ATI PN COMPREHENSIVE PREDICTOR
2026 EXIT EXAM
PRACTICE TEST
180 Questions with Detailed Rationales
1. A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. Which of
the following findings should the nurse expect?
A) Fasting blood glucose 85 mg/dL
B) Polyuria and polydipsia
C) Weight gain
D) Normal serum osmolarity
Correct Answer: B) Polyuria and polydipsia
Rationale: Type 1 diabetes mellitus results from destruction of pancreatic beta cells, leading to absolute
insulin deficiency. Without insulin, glucose cannot enter cells, causing hyperglycemia. The kidneys attempt to
excrete excess glucose through osmotic diuresis, leading to polyuria (excessive urination). Polyuria causes
dehydration, which stimulates thirst (polydipsia). These are classic manifestations of type 1 diabetes. Fasting
blood glucose of 85 mg/dL is within normal limits and would not be expected in undiagnosed diabetes.
Weight loss, not weight gain, occurs due to cellular starvation and fat breakdown. Serum osmolarity would be
elevated, not normal, due to hyperglycemia.
2. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should indicate to the nurse that the client may be experiencing digoxin
toxicity?
A) Heart rate 68 bpm
B) Blood pressure 118/76 mmHg
C) Yellow-tinged vision
D) Urinary output 50 mL/hr
Correct Answer: C) Yellow-tinged vision
Rationale: Yellow-tinged or halo vision is a classic sign of digoxin toxicity. Other signs include gastrointestinal
disturbances (nausea, vomiting, anorexia), cardiac dysrhythmias (especially bradycardia and ventricular
dysrhythmias), and neurologic symptoms (confusion, headache, fatigue). A heart rate of 68 bpm is within
normal limits and not typically a sign of toxicity. Blood pressure of 118/76 mmHg is normal. Urinary output of
50 mL/hr is adequate and not related to digoxin toxicity.
3. A nurse is assessing a client who is postoperative following abdominal surgery. Which of
the following findings should the nurse report to the provider immediately?
A) Blood pressure 110/70 mmHg
,B) Heart rate 88 bpm
C) Wound edges with serosanguineous drainage
D) Temperature 101.2°F (38.4°C)
Correct Answer: D) Temperature 101.2°F (38.4°C)
Rationale: A temperature of 101.2°F (38.4°C) in a postoperative client is concerning and may indicate
infection. While some temperature elevation can occur postoperatively, a temperature this high should be
reported. The other findings are within expected parameters for a postoperative client. Blood pressure
110/70 mmHg is adequate, heart rate 88 bpm is within normal range, and serosanguineous drainage from a
wound is a normal finding in the early postoperative period.
4. A nurse is providing teaching to a client who has a prescription for warfarin. Which of the
following statements by the client indicates understanding of the teaching ?
A) "I will take aspirin for headaches."
B) "I will eat more green leafy vegetables."
C) "I will have my blood tested regularly as prescribed."
D) "I will stop the medication if I notice bruising."
Correct Answer: C) "I will have my blood tested regularly as prescribed."
Rationale: Clients taking warfarin require regular monitoring of International Normalized Ratio (INR) to
ensure therapeutic levels and prevent complications. Aspirin should be avoided because it increases bleeding
risk. Green leafy vegetables contain vitamin K, which can decrease warfarin's effectiveness. Bruising is a
common side effect of warfarin, and the client should report excessive bruising but should not stop the
medication without provider guidance, as this could cause dangerous clotting events.
5. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which
of the following findings should the nurse expect?
A) Crackles at lung bases
B) Clubbing of fingers
C) Barrel-shaped chest
D) Bilateral pedal edema
Correct Answer: C) Barrel-shaped chest
Rationale: COPD leads to air trapping and hyperinflation of the lungs, resulting in a barrel-shaped chest
appearance due to increased anteroposterior diameter. While crackles and clubbing can occur in COPD, they
are not the classic finding. Barrel-shaped chest is a characteristic physical finding in COPD. Bilateral pedal
edema is more commonly associated with heart failure, although it can occur in later stages of COPD due to
cor pulmonale.
6. A nurse is caring for a client who has a prescription for enoxaparin. Which of the following
actions should the nurse take?
A) Administer the medication intramuscularly
B) Expel the air bubble from the prefilled syringe
C) Administer the medication in the abdomen
D) Massage the injection site after administration
,Correct Answer: C) Administer the medication in the abdomen
Rationale: Enoxaparin is a low molecular weight heparin that should be administered subcutaneously in the
abdomen. The air bubble should not be expelled from the prefilled syringe because it helps ensure complete
delivery of the medication. The medication should not be given intramuscularly. Massaging the injection site
can cause bruising and should be avoided.
