• ATI RN
Comprehensive 09/08/2026
Predictor
Ultimate ATI RN Comprehensive Predictor
2026 Exit Exam 4: 180 NGN Elite Level 3
Questions with Answers for Guaranteed Level
3 Pass and First Attempt– (2026) Actual
Questions & Answers (Chamberlain) 100%
Guarantee Pass
Which nursing intervention should be implemented postoperatively in an infant with spina bifida after repair of a
meningocele?
A.Limit fluids to prevent infection to the surgical site.
P 1
, • ATI RN
Comprehensive 09/08/2026
Predictor
B.Place the infant in the prone position.
C.Provide a low-residue diet to limit bowel movements.
D.Cover sac with a moist sterile dressing. - Correct Answer :B
Rationale:
The infant should be placed in the prone position to alleviate pressure on the surgical site, which is in the sacrum
(B). Fluids should be increased postoperatively to prevent dehydration (A). A high-fiber diet should be
implemented to prevent constipation (C). After the repair, the sac is no longer exposed, so (D) does not apply.
Which intervention(s) should the nurse implement when administering a new prescription of amitriptyline HCl
(Elavil) to a client with a depressive disorder? (Select all that apply.)
A.Explain that therapeutic effects should be achieved within 1 to 3 days.
B.Administer at bedtime to minimize sedative effects.
C.Give 1 hour after the administration of isocarboxazid (Marplan).
D.Take blood pressure prior to and after administration.
E.Assess for adverse reactions such as dry mouth and blurred vision. - Correct Answer :B,D,E
Rationale:
The drug causes sedation, so it should be given at bedtime (B). Cardiovascular adverse reactions include
orthostatic hypotension; therefore, the blood pressure should be assessed (D). This drug can cause
anticholinergic effects such as dry mouth, blurred vision, constipation, and urinary retention (E). The drug takes 2
to 6 weeks to achieve therapeutic effects (A). All monoamine oxidase (MAO) inhibitors such as isocarboxazid
should be discontinued 1 to 3 weeks prior to the administration of Elavil (C).
When administering an intramuscular injection, which factor is most important to ensure the best medication
absorption?
A.Compress the syringe plunger quickly.
B.Select a small-gauge needle.
C.Inject the needle at a 90-degree angle.
D.Select a small-diameter syringe. - Correct Answer :C
Rationale:
P 2
, • ATI RN
Comprehensive 09/08/2026
Predictor
Injecting the needle at a 90-degree angle allows the medication to be injected into the muscle so that
appropriate absorption can occur (C). Too rapid injection of the medication (A) may be painful and may cause
medication leakage and reduced absorption. (B) will reduce injection discomfort but will not affect absorption. A
syringe barrel that is too small (D) increases the pressure during the injection and may traumatize tissue without
improving medication absorption.
When assessing a normal newborn, which finding(s) should the nurse expect? (Select all that apply.)
A.Umbilical cord contains one vein and two arteries
B.Slightly edematous labia in the female newborn
C.Absence of Babinski reflex
D.Presence of white plaques on the cheeks and tongue
E.Nasal flaring noted with respirations - Correct Answer :A,B
Rationale:
These are normal findings (A and B). The others indicate abnormalities or complications and should be reported
to the primary health care provider (C, D, and E).
The outpatient clinic nurse is reviewing phone messages from last night. Which client should the nurse call back
first?
A.An 18-year-old woman who had a positive pregnancy test and wants advice on how to tell her parents
B.A woman with type 1 diabetes who has just discovered she is pregnant and is worried about her fingerstick
glucose
C.A women at 24 weeks of gestation crying about painful genital lesions on the vulva and urinary frequency
D.A women at 30 weeks of gestation who has been diagnosed with mild preeclampsia and is unable to relieve
her heartburn - Correct Answer :D
Rationale:
The women with epigastric pain should be called first (D). One of the cardinal signs of eclampsia, a life-
threatening complication of pregnancy, is epigastric pain. (A, B, and C) are less serious and should be called after
(D).
