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ATI COMPREHENSIVE EXIT EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
ATI Comprehensive Exit Exam
250 Questions with Detailed Rationales
Based on ATI Comprehensive Exit Exam Framework & NGN-Style Questions
SECTION 1: SAFETY AND INFECTION CONTROL (Questions 1-30)
Question 1
A nurse is preparing to administer a blood transfusion to a client. Fifteen minutes
after the transfusion begins, the client reports chills, back pain, and shortness of
breath. Which action should the nurse take first?
A) Slow the infusion rate
B) Notify the healthcare provider
C) Stop the transfusion
D) Administer diphenhydramine
Answer: C
Rationale: The client is exhibiting signs of a transfusion reaction (chills, back pain,
dyspnea). The nurse must immediately stop the transfusion, maintain IV access with
normal saline, and notify the provider. Slowing the infusion (A) would not address the
reaction; notifying the provider (B) should occur after stopping the transfusion.
Administering diphenhydramine (D) is not the priority action. For anaphylactic
reactions, epinephrine may be indicated .
Question 2
A nurse is caring for a client with active tuberculosis (TB). Which action should the
nurse take to prevent transmission of the infection?
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A) Initiate contact precautions
B) Restrict visitors from entering the room
C) Wear a surgical mask when caring for the client
D) Have the client wear a surgical mask during transport
Answer: D
Rationale: Clients with active TB should wear a surgical mask when outside of their
negative-pressure room to reduce the risk of transmitting airborne droplets to others.
Airborne precautions require an N95 respirator, not a surgical mask. Contact
precautions (A) are not appropriate for TB. Restricting visitors (B) is not standard
practice. The nurse should wear an N95 respirator, not a surgical mask .
Question 3
A nurse is preparing to administer an intramuscular injection to an adult client.
Which action is correct?
A) Use a 5/8-inch needle
B) Insert the needle at a 15-degree angle
C) Use the Z-track method for irritating medications
D) Aspirate before injecting all IM medications
Answer: C
Rationale: The Z-track method is used to prevent irritating medications from leaking
back into subcutaneous tissue. A 5/8-inch needle (A) is typically for subcutaneous
injections; IM injections require a 1-1.5 inch needle for adults. A 15-degree angle (B) is
for intradermal injections; IM injections are given at 90 degrees. Aspiration (D) is no
longer routinely recommended for IM injections by many guidelines .
Question 4
A nurse is caring for a client who is confused and attempting to pull out their IV line.
The provider orders restraints. Which action should the nurse take before applying
restraints?
A) Obtain verbal consent from the client
B) Try less restrictive measures first
C) Restrain all four extremities for safety
D) Apply restraints without documentation
Answer: B
Rationale: Restraints are a last resort. The nurse must attempt less restrictive
measures first (repositioning, sitters, diversions). Restraints require a provider order,
client/family notification, and frequent monitoring. Verbal consent (A) is insufficient;
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written consent or provider order is required. Restraining all four extremities (C) is
excessive. Documentation (D) is required .
Question 5
A nurse is receiving report on four clients. Which client should the nurse assess
first?
A) A client with an ileal conduit with mucus in the pouch
B) A client with an arteriovenous fistula with vibration palpated
C) A client with chronic kidney disease with cloudy dialysate outflow
D) A client who is 1 day postoperative following a vertebroplasty
Answer: C
Rationale: Cloudy dialysate outflow indicates peritonitis, a serious complication of
peritoneal dialysis requiring immediate intervention. Mucus in an ileal conduit (A) and
palpable vibration (B) are expected findings. A post-vertebroplasty client (D) is stable
unless there are acute complications .
Question 6
A nurse is caring for a client who just received the first dose of lisinopril. Which
intervention is most appropriate?
A) Administer with a full glass of water
B) Monitor for hyperkalemia
C) Provide standby assist when the client gets out of bed
D) Administer with food
Answer: C
Rationale: First-dose hypotension is a common adverse effect of ACE inhibitors like
lisinopril. The nurse should assist the client when changing positions to prevent falls.
Hyperkalemia (B) is a potential long-term effect but not the priority after the first dose.
Water and food administration (A, D) are not specifically indicated for lisinopril .
