ATI COMPREHENSIVE
EXIT EXAM
(NGN-Style Questions & Case Scenario)
Actual Qs & Ans to Pass the Exam
This ATI Exit test contains:
180 Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX (NGN)
and Case Scenario
Expert-Verified Explanations & Solutions
,────────────────────────────────────────────────────────
1) NGN FOCUS: MENTAL HEALTH / SUICIDE ASSESSMENT
SCENARIO:
An adolescent client with conduct disorder arrives at the emergency department
after threatening suicide to a teacher at school. The nurse is gathering additional
assessment data.
VITAL SIGNS (for context):
• Temperature 36.9°C (98.4°F), HR 88/min, RR 18/min, BP 108/70 mm Hg
QUESTION:
Which of the following statements should the nurse include during the assessment?
A. “Tell me about your siblings?”
B. “Tell me what kind of music you like?”
C. “Tell me how often you drink alcohol?”
D. “Tell me about your school schedule?”
CORRECT ANSWER: C. “Tell me how often you drink alcohol?”
EXPERT RATIONALE:
• Assessing for substance use, including alcohol, is critical in adolescents with
conduct disorder and suicidal ideation, as substance misuse can exacerbate mental
health issues.
• Options A, B, and D can offer general psychosocial information but do not directly
address a risk factor (substance use) that could contribute significantly to suicidal
behavior.
────────────────────────────────────────────────────────
2) NGN FOCUS: MEDICAL-SURGICAL PRIORITIZATION / HYPOPARATHYROIDISM
,SCENARIO:
A nurse on an acute medical-surgical unit is performing shift assessments on
multiple clients with varying diagnoses.
VITAL SIGNS (for context):
• Client with possible hypoparathyroidism: BP 120/78 mm Hg, HR 76/min, RR
18/min
QUESTION:
Which of the following clients is the highest priority to assess or intervene?
A. A client who has surgical hypoparathyroidism and a positive Trousseau’s sign
B. A client with Clostridium difficile infection and acute diarrhea
C. A client with acute kidney injury and urine with a low specific gravity
D. A client who has oral cancer and reports a sore on his gums
CORRECT ANSWER: A. A client who has surgical hypoparathyroidism and a positive
Trousseau’s sign
EXPERT RATIONALE:
• A positive Trousseau’s sign indicates neuromuscular irritability related to
hypocalcemia, which may progress to life-threatening tetany or seizures.
• While the other findings warrant follow-up, acute hypocalcemia poses the greatest
immediate risk.
────────────────────────────────────────────────────────
3) NGN FOCUS: PHARMACOLOGY / HEART FAILURE
SCENARIO:
A nurse is reviewing new prescriptions for a client admitted with congestive heart
failure (CHF).
,QUESTION:
Which of the following provider prescriptions should the nurse anticipate?
A. Call the provider if the client’s respiratory rate is less than 18/min
B. Give the client 500 mL IV bolus of 0.9% sodium chloride over 1 hour
C. Give the client enalapril 2.5 mg PO twice daily
D. Call the provider if the client’s pulse rate is less than 80/min
CORRECT ANSWER: C. Give the client enalapril 2.5 mg PO twice daily
EXPERT RATIONALE:
• An ACE inhibitor (e.g., enalapril) improves cardiac output and reduces afterload in
heart failure.
• Options A and D do not reflect common parameters for holding or calling the
provider in CHF management; option B (IV bolus) may worsen fluid overload.
────────────────────────────────────────────────────────
4) NGN FOCUS: PHARMACOLOGY / ANTIDEPRESSANTS
SCENARIO:
A nurse is teaching a client who has a new prescription for sertraline to treat
depression.
QUESTION:
Which statement by the client indicates an understanding of the medication
treatment plan?
A. “I will be able to start this medication and immediately feel better.”
B. “I can expect to urinate frequently while on this medication.”
C. “I understand I may experience difficulty sleeping on this medication.”
D. “I should decrease my sodium intake while on this medication.”
,CORRECT ANSWER: C. “I understand I may experience difficulty sleeping on this
medication.”
