ATI PN Comprehensive Exit Exam
ATI PN Comprehensive Exit Exam 2025/2026 – NGN
Format | 180 Authentic Questions with 100% Verified
Answers & Detailed Rationales | A+ Graded
Student Name: ______________________
Date: ______________________
Time Limit: 180 minutes
Total Questions: 180
1. A nurse is caring for a client who has a prescription for a nasogastric tube insertion for
gastric decompression. Which of the following actions should the nurse take first?
A) Measure the tube from the tip of the nose to the earlobe to the xiphoid process
B) Place the client in a high-Fowler's position
C) Lubricate the tip of the tube with a water-soluble lubricant
D) Assess for bowel sounds
Correct Answer: B
Rationale: The priority action is to position the client in a high-Fowler's position to facilitate
passage of the tube and reduce the risk of aspiration. Measuring the tube, lubricating, and
assessing bowel sounds are performed after positioning.
2. A nurse is reviewing a client's medication administration record. Which of the following
medication classifications increases the risk for constipation?
A) Antihypertensives
B) Narcotic analgesics
C) Antibiotics
D) Corticosteroids
Correct Answer: B
Rationale: Narcotic analgesics (opioids) slow gastrointestinal motility, leading to constipation.
Antihypertensives, antibiotics, and corticosteroids are not typically associated with
constipation as a primary adverse effect.
3. A nurse is assessing a client who has heart failure. The client reports shortness of breath
and a weight gain of 2.2 kg (5 lb) in 2 days. Which of the following actions should the nurse
take first?
, ATI PN Comprehensive Exit Exam
A) Administer furosemide as prescribed
B) Auscultate the client's breath sounds
C) Place the client in high-Fowler's position
D) Restrict the client's oral fluid intake
Correct Answer: C
Rationale: The priority action is to place the client in high-Fowler's position to use gravity to
reduce preload and improve ventilation. After positioning, the nurse should auscultate breath
sounds and then administer furosemide as prescribed.
4. A nurse is providing discharge teaching to a client who has a new prescription for warfarin.
Which of the following statements by the client indicates a need for further teaching?
A) "I will use an electric razor to shave."
B) "I will eat the same amount of green leafy vegetables each week."
C) "I will take ibuprofen if I have a headache."
D) "I will have my blood drawn regularly as scheduled."
Correct Answer: C
Rationale: Ibuprofen is an NSAID that increases bleeding risk and should be avoided while
taking warfarin. Acetaminophen is safer for pain relief. Consistent vitamin K intake from green
leafy vegetables is correct, and regular INR monitoring is essential.
5. A nurse is assessing a client who is 2 days postoperative following a total knee arthroplasty.
Which of the following findings should the nurse report to the provider immediately?
A) Pain score of 6 on a 0-10 scale
B) Temperature of 38°C (100.4°F)
C) Oxygen saturation of 89% on room air
D) Serosanguineous drainage on the dressing
Correct Answer: C
Rationale: An oxygen saturation of 89% indicates hypoxemia and may suggest a pulmonary
embolism, a life-threatening complication after orthopedic surgery. This requires immediate
reporting. A temperature of 100.4°F, pain of 6, and serosanguineous drainage are expected
findings.
6. A nurse is providing dietary teaching to a client who is prescribed a low-sodium diet. Which
of the following foods should the nurse instruct the client to avoid?
A) Fresh fruits
B) Canned vegetables
C) Unsalted nuts
D) Fresh poultry
Correct Answer: B
Rationale: Canned vegetables are high in sodium due to added salt during processing. Fresh
fruits, unsalted nuts, and fresh poultry are low-sodium options.
7. A nurse is preparing to administer a blood transfusion to a client. Which of the following
actions should the nurse take first?
A) Verify the client's identity using two identifiers
B) Check the expiration date of the blood product
, ATI PN Comprehensive Exit Exam
C) Obtain baseline vital signs
D) Prime the IV tubing with normal saline
Correct Answer: A
Rationale: Patient safety requires verification of identity using two identifiers before any
procedure, including blood transfusion. This is the priority action to prevent transfusion
errors.
