ATI RN COMPREHENSIVE EXIT EXAM RETAKE 2026
LATEST RELIABLE STUDY GUIDE; QUESTIONS, ANSWERS AN, Exams of
Nursing
Questions
1. A nurse on a medical-surgical unit is caring for a client with a new ileostomy. Which
assessment finding requires immediate intervention?
• A. The stoma is dark purple.
• B. The stoma is edematous and pink.
• C. The effluent is liquid green-yellow.
• D. The peristomal skin has mild erythema.
Answer: A. The stoma is dark purple.
Rationale: A dark purple or black stoma indicates ischemia/necrosis and requires
immediate surgical evaluation. A new stoma is normally pink to red and may be
edematous. Liquid effluent is expected for an ileostomy. Mild erythema is common
initially.
2. A charge nurse is assigning client care. Which client should be assigned to
an RN rather than a licensed practical nurse (LPN)?
• A. A client with diabetes mellitus requiring a fingerstick glucose check.
• B. A client with a new tracheostomy requiring initial tracheostomy care teaching.
• C. A client with an indwelling urinary catheter needing routine perineal care.
• D. A client with a stable gastrostomy tube requiring a tube feeding.
Answer: B. A client with a new tracheostomy requiring initial tracheostomy care
teaching.
Rationale: Initial client teaching and discharge planning are complex nursing actions
,that require the RN’s scope of practice. LPNs can perform stable, routine procedures
and reinforce teaching, but not initial teaching or assessment.
3. A nurse is caring for a client with acute pancreatitis. Which laboratory finding is most
indicative of this condition?
• A. Elevated serum lipase
• B. Decreased serum amylase
• C. Elevated serum calcium
• D. Decreased white blood cell count
Answer: A. Elevated serum lipase
Rationale: Lipase is more specific and remains elevated longer than amylase in
acute pancreatitis. Amylase is also elevated. Calcium may be low (hypocalcemia) due to
fat saponification. WBC count is typically elevated.
4. A nurse on a telemetry unit notes a client’s cardiac monitor shows ventricular
fibrillation. The client is unresponsive and pulseless. Which action should the nurse
take first?
• A. Defibrillate
• B. Administer epinephrine
• C. Start chest compressions
• D. Establish IV access
Answer: A. Defibrillate
Rationale: For pulseless ventricular fibrillation, the priority is immediate
defibrillation after confirming the rhythm and unresponsiveness. High-quality CPR
should be started immediately after shock or while the defibrillator charges, but the
2020 AHA guidelines emphasize early defibrillation.
,5. A nurse is reinforcing discharge teaching to a client with heart failure about daily
weights. Which statement indicates understanding?
• A. “I will weigh myself after breakfast and before voiding.”
• B. “I should wear different clothes each time to get an accurate weight.”
• C. “A weight gain of 2 to 3 pounds in a day is expected.”
• D. “I will weigh myself at the same time each morning, after voiding, before
eating.”
Answer: D. “I will weigh myself at the same time each morning, after voiding,
before eating.”
Rationale: Consistent timing, same scale, same clothing (or none), after voiding, before
eating provides the most accurate daily weight. A gain of 2–3 lbs in a day or 5 lbs in a
week should be reported.
6. A nurse is caring for a client receiving a blood transfusion. Fifteen minutes after
initiation, the client reports chills and low back pain. After stopping the transfusion, what
is the nurse’s priority action?
• A. Send the blood bag and tubing to the blood bank.
• B. Obtain a urine sample.
• C. Infuse normal saline through new tubing.
• D. Administer acetaminophen.
Answer: C. Infuse normal saline through new tubing.
Rationale: After stopping the transfusion, the nurse must keep the IV line open
with normal saline using new tubing to maintain access and prevent further
transfusion of the blood product. Then notify the provider, obtain urine, and send blood
products for investigation.
7. A nurse is planning care for a client with major depressive disorder who is started
on phenelzine, an MAOI. Which of the following foods should be removed from the
client’s meal tray?
• A. Broiled chicken breast
, • B. Cheddar cheese
• C. White rice
• D. Applesauce
Answer: B. Cheddar cheese
Rationale: MAOIs (phenelzine, tranylcypromine) require a low-tyramine diet. Aged
cheeses (cheddar, Swiss, blue) are high in tyramine and can cause hypertensive crisis.
Other high-tyramine foods: cured meats, fermented products, soy sauce, avocado, and
tap beer.
8. A nurse is caring for a client with cirrhosis who becomes confused and has asterixis
(liver flap). Which of the following interventions should the nurse anticipate?
• A. Lactulose
• B. Spironolactone
• C. Octreotide
• D. Vitamin K
Answer: A. Lactulose
Rationale: Asterixis and confusion indicate hepatic encephalopathy from elevated
ammonia. Lactulose reduces ammonia by acidifying the colon and promoting excretion.
Spironolactone is for ascites. Octreotide for variceal bleeding. Vitamin K for
coagulopathy.
9. A nurse is assessing a client who is 34 weeks pregnant and reports a sudden gush of
fluid from the vagina. The fluid is green-tinged. Which of the following actions should
the nurse take first?
• A. Assess the fetal heart rate.
• B. Perform a sterile vaginal exam.
• C. Notify the provider immediately.
• D. Administer oxygen to the client.
Answer: A. Assess the fetal heart rate.
