ATI Comprehensive Exit Exam Retake
2023 – Nursing Practice Questions and
Answer Review
Section 1: Management of Care (Questions 1–18)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days postoperative appendectomy reporting incisional pain
B. A client with a new onset of confusion and slurred speech
C. A client requesting assistance to ambulate for the first time
D. A client with a temperature of 100.2°F (37.9°C)
Correct Answer: B
Rationale: New-onset confusion and slurred speech indicate a possible stroke or
neurological emergency requiring immediate assessment. This is a priority over pain,
ambulation assistance, and low-grade fever. Using Maslow's hierarchy and ABC priority
framework, neurological changes take precedence.
2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Administering a cleansing enema
B. Measuring and recording intake and output
C. Assessing a client's surgical incision
D. Teaching a client about a new medication
Correct Answer: B
Rationale: Measuring and recording intake and output is within the UAP's scope of practice.
Administration of enemas, assessment, and teaching require a licensed nurse.
3. A nurse is reviewing advance directives with a newly admitted client. Which statement
indicates understanding?
,A. "My advance directive can only be changed by my doctor."
B. "I can designate someone to make healthcare decisions for me if I become unable."
C. "An advance directive is only for terminally ill clients."
D. "Once I sign an advance directive, it cannot be revoked."
Correct Answer: B
Rationale: A durable power of attorney for healthcare allows the client to designate a
surrogate decision-maker. Advance directives can be changed or revoked at any time by the
client and are not limited to terminally ill clients.
4. A nurse is prioritizing care for a group of clients. Which client should the nurse see first?
A. A client who is 1 day postoperative and reports pain of 6/10
B. A client with COPD reporting shortness of breath
C. A client who needs discharge teaching
D. A client requesting a laxative for constipation
Correct Answer: B
Rationale: Shortness of breath in a client with COPD indicates a potential airway/breathing
issue, which is the highest priority according to ABCs. Pain, discharge teaching, and constipation
are less urgent.
5. A nurse is preparing to transfer a client from the ICU to a medical-surgical unit. Which
action should the nurse take first?
A. Notify the client's family of the transfer
B. Complete a thorough hand-off report using SBAR
C. Gather the client's personal belongings
D. Obtain a new set of vital signs
Correct Answer: B
Rationale: Using SBAR (Situation, Background, Assessment, Recommendation) ensures safe,
effective communication during hand-off, which is the priority to maintain continuity of care and
client safety.
6. A nurse is caring for a client who speaks a different language. Which action should the
nurse take to ensure informed consent?
,A. Ask a family member to interpret
B. Use a certified medical interpreter
C. Provide written materials in the client's language only
D. Proceed with consent in English and document understanding
Correct Answer: B
Rationale: A certified medical interpreter ensures accurate communication and protects
client rights. Family members should not interpret for informed consent due to potential bias
and inaccuracy.
7. A nurse is reviewing a client's medication administration record and notes an order for a
medication the client is allergic to. Which action should the nurse take first?
A. Administer the medication and monitor for reaction
B. Hold the medication and contact the prescriber
C. Ask the pharmacy to change the order
D. Document the allergy and give the medication
Correct Answer: B
Rationale: The nurse must hold the medication and contact the prescriber immediately.
Administering a medication to which the client is allergic could cause harm. The nurse cannot
change orders independently.
8. A nurse is participating in a quality improvement committee. Which of the following is an
example of a structure indicator?
A. The rate of hospital-acquired infections
B. The number of nursing staff with BSN degrees
C. Client satisfaction scores
D. The rate of medication errors
Correct Answer: B
Rationale: Structure indicators measure the attributes of the healthcare setting, including
staffing and education levels. Outcome indicators measure results such as infection rates and
satisfaction.
, 9. A nurse is caring for a client who is being discharged. Which action best ensures continuity
of care?
A. Providing a written discharge summary to the client
B. Ensuring the client has a follow-up appointment and needed prescriptions
C. Asking the client to call if problems arise
D. Documenting discharge instructions in the chart
Correct Answer: B
Rationale: Ensuring follow-up appointments and prescriptions promotes continuity of care
and prevents readmissions. All options are helpful, but B most directly ensures continued care.
10. A nurse is assigned to care for a client who has a DNR order. The client's family requests
that the nurse perform CPR if the client arrests. Which action should the nurse take?
A. Perform CPR as the family requests
B. Explain the DNR order and notify the provider
C. Ignore the family's request
D. Ask the family to sign a waiver
Correct Answer: B
Rationale: The nurse should explain the DNR order and notify the provider. The DNR is a
legal order; the family cannot override it without proper legal procedures. The nurse should act
as an advocate and facilitate communication.
11. A nurse is reviewing the plan of care for a client. Which statement indicates a correctly
written nursing diagnosis?
A. "Client will not develop a pressure ulcer."
B. "Impaired skin integrity related to immobility as evidenced by stage 2 pressure ulcer."
C. "Pressure ulcer is healing well."
D. "Turn client every 2 hours."
Correct Answer: B
Rationale: A properly written nursing diagnosis includes the problem, related factors, and
defining characteristics. Option A is a goal, C is an evaluation, and D is an intervention.
