ATI RN FINAL COMPREHENSIVE PREDICTOR 2026 Exit
Exam with NGN Including Both Actual and Retake Exams and
Answers to Score 99% and Above Level 3 in the New 2026 - 100
Questions and Answers Already Graded A+ Premium Exam
Tested And Verified
Subject Area Nursing - Comprehensive Exit Examination
Description This exam covers the full scope of registered nursing practice including
medical-surgical, maternal-newborn, pediatric, psychiatric-mental health, and
community health nursing. It integrates clinical judgment, pharmacology, safety,
infection control, and leadership concepts. Designed to assess readiness for
entry-level practice and NCLEX-RN success.
Expected Grade A+
Total Questions 100
Duration 4 hours
Learning Outcomes 1. Apply clinical judgment frameworks to prioritize patient care across the
lifespan.
2. Integrate pharmacological principles with patient-specific factors to ensure safe
medication administration.
3. Analyze laboratory and diagnostic data to detect complications and guide
interventions.
4. Demonstrate leadership and delegation skills in managing patient assignments
and team dynamics.
5. Synthesize evidence-based practices for health promotion, disease prevention,
and patient education.
Accreditation Accredited by the Commission on Collegiate Nursing Education (CCNE) and
aligned with the National Council of State Boards of Nursing (NCSBN)
NCLEX-RN test plan.
Page 1
,1. A patient with respiratory alkalosis due to hyperventilation is being treated.
Which arterial blood gas (ABG) finding indicates the patient is compensating?
A. pH 7.48, PaCO2 30 mm Hg, HCO3- 24 mEq/L
B. pH 7.45, PaCO2 32 mm Hg, HCO3- 20 mEq/L
C. pH 7.50, PaCO2 28 mm Hg, HCO3- 26 mEq/L
D. pH 7.42, PaCO2 35 mm Hg, HCO3- 18 mEq/L
Answer: B. pH 7.45, PaCO2 32 mm Hg, HCO3- 20 mEq/L
In respiratory alkalosis, the primary disturbance is a low PaCO2. Compensation occurs
via renal excretion of bicarbonate, lowering HCO3-. Option B shows a slightly alkalotic
pH with low PaCO2 and low HCO3-, indicating metabolic compensation. Options A
and C have normal HCO3-, no compensation. Option D shows metabolic acidosis, not
compensation for respiratory alkalosis.
2. A nurse is evaluating a patient's telemetry strip and notes a rhythm with
irregularly irregular R-R intervals, absence of P waves, and a ventricular rate of
120/min. Which intervention is the priority?
A. Administer adenosine 6 mg rapid IV push
B. Prepare for synchronized cardioversion at 100 J
C. Start an IV infusion of amiodarone 150 mg over 10 minutes
D. Apply defibrillator pads and charge to 200 J
Answer: C. Start an IV infusion of amiodarone 150 mg over 10 minutes
The rhythm described is atrial fibrillation with rapid ventricular response. Priority is
rate control; amiodarone can be used for rhythm control but is not first-line for rate.
Adenosine (A) is for supraventricular tachycardia. Synchronized cardioversion (B) is
for unstable patients with atrial fibrillation, but the question does not indicate
instability. Defibrillation (D) is for pulseless ventricular tachycardia/fibrillation.
Page 2
,3. Which of the following is a contraindication for the administration of alteplase in
a patient with acute ischemic stroke?
A. Blood glucose level of 180 mg/dL
B. Systolic blood pressure 155 mm Hg after two readings
C. Platelet count of 100,000/mm³
D. History of intracranial hemorrhage 5 years ago
Answer: D. History of intracranial hemorrhage 5 years ago
Alteplase is contraindicated in patients with a history of intracranial hemorrhage.
Elevated glucose (A) and mild hypertension (B) are not absolute contraindications; BP
must be <185/110. Platelet count <100,000 is a contraindication (C), but 100,000 is
borderline; however, history of ICH is a stronger contraindication per guidelines.
4. A nurse is caring for a patient with a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. What is the
most appropriate action?
