RN ATI Comprehensive Exit Exam (Version 1 ) Actual
exam With Questions And Revised Correct Answers &
Rationales () 100% Guaranteed Pass
Item ID: V1-001
Item Type: NGN - Bowtie
Scenario: A 68-year-old male is admitted with community-acquired pneumonia. PMH:
COPD, CHF (EF 35%), diabetes type 2. Vital signs: T 38.9 °C, HR 112, RR 28, BP 98/62,
SpO₂ 88 % on 4 L NC. Labs: WBC 18.2 k/µL, lactate 3.4 mmol/L, glucose 234 mg/dL,
creatinine 1.6 mg/dL (baseline 1.0). ABG: pH 7.29, PaCO₂ 58 mmHg, PaO₂ 58 mmHg,
HCO₃ 28 mEq/L. Chest X-ray: right lower-lobe infiltrate. Current meds: metformin,
lisinopril, furosemide, tiotropium.
Question: Use the bowtie to link the priority nursing action (left), the most likely
complication to prevent (center), and the earliest indicator of that complication (right).
Options/Components:
Left (Priority Action):
1. Initiate sepsis bundle within 60 min
2. Increase NC to 6 L
3. Administer furosemide IVP
Obtain sputum culture
,Center (Complication):
A. Septic shock
B. Acute respiratory failure
C. Hyperosmolar hyperglycemic state
D. Flash pulmonary edema
Right (Earliest Indicator):
i. MAP <65 mmHg
ii. PaO₂/FiO₂ <200
iii. Serum osmolality >320 mOsm/kg
iv. Crackles auscultated bilaterally
Correct Options: 1 – A – i
Rationale (Revised & Verified):
4. The correct answer is 1 – A – i. The patient meets sepsis criteria (infection +
lactate ≥2 mmol/L + organ dysfunction—elevated creatinine). 2026 Surviving
Sepsis guidelines mandate completion of the 3-hour bundle (cultures,
broad-spectrum antibiotics, 30 mL/kg crystalloid) within 60 min of recognition.
Septic shock is the most life-threatening complication, defined by MAP <65
, mmHg despite fluid resuscitation, and is the earliest hemodynamic red flag.
Option 2 delays definitive care and risks CO₂ retention in COPD. Option 3 treats
volume overload that is not yet present. Option 4 delays antibiotics while cultures
are pending. Complications B, C, and D may evolve later but are not the
immediate threat.
Item ID: V1-002
Item Type: Traditional MCQ
Scenario: A 24-year-old G2P1 at 39 weeks is admitted in active labor. Cervix 6 cm/90
%/-1 station. FHR baseline 150 with recurrent late decelerations. IV fluid is LR at 125
mL/h. Maternal BP 110/70.
Question: Which nursing action is most appropriate?
Options:
1. Discontinue LR and start plain D5W
2. Place client in left-lateral position and increase IV rate
3. Administer 8 L O₂ by non-rebreather
Prepare for immediate cesarean
Correct Options: 2
Rationale (Revised & Verified):
4. The correct answer is 2. Late decelerations indicate uteroplacental insufficiency;
maternal hypotension or uterine hyperstimulation are common causes.
, Left-lateral positioning relieves vena-caval compression and increases placental
perfusion, while a 500 mL bolus of LR expands intravascular volume. 2026
AWHONN guidelines emphasize intrauterine resuscitation before operative
delivery. Option 1 provides inadequate volume and glucose without correcting
perfusion. Option 3 is reserved for maternal hypoxemia, not routine. Option 4 is
premature without first attempting conservative measures.
Item ID: V1-003
Item Type: NGN - Matrix
Scenario: A 55-year-old female post right mastectomy with sentinel-node dissection is
on POD #1. JP drain 75 mL serosanguinous output/8 h. BP 138/82, HR 78, RR 18, T 37
°C. Pain 4/10. Arm circumference right 24 cm, left 22 cm.
Question: Identify whether each intervention is indicated, non-essential, or
contraindicated for this client at this time.
