ATI Comprehensive Exit Exam (NGN) – ATI RN
Comprehensive Predictor Study Guide, Original
NGN-Style Practice Questions & Answers,
Comprehensive Nursing Exit Exam Preparation,
Next Generation NCLEX Clinical Judgment,
Fundamentals, Adult Medical-Surgical Nursing,
Pharmacology, Maternal-Newborn, Pediatrics,
Mental Health, Leadership, Prioritization,
Delegation, Patient Safety & NCLEX Readiness
Review
Question 1: A charge nurse is assigning clients on a medical-surgical unit.
Which client should be assigned to the most experienced registered nurse
(RN)?
A. A client with stable pneumonia receiving oral antibiotics
B. A client with a urinary tract infection requiring IV antibiotics
C. A client with chest tubes and new-onset respiratory distress with SpO₂ of 88%
D. A client with diabetes mellitus requiring routine insulin administration
CORRECT ANSWER: C. A client with chest tubes and new-onset respiratory
distress with SpO₂ of 88%
Rationale: The client with chest tubes and new-onset respiratory distress is unstable and
requires complex assessment and immediate intervention. The ABC framework (Airway,
Breathing, Circulation) prioritizes the client with respiratory compromise. Stable clients
with predictable outcomes can be assigned to less experienced RNs. Options A, B, and
D are stable clients with predictable outcomes appropriate for a newly licensed RN or
less experienced nurse .
Question 2: A nurse is preparing to delegate tasks to an assistive personnel
(AP). Which task is appropriate to delegate?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Obtaining a blood glucose reading on a diabetic client before lunch
C. Teaching a newly diagnosed diabetic client how to administer insulin
D. Evaluating the effectiveness of pain medication administered one hour ago
CORRECT ANSWER: B. Obtaining a blood glucose reading on a diabetic client
before lunch
Rationale: Obtaining a blood glucose reading is within the AP's scope of practice as it is
a routine, standardized procedure that does not require clinical judgment or assessment.
Assessment of surgical incisions (A), client teaching (C), and evaluation of medication
effectiveness (D) all require nursing judgment and cannot be delegated to AP .
,Question 3: A competent adult client refuses a life-saving blood transfusion
due to religious beliefs. Which action should the nurse take?
A. Administer the transfusion because it will save the client's life
B. Ask the family to convince the client to accept the transfusion
C. Respect the client's refusal and notify the provider
D. Obtain a court order to override the refusal
CORRECT ANSWER: C. Respect the client's refusal and notify the provider
Rationale: Competent adults have the right to refuse treatment even if it results in death
(autonomy supersedes beneficence in this context). The nurse must respect the client's
decision, ensure the client understands the consequences, document the refusal, and
notify the provider. Administering a transfusion against the client's wishes constitutes
battery .
Question 4: A client with a living will that states "no CPR" goes into pulseless
ventricular tachycardia. What should the nurse do?
A. Begin CPR immediately
B. Call a code blue but withhold compressions
C. Verify the DNR order is current and honor it
D. Ask the family for permission to start CPR
CORRECT ANSWER: C. Verify the DNR order is current and honor it
Rationale: The Do Not Resuscitate (DNR) order must be respected. The nurse should
verify the order is current and provide comfort measures only. The provider should be
notified so they can discuss the matter with the family. Beginning CPR against a valid
DNR order is inappropriate and violates the client's wishes .
Question 5: A nurse manager is reviewing incident reports from the previous
shift. Which situation requires the nurse manager to complete a formal
incident report?
A. A client received their scheduled medication 15 minutes late due to pharmacy delay
B. A client fell while attempting to get out of bed without assistance, resulting in a small
laceration
C. A family member expressed dissatisfaction with the meal options provided
D. A nursing assistant took a client's vital signs and documented them in the electronic
record
CORRECT ANSWER: B. A client fell while attempting to get out of bed without
assistance, resulting in a small laceration
,Rationale: Any client fall resulting in injury requires an incident report to document the
event, analyze contributing factors, and implement preventive measures. A minor
medication delay (A) should be documented in the client record but does not typically
require a formal incident report unless harm occurred. Family dissatisfaction (C) is a
concern but not an incident. AP taking vital signs (D) is an appropriate delegated task .
