2025 ATI COMPREHENSIVE EXIT EXAM RETAKE GUIDE |
180 EXAM QUESTIONS AND ANSWERS | GRADED A+
NCLEX-RN Preparation & Remediation Focus | Key Domains: Management of Care (Priority &
Delegation), Safety & Infection Control, Health Promotion & Maintenance, Psychosocial Integrity,
Basic Care & Comfort, Pharmacological & Parenteral Therapies, Reduction of Risk Potential,
Physiological Adaptation, Nursing Fundamentals, Clinical Judgment, and Test-Taking Strategies for
Retake Success | Expert-Aligned Structure | Exam-Ready Format
Introduction
This structured 2025 ATI Comprehensive Exit Exam Retake Guide provides 180 targeted exam-style
questions with correct answers and rationales. It is specifically designed for remediation, focusing
on common high-stakes topics, analyzing previous performance gaps, reinforcing the NCSBN
Clinical Judgment Model, and applying proven test-taking strategies to ensure success on the retake
assessment.
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the nursing clinical judgment, priority-setting frameworks (e.g., ABCs, Maslow, Acute vs.
Chronic), pathophysiological principles, and why alternative options represent critical thinking
errors common in previous attempts.
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with heart failure who has gained 1.8 kg (4 lb) in 24 hours
B. A client with type 2 diabetes who has a blood glucose of 180 mg/dL
C. A client with a chest tube who has sudden onset of dyspnea and tracheal deviation
, D. A client with appendicitis who reports mild abdominal pain
Rationale: Sudden dyspnea and tracheal deviation in a client with a chest tube indicate tension
pneumothorax—a life-threatening emergency requiring immediate intervention (ABCs:
Airway/Breathing). The heart failure client has fluid gain (concerning but not immediately
life-threatening), while the others are stable.
2. A client with a serum potassium level of 2.8 mEq/L is at risk for which complication?
A. Hypertension
B. Cardiac dysrhythmias
C. Seizures
D. Hyperreflexia
Rationale: Hypokalemia (K⁺ <3.5 mEq/L) causes cardiac irritability and dysrhythmias (e.g., U waves,
flattened T waves). Seizures and hyperreflexia occur in hypocalcemia; hypertension is not directly
linked.
3. A nurse is preparing to administer insulin glargine. Which action is appropriate?
A. Administer 30 minutes before meals
B. Administer at the same time each day
C. Mix with regular insulin in the same syringe
D. Adjust dose based on pre-meal blood glucose
,Rationale: Insulin glargine (a long-acting basal insulin) has no peak and lasts ~24 hours; it must be
given at the same time daily to maintain consistent coverage. It should never be mixed with other
insulins.
4. A client with acute pancreatitis is NPO and receiving IV fluids. The priority nursing intervention is
to:
A. Provide oral hygiene
B. Monitor for signs of hypovolemic shock
C. Encourage ambulation
D. Administer pancreatic enzymes
Rationale: Acute pancreatitis causes third-spacing of fluid, leading to hypovolemia and shock.
Monitoring vital signs, urine output, and skin turgor is critical (Reduction of Risk Potential).
Enzymes are given only with meals when oral intake resumes.
5. A client with schizophrenia is prescribed haloperidol. The nurse should monitor for which
extrapyramidal symptom?
A. Sedation
B. Acute dystonia
C. Orthostatic hypotension
D. Dry mouth
, Rationale: Haloperidol, a first-generation antipsychotic, commonly causes acute dystonia (muscle
spasms, torticollis) within hours to days of initiation. This is a medical emergency requiring
anticholinergic treatment (e.g., benztropine).
6. A nurse is caring for a client who is 1 day postoperative following a total hip arthroplasty. Which
finding requires immediate intervention?
A. Pain rated 5 on a 0–10 scale
B. Shortening of the affected leg
C. Incisional drainage of 50 mL
D. Temperature of 37.8°C (100°F)
Rationale: Leg shortening suggests hip dislocation—a surgical emergency requiring immediate
notification of the provider. Mild pain, low-grade fever, and moderate drainage are expected
postoperatively.
7. A client with heart failure is prescribed furosemide 40 mg IV. Before administration, the nurse
should check which laboratory value?
