Actual 2026 Version ATI RN Comprehensive Predictor
2023-2026 Exit Exam Practice Questions with NGN 180
Questions and Answers to Pass RN ATI Comprehensive
Predictor 2023/2026 Exit Exam with NGN (EXPANDED
VERSION 450 QUESTIONS)
Question 1
A 68-year-old male is admitted with acute exacerbation of COPD. His oxygen saturation
is 86% on room air. The nurse initiates oxygen at 2 L/min via nasal cannula. Fifteen
minutes later, the patient becomes drowsy and his respiratory rate drops from 22 to 8
breaths/min. What is the priority nursing action?
○ Increase oxygen to 4 L/min to improve saturation
○ Place the patient in Trendelenburg position
○ Decrease oxygen to 1 L/min and reassess
○ Prepare for immediate intubation
Examiners notes COPD patients with chronic hypercapnia rely on hypoxic drive. Too
much oxygen can cause respiratory depression. Aim for SpO₂ 88–92%.
Question 2
A nurse is caring for a patient receiving continuous tube feeding via a nasogastric tube.
The nurse notes that the residual volume is 400 mL after 4 hours of feeding. Which
action should the nurse take first?
,○ Discard the residual and continue the feeding
○ Hold the feeding and reassess abdominal assessment
○ Increase the infusion rate to compensate
○ Flush the tube with 30 mL of warm water
Examiners notes A residual greater than 250–300 mL suggests delayed gastric emptying.
Hold feeding, assess for distension and nausea, and notify provider.
Question 3
A nurse is reviewing laboratory results for a patient receiving spironolactone. Which
finding indicates a therapeutic response?
○ Serum potassium decreases from 6.1 to 4.8 mEq/L
○ Serum sodium increases from 135 to 140 mEq/L
○ Blood pressure decreases from 150/90 to 130/80 mm Hg
○ Urine output increases from 20 to 60 mL/hour
Examiners notes Spironolactone is a potassium-sparing diuretic used for hypertension
and heart failure. A decrease in blood pressure is the intended therapeutic response.
Monitoring potassium for hyperkalemia is important for safety, not efficacy.
Question 4
A nurse is assessing a 78-year-old female two days after a right hip replacement. She
suddenly reports shortness of breath and pleuritic chest pain. Vital signs: HR 120, RR 32,
BP 90/60, SpO₂ 89% on 2 L nasal cannula. The nurse suspects pulmonary embolism.
Select the three priority actions.
○ Place patient in high Fowler's position
○ Apply oxygen at 4–6 L/min via mask
,○ Prepare for IV access and anticoagulation orders
○ Ambulate the patient to prevent further clots
○ Notify the rapid response team
○ Massage the surgical leg to improve circulation
Examiners notes Pulmonary embolism is a life-threatening emergency. High Fowler's
position, high-flow oxygen, IV access, and rapid response notification are priorities. Do not
ambulate or massage the affected leg as this can dislodge more clots.
Question 5
A nurse is monitoring a patient receiving IV potassium chloride 20 mEq in 100 mL of
normal saline over one hour. Which finding requires immediate intervention?
○ Serum potassium level of 3.8 mEq/L
○ Patient reports burning pain at the IV site
○ Urine output of 40 mL over the last hour
○ Mild ST-segment depression on cardiac monitor
Examiners notes *IV potassium is a vesicant. Burning pain at the site indicates possible
infiltration or phlebitis, which can lead to tissue necrosis. Stop the infusion immediately
and notify the provider. Never administer potassium by IV push. Maximum infusion rate
is 10–20 mEq/hour via peripheral line.
Question 6
A nurse is caring for a patient with diabetic ketoacidosis receiving an insulin drip. Which
laboratory finding indicates that treatment is effective?
○ Serum glucose decreases from 350 to 300 mg/dL
○ Serum potassium increases from 3.2 to 4.1 mEq/L
○ Serum bicarbonate decreases from 18 to 14 mEq/L
○ Serum sodium decreases from 138 to 132 mEq/L
, Examiners notes In DKA, insulin therapy shifts potassium back into cells, so total body
potassium is depleted. A rising serum potassium level during treatment indicates
improvement. Monitor for hypokalemia as a complication.
Question 7
A postoperative patient reports sudden chest pain and dyspnea. The nurse notes
tachycardia and petechiae over the chest wall. Which complication should the nurse
suspect?
○ Atelectasis
○ Pulmonary edema
○ Fat embolism syndrome
○ Pneumothorax
Examiners notes Fat embolism syndrome typically occurs 24–72 hours after long bone or
pelvic fractures. Classic triad: respiratory distress, neurologic changes, and petechial rash
on chest, axillae, or conjunctiva.
Question 8
A nurse is preparing to administer furosemide to a patient with acute pulmonary edema.
Which assessment finding requires holding the dose and notifying the provider?
○ Blood pressure 135/85 mm Hg
○ Serum potassium 2.9 mEq/L
○ Weight gain of 1 kg in 24 hours
○ Crackles in bilateral lung bases
Examiners notes *Furosemide is a loop diuretic that can cause severe hypokalemia. A
potassium level below 3.0 mEq/L increases the risk of cardiac arrhythmias. Hold the
medication and notify the provider for potassium replacement.*
Question 9
A nurse is providing discharge teaching to a patient with a new prescription for warfarin.