Question 6: A nurse is caring for a client in a mental health facility. The client's
daughter is crying and tells the nurse she feels guilty for leaving her father in
the hospital. Which is the most appropriate therapeutic response?
A. "I'd like to know more about what's bothering you."
B. "Why are you feeling this way?"
C. "You did the right thing by bringing him here."
D. "I'm sure your father doesn't blame you."
CORRECT ANSWER: A. "I'd like to know more about what's bothering you."
Rationale: This response uses an open-ended therapeutic communication technique that
encourages the daughter to express her feelings. Asking "why" (B) can be perceived as
judgmental or confrontational. Options C and D are nontherapeutic because they offer
false reassurance and close off further discussion .
Question 7: A nurse is performing a skin assessment on a client who has risk
factors for skin cancer. Which lesion characteristic should the nurse identify as
suspicious?
A. Scaly and red
B. Asymmetric, with variegated coloring
C. Firm and rubbery
D. Brown with a wart-like texture
CORRECT ANSWER: B. Asymmetric, with variegated coloring
Rationale: The ABCDEs of melanoma assessment include Asymmetry, Border
irregularity, Color variegation, Diameter >6mm, and Evolution/changes. A lesion that is
asymmetric with variegated coloring is suspicious for malignancy and requires further
evaluation. Scaly/red lesions (A) may indicate actinic keratosis; firm/rubbery (C) may
suggest a lipoma; brown with wart-like texture (D) may indicate seborrheic keratosis .
Question 8: A nurse is caring for a client following gastric bypass surgery.
Which dietary instruction should the nurse include in discharge teaching?
A. Start each meal with a protein source
B. Consume at least 25 g of fiber daily
, C. Check blood glucose level before each meal
D. Limit meals to three times per day
CORRECT ANSWER: A. Start each meal with a protein source
Rationale: After gastric bypass surgery, clients should prioritize protein intake at each
meal to promote wound healing and prevent protein malnutrition. The pouch fills
quickly, so protein should be consumed first before other foods. High fiber intake (B)
may cause discomfort or obstruction. Frequent small meals (5-6 per day) are
recommended, not limiting to three meals (D) .
Question 9: A nurse is preparing to administer digoxin to a client. Which
finding should lead the nurse to withhold the medication?
A. Potassium level of 4.2 mEq/L
B. Apical pulse of 52 beats per minute
C. Digoxin level of 1.2 ng/mL
D. Blood pressure of 110/70 mmHg
CORRECT ANSWER: B. Apical pulse of 52 beats per minute
Rationale: Digoxin should be held if the apical pulse is less than 60 beats per minute in
an adult, as the medication slows the heart rate and can cause bradycardia. A potassium
level of 4.2 mEq/L (A) is within normal range. A digoxin level of 1.2 ng/mL (C) is within
therapeutic range (0.8-2.0 ng/mL). Blood pressure of 110/70 mmHg (D) is acceptable .
Question 10: A nurse is assessing a client's cardiovascular system. Where
should the nurse place the diaphragm of the stethoscope to best hear the
closing of the aortic heart valve?
A. Left lower sternal border
B. Left midclavicular line at the 5th intercostal space
C. Right upper sternal border at the 2nd intercostal space
D. Left upper sternal border at the 2nd intercostal space
CORRECT ANSWER: C. Right upper sternal border at the 2nd intercostal space
Rationale: The aortic valve is best auscultated at the right upper sternal border at the
2nd intercostal space (aortic area). The mitral valve is best heard at the left
midclavicular line at the 5th intercostal space (B). The pulmonic valve is best heard at
the left upper sternal border at the 2nd intercostal space (D). The tricuspid valve is best
heard at the left lower sternal border (A) .
Question 11: A nurse is caring for a client with active pulmonary tuberculosis.
Which type of precautions should the nurse initiate?