A. Hemoglobin
B. Potassium
C. Calcium
D. Platelet count
180 EXAM QUESTIONS AND ANSWERS | GRADED A+
NCLEX-RN Preparation & Remediation Focus | Key Domains: Management of Care (Priority &
Delegation), Safety & Infection Control, Health Promotion & Maintenance, Psychosocial Integrity,
Basic Care & Comfort, Pharmacological & Parenteral Therapies, Reduction of Risk Potential,
Physiological Adaptation, Nursing Fundamentals, Clinical Judgment, and Test-Taking Strategies for
Retake Success | Expert-Aligned Structure | Exam-Ready Format
Introduction
This structured 2025 ATI Comprehensive Exit Exam Retake Guide provides 180 targeted exam-style
questions with correct answers and rationales. It is specifically designed for remediation, focusing
on common high-stakes topics, analyzing previous performance gaps, reinforcing the NCSBN
Clinical Judgment Model, and applying proven test-taking strategies to ensure success on the retake
assessment.
Answer Format
All correct answers must appear in bold and cyan blue, accompanied by concise rationales
explaining the nursing clinical judgment, priority-setting frameworks (e.g., ABCs, Maslow, Acute vs.
Chronic), pathophysiological principles, and why alternative options represent critical thinking
errors common in previous attempts.
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with heart failure who has gained 1.8 kg (4 lb) in 24 hours
B. A client with type 2 diabetes who has a blood glucose of 180 mg/dL
C. A client with a chest tube who has sudden onset of dyspnea and tracheal deviation
, D. A client with appendicitis who reports mild abdominal pain
Rationale: Sudden dyspnea and tracheal deviation in a client with a chest tube indicate tension
pneumothorax—a life-threatening emergency requiring immediate intervention (ABCs:
Airway/Breathing). The heart failure client has fluid gain (concerning but not immediately
life-threatening), while the others are stable.
2. A client with a serum potassium level of 2.8 mEq/L is at risk for which complication?
A. Hypertension
B. Cardiac dysrhythmias
C. Seizures
D. Hyperreflexia
Rationale: Hypokalemia (K⁺ <3.5 mEq/L) causes cardiac irritability and dysrhythmias (e.g., U waves,
flattened T waves). Seizures and hyperreflexia occur in hypocalcemia; hypertension is not directly
linked.
3. A nurse is preparing to administer insulin glargine. Which action is appropriate?
A. Administer 30 minutes before meals
B. Administer at the same time each day
C. Mix with regular insulin in the same syringe
D. Adjust dose based on pre-meal blood glucose
,Rationale: Insulin glargine (a long-acting basal insulin) has no peak and lasts ~24 hours; it must be
given at the same time daily to maintain consistent coverage. It should never be mixed with other
insulins.
4. A client with acute pancreatitis is NPO and receiving IV fluids. The priority nursing intervention is
to:
A. Provide oral hygiene
B. Monitor for signs of hypovolemic shock
C. Encourage ambulation
D. Administer pancreatic enzymes
Rationale: Acute pancreatitis causes third-spacing of fluid, leading to hypovolemia and shock.
Monitoring vital signs, urine output, and skin turgor is critical (Reduction of Risk Potential).
Enzymes are given only with meals when oral intake resumes.
5. A client with schizophrenia is prescribed haloperidol. The nurse should monitor for which
extrapyramidal symptom?
A. Sedation
B. Acute dystonia
C. Orthostatic hypotension
D. Dry mouth
, Rationale: Haloperidol, a first-generation antipsychotic, commonly causes acute dystonia (muscle
spasms, torticollis) within hours to days of initiation. This is a medical emergency requiring
anticholinergic treatment (e.g., benztropine).
6. A nurse is caring for a client who is 1 day postoperative following a total hip arthroplasty. Which
finding requires immediate intervention?
A. Pain rated 5 on a 0–10 scale
B. Shortening of the affected leg
C. Incisional drainage of 50 mL
D. Temperature of 37.8°C (100°F)
Rationale: Leg shortening suggests hip dislocation—a surgical emergency requiring immediate
notification of the provider. Mild pain, low-grade fever, and moderate drainage are expected
postoperatively.
7. A client with heart failure is prescribed furosemide 40 mg IV. Before administration, the nurse
should check which laboratory value?
A. Hemoglobin
B. Potassium
C. Calcium
D. Platelet count
