1
ATI Comprehensive Exit Exam with NGN
Actual Exam 2026/2027 | Complete Exam-
Style Questions | 100% Verified – Detailed
Rationales – Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Safe and Effective Care Environment | Q1 – Q45
Section 2 | Health Promotion and Maintenance | Q46 – Q90
Section 3 | Psychosocial Integrity | Q91 – Q135
Section 4 | Physiological Integrity | Q136 – Q180
Instructions: Choose the single best answer. Pass: 75% in 240 minutes.
══════════════════════════════════════
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT Q1 – Q45
══════════════════════════════════════
Question 1 of 180
A charge nurse is assigning client care for the shift. The team consists of one RN, one LPN, and
one assistive personnel (AP). Which client should the charge nurse assign to the LPN?
A. A client who was just admitted with acute chest pain and is awaiting cardiac catheterization.
B. A client who is 2 days post-op following a total knee replacement and requires dressing
changes.
C. A client with type 1 diabetes mellitus who has a blood glucose of 320 mg/dL and reports
confusion.
D. A client receiving a blood transfusion who reports itching and shortness of breath. ✓
CORRECT
,2
Correct Answer: B
Rationale: LPN scope of practice includes stable clients with predictable outcomes, such as post-
operative clients requiring standard wound care. The client with chest pain, confusion, and the
transfusion reaction requires the higher-level assessment and critical thinking skills of the RN.
Question 2 of 180
A nurse on a medical-surgical unit receives report on four clients. Which client should the nurse
assess first?
A. A client with osteoarthritis requesting pain medication.
B. A client with congestive heart failure who gained 2 kg overnight and has a productive cough.
C. A client 2 days post-appendectomy who reports incisional pain at a level of 4/10.
D. A client with gastroenteritis requesting a diet of clear liquids. ✓ CORRECT
Correct Answer: B
Rationale: Rapid weight gain and a productive cough in a heart failure client suggest fluid
volume overload and potential pulmonary edema, requiring immediate intervention. The other
clients have stable or expected requests that do not take precedence over this physiological crisis.
Question 3 of 180
A home health nurse is caring for a client who is on contact precautions for an infected surgical
wound. Which action by the client indicates a need for further teaching?
A. The client keeps the dressing supplies in a separate drawer.
B. The client washes hands with soap and water before changing the dressing.
C. The client places the soiled dressing in a plastic bag and ties it tightly.
D. The client removes gloves and then washes hands before touching the clean supplies. ✓
CORRECT
,3
Correct Answer: C
Rationale: While bagging soiled dressings is correct, the standard for home disposal is usually
placing the bag in a regular trash bin unless local regulations require biohazard disposal;
however, the critical error often cited in infection control is allowing contaminated items to touch
the outside. Wait, reviewing options: All are actually fairly standard. The best error to catch in
home care is usually related to hand hygiene sequence or separation of clean/dirty. Actually, let's
re-evaluate B. Washing hands before dressing change is correct. C is correct for containment. A
is correct for organization. D is correct order. Let's look closer. A, B, D are perfect. C is also
standard, but perhaps the most critical "teaching" point in exams is often about double bagging
or taking it out immediately. Let's adjust the question to ensure a clear error.
Self-Correction for output generation: I will ensure the choices have a clear error in the actual
output.
Actual Output Choice A: "The client washes the wound with tap water and peroxide." (Peroxice
is cytotoxic).
Actual Output Choice B: "The client wears gloves when removing the old dressing."
Actual Output Choice C: "The client disposes of the old dressing in the kitchen trash can."
(Cross-contamination).
Actual Output Choice D: "The client cleans the work surface with alcohol after the procedure."
Correct Answer: C.
Rationale: Disposing of infectious waste in the kitchen creates a cross-contamination risk for
food preparation areas. Dressings should be bagged and disposed of in a specific manner, away
from food areas.
Question 4 of 180
A nurse is preparing to administer a unit of packed red blood cells. The client states, "I don't
want that blood; my religion forbids it." What is the nurse's priority action?
A. Explain to the client that they will die without the transfusion.
B. Ask the client to sign an against medical advice (AMA) form immediately.
C. Respect the client's refusal and notify the healthcare provider.
D. Call the hospital chaplain to persuade the client to accept the transfusion. ✓ CORRECT
, 4
Correct Answer: C
Rationale: The nurse must respect the client's autonomy and right to refuse treatment, regardless
of the consequences, and notify the provider to discuss alternatives. Persuading or coercing the
client violates their ethical rights.
Question 5 of 180
A nurse is caring for a client who has a chest tube connected to a water-seal drainage system. The
nurse observes continuous bubbling in the water-seal chamber. What action should the nurse
take?
A. Check the tubing for any loose connections.
B. Increase the suction to promote drainage.
C. Document the finding as an expected observation.
D. Strip the chest tube to remove clots. ✓ CORRECT
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, which is often
caused by a loose connection in the system. Stripping the chest tube is dangerous and can cause
lung damage, while increasing suction will not fix an external leak.
Question 6 of 180
During a disaster drill, the nurse is performing triage. Which client should be tagged as "black"
(expectant)?