Comprehensive Predictor Study Guide, Original
NGN-Style Practice Questions & Answers,
Comprehensive Nursing Exit Exam Preparation,
Next Generation NCLEX Clinical Judgment,
Fundamentals, Adult Medical-Surgical Nursing,
Pharmacology, Maternal-Newborn, Pediatrics,
Mental Health, Leadership, Prioritization,
Delegation, Patient Safety & NCLEX Readiness
Review
Question 1: A charge nurse is assigning clients on a medical-surgical unit.
Which client should be assigned to the most experienced registered nurse
(RN)?
A. A client with stable pneumonia receiving oral antibiotics
B. A client with a urinary tract infection requiring IV antibiotics
C. A client with chest tubes and new-onset respiratory distress with SpO₂ of 88%
D. A client with diabetes mellitus requiring routine insulin administration
CORRECT ANSWER: C. A client with chest tubes and new-onset respiratory
distress with SpO₂ of 88%
Rationale: The client with chest tubes and new-onset respiratory distress is unstable and
requires complex assessment and immediate intervention. The ABC framework (Airway,
Breathing, Circulation) prioritizes the client with respiratory compromise. Stable clients
with predictable outcomes can be assigned to less experienced RNs. Options A, B, and
D are stable clients with predictable outcomes appropriate for a newly licensed RN or
less experienced nurse .
Question 2: A nurse is preparing to delegate tasks to an assistive personnel
(AP). Which task is appropriate to delegate?
A. Assessing a postoperative client's surgical incision for signs of infection
B. Obtaining a blood glucose reading on a diabetic client before lunch
C. Teaching a newly diagnosed diabetic client how to administer insulin
D. Evaluating the effectiveness of pain medication administered one hour ago
CORRECT ANSWER: B. Obtaining a blood glucose reading on a diabetic client
before lunch
Rationale: Obtaining a blood glucose reading is within the AP's scope of practice as it is
a routine, standardized procedure that does not require clinical judgment or assessment.
Assessment of surgical incisions (A), client teaching (C), and evaluation of medication
effectiveness (D) all require nursing judgment and cannot be delegated to AP .
,Question 3: A competent adult client refuses a life-saving blood transfusion
due to religious beliefs. Which action should the nurse take?
A. Administer the transfusion because it will save the client's life
B. Ask the family to convince the client to accept the transfusion
C. Respect the client's refusal and notify the provider
D. Obtain a court order to override the refusal
CORRECT ANSWER: C. Respect the client's refusal and notify the provider
Rationale: Competent adults have the right to refuse treatment even if it results in death
(autonomy supersedes beneficence in this context). The nurse must respect the client's
decision, ensure the client understands the consequences, document the refusal, and
notify the provider. Administering a transfusion against the client's wishes constitutes
battery .
Question 4: A client with a living will that states "no CPR" goes into pulseless
ventricular tachycardia. What should the nurse do?
A. Begin CPR immediately
B. Call a code blue but withhold compressions
C. Verify the DNR order is current and honor it
D. Ask the family for permission to start CPR
CORRECT ANSWER: C. Verify the DNR order is current and honor it
Rationale: The Do Not Resuscitate (DNR) order must be respected. The nurse should
verify the order is current and provide comfort measures only. The provider should be
notified so they can discuss the matter with the family. Beginning CPR against a valid
DNR order is inappropriate and violates the client's wishes .
Question 5: A nurse manager is reviewing incident reports from the previous
shift. Which situation requires the nurse manager to complete a formal
incident report?
A. A client received their scheduled medication 15 minutes late due to pharmacy delay
B. A client fell while attempting to get out of bed without assistance, resulting in a small
laceration
C. A family member expressed dissatisfaction with the meal options provided
D. A nursing assistant took a client's vital signs and documented them in the electronic
record
CORRECT ANSWER: B. A client fell while attempting to get out of bed without
assistance, resulting in a small laceration
,Rationale: Any client fall resulting in injury requires an incident report to document the
event, analyze contributing factors, and implement preventive measures. A minor
medication delay (A) should be documented in the client record but does not typically
require a formal incident report unless harm occurred. Family dissatisfaction (C) is a
concern but not an incident. AP taking vital signs (D) is an appropriate delegated task .