7. A nurse is providing teaching to a client who is scheduled for a colonoscopy. Which of the
following instructions should the nurse include?
A) "You may have clear liquids up to 2 hours before the procedure."
B) "You will need to take laxatives the day before the procedure."
C) "You should stop taking all medications 1 week before the procedure."
D) "You can eat a light breakfast the morning of the procedure."
Correct Answer: B) "You will need to take laxatives the day before the procedure."
Rationale: Bowel preparation for a colonoscopy typically involves taking laxatives or a bowel preparation
solution the day before the procedure to ensure the colon is clear for visualization. Clients should have
nothing by mouth after midnight or as prescribed, not clear liquids up to 2 hours before. Not all medications
need to be stopped, but the provider should be consulted about specific medications (especially blood
thinners). A light breakfast is not allowed the morning of the procedure.
8. A nurse is assessing a client who has pneumonia. Which of the following findings should
the nurse report to the provider?
A) Heart rate 100 bpm
B) Respiratory rate 26/min
C) Oxygen saturation 88% on room air
D) Temperature 99.8°F (37.7°C)
Correct Answer: C) Oxygen saturation 88% on room air
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires immediate intervention. Normal
oxygen saturation is typically 95-100%. While the other findings are elevated and indicate the client is
symptomatic, an oxygen saturation of 88% is the most concerning and requires immediate reporting and
intervention to prevent respiratory failure.
9. A nurse is caring for a client who has a nasogastric tube attached to continuous suction.
Which of the following actions should the nurse take to prevent complications?
A) Irrigate the tube with sterile water every 4 hours
B) Monitor the client's electrolyte levels
C) Position the client in Trendelenburg position
D) Keep the head of the bed flat
Correct Answer: B) Monitor the client's electrolyte levels
Rationale: Continuous suctioning of gastric contents can lead to electrolyte imbalances (especially
hypokalemia, hyponatremia, and metabolic alkalosis). The nurse should monitor laboratory values and report
abnormalities. Irrigation should only be done with provider order and is not routinely done every 4 hours.
Trendelenburg position is not indicated and could increase risk of aspiration. The head of the bed should be
elevated to at least 30 degrees to prevent aspiration.
, 10. A nurse is providing discharge teaching to a client who has a new colostomy. Which of the
following statements indicates the client understands the teaching?
A) "I will change the pouch when it becomes one-third full."
B) "I will apply skin barrier cream around the stoma."
C) "I will eat foods that cause gas to help move stool through the stoma."
D) "I will avoid drinking fluids to reduce output."
Correct Answer: A) "I will change the pouch when it becomes one-third full."
Rationale: The ostomy pouch should be changed when it becomes one-third full to prevent leakage and skin
breakdown. Skin barrier products should not be placed directly on the stoma; only the peristomal skin should
be treated. Gas-producing foods should be avoided initially. Drinking adequate fluids is important to prevent
dehydration, not avoided.
11. A nurse is administering medications to a client. Which of the following actions is the best
way to prevent medication errors?
A) Document medications after administration
B) Use two client identifiers before administration
C) Ask the client if they know what medication they are receiving
D) Administer medications at the same time each day
Correct Answer: B) Use two client identifiers before administration
Rationale: The use of two client identifiers is a standard safety practice to ensure the right client receives the
right medication. This is a critical step in medication administration to prevent errors. Documentation should
occur after administration, not before. While asking the client about their medication can be helpful, it is not
the best way to prevent errors. Administering at the same time each day is important for consistency but
does not prevent errors in identifying the correct client or medication.
12. A nurse is assessing a client with heart failure who has been prescribed furosemide.
Which of the following findings indicates the medication is effective?
A) Increased edema
B) Weight gain of 2 pounds in 24 hours
C) Clear breath sounds
D) Blood pressure 88/56 mmHg
Correct Answer: C) Clear breath sounds
Rationale: Furosemide is a diuretic used to reduce fluid overload in heart failure. Clear breath sounds indicate
that pulmonary congestion is resolving and the medication is effective in reducing fluid volume. Increased
edema and weight gain would indicate worsening fluid retention. Blood pressure of 88/56 mmHg indicates
hypotension, which could be a side effect of the medication requiring intervention.
13. A nurse is providing care for a client who has a tracheostomy. Which of the following
actions should the nurse take to maintain a patent airway?