EXPERT RATIONALE:
• SSRIs like sertraline can cause insomnia or sleep disturbances.
• They do not typically cause immediate relief (option A), nor is frequent urination
or sodium restriction a common concern (options B, D).
────────────────────────────────────────────────────────
5) NGN FOCUS: MENTAL HEALTH / INTIMATE PARTNER VIOLENCE
SCENARIO:
A female client presents with bruises on her arms that she explains are from
physical abuse by her husband. She says, “I don’t know how much longer I can
take this, but I’m afraid he will hurt me if I leave.”
QUESTION:
Which of the following is an appropriate nursing intervention?
A. Offer to speak to the client’s husband regarding his abusive behavior.
B. Help the client recognize the signs of escalation of abusive behavior.
C. Assist the client to identify personal behaviors that trigger abusive behavior.
D. Assist the client to report abusive behavior to the proper authority.
CORRECT ANSWER: B. Help the client recognize the signs of escalation of abusive
behavior.
EXPERT RATIONALE:
• Educating about the cycle of violence and recognizing its escalation empowers the
client to seek help and stay safe.
• Directly confronting the abuser (option A) may endanger the client.
,• Victim blaming or attributing the abuse to the client’s behaviors (option C) is
inappropriate.
• Mandatory reporting may vary by jurisdiction; the most immediate intervention is
safety planning and education.
────────────────────────────────────────────────────────
6) NGN FOCUS: MENTAL HEALTH / SUICIDAL IDEATION ASSESSMENT
SCENARIO:
A client expressing suicidal thoughts says, “It just doesn’t seem worth it anymore.
Why not end my misery?”
QUESTION:
Which of the following responses by the nurse is most appropriate?
A. “Why do you think your life is not worth it anymore?”
B. “Do you have a plan to end your life?”
C. “I need to know what you mean by ‘misery.’”
D. “You can trust me and tell me what you’re thinking.”
CORRECT ANSWER: B. “Do you have a plan to end your life?”
EXPERT RATIONALE:
• Assessing for a specific plan is crucial for determining the immediacy of risk and
guiding intervention.
• Therapeutic communication focuses on risk assessment rather than solely
exploring feelings or offering reassurance.
────────────────────────────────────────────────────────
7) NGN FOCUS: MENTAL HEALTH / SCHIZOPHRENIA
SCENARIO:
,A nurse is caring for a client diagnosed with schizophrenia.
QUESTION:
Which of the following assessment findings should the nurse expect?
A. Decreased level of consciousness
B. Inability to identify common objects
C. Poor problem-solving ability
D. Preoccupation with somatic disturbances
CORRECT ANSWER: C. Poor problem-solving ability
EXPERT RATIONALE:
• Clients with schizophrenia often exhibit impaired executive functioning, including
difficulty with problem-solving.
• Decreased level of consciousness or inability to identify familiar objects is less
characteristic. Somatic preoccupations are more typical of somatic symptom
disorders.
────────────────────────────────────────────────────────
8) NGN FOCUS: VENOUS THROMBOEMBOLISM / SAFETY
SCENARIO:
A client with a deep vein thrombosis (DVT) of the left lower extremity is admitted.
The nurse reviews the plan of care.
QUESTION (Select the SINGLE best action):
Which of the following actions should the nurse take?
A. Position the client with the affected extremity lower than the heart.
B. Administer acetaminophen.
C. Massage the affected extremity every 4 hours.
,D. Withhold the heparin IV infusion.
CORRECT ANSWER: D. Withhold the heparin IV infusion.
EXPERT RATIONALE:
• The question as provided states “Which of the following action should the nurse
take?” but the answer given is “Withhold heparin IV infusion.” Typically, for a DVT,
you would continue anticoagulation unless contraindicated (e.g., risk of hemorrhage
or abnormal lab results).
• Because the original answer states “Withhold heparin IV infusion,” it suggests
there is a possible complication or reason to hold it (e.g., significant bleeding risk or
dangerously elevated aPTT).
• Double-check the actual scenario and labs if a hold is indicated. In general, never
massage the affected extremity (risk of embolus), and the extremity should be
elevated. Ensure clarity about why the infusion must be withheld.
