RN ATI COMPREHENSIVE EXIT ALL VERSIONS EXAM-
REVISED QUESTIONS AND ANSWERS PLUS DETAILED
RATIONALES | EXAM PREP | DOWNLOAD INSTANT PDF
2026-2027
1. A nurse on a medical-surgical unit is caring for a client who is 2 days postoperative
following a small bowel resection and reports sudden, severe shortness of breath and
pleuritic chest pain. Vital signs include heart rate 122/min, respiratory rate 32/min, blood
pressure 106/70 mm Hg, and oxygen saturation 88% on room air. Which of the following
actions should the nurse take first?
A. Administer sublingual nitroglycerin as prescribed
B. Elevate the head of the bed and administer oxygen via high-flow nonrebreather mask
C. Draw blood for a complete metabolic panel and cardiac enzymes
D. Obtain a 12-lead electrocardiogram
Answer: B
Applying the airway, breathing, and circulation (ABC) priority framework, a client exhibiting
acute signs of a massive pulmonary embolism requires immediate oxygenation and respiratory
stabilization before diagnostic tests or secondary treatments are initiated.
2. A nurse is reviewing laboratory results for a client who has chronic kidney disease and is
receiving epoetin alfa. Which of the following laboratory values indicates that the
medication is effective?
A. Serum creatinine 2.1 mg/dL
B. Hemoglobin 12 g/dL
C. Blood urea nitrogen 28 mg/dL
D. Platelet count 250,000/mm³
Answer: B
Epoetin alfa stimulates erythropoiesis in the bone marrow to treat anemia associated with
chronic kidney disease; a target hemoglobin level of 10 to 12 g/dL indicates therapeutic
effectiveness.
,3. A nurse is preparing to administer digoxin 0.125 mg orally to an older adult client with
heart failure. Prior to administration, the nurse checks the client's apical pulse and notes a
rate of 54/min. Which of the following actions should the nurse take?
A. Administer the medication and document the pulse rate
B. Withhold the dose and notify the prescribing provider
C. Recheck the pulse in 30 minutes and administer the medication if it increases to 60/min
D. Administer half of the prescribed dose
Answer: B
Digoxin has negative chronotropic effects. The nurse must withhold the medication and notify
the provider if an adult client's apical pulse is less than 60/min to prevent severe bradycardia
and toxicity.
4. A nurse is admitting a client who has active pulmonary tuberculosis. Which of the
following types of precautions should the nurse implement for this client?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Protective environment precautions
Answer: C
Mycobacterium tuberculosis is transmitted via droplet nuclei that remain suspended in the air.
Clients require placement in a negative-pressure airflow room and staff must wear N95
respirators.
5. A nurse in an emergency department is caring for a client who is experiencing an acute
asthma exacerbation. Which of the following findings indicates that the client is
experiencing worsening respiratory status despite initial interventions?
A. A productive cough with clear mucus
B. Diminished breath sounds throughout all lung fields
C. Heart rate 88/min
D. Respiratory rate 22/min
,Answer: B
Diminished or absent breath sounds, often referred to as a "silent chest," indicate severe
airway obstruction, poor ventilation, and an impending respiratory arrest.
6. A nurse is planning care for a client who has a prescription for a continuous intravenous
infusion of heparin to treat a deep vein thrombosis. Which of the following actions should
the nurse include in the plan?
A. Monitor aPTT levels every 4 to 6 hours during the initial titration phase
B. Instruct the client to use a stiff-bristle toothbrush to promote oral hygiene
C. Administer aspirin concurrently if the client reports mild headache
D. Keep protamine sulfate readily available on the unit
Answer: D
Protamine sulfate is the specific antidote for heparin overdose and must be immediately
accessible to reverse anticoagulant effects in the event of major hemorrhage.
7. A nurse is teaching a newly licensed nurse about incident reports. Which of the following
statements by the newly licensed nurse indicates an understanding of the teaching?