Question 6: A nurse is caring for a client in a mental health facility. The client's
daughter is crying and tells the nurse she feels guilty for leaving her father in
the hospital. Which is the most appropriate therapeutic response?
A. "I'd like to know more about what's bothering you."
B. "Why are you feeling this way?"
C. "You did the right thing by bringing him here."
D. "I'm sure your father doesn't blame you."
CORRECT ANSWER: A. "I'd like to know more about what's bothering you."
Rationale: This response uses an open-ended therapeutic communication technique that
encourages the daughter to express her feelings. Asking "why" (B) can be perceived as
judgmental or confrontational. Options C and D are nontherapeutic because they offer
false reassurance and close off further discussion .
Question 7: A nurse is performing a skin assessment on a client who has risk
factors for skin cancer. Which lesion characteristic should the nurse identify as
suspicious?
A. Scaly and red
B. Asymmetric, with variegated coloring
C. Firm and rubbery
D. Brown with a wart-like texture
CORRECT ANSWER: B. Asymmetric, with variegated coloring
Rationale: The ABCDEs of melanoma assessment include Asymmetry, Border
irregularity, Color variegation, Diameter >6mm, and Evolution/changes. A lesion that is
asymmetric with variegated coloring is suspicious for malignancy and requires further
evaluation. Scaly/red lesions (A) may indicate actinic keratosis; firm/rubbery (C) may
suggest a lipoma; brown with wart-like texture (D) may indicate seborrheic keratosis .
Question 8: A nurse is caring for a client following gastric bypass surgery.
Which dietary instruction should the nurse include in discharge teaching?
A. Start each meal with a protein source
B. Consume at least 25 g of fiber daily
, C. Check blood glucose level before each meal
D. Limit meals to three times per day
CORRECT ANSWER: A. Start each meal with a protein source
Rationale: After gastric bypass surgery, clients should prioritize protein intake at each
meal to promote wound healing and prevent protein malnutrition. The pouch fills
quickly, so protein should be consumed first before other foods. High fiber intake (B)
may cause discomfort or obstruction. Frequent small meals (5-6 per day) are
recommended, not limiting to three meals (D) .
Question 9: A nurse is preparing to administer digoxin to a client. Which
finding should lead the nurse to withhold the medication?
A. Potassium level of 4.2 mEq/L
B. Apical pulse of 52 beats per minute
C. Digoxin level of 1.2 ng/mL
D. Blood pressure of 110/70 mmHg
CORRECT ANSWER: B. Apical pulse of 52 beats per minute
Rationale: Digoxin should be held if the apical pulse is less than 60 beats per minute in
an adult, as the medication slows the heart rate and can cause bradycardia. A potassium
level of 4.2 mEq/L (A) is within normal range. A digoxin level of 1.2 ng/mL (C) is within
therapeutic range (0.8-2.0 ng/mL). Blood pressure of 110/70 mmHg (D) is acceptable .
Question 10: A nurse is assessing a client's cardiovascular system. Where
should the nurse place the diaphragm of the stethoscope to best hear the
closing of the aortic heart valve?
A. Left lower sternal border
B. Left midclavicular line at the 5th intercostal space
C. Right upper sternal border at the 2nd intercostal space
D. Left upper sternal border at the 2nd intercostal space
CORRECT ANSWER: C. Right upper sternal border at the 2nd intercostal space
Rationale: The aortic valve is best auscultated at the right upper sternal border at the
2nd intercostal space (aortic area). The mitral valve is best heard at the left
midclavicular line at the 5th intercostal space (B). The pulmonic valve is best heard at
the left upper sternal border at the 2nd intercostal space (D). The tricuspid valve is best
heard at the left lower sternal border (A) .
Question 11: A nurse is caring for a client with active pulmonary tuberculosis.
Which type of precautions should the nurse initiate?