A. Clamp the chest tube near the insertion site
B. Replace the drainage system immediately
C. Assess the system for an air leak
D. Increase the suction pressure until bubbling stops
Answer: C. Assess the system for an air leak
Continuous bubbling in the water-seal chamber indicates an air leak in the system. The
nurse should assess for the source (e.g., loose connections, dislodged tube). Clamping
(A) is dangerous if there is an air leak. Replacing the system (B) may be necessary but
assessment comes first. Increasing suction (D) does not fix the leak and may cause tissue
trauma.
Page 3
, 5. A patient with chronic kidney disease (CKD) stage 4 has a serum potassium of 5.8
mEq/L. Which electrocardiographic change is most likely to be observed?
A. Prolonged PR interval
B. Peaked T waves
C. ST segment depression
D. Widened QRS complex
Answer: B. Peaked T waves
Hyperkalemia (>5.5 mEq/L) typically presents with peaked, narrow T waves on ECG.
Prolonged PR interval (A) and widened QRS (D) occur with more severe hyperkalemia.
ST depression (C) is associated with hypokalemia or ischemia. Peaked T waves are an
early sign of hyperkalemia.
6. A nurse is assessing a patient who is receiving a blood transfusion. Fifteen minutes
after initiation, the patient reports lower back pain and dyspnea. Vital signs show BP
88/50 mm Hg, HR 112/min, RR 28/min, temperature 37.8°C (100°F). What is the
priority action?
A. Administer diphenhydramine 50 mg IV
B. Increase the IV rate of normal saline
C. Stop the transfusion and maintain IV access
D. Obtain a urine specimen for hemoglobin
Answer: C. Stop the transfusion and maintain IV access
These signs indicate an acute hemolytic transfusion reaction. The priority is to stop the
transfusion immediately to prevent further hemolysis. Antihistamines (A) are for
allergic reactions. Increasing IV fluids (B) may be indicated after stopping the
transfusion, but not first. Urine specimen (D) is for confirmation but not the priority.
Page 4
Exam with NGN Including Both Actual and Retake Exams and
Answers to Score 99% and Above Level 3 in the New 2026 - 100
Questions and Answers Already Graded A+ Premium Exam
Tested And Verified
Subject Area Nursing - Comprehensive Exit Examination
Description This exam covers the full scope of registered nursing practice including
medical-surgical, maternal-newborn, pediatric, psychiatric-mental health, and
community health nursing. It integrates clinical judgment, pharmacology, safety,
infection control, and leadership concepts. Designed to assess readiness for
entry-level practice and NCLEX-RN success.
Expected Grade A+
Total Questions 100
Duration 4 hours
Learning Outcomes 1. Apply clinical judgment frameworks to prioritize patient care across the
lifespan.
2. Integrate pharmacological principles with patient-specific factors to ensure safe
medication administration.
3. Analyze laboratory and diagnostic data to detect complications and guide
interventions.
4. Demonstrate leadership and delegation skills in managing patient assignments
and team dynamics.
5. Synthesize evidence-based practices for health promotion, disease prevention,
and patient education.
Accreditation Accredited by the Commission on Collegiate Nursing Education (CCNE) and
aligned with the National Council of State Boards of Nursing (NCSBN)
NCLEX-RN test plan.
Page 1
,1. A patient with respiratory alkalosis due to hyperventilation is being treated.
Which arterial blood gas (ABG) finding indicates the patient is compensating?
A. pH 7.48, PaCO2 30 mm Hg, HCO3- 24 mEq/L
B. pH 7.45, PaCO2 32 mm Hg, HCO3- 20 mEq/L
C. pH 7.50, PaCO2 28 mm Hg, HCO3- 26 mEq/L
D. pH 7.42, PaCO2 35 mm Hg, HCO3- 18 mEq/L
Answer: B. pH 7.45, PaCO2 32 mm Hg, HCO3- 20 mEq/L
In respiratory alkalosis, the primary disturbance is a low PaCO2. Compensation occurs
via renal excretion of bicarbonate, lowering HCO3-. Option B shows a slightly alkalotic
pH with low PaCO2 and low HCO3-, indicating metabolic compensation. Options A
and C have normal HCO3-, no compensation. Option D shows metabolic acidosis, not
compensation for respiratory alkalosis.