2023 – Nursing Practice Questions and
Answer Review
Section 1: Management of Care (Questions 1–18)
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client 2 days postoperative appendectomy reporting incisional pain
B. A client with a new onset of confusion and slurred speech
C. A client requesting assistance to ambulate for the first time
D. A client with a temperature of 100.2°F (37.9°C)
Correct Answer: B
Rationale: New-onset confusion and slurred speech indicate a possible stroke or
neurological emergency requiring immediate assessment. This is a priority over pain,
ambulation assistance, and low-grade fever. Using Maslow's hierarchy and ABC priority
framework, neurological changes take precedence.
2. A nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate to delegate?
A. Administering a cleansing enema
B. Measuring and recording intake and output
C. Assessing a client's surgical incision
D. Teaching a client about a new medication
Correct Answer: B
Rationale: Measuring and recording intake and output is within the UAP's scope of practice.
Administration of enemas, assessment, and teaching require a licensed nurse.
3. A nurse is reviewing advance directives with a newly admitted client. Which statement
indicates understanding?
,A. "My advance directive can only be changed by my doctor."
B. "I can designate someone to make healthcare decisions for me if I become unable."
C. "An advance directive is only for terminally ill clients."
D. "Once I sign an advance directive, it cannot be revoked."
Correct Answer: B
Rationale: A durable power of attorney for healthcare allows the client to designate a
surrogate decision-maker. Advance directives can be changed or revoked at any time by the
client and are not limited to terminally ill clients.
4. A nurse is prioritizing care for a group of clients. Which client should the nurse see first?
A. A client who is 1 day postoperative and reports pain of 6/10
B. A client with COPD reporting shortness of breath
C. A client who needs discharge teaching
D. A client requesting a laxative for constipation
Correct Answer: B
Rationale: Shortness of breath in a client with COPD indicates a potential airway/breathing
issue, which is the highest priority according to ABCs. Pain, discharge teaching, and constipation
are less urgent.
5. A nurse is preparing to transfer a client from the ICU to a medical-surgical unit. Which
action should the nurse take first?
A. Notify the client's family of the transfer
B. Complete a thorough hand-off report using SBAR
C. Gather the client's personal belongings
D. Obtain a new set of vital signs
Correct Answer: B
Rationale: Using SBAR (Situation, Background, Assessment, Recommendation) ensures safe,
effective communication during hand-off, which is the priority to maintain continuity of care and
client safety.
6. A nurse is caring for a client who speaks a different language. Which action should the
nurse take to ensure informed consent?
,A. Ask a family member to interpret
B. Use a certified medical interpreter
C. Provide written materials in the client's language only
D. Proceed with consent in English and document understanding
Correct Answer: B
Rationale: A certified medical interpreter ensures accurate communication and protects
client rights. Family members should not interpret for informed consent due to potential bias
and inaccuracy.
7. A nurse is reviewing a client's medication administration record and notes an order for a
medication the client is allergic to. Which action should the nurse take first?
A. Administer the medication and monitor for reaction
B. Hold the medication and contact the prescriber
C. Ask the pharmacy to change the order
D. Document the allergy and give the medication
Correct Answer: B
Rationale: The nurse must hold the medication and contact the prescriber immediately.
Administering a medication to which the client is allergic could cause harm. The nurse cannot
change orders independently.
8. A nurse is participating in a quality improvement committee. Which of the following is an
example of a structure indicator?
A. The rate of hospital-acquired infections
B. The number of nursing staff with BSN degrees
C. Client satisfaction scores
D. The rate of medication errors
Correct Answer: B
Rationale: Structure indicators measure the attributes of the healthcare setting, including
staffing and education levels. Outcome indicators measure results such as infection rates and
satisfaction.
, 9. A nurse is caring for a client who is being discharged. Which action best ensures continuity
of care?
A. Providing a written discharge summary to the client
B. Ensuring the client has a follow-up appointment and needed prescriptions
C. Asking the client to call if problems arise
D. Documenting discharge instructions in the chart
Correct Answer: B
Rationale: Ensuring follow-up appointments and prescriptions promotes continuity of care
and prevents readmissions. All options are helpful, but B most directly ensures continued care.
10. A nurse is assigned to care for a client who has a DNR order. The client's family requests
that the nurse perform CPR if the client arrests. Which action should the nurse take?
A. Perform CPR as the family requests
B. Explain the DNR order and notify the provider
C. Ignore the family's request
D. Ask the family to sign a waiver
Correct Answer: B
Rationale: The nurse should explain the DNR order and notify the provider. The DNR is a
legal order; the family cannot override it without proper legal procedures. The nurse should act
as an advocate and facilitate communication.
11. A nurse is reviewing the plan of care for a client. Which statement indicates a correctly
written nursing diagnosis?
A. "Client will not develop a pressure ulcer."
B. "Impaired skin integrity related to immobility as evidenced by stage 2 pressure ulcer."
C. "Pressure ulcer is healing well."
D. "Turn client every 2 hours."
Correct Answer: B
Rationale: A properly written nursing diagnosis includes the problem, related factors, and
defining characteristics. Option A is a goal, C is an evaluation, and D is an intervention.