Which statement by the patient indicates a need for further teaching?
2023-2026 Exit Exam Practice Questions with NGN 180
Questions and Answers to Pass RN ATI Comprehensive
Predictor 2023/2026 Exit Exam with NGN (EXPANDED
VERSION 450 QUESTIONS)
Question 1
A 68-year-old male is admitted with acute exacerbation of COPD. His oxygen saturation
is 86% on room air. The nurse initiates oxygen at 2 L/min via nasal cannula. Fifteen
minutes later, the patient becomes drowsy and his respiratory rate drops from 22 to 8
breaths/min. What is the priority nursing action?
○ Increase oxygen to 4 L/min to improve saturation
○ Place the patient in Trendelenburg position
○ Decrease oxygen to 1 L/min and reassess
○ Prepare for immediate intubation
Examiners notes COPD patients with chronic hypercapnia rely on hypoxic drive. Too
much oxygen can cause respiratory depression. Aim for SpO₂ 88–92%.
Question 2
A nurse is caring for a patient receiving continuous tube feeding via a nasogastric tube.
The nurse notes that the residual volume is 400 mL after 4 hours of feeding. Which
action should the nurse take first?
,○ Discard the residual and continue the feeding
○ Hold the feeding and reassess abdominal assessment
○ Increase the infusion rate to compensate
○ Flush the tube with 30 mL of warm water
Examiners notes A residual greater than 250–300 mL suggests delayed gastric emptying.
Hold feeding, assess for distension and nausea, and notify provider.
Question 3
A nurse is reviewing laboratory results for a patient receiving spironolactone. Which
finding indicates a therapeutic response?
○ Serum potassium decreases from 6.1 to 4.8 mEq/L
○ Serum sodium increases from 135 to 140 mEq/L
○ Blood pressure decreases from 150/90 to 130/80 mm Hg
○ Urine output increases from 20 to 60 mL/hour
Examiners notes Spironolactone is a potassium-sparing diuretic used for hypertension
and heart failure. A decrease in blood pressure is the intended therapeutic response.
Monitoring potassium for hyperkalemia is important for safety, not efficacy.
Question 4
A nurse is assessing a 78-year-old female two days after a right hip replacement. She
suddenly reports shortness of breath and pleuritic chest pain. Vital signs: HR 120, RR 32,
BP 90/60, SpO₂ 89% on 2 L nasal cannula. The nurse suspects pulmonary embolism.
Select the three priority actions.
○ Place patient in high Fowler's position
○ Apply oxygen at 4–6 L/min via mask
,○ Prepare for IV access and anticoagulation orders
○ Ambulate the patient to prevent further clots
○ Notify the rapid response team
○ Massage the surgical leg to improve circulation
Examiners notes Pulmonary embolism is a life-threatening emergency. High Fowler's
position, high-flow oxygen, IV access, and rapid response notification are priorities. Do not
ambulate or massage the affected leg as this can dislodge more clots.
Question 5
A nurse is monitoring a patient receiving IV potassium chloride 20 mEq in 100 mL of
normal saline over one hour. Which finding requires immediate intervention?
○ Serum potassium level of 3.8 mEq/L
○ Patient reports burning pain at the IV site
○ Urine output of 40 mL over the last hour
○ Mild ST-segment depression on cardiac monitor
Examiners notes *IV potassium is a vesicant. Burning pain at the site indicates possible
infiltration or phlebitis, which can lead to tissue necrosis. Stop the infusion immediately
and notify the provider. Never administer potassium by IV push. Maximum infusion rate
is 10–20 mEq/hour via peripheral line.
Question 6
A nurse is caring for a patient with diabetic ketoacidosis receiving an insulin drip. Which
laboratory finding indicates that treatment is effective?
○ Serum glucose decreases from 350 to 300 mg/dL
○ Serum potassium increases from 3.2 to 4.1 mEq/L
○ Serum bicarbonate decreases from 18 to 14 mEq/L
○ Serum sodium decreases from 138 to 132 mEq/L
, Examiners notes In DKA, insulin therapy shifts potassium back into cells, so total body
potassium is depleted. A rising serum potassium level during treatment indicates
improvement. Monitor for hypokalemia as a complication.
Question 7
A postoperative patient reports sudden chest pain and dyspnea. The nurse notes
tachycardia and petechiae over the chest wall. Which complication should the nurse
suspect?
○ Atelectasis
○ Pulmonary edema
○ Fat embolism syndrome
○ Pneumothorax
Examiners notes Fat embolism syndrome typically occurs 24–72 hours after long bone or
pelvic fractures. Classic triad: respiratory distress, neurologic changes, and petechial rash
on chest, axillae, or conjunctiva.
Question 8
A nurse is preparing to administer furosemide to a patient with acute pulmonary edema.
Which assessment finding requires holding the dose and notifying the provider?
○ Blood pressure 135/85 mm Hg
○ Serum potassium 2.9 mEq/L
○ Weight gain of 1 kg in 24 hours
○ Crackles in bilateral lung bases
Examiners notes *Furosemide is a loop diuretic that can cause severe hypokalemia. A
potassium level below 3.0 mEq/L increases the risk of cardiac arrhythmias. Hold the
medication and notify the provider for potassium replacement.*
Question 9
A nurse is providing discharge teaching to a patient with a new prescription for warfarin.
Which statement by the patient indicates a need for further teaching?
