ATI Comprehensive Exit Exam Retake Guide 2025 – 180 Exam
Questions and Correct Answers | Graded A+ | Complete Review
Resource
Question 1:
A nurse is caring for a client receiving IV furosemide. Which of the following findings should the
nurse report to the provider immediately?
A) Blood pressure 118/72 mm Hg
B) Potassium level 2.9 mEq/L
C) Weight loss of 1.5 kg in 24 hr
D) Urine output 2,000 mL in 24 hr
Correct Answer: B
Rationale: Hypokalemia (K+ 2.9 mEq/L) is a serious adverse effect of furosemide, a loop
diuretic, and requires immediate intervention to prevent cardiac arrhythmias (Pharmacology).
Option A is within normal limits. Option C indicates effective diuresis. Option D reflects
therapeutic output.
Question 2:
A nurse is planning care for a client who is immobile following a stroke. Which of the following
interventions should the nurse include to prevent deep vein thrombosis?
A) Apply antiembolism stockings continuously.
B) Perform active range-of-motion exercises twice daily.
C) Administer low-molecular-weight heparin subcutaneously.
D) Keep the legs elevated above heart level continuously.
Correct Answer: C
Rationale: Low-molecular-weight heparin is a standard prophylactic measure for DVT in
immobile clients, as it inhibits clotting factors (Fundamentals of Nursing). Option A requires
removal for skin checks. Option B is for mobile clients. Option D is for edema, not primary
prevention.
Question 3:
A nurse is assessing a client who is postoperative day 1 after a cholecystectomy. The client
reports sudden dyspnea and pleuritic chest pain. Which of the following actions should the
nurse take first?
A) Administer oxygen at 2 L/min via nasal cannula.
B) Assess the client's vital signs.
C) Notify the rapid response team.
,D) Encourage coughing and deep breathing.
Correct Answer: B
Rationale: Assessing vital signs establishes a baseline and identifies the severity of potential
pulmonary embolism, following ABC priorities (Medical-Surgical Nursing). Option A follows
confirmation of hypoxia. Option C occurs after assessment. Option D is contraindicated in acute
distress.
Question 4:
A nurse is teaching a client about preventing urinary tract infections. Which of the following
statements by the client indicates an understanding of the teaching?
A) "I will void every 8 hours."
B) "I should drink 8 glasses of water daily."
C) "I will wipe from back to front after toileting."
D) "I can use bubble bath during bathing."
Correct Answer: B
Rationale: Increasing fluid intake to 8 glasses (2 L) daily flushes the urinary tract, reducing
infection risk (Medical-Surgical Nursing). Option A is too infrequent. Option C increases risk.
Option D irritates the urethra.
Question 5:
A nurse is caring for a client in active labor who is receiving oxytocin infusion. The nurse notes
contractions every 2 minutes lasting 90 seconds. Which of the following actions should the
nurse take?
A) Increase the infusion rate.
B) Discontinue the infusion.
C) Change the client's position.
D) Administer oxygen via face mask.
Correct Answer: B
Rationale: Hyperstimulation (contractions <3 min apart or >90 seconds) risks fetal distress;
discontinuing oxytocin is priority (Maternal-Newborn Nursing). Option A worsens. Option C is
adjunct. Option D follows assessment.
Question 6:
A nurse is providing discharge teaching to the parents of a newborn who had a circumcision.
Which of the following instructions should the nurse include?
A) "Apply petroleum gauze to the penis with each diaper change."
B) "Clean the site with alcohol swabs daily."
C) "Expect bright red bleeding for 24 hours."
, D) "Submerge the penis in warm water daily."
Correct Answer: A
Rationale: Petroleum gauze prevents adhesions and promotes healing (Maternal-Newborn
Nursing). Option B dries and irritates. Option C indicates hemorrhage. Option D risks infection.
Question 7:
A nurse is assessing a 2-month-old infant during a well-child visit. Which of the following
findings should the nurse identify as a red flag for developmental delay?
A) Does not lift head when prone
B) Coos and laughs
C) Turns head to sound
D) Grasps rattle briefly
Correct Answer: A
Rationale: Head control by 2 months is expected; delay suggests motor issues (Pediatric
Nursing). Options B-D are normal milestones.
Question 8:
A nurse is caring for a 4-year-old child who has acute otitis media. Which of the following pain
management interventions should the nurse recommend?
A) Administer acetaminophen 15 mg/kg every 4 hours.
B) Apply warm compresses to the ear.
C) Encourage prone positioning.
D) Administer amoxicillin 250 mg BID.
Correct Answer: A
Rationale: Acetaminophen provides symptomatic relief at weight-based dosing (Pediatric
Nursing). Option B adjunct. Option C worsens pain. Option D is antibiotic, not pain.
Question 9:
A nurse is using therapeutic communication with a client who has schizophrenia and reports
auditory hallucinations telling them to harm others. Which of the following responses should the
nurse make?
A) "What are the voices telling you to do?"
B) "The voices are not real and will stop."
C) "Let's ignore the voices and talk about your day."
D) "You are safe here; I will stay with you."