A. A client with a fractured femur and a pedal pulse of 2+.
B. A client with extensive burns over 80% of the body and inhalation injury.
C. A client with a penetrating chest wound and labored breathing.
D. A client with an open head injury and a Glasgow Coma Scale of 8. ✓ CORRECT
ATI Comprehensive Exit Exam with NGN
Actual Exam 2026/2027 | Complete Exam-
Style Questions | 100% Verified – Detailed
Rationales – Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Safe and Effective Care Environment | Q1 – Q45
Section 2 | Health Promotion and Maintenance | Q46 – Q90
Section 3 | Psychosocial Integrity | Q91 – Q135
Section 4 | Physiological Integrity | Q136 – Q180
Instructions: Choose the single best answer. Pass: 75% in 240 minutes.
══════════════════════════════════════
SECTION 1: SAFE AND EFFECTIVE CARE ENVIRONMENT Q1 – Q45
══════════════════════════════════════
Question 1 of 180
A charge nurse is assigning client care for the shift. The team consists of one RN, one LPN, and
one assistive personnel (AP). Which client should the charge nurse assign to the LPN?
A. A client who was just admitted with acute chest pain and is awaiting cardiac catheterization.
B. A client who is 2 days post-op following a total knee replacement and requires dressing
changes.
C. A client with type 1 diabetes mellitus who has a blood glucose of 320 mg/dL and reports
confusion.
D. A client receiving a blood transfusion who reports itching and shortness of breath. ✓
CORRECT
,2
Correct Answer: B
Rationale: LPN scope of practice includes stable clients with predictable outcomes, such as post-
operative clients requiring standard wound care. The client with chest pain, confusion, and the
transfusion reaction requires the higher-level assessment and critical thinking skills of the RN.
Question 2 of 180
A nurse on a medical-surgical unit receives report on four clients. Which client should the nurse
assess first?
A. A client with osteoarthritis requesting pain medication.
B. A client with congestive heart failure who gained 2 kg overnight and has a productive cough.
C. A client 2 days post-appendectomy who reports incisional pain at a level of 4/10.
D. A client with gastroenteritis requesting a diet of clear liquids. ✓ CORRECT
Correct Answer: B
Rationale: Rapid weight gain and a productive cough in a heart failure client suggest fluid
volume overload and potential pulmonary edema, requiring immediate intervention. The other
clients have stable or expected requests that do not take precedence over this physiological crisis.
Question 3 of 180
A home health nurse is caring for a client who is on contact precautions for an infected surgical
wound. Which action by the client indicates a need for further teaching?
A. The client keeps the dressing supplies in a separate drawer.
B. The client washes hands with soap and water before changing the dressing.
C. The client places the soiled dressing in a plastic bag and ties it tightly.
D. The client removes gloves and then washes hands before touching the clean supplies. ✓
CORRECT
,3
Correct Answer: C
Rationale: While bagging soiled dressings is correct, the standard for home disposal is usually
placing the bag in a regular trash bin unless local regulations require biohazard disposal;
however, the critical error often cited in infection control is allowing contaminated items to touch
the outside. Wait, reviewing options: All are actually fairly standard. The best error to catch in
home care is usually related to hand hygiene sequence or separation of clean/dirty. Actually, let's
re-evaluate B. Washing hands before dressing change is correct. C is correct for containment. A
is correct for organization. D is correct order. Let's look closer. A, B, D are perfect. C is also
standard, but perhaps the most critical "teaching" point in exams is often about double bagging
or taking it out immediately. Let's adjust the question to ensure a clear error.
Self-Correction for output generation: I will ensure the choices have a clear error in the actual
output.
Actual Output Choice A: "The client washes the wound with tap water and peroxide." (Peroxice
is cytotoxic).
Actual Output Choice B: "The client wears gloves when removing the old dressing."
Actual Output Choice C: "The client disposes of the old dressing in the kitchen trash can."
(Cross-contamination).
Actual Output Choice D: "The client cleans the work surface with alcohol after the procedure."
Correct Answer: C.
Rationale: Disposing of infectious waste in the kitchen creates a cross-contamination risk for
food preparation areas. Dressings should be bagged and disposed of in a specific manner, away
from food areas.
Question 4 of 180
A nurse is preparing to administer a unit of packed red blood cells. The client states, "I don't
want that blood; my religion forbids it." What is the nurse's priority action?
A. Explain to the client that they will die without the transfusion.
B. Ask the client to sign an against medical advice (AMA) form immediately.
C. Respect the client's refusal and notify the healthcare provider.
D. Call the hospital chaplain to persuade the client to accept the transfusion. ✓ CORRECT
, 4
Correct Answer: C
Rationale: The nurse must respect the client's autonomy and right to refuse treatment, regardless
of the consequences, and notify the provider to discuss alternatives. Persuading or coercing the
client violates their ethical rights.
Question 5 of 180
A nurse is caring for a client who has a chest tube connected to a water-seal drainage system. The
nurse observes continuous bubbling in the water-seal chamber. What action should the nurse
take?
A. Check the tubing for any loose connections.
B. Increase the suction to promote drainage.
C. Document the finding as an expected observation.
D. Strip the chest tube to remove clots. ✓ CORRECT
Correct Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, which is often
caused by a loose connection in the system. Stripping the chest tube is dangerous and can cause
lung damage, while increasing suction will not fix an external leak.
Question 6 of 180
During a disaster drill, the nurse is performing triage. Which client should be tagged as "black"
(expectant)?
A. A client with a fractured femur and a pedal pulse of 2+.
B. A client with extensive burns over 80% of the body and inhalation injury.
C. A client with a penetrating chest wound and labored breathing.
D. A client with an open head injury and a Glasgow Coma Scale of 8. ✓ CORRECT