2. A nurse is evaluating a patient's telemetry strip and notes a rhythm with
irregularly irregular R-R intervals, absence of P waves, and a ventricular rate of
120/min. Which intervention is the priority?
A. Administer adenosine 6 mg rapid IV push
B. Prepare for synchronized cardioversion at 100 J
C. Start an IV infusion of amiodarone 150 mg over 10 minutes
D. Apply defibrillator pads and charge to 200 J
Answer: C. Start an IV infusion of amiodarone 150 mg over 10 minutes
The rhythm described is atrial fibrillation with rapid ventricular response. Priority is
rate control; amiodarone can be used for rhythm control but is not first-line for rate.
Adenosine (A) is for supraventricular tachycardia. Synchronized cardioversion (B) is
for unstable patients with atrial fibrillation, but the question does not indicate
instability. Defibrillation (D) is for pulseless ventricular tachycardia/fibrillation.
Page 2
,3. Which of the following is a contraindication for the administration of alteplase in
a patient with acute ischemic stroke?
A. Blood glucose level of 180 mg/dL
B. Systolic blood pressure 155 mm Hg after two readings
C. Platelet count of 100,000/mm³
D. History of intracranial hemorrhage 5 years ago
Answer: D. History of intracranial hemorrhage 5 years ago
Alteplase is contraindicated in patients with a history of intracranial hemorrhage.
Elevated glucose (A) and mild hypertension (B) are not absolute contraindications; BP
must be <185/110. Platelet count <100,000 is a contraindication (C), but 100,000 is
borderline; however, history of ICH is a stronger contraindication per guidelines.
4. A nurse is caring for a patient with a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. What is the
most appropriate action?
A. Clamp the chest tube near the insertion site
B. Replace the drainage system immediately
C. Assess the system for an air leak
D. Increase the suction pressure until bubbling stops
Answer: C. Assess the system for an air leak
Continuous bubbling in the water-seal chamber indicates an air leak in the system. The
nurse should assess for the source (e.g., loose connections, dislodged tube). Clamping
(A) is dangerous if there is an air leak. Replacing the system (B) may be necessary but
assessment comes first. Increasing suction (D) does not fix the leak and may cause tissue
trauma.
Page 3
, 5. A patient with chronic kidney disease (CKD) stage 4 has a serum potassium of 5.8
mEq/L. Which electrocardiographic change is most likely to be observed?
A. Prolonged PR interval
B. Peaked T waves
C. ST segment depression
D. Widened QRS complex
Answer: B. Peaked T waves
Hyperkalemia (>5.5 mEq/L) typically presents with peaked, narrow T waves on ECG.
Prolonged PR interval (A) and widened QRS (D) occur with more severe hyperkalemia.
ST depression (C) is associated with hypokalemia or ischemia. Peaked T waves are an
early sign of hyperkalemia.
6. A nurse is assessing a patient who is receiving a blood transfusion. Fifteen minutes
after initiation, the patient reports lower back pain and dyspnea. Vital signs show BP
88/50 mm Hg, HR 112/min, RR 28/min, temperature 37.8°C (100°F). What is the
priority action?
A. Administer diphenhydramine 50 mg IV
B. Increase the IV rate of normal saline
C. Stop the transfusion and maintain IV access
D. Obtain a urine specimen for hemoglobin
Answer: C. Stop the transfusion and maintain IV access
These signs indicate an acute hemolytic transfusion reaction. The priority is to stop the
transfusion immediately to prevent further hemolysis. Antihistamines (A) are for
allergic reactions. Increasing IV fluids (B) may be indicated after stopping the
transfusion, but not first. Urine specimen (D) is for confirmation but not the priority.
Page 4