8. A nurse is caring for a client who has a new colostomy. The client expresses feelings of
disgust and anger about the stoma. Which of the following responses by the nurse is most
therapeutic?
A) "You should be grateful that this surgery saved your life."
B) "It is normal to feel this way. Tell me more about your concerns."
C) "You will get used to it in time."
D) "Would you like to speak with another client who has a colostomy?"
Correct Answer: B
Rationale: Acknowledging the client's feelings and encouraging further expression is
therapeutic. It validates the client's emotions and opens communication. Minimizing feelings
or offering false reassurance is not therapeutic.
9. A nurse is assessing a client who reports fatigue, weight gain, and cold intolerance. Which
of the following laboratory tests should the nurse anticipate?
A) Thyroid-stimulating hormone (TSH)
B) Complete blood count (CBC)
C) Serum glucose
D) Serum electrolytes
Correct Answer: A
Rationale: Fatigue, weight gain, and cold intolerance are classic symptoms of hypothyroidism.
TSH is the primary screening test for thyroid dysfunction.
10. A nurse is preparing to administer enoxaparin subcutaneously. Which of the following
actions is correct?
A) Aspirate before injecting to check for blood return
B) Administer the injection in the deltoid muscle
C) Inject the medication into the abdomen while pinching the skin
D) Massage the injection site after administration
Correct Answer: C
Rationale: Enoxaparin should be administered subcutaneously into the abdomen while
pinching the skin to ensure proper delivery into subcutaneous tissue. Aspiration is not
recommended, and massage can cause hematoma formation.
11. A nurse is assessing a client's electrocardiogram (ECG). Which of the following findings
indicates hyperkalemia?
A) Flattened T waves
B) Prominent U waves
C) Tall, peaked T waves
D) Prolonged QT interval
, ATI PN Comprehensive Exit Exam
Correct Answer: C
Rationale: Tall, peaked T waves are an early ECG sign of hyperkalemia. Flattened T waves and
prominent U waves suggest hypokalemia. Prolonged QT interval may occur with electrolyte
imbalances but is not specific to hyperkalemia.
12. A nurse is caring for a client receiving a continuous IV infusion of heparin. Which of the
following laboratory values should the nurse monitor?
A) INR
B) aPTT
C) PT
D) Platelet count
Correct Answer: B
Rationale: Heparin therapy is monitored by activated partial thromboplastin time (aPTT). INR
and PT are used to monitor warfarin therapy. Platelet count is monitored for heparin-induced
thrombocytopenia but is not the primary monitoring parameter.
13. A nurse is providing teaching to a client with a new diagnosis of diabetes mellitus. Which
of the following statements by the client indicates an understanding of hyperglycemia
symptoms?
A) "I will feel shaky and sweaty if my blood sugar is too high."
B) "I will have increased thirst and frequent urination if my blood sugar is too high."
C) "I will have blurred vision and confusion if my blood sugar is too low."
D) "I will have a fast heart rate and anxiety if my blood sugar is too high."
Correct Answer: B
Rationale: Hyperglycemia causes polyuria, polydipsia, and polyphagia. Shaky, sweaty, fast
heart rate, and anxiety are symptoms of hypoglycemia.
14. A nurse is preparing to administer IV vancomycin. Which of the following findings requires
immediate intervention?
A) Client reports flushing and rash on the face and neck
B) Client reports nausea and vomiting
C) Client reports headache
D) Client reports dizziness
Correct Answer: A
Rationale: Flushing and rash on the face and neck indicate red man syndrome, a rapid
infusion-related reaction to vancomycin. The nurse should stop the infusion and notify the
provider. Nausea, headache, and dizziness are less urgent.
15. A nurse is assessing a client with a tracheostomy. Which of the following findings should
the nurse report to the provider immediately?
