ATI RN Comprehensive Exit Exam Prep 2026 | Versions 1–4 |
200 Practice Questions with Answers & Rationales | Nursing
A+ Study Guide
SECTION A: FUNDAMENTALS OF NURSING & SAFE CARE ENVIRONMENT (Questions 1–50)
1. A nurse is caring for a client who has a new diagnosis of type 1 diabetes and is distressed about self-
injection. Which response by the nurse is most therapeutic?
A. “Tell me what concerns you the most about giving yourself insulin.”
B. “You will get used to it after a few weeks.”
C. “Would you prefer to have a family member give the injections?”
D. “Many diabetics feel this way at first.”
Answer: A
Rationale: Open-ended questioning encourages expression of feelings and identifies specific concerns,
promoting therapeutic communication.
2. A client is receiving a blood transfusion and reports chills and low back pain. Vital signs: BP 90/60, HR
120, temperature 101.2°F (38.4°C). What is the priority action?
A. Stop the transfusion and infuse normal saline through new tubing
B. Slow the transfusion rate and notify the provider
C. Administer acetaminophen and continue the transfusion
D. Obtain a urine sample for hemoglobin
Answer: A
Rationale: Symptoms indicate acute hemolytic reaction; stop transfusion immediately, maintain IV
access with saline, and notify blood bank.
3. A nurse is preparing to insert a nasogastric tube. Which action demonstrates correct infection
control?
A. Perform hand hygiene and apply clean gloves
B. Use sterile gloves and a sterile drape
,C. Wear a face shield and sterile gown
D. Perform hand hygiene only
Answer: A
Rationale: NG tube insertion is a clean, not sterile, procedure; hand hygiene and clean gloves are
sufficient.
4. A client with heart failure is being discharged. Which statement indicates understanding of dietary
restrictions?
A. “I should limit my daily fluid intake to 2 liters and avoid canned soups.”
B. “I can use salt substitutes freely because they are sodium-free.”
C. “I should drink at least 3 liters of water daily to prevent dehydration.”
D. “I will eat bananas daily to increase potassium levels.”
Answer: A
Rationale: Fluid restriction (usually 1.5-2 L/day) and low-sodium diet are key; salt substitutes may
contain potassium and be dangerous with ACE inhibitors.
5. A nurse is caring for a client with an indwelling urinary catheter. Which finding should be reported as
a possible catheter-associated urinary tract infection (CAUTI)?
A. Cloudy, foul-smelling urine with sediment
B. Dark yellow concentrated urine
C. Urine output of 40 mL/hr
D. Urine specific gravity of 1.025
Answer: A
Rationale: Cloudy, foul-smelling urine is a classic sign of CAUTI; concentrated urine indicates
dehydration, not infection.
6. A postoperative client is receiving morphine via patient-controlled analgesia (PCA). The respiratory
rate is 8/min. What is the priority action?
A. Stop the PCA infusion and notify the provider
B. Administer naloxone immediately
C. Increase the demand dose to improve pain control
,D. Place the client in high-Fowler’s position
Answer: A
Rationale: Respiratory depression requires stopping the opioid source first; naloxone may be given after,
but stopping the infusion is priority.
7. A nurse assesses a peripheral IV site that is warm, edematous, and reddened along the vein. What is
the most appropriate intervention?
A. Discontinue the IV and restart in a different location
B. Apply a warm compress and continue the infusion
C. Flush the IV with 10 mL normal saline
D. Elevate the extremity and slow the infusion rate
Answer: A
Rationale: Signs indicate phlebitis; the IV must be removed to prevent further irritation or infection.
8. A nurse is teaching a client about using an incentive spirometer after thoracic surgery. Which
instruction is correct?
A. “Inhale slowly and deeply, then hold your breath for 3-5 seconds.”
B. “Exhale forcefully into the device to measure lung capacity.”
C. “Use the device every 4 hours while awake only.”
D. “Lie flat on your back while using the spirometer.”
Answer: A
Rationale: Sustained deep inhalation promotes lung expansion and prevents atelectasis; breath hold
increases alveolar inflation.
9. A client has a prescription for digoxin 0.25 mg daily. Which finding would prompt the nurse to
withhold the medication?
A. Apical pulse of 52 beats/min
B. Blood pressure of 110/70 mm Hg
C. Potassium level of 4.0 mEq/L
D. Respiratory rate of 18/min
, Answer: A
Rationale: Digoxin is withheld for apical pulse <60 bpm in adults; hypokalemia also increases toxicity risk
but pulse is immediate concern.
10. A client with a new colostomy has a stoma that is dark purple and edematous. What should the
nurse do first?
A. Notify the surgeon immediately
B. Apply a cold compress to reduce edema
C. Gently massage the stoma to improve circulation
D. Document the finding as normal for a new stoma
Answer: A
Rationale: Dark purple indicates ischemia or necrosis; this is a surgical emergency requiring immediate
evaluation.
11. A nurse is caring for a client receiving continuous enteral feeding via nasogastric tube. Which finding
indicates feeding intolerance?
A. Gastric residual volume of 300 mL
B. Bowel sounds present in all quadrants
C. Blood glucose of 110 mg/dL
D. Urine output of 1,500 mL in 24 hours
Answer: A
Rationale: High gastric residual (>250-500 mL) suggests delayed gastric emptying and aspiration risk.
12. A confused client attempts to pull out their IV line. The nurse applies wrist restraints. Which action is
most important?