A) Suction the tracheostomy every 15 minutes
B) Clean the inner cannula with sterile water
2026 EXIT EXAM
PRACTICE TEST
180 Questions with Detailed Rationales
1. A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus. Which of
the following findings should the nurse expect?
A) Fasting blood glucose 85 mg/dL
B) Polyuria and polydipsia
C) Weight gain
D) Normal serum osmolarity
Correct Answer: B) Polyuria and polydipsia
Rationale: Type 1 diabetes mellitus results from destruction of pancreatic beta cells, leading to absolute
insulin deficiency. Without insulin, glucose cannot enter cells, causing hyperglycemia. The kidneys attempt to
excrete excess glucose through osmotic diuresis, leading to polyuria (excessive urination). Polyuria causes
dehydration, which stimulates thirst (polydipsia). These are classic manifestations of type 1 diabetes. Fasting
blood glucose of 85 mg/dL is within normal limits and would not be expected in undiagnosed diabetes.
Weight loss, not weight gain, occurs due to cellular starvation and fat breakdown. Serum osmolarity would be
elevated, not normal, due to hyperglycemia.
2. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should indicate to the nurse that the client may be experiencing digoxin
toxicity?
A) Heart rate 68 bpm
B) Blood pressure 118/76 mmHg
C) Yellow-tinged vision
D) Urinary output 50 mL/hr
Correct Answer: C) Yellow-tinged vision
Rationale: Yellow-tinged or halo vision is a classic sign of digoxin toxicity. Other signs include gastrointestinal
disturbances (nausea, vomiting, anorexia), cardiac dysrhythmias (especially bradycardia and ventricular
dysrhythmias), and neurologic symptoms (confusion, headache, fatigue). A heart rate of 68 bpm is within
normal limits and not typically a sign of toxicity. Blood pressure of 118/76 mmHg is normal. Urinary output of
50 mL/hr is adequate and not related to digoxin toxicity.
3. A nurse is assessing a client who is postoperative following abdominal surgery. Which of
the following findings should the nurse report to the provider immediately?
A) Blood pressure 110/70 mmHg
,B) Heart rate 88 bpm
C) Wound edges with serosanguineous drainage
D) Temperature 101.2°F (38.4°C)
Correct Answer: D) Temperature 101.2°F (38.4°C)
Rationale: A temperature of 101.2°F (38.4°C) in a postoperative client is concerning and may indicate
infection. While some temperature elevation can occur postoperatively, a temperature this high should be
reported. The other findings are within expected parameters for a postoperative client. Blood pressure
110/70 mmHg is adequate, heart rate 88 bpm is within normal range, and serosanguineous drainage from a
wound is a normal finding in the early postoperative period.
4. A nurse is providing teaching to a client who has a prescription for warfarin. Which of the
following statements by the client indicates understanding of the teaching ?
A) "I will take aspirin for headaches."
B) "I will eat more green leafy vegetables."
C) "I will have my blood tested regularly as prescribed."
D) "I will stop the medication if I notice bruising."
Correct Answer: C) "I will have my blood tested regularly as prescribed."
Rationale: Clients taking warfarin require regular monitoring of International Normalized Ratio (INR) to
ensure therapeutic levels and prevent complications. Aspirin should be avoided because it increases bleeding
risk. Green leafy vegetables contain vitamin K, which can decrease warfarin's effectiveness. Bruising is a
common side effect of warfarin, and the client should report excessive bruising but should not stop the
medication without provider guidance, as this could cause dangerous clotting events.
5. A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which
of the following findings should the nurse expect?
A) Crackles at lung bases
B) Clubbing of fingers
C) Barrel-shaped chest
D) Bilateral pedal edema
Correct Answer: C) Barrel-shaped chest
Rationale: COPD leads to air trapping and hyperinflation of the lungs, resulting in a barrel-shaped chest
appearance due to increased anteroposterior diameter. While crackles and clubbing can occur in COPD, they
are not the classic finding. Barrel-shaped chest is a characteristic physical finding in COPD. Bilateral pedal
edema is more commonly associated with heart failure, although it can occur in later stages of COPD due to
cor pulmonale.
6. A nurse is caring for a client who has a prescription for enoxaparin. Which of the following
actions should the nurse take?
A) Administer the medication intramuscularly
B) Expel the air bubble from the prefilled syringe
C) Administer the medication in the abdomen
D) Massage the injection site after administration
,Correct Answer: C) Administer the medication in the abdomen
Rationale: Enoxaparin is a low molecular weight heparin that should be administered subcutaneously in the
abdomen. The air bubble should not be expelled from the prefilled syringe because it helps ensure complete
delivery of the medication. The medication should not be given intramuscularly. Massaging the injection site
can cause bruising and should be avoided.