────────────────────────────────────────────────────────
9) NGN FOCUS: PHARMACOLOGY / ENOXAPARIN ADMINISTRATION
SCENARIO:
A client with a new prescription for enoxaparin to prevent DVT asks the nurse how
to administer it safely.
QUESTION:
Which of the following is an appropriate action by the nurse?
A. Expel the air bubble at the top of the prefilled syringe.
B. Massage the injection site to evenly distribute the medication.
C. Inject the medication into the lateral abdominal wall.
D. Administer an NSAID for injection-site discomfort.
CORRECT ANSWER: C. Inject the medication into the lateral abdominal wall.
, EXPERT RATIONALE:
• Low-molecular-weight heparin (LMWH) is commonly injected subcutaneously into
the anterolateral or posterolateral abdominal wall (“love handles”) without expelling
the air bubble.
• Massaging can increase bruising.
• NSAIDs can increase bleeding risk.
────────────────────────────────────────────────────────
10) NGN FOCUS: ONCOLOGY / LAB VALUES
SCENARIO:
A nurse is caring for four clients. Which of the following client data should be
reported to the provider immediately?
A. A client with pleurisy who reports pain of 6 on a 0–10 scale when coughing
B. A client with a total of 110 mL of serosanguineous drainage from a Jackson-Pratt
drain in the first 24 hours post-op
C. A client who is 4 hours postoperative and has a heart rate of 98/min
D. A client who has a prescription for chemotherapy and an absolute neutrophil
count (ANC) of 75/mm³
CORRECT ANSWER: D. A client who has a prescription for chemotherapy and an
ANC of 75/mm³
EXPERT RATIONALE:
• An ANC under 500/mm³ places the client at critical risk for infection (severe
neutropenia). This requires prompt intervention.
• The other findings are either expected or less urgent.
────────────────────────────────────────────────────────
11) NGN FOCUS: PAIN MANAGEMENT / END-STAGE DISEASE
EXIT EXAM
(NGN-Style Questions & Case Scenario)
Actual Qs & Ans to Pass the Exam
This ATI Exit test contains:
180 Qs & Ans
passing score Guarantee
Format Set of Multiple-choice
questions with incorporating Next Generation NCLEX (NGN)
and Case Scenario
Expert-Verified Explanations & Solutions
,────────────────────────────────────────────────────────
1) NGN FOCUS: MENTAL HEALTH / SUICIDE ASSESSMENT
SCENARIO:
An adolescent client with conduct disorder arrives at the emergency department
after threatening suicide to a teacher at school. The nurse is gathering additional
assessment data.
VITAL SIGNS (for context):
• Temperature 36.9°C (98.4°F), HR 88/min, RR 18/min, BP 108/70 mm Hg
QUESTION:
Which of the following statements should the nurse include during the assessment?
A. “Tell me about your siblings?”
B. “Tell me what kind of music you like?”
C. “Tell me how often you drink alcohol?”
D. “Tell me about your school schedule?”
CORRECT ANSWER: C. “Tell me how often you drink alcohol?”
EXPERT RATIONALE:
• Assessing for substance use, including alcohol, is critical in adolescents with
conduct disorder and suicidal ideation, as substance misuse can exacerbate mental
health issues.
• Options A, B, and D can offer general psychosocial information but do not directly
address a risk factor (substance use) that could contribute significantly to suicidal
behavior.
────────────────────────────────────────────────────────
2) NGN FOCUS: MEDICAL-SURGICAL PRIORITIZATION / HYPOPARATHYROIDISM
,SCENARIO:
A nurse on an acute medical-surgical unit is performing shift assessments on
multiple clients with varying diagnoses.
VITAL SIGNS (for context):
• Client with possible hypoparathyroidism: BP 120/78 mm Hg, HR 76/min, RR
18/min
QUESTION:
Which of the following clients is the highest priority to assess or intervene?