Options/Components:
1. Elevate right arm on pillow above heart level
2. Obtain order for thrombolytic therapy
3. Begin passive range-of-motion exercises to 90° shoulder flexion
4. Apply 30 mmHg compression sleeve
Restrict IV access to left arm only
Correct Options: Indicated: 1, 5. Non-essential: 3. Contraindicated: 2, 4.
exam With Questions And Revised Correct Answers &
Rationales () 100% Guaranteed Pass
Item ID: V1-001
Item Type: NGN - Bowtie
Scenario: A 68-year-old male is admitted with community-acquired pneumonia. PMH:
COPD, CHF (EF 35%), diabetes type 2. Vital signs: T 38.9 °C, HR 112, RR 28, BP 98/62,
SpO₂ 88 % on 4 L NC. Labs: WBC 18.2 k/µL, lactate 3.4 mmol/L, glucose 234 mg/dL,
creatinine 1.6 mg/dL (baseline 1.0). ABG: pH 7.29, PaCO₂ 58 mmHg, PaO₂ 58 mmHg,
HCO₃ 28 mEq/L. Chest X-ray: right lower-lobe infiltrate. Current meds: metformin,
lisinopril, furosemide, tiotropium.
Question: Use the bowtie to link the priority nursing action (left), the most likely
complication to prevent (center), and the earliest indicator of that complication (right).
Options/Components:
Left (Priority Action):
1. Initiate sepsis bundle within 60 min
2. Increase NC to 6 L
3. Administer furosemide IVP
Obtain sputum culture
,Center (Complication):
A. Septic shock
B. Acute respiratory failure
C. Hyperosmolar hyperglycemic state
D. Flash pulmonary edema
Right (Earliest Indicator):
i. MAP <65 mmHg
ii. PaO₂/FiO₂ <200
iii. Serum osmolality >320 mOsm/kg
iv. Crackles auscultated bilaterally
Correct Options: 1 – A – i
Rationale (Revised & Verified):
4. The correct answer is 1 – A – i. The patient meets sepsis criteria (infection +
lactate ≥2 mmol/L + organ dysfunction—elevated creatinine). 2026 Surviving
Sepsis guidelines mandate completion of the 3-hour bundle (cultures,
broad-spectrum antibiotics, 30 mL/kg crystalloid) within 60 min of recognition.
Septic shock is the most life-threatening complication, defined by MAP <65
, mmHg despite fluid resuscitation, and is the earliest hemodynamic red flag.
Option 2 delays definitive care and risks CO₂ retention in COPD. Option 3 treats
volume overload that is not yet present. Option 4 delays antibiotics while cultures
are pending. Complications B, C, and D may evolve later but are not the
immediate threat.
Item ID: V1-002
Item Type: Traditional MCQ
Scenario: A 24-year-old G2P1 at 39 weeks is admitted in active labor. Cervix 6 cm/90
%/-1 station. FHR baseline 150 with recurrent late decelerations. IV fluid is LR at 125
mL/h. Maternal BP 110/70.
Question: Which nursing action is most appropriate?
Options:
1. Discontinue LR and start plain D5W
2. Place client in left-lateral position and increase IV rate
3. Administer 8 L O₂ by non-rebreather
Prepare for immediate cesarean
Correct Options: 2
Rationale (Revised & Verified):
4. The correct answer is 2. Late decelerations indicate uteroplacental insufficiency;
maternal hypotension or uterine hyperstimulation are common causes.
, Left-lateral positioning relieves vena-caval compression and increases placental
perfusion, while a 500 mL bolus of LR expands intravascular volume. 2026
AWHONN guidelines emphasize intrauterine resuscitation before operative
delivery. Option 1 provides inadequate volume and glucose without correcting
perfusion. Option 3 is reserved for maternal hypoxemia, not routine. Option 4 is
premature without first attempting conservative measures.
Item ID: V1-003
Item Type: NGN - Matrix
Scenario: A 55-year-old female post right mastectomy with sentinel-node dissection is
on POD #1. JP drain 75 mL serosanguinous output/8 h. BP 138/82, HR 78, RR 18, T 37
°C. Pain 4/10. Arm circumference right 24 cm, left 22 cm.
Question: Identify whether each intervention is indicated, non-essential, or
contraindicated for this client at this time.
Options/Components:
1. Elevate right arm on pillow above heart level
2. Obtain order for thrombolytic therapy
3. Begin passive range-of-motion exercises to 90° shoulder flexion
4. Apply 30 mmHg compression sleeve
Restrict IV access to left arm only
Correct Options: Indicated: 1, 5. Non-essential: 3. Contraindicated: 2, 4.
