnitus and dizziness .
The nurse should hold the medication and notify the provider to prevent further damage
and discuss an alternative antibiotic.
Question 4: A nurse is performing a focused assessment on 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 for the past 4 hours has been 100 mL.
Which of the following actions should the nurse take first?
A. Notify the healthcare provider immediately.
B. Assess the client's IV site for patency and infiltration.
C. Continue to monitor the client's urinary output.
D. Increase the IV infusion rate to 150 mL/hr.
CORRECT ANSWER: B. Assess the client's IV site for patency and infiltration.
Rationale: Urine output of less than 30 mL/hour indicates oliguria and requires prompt
action . However, before notifying the provider, the nurse must first assess for
correctable causes, such as a non-functioning IV line. Assessing the IV site is the priority
to determine if the client is receiving the prescribed fluids.
Question 5: A nurse is receiving change-of-shift report on four clients. Which
of the following clients should the nurse assess first?
A. A client with diabetes mellitus who has a blood glucose level of 185 mg/dL.
B. A client with a hip fracture who has a new onset of tachypnea.
C. A client who is 12 hours post-appendectomy and has a temperature of 38°C
(100.4°F).
D. A client with chronic kidney disease who has a hemoglobin level of 10.2 g/dL.
CORRECT ANSWER: B. A client with a hip fracture who has a new onset of
tachypnea.
Rationale: A new onset of tachypnea in a client with a hip fracture is a significant finding
that could indicate a pulmonary embolism, which is a life-threatening complication .
This client requires immediate assessment and intervention.
,Question 6: A nurse is caring for a client who is 2 hours post-operative
following a bronchoscopy. Which of the following actions by the assistive
personnel (AP) requires the nurse to intervene?
A. Assisting the client to a semi-Fowler's position.
B. Encouraging the client to use the incentive spirometer.
C. Offering the client a glass of water.
D. Checking the client's pulse oximetry reading.
CORRECT ANSWER: C. Offering the client a glass of water.
Rationale: Following a bronchoscopy, the client's gag reflex is impaired due to topical
anesthesia. Offering fluids before the gag reflex returns places the client at significant
risk for aspiration . The nurse must assess the gag reflex before allowing the client to
take anything by mouth.
Question 7: A nurse is preparing to administer a client's morning medications.
Which of the following actions should the nurse take to verify the client's
identity?
A. Ask the client to state their room number.
B. Verify the client's identity with a family member.
C. Check the name on the client's door.
D. Scan the facility identification band and compare to the MAR.
CORRECT ANSWER: D. Scan the facility identification band and compare to
the MAR.
Rationale: Verifying client identity using at least two unique identifiers (e.g., name and
date of birth) is essential for safety . Scanning the facility identification band and
comparing it to the Medication Administration Record (MAR) is the most reliable
method, ensuring the right medication is given to the right client.
Question 8: A nurse is providing discharge instructions to a client with a new
prescription for a metered-dose inhaler (MDI). Which of the following
statements by the client indicates a correct understanding of the teaching?
A. "I should hold the medication in my mouth for 5 seconds after inhaling."
B. "I should shake the inhaler well before each use."
C. "I should exhale forcefully after inhaling the medication."
D. "I will rinse my mouth after every third dose."
CORRECT ANSWER: B. "I should shake the inhaler well before each use."
Rationale: Proper MDI technique includes shaking the inhaler well before each use,
holding the inhaler upright, and exhaling completely before placing the mouthpiece in
the mouth. The client should then inhale deeply and hold their breath for 5-10 seconds
to allow for medication deposition.
, Question 9: A nurse is assessing a client who has a new diagnosis of
schizophrenia and is prescribed risperidone. Which of the following findings
should the nurse document as a common side effect of this medication?
A. Orthostatic hypotension.
B. Weight loss.
C. Hyperglycemia.
D. Tachycardia.
CORRECT ANSWER: A. Orthostatic hypotension.
Rationale: Risperidone, an atypical antipsychotic, commonly causes orthostatic
hypotension due to its alpha-1 adrenergic receptor antagonism . The nurse should
educate the client to rise slowly from a sitting or lying position to prevent falls. Other
common side effects include weight gain, sedation, and extrapyramidal symptoms.
Question 10: A nurse is providing education to the parents of a newborn about
why their baby is receiving a Vitamin K injection. Which of the following
explanations should the nurse provide?
A. To prevent infection.
B. To prevent bleeding.
C. To promote healthy skin.
D. To promote bone growth.
CORRECT ANSWER: B. To prevent bleeding.
Rationale: Newborns have low levels of Vitamin K because it is not readily transferred
across the placenta and is not synthesized in the gut until normal flora are established .
Vitamin K is essential for the synthesis of clotting factors in the liver. The injection
prevents Vitamin K deficiency bleeding (VKDB), a serious hemorrhagic condition.
Question 11: A nurse is planning care for a client who is on fall precautions.
Which of the following interventions should the nurse include in the plan of
care?
A. Keep the bed in the highest position for easy access.
B. Place all four side rails in the up position at all times.
C. Keep the call light within the client's reach.
D. Encourage the client to use the bathroom without assistance to maintain
independence.
CORRECT ANSWER: C. Keep the call light within the client's reach.
Rationale: Keeping the call light within reach is a standard fall prevention intervention,
allowing the client to call for assistance before getting out of bed. Side rails should be
used with caution as they can be a restraint; the bed should be in its lowest position.
Encouraging independence without ensuring safety is inappropriate.