A) Small amount of thick secretions
B) Skin irritation around the stoma
C) Oxygen saturation of 88% on room air
D) Client able to speak
Correct Answer: C
Rationale: Oxygen saturation of 88% indicates hypoxemia and may indicate tube obstruction
ATI PN Comprehensive Exit Exam 2025/2026 – NGN
Format | 180 Authentic Questions with 100% Verified
Answers & Detailed Rationales | A+ Graded
Student Name: ______________________
Date: ______________________
Time Limit: 180 minutes
Total Questions: 180
1. A nurse is caring for a client who has a prescription for a nasogastric tube insertion for
gastric decompression. Which of the following actions should the nurse take first?
A) Measure the tube from the tip of the nose to the earlobe to the xiphoid process
B) Place the client in a high-Fowler's position
C) Lubricate the tip of the tube with a water-soluble lubricant
D) Assess for bowel sounds
Correct Answer: B
Rationale: The priority action is to position the client in a high-Fowler's position to facilitate
passage of the tube and reduce the risk of aspiration. Measuring the tube, lubricating, and
assessing bowel sounds are performed after positioning.
2. A nurse is reviewing a client's medication administration record. Which of the following
medication classifications increases the risk for constipation?
A) Antihypertensives
B) Narcotic analgesics
C) Antibiotics
D) Corticosteroids
Correct Answer: B
Rationale: Narcotic analgesics (opioids) slow gastrointestinal motility, leading to constipation.
Antihypertensives, antibiotics, and corticosteroids are not typically associated with
constipation as a primary adverse effect.
3. A nurse is assessing a client who has heart failure. The client reports shortness of breath
and a weight gain of 2.2 kg (5 lb) in 2 days. Which of the following actions should the nurse
take first?
, ATI PN Comprehensive Exit Exam
A) Administer furosemide as prescribed
B) Auscultate the client's breath sounds
C) Place the client in high-Fowler's position
D) Restrict the client's oral fluid intake
Correct Answer: C
Rationale: The priority action is to place the client in high-Fowler's position to use gravity to
reduce preload and improve ventilation. After positioning, the nurse should auscultate breath
sounds and then administer furosemide as prescribed.
4. A nurse is providing discharge teaching to a client who has a new prescription for warfarin.
Which of the following statements by the client indicates a need for further teaching?
A) "I will use an electric razor to shave."
B) "I will eat the same amount of green leafy vegetables each week."
C) "I will take ibuprofen if I have a headache."
D) "I will have my blood drawn regularly as scheduled."
Correct Answer: C
Rationale: Ibuprofen is an NSAID that increases bleeding risk and should be avoided while
taking warfarin. Acetaminophen is safer for pain relief. Consistent vitamin K intake from green
leafy vegetables is correct, and regular INR monitoring is essential.
5. A nurse is assessing a client who is 2 days postoperative following a total knee arthroplasty.
Which of the following findings should the nurse report to the provider immediately?
A) Pain score of 6 on a 0-10 scale
B) Temperature of 38°C (100.4°F)
C) Oxygen saturation of 89% on room air
D) Serosanguineous drainage on the dressing
Correct Answer: C
Rationale: An oxygen saturation of 89% indicates hypoxemia and may suggest a pulmonary
embolism, a life-threatening complication after orthopedic surgery. This requires immediate
reporting. A temperature of 100.4°F, pain of 6, and serosanguineous drainage are expected
findings.
6. A nurse is providing dietary teaching to a client who is prescribed a low-sodium diet. Which
of the following foods should the nurse instruct the client to avoid?
A) Fresh fruits
B) Canned vegetables
C) Unsalted nuts
D) Fresh poultry
Correct Answer: B
Rationale: Canned vegetables are high in sodium due to added salt during processing. Fresh
fruits, unsalted nuts, and fresh poultry are low-sodium options.
7. A nurse is preparing to administer a blood transfusion to a client. Which of the following
actions should the nurse take first?
A) Verify the client's identity using two identifiers
B) Check the expiration date of the blood product
, ATI PN Comprehensive Exit Exam
C) Obtain baseline vital signs
D) Prime the IV tubing with normal saline
Correct Answer: A
Rationale: Patient safety requires verification of identity using two identifiers before any
procedure, including blood transfusion. This is the priority action to prevent transfusion
errors.