A. A client who has surgical hypoparathyroidism and a positive Trousseau’s sign
B. A client with Clostridium difficile infection and acute diarrhea
C. A client with acute kidney injury and urine with a low specific gravity
D. A client who has oral cancer and reports a sore on his gums
CORRECT ANSWER: A. A client who has surgical hypoparathyroidism and a positive
Trousseau’s sign
EXPERT RATIONALE:
• A positive Trousseau’s sign indicates neuromuscular irritability related to
hypocalcemia, which may progress to life-threatening tetany or seizures.
• While the other findings warrant follow-up, acute hypocalcemia poses the greatest
immediate risk.
────────────────────────────────────────────────────────
3) NGN FOCUS: PHARMACOLOGY / HEART FAILURE
SCENARIO:
A nurse is reviewing new prescriptions for a client admitted with congestive heart
failure (CHF).
,QUESTION:
Which of the following provider prescriptions should the nurse anticipate?
A. Call the provider if the client’s respiratory rate is less than 18/min
B. Give the client 500 mL IV bolus of 0.9% sodium chloride over 1 hour
C. Give the client enalapril 2.5 mg PO twice daily
D. Call the provider if the client’s pulse rate is less than 80/min
CORRECT ANSWER: C. Give the client enalapril 2.5 mg PO twice daily
EXPERT RATIONALE:
• An ACE inhibitor (e.g., enalapril) improves cardiac output and reduces afterload in
heart failure.
• Options A and D do not reflect common parameters for holding or calling the
provider in CHF management; option B (IV bolus) may worsen fluid overload.
────────────────────────────────────────────────────────
4) NGN FOCUS: PHARMACOLOGY / ANTIDEPRESSANTS
SCENARIO:
A nurse is teaching a client who has a new prescription for sertraline to treat
depression.
QUESTION:
Which statement by the client indicates an understanding of the medication
treatment plan?
A. “I will be able to start this medication and immediately feel better.”
B. “I can expect to urinate frequently while on this medication.”
C. “I understand I may experience difficulty sleeping on this medication.”
D. “I should decrease my sodium intake while on this medication.”
,CORRECT ANSWER: C. “I understand I may experience difficulty sleeping on this
medication.”
EXPERT RATIONALE:
• SSRIs like sertraline can cause insomnia or sleep disturbances.
• They do not typically cause immediate relief (option A), nor is frequent urination
or sodium restriction a common concern (options B, D).
────────────────────────────────────────────────────────
5) NGN FOCUS: MENTAL HEALTH / INTIMATE PARTNER VIOLENCE
SCENARIO:
A female client presents with bruises on her arms that she explains are from
physical abuse by her husband. She says, “I don’t know how much longer I can
take this, but I’m afraid he will hurt me if I leave.”
QUESTION:
Which of the following is an appropriate nursing intervention?
A. Offer to speak to the client’s husband regarding his abusive behavior.
B. Help the client recognize the signs of escalation of abusive behavior.
C. Assist the client to identify personal behaviors that trigger abusive behavior.
D. Assist the client to report abusive behavior to the proper authority.
CORRECT ANSWER: B. Help the client recognize the signs of escalation of abusive
behavior.
EXPERT RATIONALE:
• Educating about the cycle of violence and recognizing its escalation empowers the
client to seek help and stay safe.
• Directly confronting the abuser (option A) may endanger the client.
,• Victim blaming or attributing the abuse to the client’s behaviors (option C) is
inappropriate.
• Mandatory reporting may vary by jurisdiction; the most immediate intervention is
safety planning and education.
────────────────────────────────────────────────────────
6) NGN FOCUS: MENTAL HEALTH / SUICIDAL IDEATION ASSESSMENT
SCENARIO:
A client expressing suicidal thoughts says, “It just doesn’t seem worth it anymore.
Why not end my misery?”
QUESTION:
Which of the following responses by the nurse is most appropriate?
A. “Why do you think your life is not worth it anymore?”
B. “Do you have a plan to end your life?”
C. “I need to know what you mean by ‘misery.’”
D. “You can trust me and tell me what you’re thinking.”
CORRECT ANSWER: B. “Do you have a plan to end your life?”