P 3
, • ATI RN
Comprehensive 09/08/2026
Predictor
The charge nurse is making assignments for the upcoming shift. Which client is most appropriate to assign to the
licensed practical nurse (LPN)?
A.A client with nausea who needs a nasogastric tube inserted
B.A client in hypertensive crisis who needs titration of IV nitroglycerin
C.
A newly admitted client who needs to have a plan of care established
D.A client who is ready for discharge who needs discharge teaching - Correct Answer :A
Rationale:
This client has a need for a skill that is within the scope of practice for the LPN (A). Titration of an IV drip,
establishing care plans, and discharge teaching are within the scope of practice of a registered nurse (RN) and
are not delegated (B, C, and D).
A nurse working in a community health setting is performing primary health screenings. Which individual is at
highest risk for contracting an HIV infection?
A.A 17-year-old who is sexually active with numerous partners
B.A 45-year-old lesbian who has been sexually active with two partners in the past year
C.A 30-year-old cocaine user who inhales the drug and works in a topless bar
D.A 34-year-old male homosexual who is in a monogamous relationship - Correct Answer :A
Rationale:
(A) is at greatest risk for contracting sexually transmitted diseases, including HIV, because the greater the
number of sexual partners, the greater the risk for contracting an STD. (B) comprises the group of lowest
infected persons because there is little transfer of body fluid during sexual acts. (C), who free-bases, would not
be sharing needles, so contracting an STD is not necessarily a risk. A male homosexual in a monogamous
relationship has a decreased risk of contracting HIV as long as both partners are monogamous and neither is
infected (D).
The charge nurse reviews the charting of a graduate nurse. Which indicates a need for further education on
documentation?
A.Uses descriptive words such as "gurgling" to describe breath sounds
B.Records temperature 30 minutes before and after giving acetaminophen
P 4
Comprehensive 09/08/2026
Predictor
Ultimate ATI RN Comprehensive Predictor
2026 Exit Exam 4: 180 NGN Elite Level 3
Questions with Answers for Guaranteed Level
3 Pass and First Attempt– (2026) Actual
Questions & Answers (Chamberlain) 100%
Guarantee Pass
Which nursing intervention should be implemented postoperatively in an infant with spina bifida after repair of a
meningocele?
A.Limit fluids to prevent infection to the surgical site.
P 1
, • ATI RN
Comprehensive 09/08/2026
Predictor
B.Place the infant in the prone position.
C.Provide a low-residue diet to limit bowel movements.
D.Cover sac with a moist sterile dressing. - Correct Answer :B
Rationale:
The infant should be placed in the prone position to alleviate pressure on the surgical site, which is in the sacrum
(B). Fluids should be increased postoperatively to prevent dehydration (A). A high-fiber diet should be
implemented to prevent constipation (C). After the repair, the sac is no longer exposed, so (D) does not apply.
Which intervention(s) should the nurse implement when administering a new prescription of amitriptyline HCl
(Elavil) to a client with a depressive disorder? (Select all that apply.)
A.Explain that therapeutic effects should be achieved within 1 to 3 days.
B.Administer at bedtime to minimize sedative effects.
C.Give 1 hour after the administration of isocarboxazid (Marplan).
D.Take blood pressure prior to and after administration.
E.Assess for adverse reactions such as dry mouth and blurred vision. - Correct Answer :B,D,E
Rationale:
The drug causes sedation, so it should be given at bedtime (B). Cardiovascular adverse reactions include
orthostatic hypotension; therefore, the blood pressure should be assessed (D). This drug can cause
anticholinergic effects such as dry mouth, blurred vision, constipation, and urinary retention (E). The drug takes 2
to 6 weeks to achieve therapeutic effects (A). All monoamine oxidase (MAO) inhibitors such as isocarboxazid
should be discontinued 1 to 3 weeks prior to the administration of Elavil (C).
