RN ATI Comprehensive Exit Exam (Version 2 )
Actual exam With Questions And Revised Correct
Answers & Rationales () 100%
Guaranteed Pass
Item ID: V2-001
Item Type: NGN - Extended Multiple Response
Scenario: A 68-year-old woman is admitted to the telemetry unit with new-onset atrial
fibrillation. Vital signs: BP 142/88 mmHg, HR 136-154 bpm irregular, RR 22/min, SpO₂
94 % on 2 L nasal cannula, T 37.1 °C. History: HTN, HFpEF, CKD stage 3. Current meds:
metoprolol XL 50 mg PO daily, apixaban 5 mg PO BID, furosemide 40 mg PO daily. Labs:
K 4.0 mEq/L, Mg 1.4 mg/dL, Cr 1.6 mg/dL, INR 1.0, aPTT 28 s. ECG shows rapid AF with
variable ventricular response. Nurse is preparing bedside for possible synchronized
cardioversion.
Question: Which four actions must the nurse complete before the procedure? (Select 4.)
Options:
A. Verify signed consent is on the chart
B. Place defibrillation pads in anterior-lateral position
C. Confirm NPO status for ≥6 h
D. Pre-medicate with ketamine 1 mg/kg IV
E. Check that synchronized mode is selected on defibrillator
,F. Administer a 500 mL crystalloid bolus
G. Confirm IV access and patent line
Correct Choices: A, C, E, G
Rationale (Revised & Verified):
● Correct Answer: A, C, E, G
● Analysis: 2025 AHA/ACC guidelines require verified consent, ≥6 h fast to reduce
aspiration risk, synchronized mode to avoid R-on-T, and reliable access for
sedation.
● Distractor Breakdown: B—pads are applied by provider or per protocol, not solely
nurse; D—ketamine dosing is provider order; F—fluid bolus is contraindicated in
HFpEF.
Item ID: V2-002
Item Type: Traditional MCQ
Scenario: A 19-year-old primigravida at 39 2/7 weeks is admitted in active labor. Cervix
6 cm/90 %/0 station, contractions q3 min. FHR baseline 155 bpm, moderate variability,
recurrent late decelerations. Maternal temp 37.3 °C, BP 118/76, RR 18. IV lactated
Ringer’s infusing at 125 mL/h.
Question: What is the nurse’s priority intervention?
Options:
A. Administer 8–10 L/min oxygen via non-rebreather
B. Turn patient to left lateral position
,C. Discontinue oxytocin if infusing
D. Increase IV fluid rate to 250 mL/h
Correct Answer: C
Rationale (Revised & Verified):
● Correct Answer: C
● Analysis: 2025 AWHONN guidelines identify late decels as uteroplacental
insufficiency; stopping oxytocin reduces uterine hyperstimulation and is first
priority.
● Distractor Breakdown: A—oxygen is adjunct after stopping oxytocin;
B—positioning helps but does not remove causative factor; D—fluids do not
immediately improve placental perfusion.
Item ID: V2-003
Item Type: NGN - Matrix
Scenario: A 54-year-old man post right hemicolectomy 8 h ago has PCA hydromorphone
0.2 mg/mL, basal 0.2 mg/h, bolus 0.2 mg, lock-out 10 min. Reported pain 6/10 at 0400,
now 3/10. Respiratory rate 9/min, SpO₂ 90 %, difficult to arouse. Pupils 2 mm bilaterally.
Question: Identify for each finding whether it is an expected opioid side-effect or a
critical safety signal requiring immediate escalation.
Matrix:
Finding | Expected side-effect | Critical safety signal
A. RR 9/min | ☐ | ☐
, B. Pain drop 6→3 | ☐ | ☐
C. SpO₂ 90 % | ☐ | ☐
D. Pinpoint pupils | ☐ | ☐
Correct Responses: A-Critical, B-Expected, C-Critical, D-Critical
Rationale (Revised & Verified):
● Correct Answer: A-Critical, B-Expected, C-Critical, D-Critical
● Analysis: 2025 ISMP lists RR <10, SpO₂ <92 %, and pinpoint pupils as red-flag
respiratory depression; pain reduction is desired.
● Distractor Breakdown: Selecting “Expected” for RR 9 or SpO₂ 90 delays naloxone;
mislabeling pain drop as “Critical” may prompt unnecessary dose increase.
Item ID: V2-004
Item Type: Traditional MCQ
Scenario: A 7-year-old with newly diagnosed type 1 DM is receiving diabetes education.
Child weighs 25 kg. Provider orders rapid-acting insulin 1 unit per 10 g CHO, correction 1
unit per 50 mg/dL >150 mg/dL. Pre-lunch glucose 238 mg/dL, CHO count 65 g.
Question: What is the total lunch insulin dose?