EXPERT RATIONALE:
• Assessing for a specific plan is crucial for determining the immediacy of risk and
guiding intervention.
• Therapeutic communication focuses on risk assessment rather than solely
exploring feelings or offering reassurance.
────────────────────────────────────────────────────────
7) NGN FOCUS: MENTAL HEALTH / SCHIZOPHRENIA
SCENARIO:
,A nurse is caring for a client diagnosed with schizophrenia.
QUESTION:
Which of the following assessment findings should the nurse expect?
A. Decreased level of consciousness
B. Inability to identify common objects
C. Poor problem-solving ability
D. Preoccupation with somatic disturbances
CORRECT ANSWER: C. Poor problem-solving ability
EXPERT RATIONALE:
• Clients with schizophrenia often exhibit impaired executive functioning, including
difficulty with problem-solving.
• Decreased level of consciousness or inability to identify familiar objects is less
characteristic. Somatic preoccupations are more typical of somatic symptom
disorders.
────────────────────────────────────────────────────────
8) NGN FOCUS: VENOUS THROMBOEMBOLISM / SAFETY
SCENARIO:
A client with a deep vein thrombosis (DVT) of the left lower extremity is admitted.
The nurse reviews the plan of care.
QUESTION (Select the SINGLE best action):
Which of the following actions should the nurse take?
A. Position the client with the affected extremity lower than the heart.
B. Administer acetaminophen.
C. Massage the affected extremity every 4 hours.
,D. Withhold the heparin IV infusion.
CORRECT ANSWER: D. Withhold the heparin IV infusion.
EXPERT RATIONALE:
• The question as provided states “Which of the following action should the nurse
take?” but the answer given is “Withhold heparin IV infusion.” Typically, for a DVT,
you would continue anticoagulation unless contraindicated (e.g., risk of hemorrhage
or abnormal lab results).
• Because the original answer states “Withhold heparin IV infusion,” it suggests
there is a possible complication or reason to hold it (e.g., significant bleeding risk or
dangerously elevated aPTT).
• Double-check the actual scenario and labs if a hold is indicated. In general, never
massage the affected extremity (risk of embolus), and the extremity should be
elevated. Ensure clarity about why the infusion must be withheld.
────────────────────────────────────────────────────────
9) NGN FOCUS: PHARMACOLOGY / ENOXAPARIN ADMINISTRATION
SCENARIO:
A client with a new prescription for enoxaparin to prevent DVT asks the nurse how
to administer it safely.
QUESTION:
Which of the following is an appropriate action by the nurse?
A. Expel the air bubble at the top of the prefilled syringe.
B. Massage the injection site to evenly distribute the medication.
C. Inject the medication into the lateral abdominal wall.
D. Administer an NSAID for injection-site discomfort.
CORRECT ANSWER: C. Inject the medication into the lateral abdominal wall.
, EXPERT RATIONALE:
• Low-molecular-weight heparin (LMWH) is commonly injected subcutaneously into
the anterolateral or posterolateral abdominal wall (“love handles”) without expelling
the air bubble.
• Massaging can increase bruising.
• NSAIDs can increase bleeding risk.
────────────────────────────────────────────────────────
10) NGN FOCUS: ONCOLOGY / LAB VALUES
SCENARIO:
A nurse is caring for four clients. Which of the following client data should be
reported to the provider immediately?
A. A client with pleurisy who reports pain of 6 on a 0–10 scale when coughing
B. A client with a total of 110 mL of serosanguineous drainage from a Jackson-Pratt
drain in the first 24 hours post-op
C. A client who is 4 hours postoperative and has a heart rate of 98/min
D. A client who has a prescription for chemotherapy and an absolute neutrophil
count (ANC) of 75/mm³
CORRECT ANSWER: D. A client who has a prescription for chemotherapy and an
ANC of 75/mm³
EXPERT RATIONALE:
• An ANC under 500/mm³ places the client at critical risk for infection (severe
neutropenia). This requires prompt intervention.
• The other findings are either expected or less urgent.
────────────────────────────────────────────────────────
11) NGN FOCUS: PAIN MANAGEMENT / END-STAGE DISEASE