Question 7
A nurse is caring for a client who has a new prescription for vancomycin. The nurse
notes flushing, rash, and pruritus on the client's upper body during the infusion.
Which action should the nurse take?
A) Stop the infusion and notify the provider
B) Slow the infusion rate
C) Administer diphenhydramine
D) Document the findings and continue monitoring
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Answer: B
Rationale: Red Man Syndrome is a non-allergic reaction to rapid vancomycin infusion,
characterized by flushing, rash, and pruritus on the upper body and face. Slowing the
infusion rate is the appropriate intervention. Stopping the infusion (A) is not necessary
for this reaction. Diphenhydramine (C) may be given but is not the priority; slowing the
infusion is the primary intervention. Documentation alone (D) is insufficient .
Question 8
A nurse is delegating tasks to assistive personnel (AP). Which task should the nurse
delegate?
A) Teaching a client how to use an inhaler
B) Assessing a client's lung sounds
C) Measuring a client's intake and output
D) Evaluating the effectiveness of pain medication
Answer: C
Rationale: Measuring intake and output is a delegable task for AP. Teaching (A),
assessment (B), and evaluation (D) are nursing responsibilities that require clinical
judgment and cannot be delegated to AP. The five rights of delegation must be followed:
right task, right circumstances, right person, right direction, and right supervision .
Question 9
A nurse is preparing a client for surgery. Which action is most important to prevent
a surgical site infection?
A) Administer preoperative antibiotics as prescribed
B) Shave the surgical site the morning of surgery
C) Instruct the client to shower with antimicrobial soap
D) Ensure the client has a negative pregnancy test
Answer: A
Rationale: Administering preoperative antibiotics within 60 minutes of the incision is a
key Surgical Care Improvement Project (SCIP) measure to prevent surgical site
infections. Shaving (B) should be done with clippers, not razors, to prevent micro-
abrasions. Antimicrobial showering (C) is beneficial but not the priority. Pregnancy
testing (D) is unrelated to infection prevention .
Question 10
A nurse is caring for a client with a central line. Which assessment finding indicates
a central line-associated bloodstream infection (CLABSI)?
ATI COMPREHENSIVE EXIT EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
ATI Comprehensive Exit Exam
250 Questions with Detailed Rationales
Based on ATI Comprehensive Exit Exam Framework & NGN-Style Questions
SECTION 1: SAFETY AND INFECTION CONTROL (Questions 1-30)
Question 1
A nurse is preparing to administer a blood transfusion to a client. Fifteen minutes
after the transfusion begins, the client reports chills, back pain, and shortness of
breath. Which action should the nurse take first?
A) Slow the infusion rate
B) Notify the healthcare provider
C) Stop the transfusion
D) Administer diphenhydramine
Answer: C
Rationale: The client is exhibiting signs of a transfusion reaction (chills, back pain,
dyspnea). The nurse must immediately stop the transfusion, maintain IV access with
normal saline, and notify the provider. Slowing the infusion (A) would not address the
reaction; notifying the provider (B) should occur after stopping the transfusion.
Administering diphenhydramine (D) is not the priority action. For anaphylactic
reactions, epinephrine may be indicated .
Question 2
A nurse is caring for a client with active tuberculosis (TB). Which action should the
nurse take to prevent transmission of the infection?
, Page 2 of 90
A) Initiate contact precautions
B) Restrict visitors from entering the room
C) Wear a surgical mask when caring for the client
D) Have the client wear a surgical mask during transport
Answer: D
Rationale: Clients with active TB should wear a surgical mask when outside of their
negative-pressure room to reduce the risk of transmitting airborne droplets to others.
Airborne precautions require an N95 respirator, not a surgical mask. Contact
precautions (A) are not appropriate for TB. Restricting visitors (B) is not standard
practice. The nurse should wear an N95 respirator, not a surgical mask .
Question 3
A nurse is preparing to administer an intramuscular injection to an adult client.
Which action is correct?
A) Use a 5/8-inch needle
B) Insert the needle at a 15-degree angle
C) Use the Z-track method for irritating medications
D) Aspirate before injecting all IM medications
Answer: C
Rationale: The Z-track method is used to prevent irritating medications from leaking
back into subcutaneous tissue. A 5/8-inch needle (A) is typically for subcutaneous
injections; IM injections require a 1-1.5 inch needle for adults. A 15-degree angle (B) is
for intradermal injections; IM injections are given at 90 degrees. Aspiration (D) is no
longer routinely recommended for IM injections by many guidelines .