A. Obtain a provider’s order within 1 hour
B. Tie the restraints to the side rail of the bed
C. Remove restraints every 4 hours for skin assessment
D. Use a square knot to secure the restraints
Answer: A
200 Practice Questions with Answers & Rationales | Nursing
A+ Study Guide
SECTION A: FUNDAMENTALS OF NURSING & SAFE CARE ENVIRONMENT (Questions 1–50)
1. A nurse is caring for a client who has a new diagnosis of type 1 diabetes and is distressed about self-
injection. Which response by the nurse is most therapeutic?
A. “Tell me what concerns you the most about giving yourself insulin.”
B. “You will get used to it after a few weeks.”
C. “Would you prefer to have a family member give the injections?”
D. “Many diabetics feel this way at first.”
Answer: A
Rationale: Open-ended questioning encourages expression of feelings and identifies specific concerns,
promoting therapeutic communication.
2. A client is receiving a blood transfusion and reports chills and low back pain. Vital signs: BP 90/60, HR
120, temperature 101.2°F (38.4°C). What is the priority action?
A. Stop the transfusion and infuse normal saline through new tubing
B. Slow the transfusion rate and notify the provider
C. Administer acetaminophen and continue the transfusion
D. Obtain a urine sample for hemoglobin
Answer: A
Rationale: Symptoms indicate acute hemolytic reaction; stop transfusion immediately, maintain IV
access with saline, and notify blood bank.
3. A nurse is preparing to insert a nasogastric tube. Which action demonstrates correct infection
control?
A. Perform hand hygiene and apply clean gloves
B. Use sterile gloves and a sterile drape
,C. Wear a face shield and sterile gown
D. Perform hand hygiene only
Answer: A
Rationale: NG tube insertion is a clean, not sterile, procedure; hand hygiene and clean gloves are
sufficient.
4. A client with heart failure is being discharged. Which statement indicates understanding of dietary
restrictions?
A. “I should limit my daily fluid intake to 2 liters and avoid canned soups.”
B. “I can use salt substitutes freely because they are sodium-free.”
C. “I should drink at least 3 liters of water daily to prevent dehydration.”
D. “I will eat bananas daily to increase potassium levels.”
Answer: A
Rationale: Fluid restriction (usually 1.5-2 L/day) and low-sodium diet are key; salt substitutes may
contain potassium and be dangerous with ACE inhibitors.
5. A nurse is caring for a client with an indwelling urinary catheter. Which finding should be reported as
a possible catheter-associated urinary tract infection (CAUTI)?
A. Cloudy, foul-smelling urine with sediment
B. Dark yellow concentrated urine
C. Urine output of 40 mL/hr
D. Urine specific gravity of 1.025
Answer: A
Rationale: Cloudy, foul-smelling urine is a classic sign of CAUTI; concentrated urine indicates
dehydration, not infection.
6. A postoperative client is receiving morphine via patient-controlled analgesia (PCA). The respiratory
rate is 8/min. What is the priority action?
A. Stop the PCA infusion and notify the provider
B. Administer naloxone immediately
C. Increase the demand dose to improve pain control
,D. Place the client in high-Fowler’s position
Answer: A
Rationale: Respiratory depression requires stopping the opioid source first; naloxone may be given after,
but stopping the infusion is priority.
7. A nurse assesses a peripheral IV site that is warm, edematous, and reddened along the vein. What is
the most appropriate intervention?
A. Discontinue the IV and restart in a different location
B. Apply a warm compress and continue the infusion
C. Flush the IV with 10 mL normal saline
D. Elevate the extremity and slow the infusion rate
Answer: A
Rationale: Signs indicate phlebitis; the IV must be removed to prevent further irritation or infection.
8. A nurse is teaching a client about using an incentive spirometer after thoracic surgery. Which
instruction is correct?
A. “Inhale slowly and deeply, then hold your breath for 3-5 seconds.”
B. “Exhale forcefully into the device to measure lung capacity.”
C. “Use the device every 4 hours while awake only.”
D. “Lie flat on your back while using the spirometer.”
Answer: A
Rationale: Sustained deep inhalation promotes lung expansion and prevents atelectasis; breath hold
increases alveolar inflation.
9. A client has a prescription for digoxin 0.25 mg daily. Which finding would prompt the nurse to
withhold the medication?
A. Apical pulse of 52 beats/min
B. Blood pressure of 110/70 mm Hg
C. Potassium level of 4.0 mEq/L
D. Respiratory rate of 18/min
, Answer: A
Rationale: Digoxin is withheld for apical pulse <60 bpm in adults; hypokalemia also increases toxicity risk
but pulse is immediate concern.
10. A client with a new colostomy has a stoma that is dark purple and edematous. What should the
nurse do first?
A. Notify the surgeon immediately
B. Apply a cold compress to reduce edema
C. Gently massage the stoma to improve circulation
D. Document the finding as normal for a new stoma
Answer: A
Rationale: Dark purple indicates ischemia or necrosis; this is a surgical emergency requiring immediate
evaluation.
11. A nurse is caring for a client receiving continuous enteral feeding via nasogastric tube. Which finding
indicates feeding intolerance?
A. Gastric residual volume of 300 mL
B. Bowel sounds present in all quadrants
C. Blood glucose of 110 mg/dL
D. Urine output of 1,500 mL in 24 hours
Answer: A
Rationale: High gastric residual (>250-500 mL) suggests delayed gastric emptying and aspiration risk.
12. A confused client attempts to pull out their IV line. The nurse applies wrist restraints. Which action is
most important?
A. Obtain a provider’s order within 1 hour
B. Tie the restraints to the side rail of the bed
C. Remove restraints every 4 hours for skin assessment
D. Use a square knot to secure the restraints
Answer: A