A. "I should document in the client's medical record that an incident report was filed."
B. "Incident reports are placed permanently in the client's electronic health record."
C. "Incident reports assist in risk management and quality improvement by identifying system
issues."
D. "I only need to file an incident report if the client sustains permanent physical injury."
Answer: C
Incident reports are risk management tools used internally to analyze errors, track trends, and
implement system improvements to enhance client safety.
8. A nurse is caring for a client who is receiving total parenteral nutrition (TPN) via a
peripherally inserted central catheter. The TPN solution has just run out, and the next bag
is not yet available from the pharmacy. Which of the following actions should the nurse
take immediately?
A. Infuse 0.9% sodium chloride through the line
, B. Infuse 10% dextrose in water at the same rate as the TPN
C. Flush the catheter with heparinized saline and clamp it
D. Discontinue the infusion and monitor blood pressure hourly
Answer: B
Abruptly stopping TPN places the client at high risk for severe rebound hypoglycemia.
Infusing 10% or 20% dextrose in water at the prescribed TPN rate prevents this complication
until the new bag arrives.
9. A nurse is assessing a client who has left-sided heart failure. Which of the following
clinical manifestations should the nurse expect to find?
A. Jugular vein distention
B. Dependent pedal edema
C. Frothy, pink-tinged sputum
D. Anorexia and right upper quadrant tenderness
Answer: C
Left-sided heart failure leads to fluid backup into the pulmonary vasculature, resulting in
pulmonary congestion, dyspnea, orthopnea, and cough productive of frothy, blood-tinged
sputum.
10. A nurse is caring for a client who has a suspected diagnosis of appendicitis. Which of
the following areas should the nurse palpate to assess for McBurney's point tenderness?
A. Right upper quadrant of the abdomen
B. Left lower quadrant of the abdomen
C. Right lower quadrant, one-third of the distance from the anterior superior iliac spine to the
umbilicus
D. Suprapubic region directly above the symphysis pubis
Answer: C
McBurney's point is located in the right lower quadrant and is the classic anatomical site of
maximal tenderness in acute appendicitis.
REVISED QUESTIONS AND ANSWERS PLUS DETAILED
RATIONALES | EXAM PREP | DOWNLOAD INSTANT PDF
2026-2027
1. A nurse on a medical-surgical unit is caring for a client who is 2 days postoperative
following a small bowel resection and reports sudden, severe shortness of breath and
pleuritic chest pain. Vital signs include heart rate 122/min, respiratory rate 32/min, blood
pressure 106/70 mm Hg, and oxygen saturation 88% on room air. Which of the following
actions should the nurse take first?
A. Administer sublingual nitroglycerin as prescribed
B. Elevate the head of the bed and administer oxygen via high-flow nonrebreather mask
C. Draw blood for a complete metabolic panel and cardiac enzymes
D. Obtain a 12-lead electrocardiogram
Answer: B
Applying the airway, breathing, and circulation (ABC) priority framework, a client exhibiting
acute signs of a massive pulmonary embolism requires immediate oxygenation and respiratory
stabilization before diagnostic tests or secondary treatments are initiated.
2. A nurse is reviewing laboratory results for a client who has chronic kidney disease and is
receiving epoetin alfa. Which of the following laboratory values indicates that the
medication is effective?
A. Serum creatinine 2.1 mg/dL
B. Hemoglobin 12 g/dL
C. Blood urea nitrogen 28 mg/dL
D. Platelet count 250,000/mm³
Answer: B
Epoetin alfa stimulates erythropoiesis in the bone marrow to treat anemia associated with
chronic kidney disease; a target hemoglobin level of 10 to 12 g/dL indicates therapeutic
effectiveness.
,3. A nurse is preparing to administer digoxin 0.125 mg orally to an older adult client with
heart failure. Prior to administration, the nurse checks the client's apical pulse and notes a
rate of 54/min. Which of the following actions should the nurse take?