When administering an intramuscular injection, which factor is most important to ensure the best medication
absorption?
A.Compress the syringe plunger quickly.
B.Select a small-gauge needle.
C.Inject the needle at a 90-degree angle.
D.Select a small-diameter syringe. - Correct Answer :C
Rationale:
P 2
, • ATI RN
Comprehensive 09/08/2026
Predictor
Injecting the needle at a 90-degree angle allows the medication to be injected into the muscle so that
appropriate absorption can occur (C). Too rapid injection of the medication (A) may be painful and may cause
medication leakage and reduced absorption. (B) will reduce injection discomfort but will not affect absorption. A
syringe barrel that is too small (D) increases the pressure during the injection and may traumatize tissue without
improving medication absorption.
When assessing a normal newborn, which finding(s) should the nurse expect? (Select all that apply.)
A.Umbilical cord contains one vein and two arteries
B.Slightly edematous labia in the female newborn
C.Absence of Babinski reflex
D.Presence of white plaques on the cheeks and tongue
E.Nasal flaring noted with respirations - Correct Answer :A,B
Rationale:
These are normal findings (A and B). The others indicate abnormalities or complications and should be reported
to the primary health care provider (C, D, and E).
The outpatient clinic nurse is reviewing phone messages from last night. Which client should the nurse call back
first?
A.An 18-year-old woman who had a positive pregnancy test and wants advice on how to tell her parents
B.A woman with type 1 diabetes who has just discovered she is pregnant and is worried about her fingerstick
glucose
C.A women at 24 weeks of gestation crying about painful genital lesions on the vulva and urinary frequency
D.A women at 30 weeks of gestation who has been diagnosed with mild preeclampsia and is unable to relieve
her heartburn - Correct Answer :D
Rationale:
The women with epigastric pain should be called first (D). One of the cardinal signs of eclampsia, a life-
threatening complication of pregnancy, is epigastric pain. (A, B, and C) are less serious and should be called after
(D).
P 3
, • ATI RN
Comprehensive 09/08/2026
Predictor
The charge nurse is making assignments for the upcoming shift. Which client is most appropriate to assign to the
licensed practical nurse (LPN)?
A.A client with nausea who needs a nasogastric tube inserted
B.A client in hypertensive crisis who needs titration of IV nitroglycerin
C.
A newly admitted client who needs to have a plan of care established
D.A client who is ready for discharge who needs discharge teaching - Correct Answer :A
Rationale:
This client has a need for a skill that is within the scope of practice for the LPN (A). Titration of an IV drip,
establishing care plans, and discharge teaching are within the scope of practice of a registered nurse (RN) and
are not delegated (B, C, and D).
A nurse working in a community health setting is performing primary health screenings. Which individual is at
highest risk for contracting an HIV infection?
A.A 17-year-old who is sexually active with numerous partners
B.A 45-year-old lesbian who has been sexually active with two partners in the past year
C.A 30-year-old cocaine user who inhales the drug and works in a topless bar
D.A 34-year-old male homosexual who is in a monogamous relationship - Correct Answer :A
Rationale:
(A) is at greatest risk for contracting sexually transmitted diseases, including HIV, because the greater the
number of sexual partners, the greater the risk for contracting an STD. (B) comprises the group of lowest
infected persons because there is little transfer of body fluid during sexual acts. (C), who free-bases, would not
be sharing needles, so contracting an STD is not necessarily a risk. A male homosexual in a monogamous
relationship has a decreased risk of contracting HIV as long as both partners are monogamous and neither is
infected (D).
The charge nurse reviews the charting of a graduate nurse. Which indicates a need for further education on
documentation?
A.Uses descriptive words such as "gurgling" to describe breath sounds
B.Records temperature 30 minutes before and after giving acetaminophen
P 4
