ATI COMPREHENSIVE EXIT EXAM REVIEW | NEXT
GEN NCLEX TEST BANK VERSIONS 1-4 | 720 TOTAL
QUESTIONS & RATIONALES
This ultimate Next Generation NCLEX (NGN) prep guide
features 180 high-yield, practice test bank questions
across multiple exam versions to mirror the actual ATI
Comprehensive Exit Exam experience. Each question
delivers robust medical-surgical, pharmacological, and
pediatric clinical scenarios paired with clear answer keys
and in-depth rationales designed to sharpen your nursing
clinical judgment.
Q1. A nurse is reviewing the electronic health
record of a client prescribed lithium carbonate for
bipolar disorder. Which laboratory value should the
nurse report to the provider immediately?
A. Serum lithium level 0.8 mEq/L
B. Sodium level 128 mEq/L
C. Potassium level 3.6 mEq/L
D. White blood cell count 6,500/mm³
Answer: B. Sodium level 128 mEq/L
Rationale: Lithium is a salt that is chemically
similar to sodium. When a client's sodium level
drops below normal (hyponatremia), the
, kidneys retain lithium in an attempt to maintain
electrolyte balance. This significantly increases
the risk of severe lithium toxicity. Option A is
within the therapeutic range (0.6–1.2 mEq/L).
Options C and D are normal physiological
values.
Q2. A nurse in the emergency department is caring
for a client presenting with an acute myocardial
infarction. Which intervention should the nurse
perform first?
A. Obtain a 12-lead electrocardiogram (ECG)
B. Administer morphine sulfate 2 mg
intravenously
C. Draw blood samples for cardiac troponin
levels
D. Initiate oxygen therapy via nasal cannula at 2
L/min
Answer: A. Obtain a 12-lead electrocardiogram
(ECG)
Rationale: When a client presents with
suspected acute coronary syndrome, a 12-lead
ECG must be obtained and interpreted within 10
, minutes of arrival to differentiate between a
STEMI and a NSTEMI. This drives the entire
medical trajectory, including reperfusion
therapy. While oxygen, pain management, and
labs are important, the diagnostic ECG takes
immediate priority.
Q3. A nurse is caring for a client who is 12 hours
postoperative following a total thyroidectomy. The
client reports a tingling sensation around their
mouth and fingers. Which action should the nurse
take first?
A. Check the client's surgical dressing for
hemorrhage.
B. Administer an oral calcium carbonate
supplement.
C. Assess for Chvostek's sign or Trousseau's
sign.
D. Document the findings in the client's medical
record.
Answer: C. Assess for Chvostek's sign or
Trousseau's sign.
, Rationale: Perioral and digital tingling are
classic signs of hypocalcemia, a major risk
following a thyroidectomy if the parathyroid
glands are accidentally damaged or removed.
The nurse must immediately assess for
neuromuscular irritability using Chvostek's or
Trousseau's sign to confirm hypocalcemia
before obtaining an order for IV calcium
gluconate.
Q4. A client with chronic kidney disease (CKD) is
scheduled for an outpatient hemodialysis session in
two hours. The nurse notes the client's morning
medications include atenolol, furosemide, and
captopril. What is the appropriate nursing action?
A. Administer all medications as scheduled to
maintain blood pressure control.
B. Hold all antihypertensive medications until
after the hemodialysis session.
C. Give the furosemide but hold the atenolol and
captopril.
D. Crushing the medications and administering
them with applesauce.
GEN NCLEX TEST BANK VERSIONS 1-4 | 720 TOTAL
QUESTIONS & RATIONALES
This ultimate Next Generation NCLEX (NGN) prep guide
features 180 high-yield, practice test bank questions
across multiple exam versions to mirror the actual ATI
Comprehensive Exit Exam experience. Each question
delivers robust medical-surgical, pharmacological, and
pediatric clinical scenarios paired with clear answer keys
and in-depth rationales designed to sharpen your nursing
clinical judgment.
Q1. A nurse is reviewing the electronic health
record of a client prescribed lithium carbonate for
bipolar disorder. Which laboratory value should the
nurse report to the provider immediately?
A. Serum lithium level 0.8 mEq/L
B. Sodium level 128 mEq/L
C. Potassium level 3.6 mEq/L
D. White blood cell count 6,500/mm³
Answer: B. Sodium level 128 mEq/L
Rationale: Lithium is a salt that is chemically
similar to sodium. When a client's sodium level
drops below normal (hyponatremia), the
, kidneys retain lithium in an attempt to maintain
electrolyte balance. This significantly increases
the risk of severe lithium toxicity. Option A is
within the therapeutic range (0.6–1.2 mEq/L).
Options C and D are normal physiological
values.
Q2. A nurse in the emergency department is caring
for a client presenting with an acute myocardial
infarction. Which intervention should the nurse
perform first?
A. Obtain a 12-lead electrocardiogram (ECG)
B. Administer morphine sulfate 2 mg
intravenously
C. Draw blood samples for cardiac troponin
levels
D. Initiate oxygen therapy via nasal cannula at 2
L/min
Answer: A. Obtain a 12-lead electrocardiogram
(ECG)
Rationale: When a client presents with
suspected acute coronary syndrome, a 12-lead
ECG must be obtained and interpreted within 10
, minutes of arrival to differentiate between a
STEMI and a NSTEMI. This drives the entire
medical trajectory, including reperfusion
therapy. While oxygen, pain management, and
labs are important, the diagnostic ECG takes
immediate priority.
Q3. A nurse is caring for a client who is 12 hours
postoperative following a total thyroidectomy. The
client reports a tingling sensation around their
mouth and fingers. Which action should the nurse
take first?
A. Check the client's surgical dressing for
hemorrhage.
B. Administer an oral calcium carbonate
supplement.
C. Assess for Chvostek's sign or Trousseau's
sign.
D. Document the findings in the client's medical
record.
Answer: C. Assess for Chvostek's sign or
Trousseau's sign.
, Rationale: Perioral and digital tingling are
classic signs of hypocalcemia, a major risk
following a thyroidectomy if the parathyroid
glands are accidentally damaged or removed.
The nurse must immediately assess for
neuromuscular irritability using Chvostek's or
Trousseau's sign to confirm hypocalcemia
before obtaining an order for IV calcium
gluconate.
Q4. A client with chronic kidney disease (CKD) is
scheduled for an outpatient hemodialysis session in
two hours. The nurse notes the client's morning
medications include atenolol, furosemide, and
captopril. What is the appropriate nursing action?
A. Administer all medications as scheduled to
maintain blood pressure control.
B. Hold all antihypertensive medications until
after the hemodialysis session.
C. Give the furosemide but hold the atenolol and
captopril.
D. Crushing the medications and administering
them with applesauce.
