ATI Comprehensive Exit Exam Practice Questions with
verified answers plus rationales 2026/2027 version
1. A nurse is caring for a client who has a new prescription for hydrochlorothiazide. Which
of the following laboratory values should the nurse monitor?
• A. Serum sodium
• B. Serum potassium
• C. Serum calcium
• D. Serum magnesium
Answer: B. Serum potassium
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia (potassium
depletion). The nurse should monitor serum potassium levels and assess for signs of
hypokalemia such as muscle weakness and cardiac dysrhythmias.
2. A nurse is providing teaching to a client who has a new prescription for digoxin. Which
of the following should the nurse include in the teaching?
• A. "Take your pulse for 1 full minute before taking this medication."
• B. "You may take this medication with antacids."
• C. "You should double the dose if you miss a dose."
• D. "This medication will cause your urine to turn orange."
Answer: A. "Take your pulse for 1 full minute before taking this medication."
Rationale: Digoxin has a narrow therapeutic range and can cause bradycardia. The client should
take their pulse for 1 full minute before each dose and hold the dose if the pulse is below 60/min.
3. A nurse is caring for a client who is receiving heparin therapy. Which of the following
laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?
• A. aPTT
• B. INR
• C. Platelet count
• D. PT
Answer: A. aPTT
,Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
The therapeutic goal for aPTT on heparin is 1.5 to 2.5 times the normal control value.
4. A nurse is preparing to administer enoxaparin to a client. Which of the following actions
should the nurse take?
• A. Administer the medication intramuscularly in the ventrogluteal site.
• B. Administer the medication subcutaneously in the abdomen.
• C. Expel the air bubble from the prefilled syringe before injection.
• D. Massage the injection site after administration.
Answer: B. Administer the medication subcutaneously in the abdomen.
Rationale: Enoxaparin (Lovenox) is a low molecular weight heparin administered
subcutaneously in the abdomen. The air bubble should not be expelled as it ensures complete
medication delivery. The site should not be massaged to avoid bruising.
5. A nurse is caring for a client who has atrial fibrillation and is prescribed warfarin. The
client's INR is 4.5. Which of the following actions should the nurse take?
• A. Administer the warfarin as prescribed.
• B. Hold the warfarin and notify the provider.
• C. Administer vitamin K intramuscularly.
• D. Increase the warfarin dose.
Answer: B. Hold the warfarin and notify the provider.
Rationale: Therapeutic INR for atrial fibrillation is 2-3. An INR of 4.5 is elevated and indicates
an increased risk of bleeding. The nurse should hold the warfarin and notify the provider.
Vitamin K may be ordered, but the decision is made by the provider.
6. A nurse is providing teaching to a client who has a new prescription for furosemide.
Which of the following foods should the nurse encourage the client to eat?
• A. Bananas
• B. Apples
• C. Green beans
, • D. Bread
Answer: A. Bananas
Rationale: Furosemide is a loop diuretic that causes potassium loss (hypokalemia). Clients
should be encouraged to eat potassium-rich foods such as bananas, oranges, and potatoes.
7. A nurse is administering an IV infusion of normal saline to a client who has
hypovolemia. Which of the following findings indicates the client is responding to the
treatment?
• A. Decreased blood pressure
• B. Increased urine output
• C. Increased heart rate
• D. Decreased skin turgor
Answer: B. Increased urine output
Rationale: In hypovolemia, fluid resuscitation should result in improved urinary output (at least
30 mL/hr), increased blood pressure, and decreased heart rate. Increased urine output indicates
adequate renal perfusion.
8. A nurse is preparing to transfuse a unit of packed red blood cells to a client. Which of
the following actions should the nurse take first?
• A. Verify the client's identity with another nurse.
• B. Prime the IV tubing with normal saline.
• C. Obtain the client's vital signs.
• D. Check the expiration date on the blood unit.
Answer: A. Verify the client's identity with another nurse.
Rationale: The first priority in a blood transfusion is to verify the client's identity with another
licensed nurse to prevent transfusion errors. This is done by checking two client identifiers per
facility policy.
, 9. A nurse is caring for a client who is receiving a blood transfusion and develops chills,
fever, and back pain. Which of the following actions should the nurse take first?
• A. Notify the provider.
• B. Stop the transfusion.
• C. Administer an antihistamine.
• D. Obtain a urine specimen.
Answer: B. Stop the transfusion.
Rationale: Chills, fever, and back pain are signs of a transfusion reaction. The nurse should stop
the transfusion first to prevent further complications. The provider should be notified after the
transfusion is stopped.
10. A nurse is performing a focused assessment on a client who has a history of chronic
obstructive pulmonary disease (COPD) and is receiving oxygen at 2 L/min via nasal
cannula. The client reports shortness of breath and has an oxygen saturation of 88%.
Which of the following actions should the nurse take?
• A. Increase the oxygen to 4 L/min.
• B. Notify the provider immediately.
• C. Encourage the client to cough and deep breathe.
• D. Assess the client's respiratory rate and depth.
Answer: A. Increase the oxygen to 4 L/min.
Rationale: In COPD clients, oxygen should be titrated to maintain SpO2 ≥ 90%. An SpO2 of
88% is below the target; the nurse should increase the oxygen and reassess. Oxygen should not
be withheld due to the hypoxic drive concern (this applies only to severe COPD with CO2
retention).
11. A nurse is providing teaching to a client who has a new prescription for metformin.
Which of the following should the nurse include in the teaching?
• A. "This medication may cause weight gain."
• B. "You should take this medication with meals."
• C. "You may experience hypoglycemia while taking this medication."
• D. "You should monitor your blood glucose daily."