A. Administer the medication and document the pulse rate
B. Withhold the dose and notify the prescribing provider
C. Recheck the pulse in 30 minutes and administer the medication if it increases to 60/min
D. Administer half of the prescribed dose
Answer: B
Digoxin has negative chronotropic effects. The nurse must withhold the medication and notify
the provider if an adult client's apical pulse is less than 60/min to prevent severe bradycardia
and toxicity.
4. A nurse is admitting a client who has active pulmonary tuberculosis. Which of the
following types of precautions should the nurse implement for this client?
A. Contact precautions
B. Droplet precautions
C. Airborne precautions
D. Protective environment precautions
Answer: C
Mycobacterium tuberculosis is transmitted via droplet nuclei that remain suspended in the air.
Clients require placement in a negative-pressure airflow room and staff must wear N95
respirators.
5. A nurse in an emergency department is caring for a client who is experiencing an acute
asthma exacerbation. Which of the following findings indicates that the client is
experiencing worsening respiratory status despite initial interventions?
A. A productive cough with clear mucus
B. Diminished breath sounds throughout all lung fields
C. Heart rate 88/min
D. Respiratory rate 22/min
,Answer: B
Diminished or absent breath sounds, often referred to as a "silent chest," indicate severe
airway obstruction, poor ventilation, and an impending respiratory arrest.
6. A nurse is planning care for a client who has a prescription for a continuous intravenous
infusion of heparin to treat a deep vein thrombosis. Which of the following actions should
the nurse include in the plan?
A. Monitor aPTT levels every 4 to 6 hours during the initial titration phase
B. Instruct the client to use a stiff-bristle toothbrush to promote oral hygiene
C. Administer aspirin concurrently if the client reports mild headache
D. Keep protamine sulfate readily available on the unit
Answer: D
Protamine sulfate is the specific antidote for heparin overdose and must be immediately
accessible to reverse anticoagulant effects in the event of major hemorrhage.
7. A nurse is teaching a newly licensed nurse about incident reports. Which of the following
statements by the newly licensed nurse indicates an understanding of the teaching?
A. "I should document in the client's medical record that an incident report was filed."
B. "Incident reports are placed permanently in the client's electronic health record."
C. "Incident reports assist in risk management and quality improvement by identifying system
issues."
D. "I only need to file an incident report if the client sustains permanent physical injury."
Answer: C
Incident reports are risk management tools used internally to analyze errors, track trends, and
implement system improvements to enhance client safety.
8. A nurse is caring for a client who is receiving total parenteral nutrition (TPN) via a
peripherally inserted central catheter. The TPN solution has just run out, and the next bag
is not yet available from the pharmacy. Which of the following actions should the nurse
take immediately?
A. Infuse 0.9% sodium chloride through the line
, B. Infuse 10% dextrose in water at the same rate as the TPN
C. Flush the catheter with heparinized saline and clamp it
D. Discontinue the infusion and monitor blood pressure hourly
Answer: B
Abruptly stopping TPN places the client at high risk for severe rebound hypoglycemia.
Infusing 10% or 20% dextrose in water at the prescribed TPN rate prevents this complication
until the new bag arrives.
9. A nurse is assessing a client who has left-sided heart failure. Which of the following
clinical manifestations should the nurse expect to find?
A. Jugular vein distention
B. Dependent pedal edema
C. Frothy, pink-tinged sputum
D. Anorexia and right upper quadrant tenderness
Answer: C
Left-sided heart failure leads to fluid backup into the pulmonary vasculature, resulting in
pulmonary congestion, dyspnea, orthopnea, and cough productive of frothy, blood-tinged
sputum.
10. A nurse is caring for a client who has a suspected diagnosis of appendicitis. Which of
the following areas should the nurse palpate to assess for McBurney's point tenderness?
A. Right upper quadrant of the abdomen
B. Left lower quadrant of the abdomen
C. Right lower quadrant, one-third of the distance from the anterior superior iliac spine to the
umbilicus
D. Suprapubic region directly above the symphysis pubis
Answer: C
McBurney's point is located in the right lower quadrant and is the classic anatomical site of
maximal tenderness in acute appendicitis.
