NEXT GEN ATI RN Comprehensive Predictor Exit
Exam Level 3 2026 Newest Proctored Exit Exam |
Real Screenshot-Based Questions and Correct
Answers — Pass on First Attempt
Question 1 of 180
A nurse is caring for a client who has a new diagnosis of hypertension. Which of the
following lifestyle modifications should the nurse recommend first?
A. Reduce dietary sodium intake
B. Begin a daily aerobic exercise program
C. Limit alcohol consumption to 2 drinks per day
D. Stop smoking tobacco
✓ A. Reduce dietary sodium intake
Detailed Rationale:
Why A is correct: Sodium restriction directly reduces blood volume and vascular
resistance, lowering blood pressure within weeks. It is the most immediate and
effective first-line lifestyle intervention for hypertension.
Why B is incorrect: Aerobic exercise is beneficial but takes weeks to months to show
significant blood pressure reduction. It is important but not the first
recommendation.
Why C is incorrect: Limiting alcohol to 1–2 drinks per day can lower blood pressure,
but this is a secondary intervention after sodium reduction.
Why D is incorrect: Smoking cessation is critical for cardiovascular health, but its
primary benefit is reducing heart disease and cancer risk, not directly lowering blood
pressure as quickly as sodium restriction.
Question 2 of 180
A nurse is assessing a client who is receiving a continuous morphine infusion. The
client's respiratory rate is 8/min. Which of the following medications should the
nurse anticipate administering?
, A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
✓ A. Naloxone
Detailed Rationale:
Why A is correct: Naloxone is an opioid antagonist that rapidly reverses opioid-
induced respiratory depression by competing for opioid receptors in the central
nervous system.
Why B is incorrect: Flumazenil reverses benzodiazepines (e.g., diazepam,
lorazepam), not opioids.
Why C is incorrect: Acetylcysteine is used for acetaminophen (Tylenol) overdose to
prevent hepatotoxicity.
Why D is incorrect: Protamine sulfate reverses heparin, not opioids.
Question 3 of 180
A nurse is providing discharge teaching to a client who has a new prescription for a
metered-dose inhaler (MDI) containing a corticosteroid. Which of the following
instructions should the nurse include?
A. "Use the inhaler immediately before exercise."
B. "Rinse your mouth with water after each use."
C. "Shake the inhaler vigorously for 30 seconds."
D. "Store the inhaler in the refrigerator."
✓ B. "Rinse your mouth with water after each use."
Detailed Rationale:
Why B is correct: Corticosteroid inhalers (e.g., fluticasone, budesonide) can cause
oral candidiasis (thrush). Rinsing the mouth removes residual medication from the
oral mucosa, preventing fungal overgrowth.
Why A is incorrect: Corticosteroids are maintenance medications used daily to
reduce airway inflammation, not rescue inhalers. Albuterol (short-acting beta-
agonist) is used before exercise for bronchospasm prevention.
Why C is incorrect: Shaking is recommended for albuterol MDIs to mix the
suspension, but not necessary for many corticosteroid MDIs. Even when shaking is
indicated, 30 seconds is excessive (a few seconds is sufficient).
, Why D is incorrect: Corticosteroid inhalers should be stored at room temperature.
Refrigeration can damage the canister and affect medication delivery.
Question 4 of 180
A nurse is caring for a client who has a new diagnosis of chronic obstructive
pulmonary disease (COPD). Which of the following findings should the nurse expect?
A. Increased anteroposterior chest diameter
B. Decreased residual lung volume
C. Normal breath sounds throughout
D. Weight gain due to fluid retention
✓ A. Increased anteroposterior chest diameter
Detailed Rationale:
Why A is correct: COPD causes air trapping and hyperinflation of the lungs, leading
to a barrel chest (increased anteroposterior diameter). The ribs become more
horizontal, and the chest appears rounded.
Why B is incorrect: Residual volume (air remaining in the lungs after maximal
exhalation) is increased in COPD due to air trapping, not decreased.
Why C is incorrect: Breath sounds in COPD are typically diminished or distant due to
hyperinflation and reduced air movement. Wheezing may also be present.
Why D is incorrect: Weight loss (not gain) is common in advanced COPD due to
increased work of breathing, decreased appetite, and systemic inflammation.
Question 5 of 180
A nurse is preparing to insert an indwelling urinary catheter for a male client. Which
of the following actions should the nurse take?