Answer: B. "You should take this medication with meals."
verified answers plus rationales 2026/2027 version
1. A nurse is caring for a client who has a new prescription for hydrochlorothiazide. Which
of the following laboratory values should the nurse monitor?
• A. Serum sodium
• B. Serum potassium
• C. Serum calcium
• D. Serum magnesium
Answer: B. Serum potassium
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia (potassium
depletion). The nurse should monitor serum potassium levels and assess for signs of
hypokalemia such as muscle weakness and cardiac dysrhythmias.
2. A nurse is providing teaching to a client who has a new prescription for digoxin. Which
of the following should the nurse include in the teaching?
• A. "Take your pulse for 1 full minute before taking this medication."
• B. "You may take this medication with antacids."
• C. "You should double the dose if you miss a dose."
• D. "This medication will cause your urine to turn orange."
Answer: A. "Take your pulse for 1 full minute before taking this medication."
Rationale: Digoxin has a narrow therapeutic range and can cause bradycardia. The client should
take their pulse for 1 full minute before each dose and hold the dose if the pulse is below 60/min.
3. A nurse is caring for a client who is receiving heparin therapy. Which of the following
laboratory values should the nurse monitor to evaluate the effectiveness of the therapy?
• A. aPTT
• B. INR
• C. Platelet count
• D. PT
Answer: A. aPTT
,Rationale: Heparin therapy is monitored using the activated partial thromboplastin time (aPTT).
The therapeutic goal for aPTT on heparin is 1.5 to 2.5 times the normal control value.
4. A nurse is preparing to administer enoxaparin to a client. Which of the following actions
should the nurse take?
• A. Administer the medication intramuscularly in the ventrogluteal site.
• B. Administer the medication subcutaneously in the abdomen.
• C. Expel the air bubble from the prefilled syringe before injection.
• D. Massage the injection site after administration.
Answer: B. Administer the medication subcutaneously in the abdomen.
Rationale: Enoxaparin (Lovenox) is a low molecular weight heparin administered
subcutaneously in the abdomen. The air bubble should not be expelled as it ensures complete
medication delivery. The site should not be massaged to avoid bruising.
5. A nurse is caring for a client who has atrial fibrillation and is prescribed warfarin. The
client's INR is 4.5. Which of the following actions should the nurse take?
• A. Administer the warfarin as prescribed.
• B. Hold the warfarin and notify the provider.
• C. Administer vitamin K intramuscularly.
• D. Increase the warfarin dose.
Answer: B. Hold the warfarin and notify the provider.
Rationale: Therapeutic INR for atrial fibrillation is 2-3. An INR of 4.5 is elevated and indicates
an increased risk of bleeding. The nurse should hold the warfarin and notify the provider.
Vitamin K may be ordered, but the decision is made by the provider.
6. A nurse is providing teaching to a client who has a new prescription for furosemide.
Which of the following foods should the nurse encourage the client to eat?
• A. Bananas
• B. Apples
• C. Green beans
, • D. Bread
Answer: A. Bananas
Rationale: Furosemide is a loop diuretic that causes potassium loss (hypokalemia). Clients
should be encouraged to eat potassium-rich foods such as bananas, oranges, and potatoes.
7. A nurse is administering an IV infusion of normal saline to a client who has
hypovolemia. Which of the following findings indicates the client is responding to the
treatment?
• A. Decreased blood pressure
• B. Increased urine output
• C. Increased heart rate
• D. Decreased skin turgor
Answer: B. Increased urine output
Rationale: In hypovolemia, fluid resuscitation should result in improved urinary output (at least
30 mL/hr), increased blood pressure, and decreased heart rate. Increased urine output indicates
adequate renal perfusion.
8. A nurse is preparing to transfuse a unit of packed red blood cells to a client. Which of
the following actions should the nurse take first?
• A. Verify the client's identity with another nurse.
• B. Prime the IV tubing with normal saline.
• C. Obtain the client's vital signs.
• D. Check the expiration date on the blood unit.
Answer: A. Verify the client's identity with another nurse.
Rationale: The first priority in a blood transfusion is to verify the client's identity with another
licensed nurse to prevent transfusion errors. This is done by checking two client identifiers per
facility policy.
, 9. A nurse is caring for a client who is receiving a blood transfusion and develops chills,
fever, and back pain. Which of the following actions should the nurse take first?
• A. Notify the provider.
• B. Stop the transfusion.
• C. Administer an antihistamine.
• D. Obtain a urine specimen.
Answer: B. Stop the transfusion.
Rationale: Chills, fever, and back pain are signs of a transfusion reaction. The nurse should stop
the transfusion first to prevent further complications. The provider should be notified after the
transfusion is stopped.
10. A nurse is performing a focused assessment on a client who has a history of chronic
obstructive pulmonary disease (COPD) and is receiving oxygen at 2 L/min via nasal
cannula. The client reports shortness of breath and has an oxygen saturation of 88%.
Which of the following actions should the nurse take?
• A. Increase the oxygen to 4 L/min.
• B. Notify the provider immediately.
• C. Encourage the client to cough and deep breathe.
• D. Assess the client's respiratory rate and depth.
Answer: A. Increase the oxygen to 4 L/min.
Rationale: In COPD clients, oxygen should be titrated to maintain SpO2 ≥ 90%. An SpO2 of
88% is below the target; the nurse should increase the oxygen and reassess. Oxygen should not
be withheld due to the hypoxic drive concern (this applies only to severe COPD with CO2
retention).
11. A nurse is providing teaching to a client who has a new prescription for metformin.
Which of the following should the nurse include in the teaching?
• A. "This medication may cause weight gain."
• B. "You should take this medication with meals."
• C. "You may experience hypoglycemia while taking this medication."
• D. "You should monitor your blood glucose daily."
Answer: B. "You should take this medication with meals."