Question 4
A nurse is caring for a client who is confused and attempting to pull out their IV line.
The provider orders restraints. Which action should the nurse take before applying
restraints?
A) Obtain verbal consent from the client
B) Try less restrictive measures first
C) Restrain all four extremities for safety
D) Apply restraints without documentation
Answer: B
Rationale: Restraints are a last resort. The nurse must attempt less restrictive
measures first (repositioning, sitters, diversions). Restraints require a provider order,
client/family notification, and frequent monitoring. Verbal consent (A) is insufficient;
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written consent or provider order is required. Restraining all four extremities (C) is
excessive. Documentation (D) is required .
Question 5
A nurse is receiving report on four clients. Which client should the nurse assess
first?
A) A client with an ileal conduit with mucus in the pouch
B) A client with an arteriovenous fistula with vibration palpated
C) A client with chronic kidney disease with cloudy dialysate outflow
D) A client who is 1 day postoperative following a vertebroplasty
Answer: C
Rationale: Cloudy dialysate outflow indicates peritonitis, a serious complication of
peritoneal dialysis requiring immediate intervention. Mucus in an ileal conduit (A) and
palpable vibration (B) are expected findings. A post-vertebroplasty client (D) is stable
unless there are acute complications .
Question 6
A nurse is caring for a client who just received the first dose of lisinopril. Which
intervention is most appropriate?
A) Administer with a full glass of water
B) Monitor for hyperkalemia
C) Provide standby assist when the client gets out of bed
D) Administer with food
Answer: C
Rationale: First-dose hypotension is a common adverse effect of ACE inhibitors like
lisinopril. The nurse should assist the client when changing positions to prevent falls.
Hyperkalemia (B) is a potential long-term effect but not the priority after the first dose.
Water and food administration (A, D) are not specifically indicated for lisinopril .
Question 7
A nurse is caring for a client who has a new prescription for vancomycin. The nurse
notes flushing, rash, and pruritus on the client's upper body during the infusion.
Which action should the nurse take?
A) Stop the infusion and notify the provider
B) Slow the infusion rate
C) Administer diphenhydramine
D) Document the findings and continue monitoring
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Answer: B
Rationale: Red Man Syndrome is a non-allergic reaction to rapid vancomycin infusion,
characterized by flushing, rash, and pruritus on the upper body and face. Slowing the
infusion rate is the appropriate intervention. Stopping the infusion (A) is not necessary
for this reaction. Diphenhydramine (C) may be given but is not the priority; slowing the
infusion is the primary intervention. Documentation alone (D) is insufficient .
Question 8
A nurse is delegating tasks to assistive personnel (AP). Which task should the nurse
delegate?
A) Teaching a client how to use an inhaler
B) Assessing a client's lung sounds
C) Measuring a client's intake and output
D) Evaluating the effectiveness of pain medication
Answer: C
Rationale: Measuring intake and output is a delegable task for AP. Teaching (A),
assessment (B), and evaluation (D) are nursing responsibilities that require clinical
judgment and cannot be delegated to AP. The five rights of delegation must be followed:
right task, right circumstances, right person, right direction, and right supervision .
Question 9
A nurse is preparing a client for surgery. Which action is most important to prevent
a surgical site infection?
A) Administer preoperative antibiotics as prescribed
B) Shave the surgical site the morning of surgery
C) Instruct the client to shower with antimicrobial soap
D) Ensure the client has a negative pregnancy test
Answer: A
Rationale: Administering preoperative antibiotics within 60 minutes of the incision is a
key Surgical Care Improvement Project (SCIP) measure to prevent surgical site
infections. Shaving (B) should be done with clippers, not razors, to prevent micro-
abrasions. Antimicrobial showering (C) is beneficial but not the priority. Pregnancy
testing (D) is unrelated to infection prevention .
Question 10
A nurse is caring for a client with a central line. Which assessment finding indicates
a central line-associated bloodstream infection (CLABSI)?