7. A nurse is providing teaching to a client who is scheduled for a colonoscopy. Which of the
following instructions should the nurse include?
A) "You may have clear liquids up to 2 hours before the procedure."
B) "You will need to take laxatives the day before the procedure."
C) "You should stop taking all medications 1 week before the procedure."
D) "You can eat a light breakfast the morning of the procedure."
Correct Answer: B) "You will need to take laxatives the day before the procedure."
Rationale: Bowel preparation for a colonoscopy typically involves taking laxatives or a bowel preparation
solution the day before the procedure to ensure the colon is clear for visualization. Clients should have
nothing by mouth after midnight or as prescribed, not clear liquids up to 2 hours before. Not all medications
need to be stopped, but the provider should be consulted about specific medications (especially blood
thinners). A light breakfast is not allowed the morning of the procedure.
8. A nurse is assessing a client who has pneumonia. Which of the following findings should
the nurse report to the provider?
A) Heart rate 100 bpm
B) Respiratory rate 26/min
C) Oxygen saturation 88% on room air
D) Temperature 99.8°F (37.7°C)
Correct Answer: C) Oxygen saturation 88% on room air
Rationale: An oxygen saturation of 88% indicates hypoxemia and requires immediate intervention. Normal
oxygen saturation is typically 95-100%. While the other findings are elevated and indicate the client is
symptomatic, an oxygen saturation of 88% is the most concerning and requires immediate reporting and
intervention to prevent respiratory failure.
9. A nurse is caring for a client who has a nasogastric tube attached to continuous suction.
Which of the following actions should the nurse take to prevent complications?
A) Irrigate the tube with sterile water every 4 hours
B) Monitor the client's electrolyte levels
C) Position the client in Trendelenburg position
D) Keep the head of the bed flat
Correct Answer: B) Monitor the client's electrolyte levels
Rationale: Continuous suctioning of gastric contents can lead to electrolyte imbalances (especially
hypokalemia, hyponatremia, and metabolic alkalosis). The nurse should monitor laboratory values and report
abnormalities. Irrigation should only be done with provider order and is not routinely done every 4 hours.
Trendelenburg position is not indicated and could increase risk of aspiration. The head of the bed should be
elevated to at least 30 degrees to prevent aspiration.
, 10. A nurse is providing discharge teaching to a client who has a new colostomy. Which of the
following statements indicates the client understands the teaching?
A) "I will change the pouch when it becomes one-third full."
B) "I will apply skin barrier cream around the stoma."
C) "I will eat foods that cause gas to help move stool through the stoma."
D) "I will avoid drinking fluids to reduce output."
Correct Answer: A) "I will change the pouch when it becomes one-third full."
Rationale: The ostomy pouch should be changed when it becomes one-third full to prevent leakage and skin
breakdown. Skin barrier products should not be placed directly on the stoma; only the peristomal skin should
be treated. Gas-producing foods should be avoided initially. Drinking adequate fluids is important to prevent
dehydration, not avoided.
11. A nurse is administering medications to a client. Which of the following actions is the best
way to prevent medication errors?
A) Document medications after administration
B) Use two client identifiers before administration
C) Ask the client if they know what medication they are receiving
D) Administer medications at the same time each day
Correct Answer: B) Use two client identifiers before administration
Rationale: The use of two client identifiers is a standard safety practice to ensure the right client receives the
right medication. This is a critical step in medication administration to prevent errors. Documentation should
occur after administration, not before. While asking the client about their medication can be helpful, it is not
the best way to prevent errors. Administering at the same time each day is important for consistency but
does not prevent errors in identifying the correct client or medication.
12. A nurse is assessing a client with heart failure who has been prescribed furosemide.
Which of the following findings indicates the medication is effective?
A) Increased edema
B) Weight gain of 2 pounds in 24 hours
C) Clear breath sounds
D) Blood pressure 88/56 mmHg
Correct Answer: C) Clear breath sounds
Rationale: Furosemide is a diuretic used to reduce fluid overload in heart failure. Clear breath sounds indicate
that pulmonary congestion is resolving and the medication is effective in reducing fluid volume. Increased
edema and weight gain would indicate worsening fluid retention. Blood pressure of 88/56 mmHg indicates
hypotension, which could be a side effect of the medication requiring intervention.
13. A nurse is providing care for a client who has a tracheostomy. Which of the following
actions should the nurse take to maintain a patent airway?
A) Suction the tracheostomy every 15 minutes
B) Clean the inner cannula with sterile water
