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: 68-year-old man, 3 days post-CABG ×3, transferred to step-down. PMH: T2DM,
HTN, CKD stage 3. Vitals: BP 98/62 mm Hg, HR 104/min, RR 26/min, SpO₂ 93 % on 4 L
NC. Chest tube output 110 mL/h serosanguinous for last 3 h. Labs: Hgb 9.1 g/dL (preop
12.4), K 3.2 mEq/L, SCr 1.9 mg/dL (↑ from 1.3). Medications: metoprolol 25 mg PO BID,
lispro-ac sliding scale, furosemide 40 mg IV q8h, vancomycin 1 g IV q12h. Currently
restless, denies chest pain.
Question: Which assessment findings require immediate follow-up by the RN? (Select
ALL that apply.)
Options:
A. Chest tube output >100 mL/h for 3 consecutive hours
B. Systolic BP <100 mm Hg with HR >100/min
,C. Serum potassium 3.2 mEq/L
D. Oxygen saturation 93 % on 4 L NC
E. Serum creatinine increase ≥0.3 mg/dL within 48 h
Correct Choices: A, B, C, E
Rationale (Revised & Verified):
● Correct Answer: A, B, C, E
● Analysis: Post-CABG bleeding >100 mL/h for >2 h signals excessive hemorrhage
(2025 AATS guidelines). Hypotension with tachycardia indicates hypovolemic or
cardiogenic shock risk. Hypokalemia <3.5 mEq/L raises lethal-arrhythmia risk in
post-MI patients on β-blockers & diuretics. ≥0.3 mg/dL SCr rise within 48 h meets
2025 KDIGO AKI criteria—nephrotoxic vancomycin likely contributor. Oxygen
saturation 93 % is sub-optimal but not immediate if patient is stable and trending
upward.
● Distractor Breakdown: D—While 93 % is below target, it is not an immediate
emergency; first escalate if <90 % or work of breathing increases.
Item ID: V2-002
Item Type: Traditional MCQ
Scenario: 26-year-old G2P1 at 39 weeks admitted in active labor. Cervix 6 cm/90 %/0
station, fetal cephalic. FHR baseline 145/min, moderate variability, recurrent late
decelerations with 3 contractions/10 min. Maternal vitals stable. IV lactated Ringer’s
infusing, patient on oxygen 10 L via face mask.
, Question: What is the RN’s priority action?
Options:
A. Turn patient to left lateral position
B. Increase IV fluid rate
C. Prepare for emergent cesarean birth
D. Administer terbutaline 0.25 mg SQ
Rationale (Revised & Verified):
● Correct Answer: A
● Analysis: Left lateral displacement alleviates aortocaval compression, improving
uteroplacental perfusion and is the first intrauterine resuscitation step for late
decels (ACOG 2025). Often corrects pattern without further intervention.
● Distractor Breakdown: B—Fluid bolus helps but is secondary; positioning gives
immediate benefit. C—Operative delivery considered only after resuscitation fails.
D—Terbutaline stops contractions but is not first-line for late decels.
Item ID: V2-003
Item Type: NGN - Matrix
Scenario: 55-year-old woman, POD#1 laparoscopic sigmoid colectomy for diverticulitis.
PCA hydromorphone, ambulating with assistance. Suddenly reports dyspnea and
Actual exam With Questions And Revised Correct
Answers & Rationales () 100%
Guaranteed Pass
Item ID: V2-001
Item Type: NGN - Extended Multiple Response
Scenario: 68-year-old man, 3 days post-CABG ×3, transferred to step-down. PMH: T2DM,
HTN, CKD stage 3. Vitals: BP 98/62 mm Hg, HR 104/min, RR 26/min, SpO₂ 93 % on 4 L
NC. Chest tube output 110 mL/h serosanguinous for last 3 h. Labs: Hgb 9.1 g/dL (preop
12.4), K 3.2 mEq/L, SCr 1.9 mg/dL (↑ from 1.3). Medications: metoprolol 25 mg PO BID,
lispro-ac sliding scale, furosemide 40 mg IV q8h, vancomycin 1 g IV q12h. Currently
restless, denies chest pain.
Question: Which assessment findings require immediate follow-up by the RN? (Select
ALL that apply.)
Options:
A. Chest tube output >100 mL/h for 3 consecutive hours
B. Systolic BP <100 mm Hg with HR >100/min
,C. Serum potassium 3.2 mEq/L
D. Oxygen saturation 93 % on 4 L NC
E. Serum creatinine increase ≥0.3 mg/dL within 48 h
Correct Choices: A, B, C, E
Rationale (Revised & Verified):
● Correct Answer: A, B, C, E
● Analysis: Post-CABG bleeding >100 mL/h for >2 h signals excessive hemorrhage
(2025 AATS guidelines). Hypotension with tachycardia indicates hypovolemic or
cardiogenic shock risk. Hypokalemia <3.5 mEq/L raises lethal-arrhythmia risk in
post-MI patients on β-blockers & diuretics. ≥0.3 mg/dL SCr rise within 48 h meets
2025 KDIGO AKI criteria—nephrotoxic vancomycin likely contributor. Oxygen
saturation 93 % is sub-optimal but not immediate if patient is stable and trending
upward.
● Distractor Breakdown: D—While 93 % is below target, it is not an immediate
emergency; first escalate if <90 % or work of breathing increases.
Item ID: V2-002
Item Type: Traditional MCQ
Scenario: 26-year-old G2P1 at 39 weeks admitted in active labor. Cervix 6 cm/90 %/0
station, fetal cephalic. FHR baseline 145/min, moderate variability, recurrent late
decelerations with 3 contractions/10 min. Maternal vitals stable. IV lactated Ringer’s
infusing, patient on oxygen 10 L via face mask.
, Question: What is the RN’s priority action?
Options:
A. Turn patient to left lateral position
B. Increase IV fluid rate
C. Prepare for emergent cesarean birth
D. Administer terbutaline 0.25 mg SQ
Rationale (Revised & Verified):
● Correct Answer: A
● Analysis: Left lateral displacement alleviates aortocaval compression, improving
uteroplacental perfusion and is the first intrauterine resuscitation step for late
decels (ACOG 2025). Often corrects pattern without further intervention.
● Distractor Breakdown: B—Fluid bolus helps but is secondary; positioning gives
immediate benefit. C—Operative delivery considered only after resuscitation fails.
D—Terbutaline stops contractions but is not first-line for late decels.
Item ID: V2-003
Item Type: NGN - Matrix
Scenario: 55-year-old woman, POD#1 laparoscopic sigmoid colectomy for diverticulitis.
PCA hydromorphone, ambulating with assistance. Suddenly reports dyspnea and