A. Cleanse the meatus in a circular motion from the base toward the tip.
B. Insert the catheter 7–10 cm (3–4 inches) until urine flows.
C. Use sterile technique throughout the procedure.
D. Inflate the balloon before inserting the catheter.
✓ C. Use sterile technique throughout the procedure.
Detailed Rationale:
, Why C is correct: Sterile technique (sterile gloves, sterile drapes, sterile catheter and
supplies) is essential to prevent catheter-associated urinary tract infection (CAUTI).
Why A is incorrect: The meatus should be cleansed from the tip outward toward the
base (not base to tip) to avoid introducing bacteria from the perineum into the
urethra. Circular motion is used, but direction matters.
Why B is incorrect: For a male client, the catheter should be inserted 17–22 cm (7–9
inches) until urine flows, because the male urethra is longer (approximately 20 cm).
Inserting only 7–10 cm would not reach the bladder.
Why D is incorrect: The balloon must never be inflated before the catheter is fully
inserted into the bladder. Inflating in the urethra causes trauma, pain, and bleeding.
Question 6 of 180
A nurse is assessing a client who has a sodium level of 155 mEq/L. Which of the
following findings should the nurse expect?
A. Dry mucous membranes
B. Positive Chvostek's sign
C. Muscle cramps
D. Bradycardia
✓ A. Dry mucous membranes
Detailed Rationale:
Why A is correct: A sodium level of 155 mEq/L indicates hypernatremia (normal
135–145). Hypernatremia causes cellular dehydration due to high serum osmolality,
leading to dry mucous membranes (mouth, lips, eyes), intense thirst, and lethargy.
Why B is incorrect: Positive Chvostek's sign (facial twitching when tapping the cheek
over the facial nerve) indicates hypocalcemia, not hypernatremia.
Why C is incorrect: Muscle cramps are more common in hyponatremia (low sodium)
or hypocalcemia. Hypernatremia typically causes neurological symptoms (confusion,
seizures) rather than cramps.
Why D is incorrect: Tachycardia (not bradycardia) occurs in hypernatremia due to
hypovolemia (decreased blood volume). Bradycardia is not associated with
hypernatremia.
Question 7 of 180
Exam Level 3 2026 Newest Proctored Exit Exam |
Real Screenshot-Based Questions and Correct
Answers — Pass on First Attempt
Question 1 of 180
A nurse is caring for a client who has a new diagnosis of hypertension. Which of the
following lifestyle modifications should the nurse recommend first?
A. Reduce dietary sodium intake
B. Begin a daily aerobic exercise program
C. Limit alcohol consumption to 2 drinks per day
D. Stop smoking tobacco
✓ A. Reduce dietary sodium intake
Detailed Rationale:
Why A is correct: Sodium restriction directly reduces blood volume and vascular
resistance, lowering blood pressure within weeks. It is the most immediate and
effective first-line lifestyle intervention for hypertension.
Why B is incorrect: Aerobic exercise is beneficial but takes weeks to months to show
significant blood pressure reduction. It is important but not the first
recommendation.
Why C is incorrect: Limiting alcohol to 1–2 drinks per day can lower blood pressure,
but this is a secondary intervention after sodium reduction.
Why D is incorrect: Smoking cessation is critical for cardiovascular health, but its
primary benefit is reducing heart disease and cancer risk, not directly lowering blood
pressure as quickly as sodium restriction.
Question 2 of 180
A nurse is assessing a client who is receiving a continuous morphine infusion. The
client's respiratory rate is 8/min. Which of the following medications should the
nurse anticipate administering?
, A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
✓ A. Naloxone
Detailed Rationale:
Why A is correct: Naloxone is an opioid antagonist that rapidly reverses opioid-
induced respiratory depression by competing for opioid receptors in the central
nervous system.
Why B is incorrect: Flumazenil reverses benzodiazepines (e.g., diazepam,
lorazepam), not opioids.
Why C is incorrect: Acetylcysteine is used for acetaminophen (Tylenol) overdose to
prevent hepatotoxicity.
Why D is incorrect: Protamine sulfate reverses heparin, not opioids.
Question 3 of 180
A nurse is providing discharge teaching to a client who has a new prescription for a
metered-dose inhaler (MDI) containing a corticosteroid. Which of the following
instructions should the nurse include?