Correct Answer: A
Questions and Correct Answers | Graded A+ | Complete Review
Resource
Question 1:
A nurse is caring for a client receiving IV furosemide. Which of the following findings should the
nurse report to the provider immediately?
A) Blood pressure 118/72 mm Hg
B) Potassium level 2.9 mEq/L
C) Weight loss of 1.5 kg in 24 hr
D) Urine output 2,000 mL in 24 hr
Correct Answer: B
Rationale: Hypokalemia (K+ 2.9 mEq/L) is a serious adverse effect of furosemide, a loop
diuretic, and requires immediate intervention to prevent cardiac arrhythmias (Pharmacology).
Option A is within normal limits. Option C indicates effective diuresis. Option D reflects
therapeutic output.
Question 2:
A nurse is planning care for a client who is immobile following a stroke. Which of the following
interventions should the nurse include to prevent deep vein thrombosis?
A) Apply antiembolism stockings continuously.
B) Perform active range-of-motion exercises twice daily.
C) Administer low-molecular-weight heparin subcutaneously.
D) Keep the legs elevated above heart level continuously.
Correct Answer: C
Rationale: Low-molecular-weight heparin is a standard prophylactic measure for DVT in
immobile clients, as it inhibits clotting factors (Fundamentals of Nursing). Option A requires
removal for skin checks. Option B is for mobile clients. Option D is for edema, not primary
prevention.
Question 3:
A nurse is assessing a client who is postoperative day 1 after a cholecystectomy. The client
reports sudden dyspnea and pleuritic chest pain. Which of the following actions should the
nurse take first?
A) Administer oxygen at 2 L/min via nasal cannula.
B) Assess the client's vital signs.
C) Notify the rapid response team.
,D) Encourage coughing and deep breathing.
Correct Answer: B
Rationale: Assessing vital signs establishes a baseline and identifies the severity of potential
pulmonary embolism, following ABC priorities (Medical-Surgical Nursing). Option A follows
confirmation of hypoxia. Option C occurs after assessment. Option D is contraindicated in acute
distress.
Question 4:
A nurse is teaching a client about preventing urinary tract infections. Which of the following
statements by the client indicates an understanding of the teaching?
A) "I will void every 8 hours."
B) "I should drink 8 glasses of water daily."
C) "I will wipe from back to front after toileting."
D) "I can use bubble bath during bathing."
Correct Answer: B
Rationale: Increasing fluid intake to 8 glasses (2 L) daily flushes the urinary tract, reducing
infection risk (Medical-Surgical Nursing). Option A is too infrequent. Option C increases risk.
Option D irritates the urethra.
Question 5:
A nurse is caring for a client in active labor who is receiving oxytocin infusion. The nurse notes
contractions every 2 minutes lasting 90 seconds. Which of the following actions should the
nurse take?
A) Increase the infusion rate.
B) Discontinue the infusion.
C) Change the client's position.
D) Administer oxygen via face mask.
Correct Answer: B
Rationale: Hyperstimulation (contractions <3 min apart or >90 seconds) risks fetal distress;
discontinuing oxytocin is priority (Maternal-Newborn Nursing). Option A worsens. Option C is
adjunct. Option D follows assessment.
Question 6:
A nurse is providing discharge teaching to the parents of a newborn who had a circumcision.
Which of the following instructions should the nurse include?
A) "Apply petroleum gauze to the penis with each diaper change."
B) "Clean the site with alcohol swabs daily."
C) "Expect bright red bleeding for 24 hours."
, D) "Submerge the penis in warm water daily."
Correct Answer: A
Rationale: Petroleum gauze prevents adhesions and promotes healing (Maternal-Newborn
Nursing). Option B dries and irritates. Option C indicates hemorrhage. Option D risks infection.
Question 7:
A nurse is assessing a 2-month-old infant during a well-child visit. Which of the following
findings should the nurse identify as a red flag for developmental delay?
A) Does not lift head when prone
B) Coos and laughs
C) Turns head to sound
D) Grasps rattle briefly
Correct Answer: A
Rationale: Head control by 2 months is expected; delay suggests motor issues (Pediatric
Nursing). Options B-D are normal milestones.
Question 8:
A nurse is caring for a 4-year-old child who has acute otitis media. Which of the following pain
management interventions should the nurse recommend?
A) Administer acetaminophen 15 mg/kg every 4 hours.
B) Apply warm compresses to the ear.
C) Encourage prone positioning.
D) Administer amoxicillin 250 mg BID.
Correct Answer: A
Rationale: Acetaminophen provides symptomatic relief at weight-based dosing (Pediatric
Nursing). Option B adjunct. Option C worsens pain. Option D is antibiotic, not pain.
Question 9:
A nurse is using therapeutic communication with a client who has schizophrenia and reports
auditory hallucinations telling them to harm others. Which of the following responses should the
nurse make?
A) "What are the voices telling you to do?"
B) "The voices are not real and will stop."
C) "Let's ignore the voices and talk about your day."
D) "You are safe here; I will stay with you."
Correct Answer: A