8. A nurse is caring for a client who has a new colostomy. The client expresses feelings of
disgust and anger about the stoma. Which of the following responses by the nurse is most
therapeutic?
A) "You should be grateful that this surgery saved your life."
B) "It is normal to feel this way. Tell me more about your concerns."
C) "You will get used to it in time."
D) "Would you like to speak with another client who has a colostomy?"
Correct Answer: B
Rationale: Acknowledging the client's feelings and encouraging further expression is
therapeutic. It validates the client's emotions and opens communication. Minimizing feelings
or offering false reassurance is not therapeutic.
9. A nurse is assessing a client who reports fatigue, weight gain, and cold intolerance. Which
of the following laboratory tests should the nurse anticipate?
A) Thyroid-stimulating hormone (TSH)
B) Complete blood count (CBC)
C) Serum glucose
D) Serum electrolytes
Correct Answer: A
Rationale: Fatigue, weight gain, and cold intolerance are classic symptoms of hypothyroidism.
TSH is the primary screening test for thyroid dysfunction.
10. A nurse is preparing to administer enoxaparin subcutaneously. Which of the following
actions is correct?
A) Aspirate before injecting to check for blood return
B) Administer the injection in the deltoid muscle
C) Inject the medication into the abdomen while pinching the skin
D) Massage the injection site after administration
Correct Answer: C
Rationale: Enoxaparin should be administered subcutaneously into the abdomen while
pinching the skin to ensure proper delivery into subcutaneous tissue. Aspiration is not
recommended, and massage can cause hematoma formation.
11. A nurse is assessing a client's electrocardiogram (ECG). Which of the following findings
indicates hyperkalemia?
A) Flattened T waves
B) Prominent U waves
C) Tall, peaked T waves
D) Prolonged QT interval
, ATI PN Comprehensive Exit Exam
Correct Answer: C
Rationale: Tall, peaked T waves are an early ECG sign of hyperkalemia. Flattened T waves and
prominent U waves suggest hypokalemia. Prolonged QT interval may occur with electrolyte
imbalances but is not specific to hyperkalemia.
12. A nurse is caring for a client receiving a continuous IV infusion of heparin. Which of the
following laboratory values should the nurse monitor?
A) INR
B) aPTT
C) PT
D) Platelet count
Correct Answer: B
Rationale: Heparin therapy is monitored by activated partial thromboplastin time (aPTT). INR
and PT are used to monitor warfarin therapy. Platelet count is monitored for heparin-induced
thrombocytopenia but is not the primary monitoring parameter.
13. A nurse is providing teaching to a client with a new diagnosis of diabetes mellitus. Which
of the following statements by the client indicates an understanding of hyperglycemia
symptoms?
A) "I will feel shaky and sweaty if my blood sugar is too high."
B) "I will have increased thirst and frequent urination if my blood sugar is too high."
C) "I will have blurred vision and confusion if my blood sugar is too low."
D) "I will have a fast heart rate and anxiety if my blood sugar is too high."
Correct Answer: B
Rationale: Hyperglycemia causes polyuria, polydipsia, and polyphagia. Shaky, sweaty, fast
heart rate, and anxiety are symptoms of hypoglycemia.
14. A nurse is preparing to administer IV vancomycin. Which of the following findings requires
immediate intervention?
A) Client reports flushing and rash on the face and neck
B) Client reports nausea and vomiting
C) Client reports headache
D) Client reports dizziness
Correct Answer: A
Rationale: Flushing and rash on the face and neck indicate red man syndrome, a rapid
infusion-related reaction to vancomycin. The nurse should stop the infusion and notify the
provider. Nausea, headache, and dizziness are less urgent.
15. A nurse is assessing a client with a tracheostomy. Which of the following findings should
the nurse report to the provider immediately?
A) Small amount of thick secretions
B) Skin irritation around the stoma
C) Oxygen saturation of 88% on room air
D) Client able to speak
Correct Answer: C
Rationale: Oxygen saturation of 88% indicates hypoxemia and may indicate tube obstruction