Rationale: Green-tinged fluid indicates meconium-stained amniotic fluid, which can
LATEST RELIABLE STUDY GUIDE; QUESTIONS, ANSWERS AN, Exams of
Nursing
Questions
1. A nurse on a medical-surgical unit is caring for a client with a new ileostomy. Which
assessment finding requires immediate intervention?
• A. The stoma is dark purple.
• B. The stoma is edematous and pink.
• C. The effluent is liquid green-yellow.
• D. The peristomal skin has mild erythema.
Answer: A. The stoma is dark purple.
Rationale: A dark purple or black stoma indicates ischemia/necrosis and requires
immediate surgical evaluation. A new stoma is normally pink to red and may be
edematous. Liquid effluent is expected for an ileostomy. Mild erythema is common
initially.
2. A charge nurse is assigning client care. Which client should be assigned to
an RN rather than a licensed practical nurse (LPN)?
• A. A client with diabetes mellitus requiring a fingerstick glucose check.
• B. A client with a new tracheostomy requiring initial tracheostomy care teaching.
• C. A client with an indwelling urinary catheter needing routine perineal care.
• D. A client with a stable gastrostomy tube requiring a tube feeding.
Answer: B. A client with a new tracheostomy requiring initial tracheostomy care
teaching.
Rationale: Initial client teaching and discharge planning are complex nursing actions
,that require the RN’s scope of practice. LPNs can perform stable, routine procedures
and reinforce teaching, but not initial teaching or assessment.
3. A nurse is caring for a client with acute pancreatitis. Which laboratory finding is most
indicative of this condition?
• A. Elevated serum lipase
• B. Decreased serum amylase
• C. Elevated serum calcium
• D. Decreased white blood cell count
Answer: A. Elevated serum lipase
Rationale: Lipase is more specific and remains elevated longer than amylase in
acute pancreatitis. Amylase is also elevated. Calcium may be low (hypocalcemia) due to
fat saponification. WBC count is typically elevated.
4. A nurse on a telemetry unit notes a client’s cardiac monitor shows ventricular
fibrillation. The client is unresponsive and pulseless. Which action should the nurse
take first?
• A. Defibrillate
• B. Administer epinephrine
• C. Start chest compressions
• D. Establish IV access
Answer: A. Defibrillate
Rationale: For pulseless ventricular fibrillation, the priority is immediate
defibrillation after confirming the rhythm and unresponsiveness. High-quality CPR
should be started immediately after shock or while the defibrillator charges, but the
2020 AHA guidelines emphasize early defibrillation.
,5. A nurse is reinforcing discharge teaching to a client with heart failure about daily
weights. Which statement indicates understanding?
• A. “I will weigh myself after breakfast and before voiding.”
• B. “I should wear different clothes each time to get an accurate weight.”
• C. “A weight gain of 2 to 3 pounds in a day is expected.”
• D. “I will weigh myself at the same time each morning, after voiding, before
eating.”
Answer: D. “I will weigh myself at the same time each morning, after voiding,
before eating.”
Rationale: Consistent timing, same scale, same clothing (or none), after voiding, before
eating provides the most accurate daily weight. A gain of 2–3 lbs in a day or 5 lbs in a
week should be reported.
6. A nurse is caring for a client receiving a blood transfusion. Fifteen minutes after
initiation, the client reports chills and low back pain. After stopping the transfusion, what
is the nurse’s priority action?
• A. Send the blood bag and tubing to the blood bank.
• B. Obtain a urine sample.
• C. Infuse normal saline through new tubing.
• D. Administer acetaminophen.
Answer: C. Infuse normal saline through new tubing.
Rationale: After stopping the transfusion, the nurse must keep the IV line open
with normal saline using new tubing to maintain access and prevent further
transfusion of the blood product. Then notify the provider, obtain urine, and send blood
products for investigation.
7. A nurse is planning care for a client with major depressive disorder who is started
on phenelzine, an MAOI. Which of the following foods should be removed from the
client’s meal tray?
• A. Broiled chicken breast
, • B. Cheddar cheese
• C. White rice
• D. Applesauce
Answer: B. Cheddar cheese
Rationale: MAOIs (phenelzine, tranylcypromine) require a low-tyramine diet. Aged
cheeses (cheddar, Swiss, blue) are high in tyramine and can cause hypertensive crisis.
Other high-tyramine foods: cured meats, fermented products, soy sauce, avocado, and
tap beer.
8. A nurse is caring for a client with cirrhosis who becomes confused and has asterixis
(liver flap). Which of the following interventions should the nurse anticipate?
• A. Lactulose
• B. Spironolactone
• C. Octreotide
• D. Vitamin K
Answer: A. Lactulose
Rationale: Asterixis and confusion indicate hepatic encephalopathy from elevated
ammonia. Lactulose reduces ammonia by acidifying the colon and promoting excretion.
Spironolactone is for ascites. Octreotide for variceal bleeding. Vitamin K for
coagulopathy.
9. A nurse is assessing a client who is 34 weeks pregnant and reports a sudden gush of
fluid from the vagina. The fluid is green-tinged. Which of the following actions should
the nurse take first?
• A. Assess the fetal heart rate.
• B. Perform a sterile vaginal exam.
• C. Notify the provider immediately.
• D. Administer oxygen to the client.
Answer: A. Assess the fetal heart rate.
Rationale: Green-tinged fluid indicates meconium-stained amniotic fluid, which can