A. "Use the inhaler immediately before exercise."
B. "Rinse your mouth with water after each use."
C. "Shake the inhaler vigorously for 30 seconds."
D. "Store the inhaler in the refrigerator."
✓ B. "Rinse your mouth with water after each use."
Detailed Rationale:
Why B is correct: Corticosteroid inhalers (e.g., fluticasone, budesonide) can cause
oral candidiasis (thrush). Rinsing the mouth removes residual medication from the
oral mucosa, preventing fungal overgrowth.
Why A is incorrect: Corticosteroids are maintenance medications used daily to
reduce airway inflammation, not rescue inhalers. Albuterol (short-acting beta-
agonist) is used before exercise for bronchospasm prevention.
Why C is incorrect: Shaking is recommended for albuterol MDIs to mix the
suspension, but not necessary for many corticosteroid MDIs. Even when shaking is
indicated, 30 seconds is excessive (a few seconds is sufficient).
, Why D is incorrect: Corticosteroid inhalers should be stored at room temperature.
Refrigeration can damage the canister and affect medication delivery.
Question 4 of 180
A nurse is caring for a client who has a new diagnosis of chronic obstructive
pulmonary disease (COPD). Which of the following findings should the nurse expect?
A. Increased anteroposterior chest diameter
B. Decreased residual lung volume
C. Normal breath sounds throughout
D. Weight gain due to fluid retention
✓ A. Increased anteroposterior chest diameter
Detailed Rationale:
Why A is correct: COPD causes air trapping and hyperinflation of the lungs, leading
to a barrel chest (increased anteroposterior diameter). The ribs become more
horizontal, and the chest appears rounded.
Why B is incorrect: Residual volume (air remaining in the lungs after maximal
exhalation) is increased in COPD due to air trapping, not decreased.
Why C is incorrect: Breath sounds in COPD are typically diminished or distant due to
hyperinflation and reduced air movement. Wheezing may also be present.
Why D is incorrect: Weight loss (not gain) is common in advanced COPD due to
increased work of breathing, decreased appetite, and systemic inflammation.
Question 5 of 180
A nurse is preparing to insert an indwelling urinary catheter for a male client. Which
of the following actions should the nurse take?
A. Cleanse the meatus in a circular motion from the base toward the tip.
B. Insert the catheter 7–10 cm (3–4 inches) until urine flows.
C. Use sterile technique throughout the procedure.
D. Inflate the balloon before inserting the catheter.
✓ C. Use sterile technique throughout the procedure.
Detailed Rationale:
, Why C is correct: Sterile technique (sterile gloves, sterile drapes, sterile catheter and
supplies) is essential to prevent catheter-associated urinary tract infection (CAUTI).
Why A is incorrect: The meatus should be cleansed from the tip outward toward the
base (not base to tip) to avoid introducing bacteria from the perineum into the
urethra. Circular motion is used, but direction matters.
Why B is incorrect: For a male client, the catheter should be inserted 17–22 cm (7–9
inches) until urine flows, because the male urethra is longer (approximately 20 cm).
Inserting only 7–10 cm would not reach the bladder.
Why D is incorrect: The balloon must never be inflated before the catheter is fully
inserted into the bladder. Inflating in the urethra causes trauma, pain, and bleeding.
Question 6 of 180
A nurse is assessing a client who has a sodium level of 155 mEq/L. Which of the
following findings should the nurse expect?
A. Dry mucous membranes
B. Positive Chvostek's sign
C. Muscle cramps
D. Bradycardia
✓ A. Dry mucous membranes
Detailed Rationale:
Why A is correct: A sodium level of 155 mEq/L indicates hypernatremia (normal
135–145). Hypernatremia causes cellular dehydration due to high serum osmolality,
leading to dry mucous membranes (mouth, lips, eyes), intense thirst, and lethargy.
Why B is incorrect: Positive Chvostek's sign (facial twitching when tapping the cheek
over the facial nerve) indicates hypocalcemia, not hypernatremia.
Why C is incorrect: Muscle cramps are more common in hyponatremia (low sodium)
or hypocalcemia. Hypernatremia typically causes neurological symptoms (confusion,
seizures) rather than cramps.
Why D is incorrect: Tachycardia (not bradycardia) occurs in hypernatremia due to
hypovolemia (decreased blood volume). Bradycardia is not associated with
hypernatremia.
Question 7 of 180