Options:
A. 5 units
B. 7 units
C. 8 units
Actual exam With Questions And Revised Correct
Answers & Rationales () 100%
Guaranteed Pass
Item ID: V2-001
Item Type: NGN - Extended Multiple Response
Scenario: A 68-year-old woman is admitted to the telemetry unit with new-onset atrial
fibrillation. Vital signs: BP 142/88 mmHg, HR 136-154 bpm irregular, RR 22/min, SpO₂
94 % on 2 L nasal cannula, T 37.1 °C. History: HTN, HFpEF, CKD stage 3. Current meds:
metoprolol XL 50 mg PO daily, apixaban 5 mg PO BID, furosemide 40 mg PO daily. Labs:
K 4.0 mEq/L, Mg 1.4 mg/dL, Cr 1.6 mg/dL, INR 1.0, aPTT 28 s. ECG shows rapid AF with
variable ventricular response. Nurse is preparing bedside for possible synchronized
cardioversion.
Question: Which four actions must the nurse complete before the procedure? (Select 4.)
Options:
A. Verify signed consent is on the chart
B. Place defibrillation pads in anterior-lateral position
C. Confirm NPO status for ≥6 h
D. Pre-medicate with ketamine 1 mg/kg IV
E. Check that synchronized mode is selected on defibrillator
,F. Administer a 500 mL crystalloid bolus
G. Confirm IV access and patent line
Correct Choices: A, C, E, G
Rationale (Revised & Verified):
● Correct Answer: A, C, E, G
● Analysis: 2025 AHA/ACC guidelines require verified consent, ≥6 h fast to reduce
aspiration risk, synchronized mode to avoid R-on-T, and reliable access for
sedation.
● Distractor Breakdown: B—pads are applied by provider or per protocol, not solely
nurse; D—ketamine dosing is provider order; F—fluid bolus is contraindicated in
HFpEF.
Item ID: V2-002
Item Type: Traditional MCQ
Scenario: A 19-year-old primigravida at 39 2/7 weeks is admitted in active labor. Cervix
6 cm/90 %/0 station, contractions q3 min. FHR baseline 155 bpm, moderate variability,
recurrent late decelerations. Maternal temp 37.3 °C, BP 118/76, RR 18. IV lactated
Ringer’s infusing at 125 mL/h.
Question: What is the nurse’s priority intervention?
Options:
A. Administer 8–10 L/min oxygen via non-rebreather
B. Turn patient to left lateral position
,C. Discontinue oxytocin if infusing
D. Increase IV fluid rate to 250 mL/h
Correct Answer: C
Rationale (Revised & Verified):
● Correct Answer: C
● Analysis: 2025 AWHONN guidelines identify late decels as uteroplacental
insufficiency; stopping oxytocin reduces uterine hyperstimulation and is first
priority.
● Distractor Breakdown: A—oxygen is adjunct after stopping oxytocin;
B—positioning helps but does not remove causative factor; D—fluids do not
immediately improve placental perfusion.
Item ID: V2-003
Item Type: NGN - Matrix
Scenario: A 54-year-old man post right hemicolectomy 8 h ago has PCA hydromorphone
0.2 mg/mL, basal 0.2 mg/h, bolus 0.2 mg, lock-out 10 min. Reported pain 6/10 at 0400,
now 3/10. Respiratory rate 9/min, SpO₂ 90 %, difficult to arouse. Pupils 2 mm bilaterally.
Question: Identify for each finding whether it is an expected opioid side-effect or a
critical safety signal requiring immediate escalation.
Matrix:
Finding | Expected side-effect | Critical safety signal
A. RR 9/min | ☐ | ☐
, B. Pain drop 6→3 | ☐ | ☐
C. SpO₂ 90 % | ☐ | ☐
D. Pinpoint pupils | ☐ | ☐
Correct Responses: A-Critical, B-Expected, C-Critical, D-Critical
Rationale (Revised & Verified):
● Correct Answer: A-Critical, B-Expected, C-Critical, D-Critical
● Analysis: 2025 ISMP lists RR <10, SpO₂ <92 %, and pinpoint pupils as red-flag
respiratory depression; pain reduction is desired.
● Distractor Breakdown: Selecting “Expected” for RR 9 or SpO₂ 90 delays naloxone;
mislabeling pain drop as “Critical” may prompt unnecessary dose increase.
Item ID: V2-004
Item Type: Traditional MCQ
Scenario: A 7-year-old with newly diagnosed type 1 DM is receiving diabetes education.
Child weighs 25 kg. Provider orders rapid-acting insulin 1 unit per 10 g CHO, correction 1
unit per 50 mg/dL >150 mg/dL. Pre-lunch glucose 238 mg/dL, CHO count 65 g.
Question: What is the total lunch insulin dose?
Options:
A. 5 units
B. 7 units
C. 8 units
