ATI PN COMPREHENSIVE PREDICTOR 2026 EXIT EXAM
Complete 180-Question NGN & Traditional Item Bank with Clinical Rationales
Category: Medical-Surgical Nursing (Items)
Question 1: A nurse is caring for a client who has heart failure and is receiving furosemide. Which of
the following laboratory findings should the nurse report immediately?
A) Sodium 138 mEq/L
B) Potassium 3.1 mEq/L
C) Chloride 100 mEq/L
D) Magnesium 2.0 mEq/L
Correct Answer: B — Furosemide is a loop diuretic that wastes potassium. A serum potassium level of 3.1 mEq/L is
hypokalemic and increases the risk of digoxin toxicity and life-threatening cardiac dysrhythmias.
Question 2: A nurse is assessing a client with left-sided heart failure. Which of the following findings
should the nurse expect?
A) Jugular vein distension
B) Dependent peripheral edema
C) Exertional dyspnea and crackles in lung bases
D) Right upper quadrant abdominal tenderness
Correct Answer: C — Left-sided heart failure results in pulmonary congestion, leading to dyspnea, orthopnea, and
crackles in the lung bases. Right-sided failure causes peripheral edema and JVD.
Question 3: A nurse is providing discharge teaching to a client with a new prescription for warfarin.
Which of the following statements by the client indicates an understanding of the teaching?
A) 'I will increase my intake of dark green leafy vegetables.'
B) 'I will use a soft-bristled toothbrush and an electric razor.'
C) 'I can take aspirin for headaches while on warfarin.'
D) 'My INR therapeutic range will be checked once a year.'
Correct Answer: B — A soft-bristled toothbrush and electric razor minimize bleeding risks. Green leafy vegetables
contain vitamin K, which antagonizes warfarin, and must be consumed consistently rather than increased. Aspirin
increases bleeding risk and should be avoided unless prescribed.
Question 4: A nurse is caring for a client who has a suspected myocardial infarction. Which of the
following diagnostic tests is the priority indicator of acute myocardial injury?
A) Complete blood count
B) Serum cardiac troponin T and I
C) Serum electrolytes
D) Chest x-ray
Correct Answer: B — Cardiac troponin is highly specific for myocardial injury and is the gold-standard biomarker for
diagnosing a myocardial infarction.
,Question 5: A nurse is assessing a client following a thyroidectomy. Which of the following findings is
indicative of hypocalcemia resulting from inadvertent parathyroid gland damage?
A) Trousseau's sign
B) Bradycardia
C) Hyperactive bowel sounds
D) Polyuria
Correct Answer: A — Inadvertent damage to the parathyroid glands during thyroid surgery leads to hypocalcemia,
manifested by positive Chvostek's and Trousseau's signs, muscle tremors, and tetany.
Question 6: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 7: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 8: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 9: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
,Question 10: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 11: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 12: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 13: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 14: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
, Question 15: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 16: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 17: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 18: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 19: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Complete 180-Question NGN & Traditional Item Bank with Clinical Rationales
Category: Medical-Surgical Nursing (Items)
Question 1: A nurse is caring for a client who has heart failure and is receiving furosemide. Which of
the following laboratory findings should the nurse report immediately?
A) Sodium 138 mEq/L
B) Potassium 3.1 mEq/L
C) Chloride 100 mEq/L
D) Magnesium 2.0 mEq/L
Correct Answer: B — Furosemide is a loop diuretic that wastes potassium. A serum potassium level of 3.1 mEq/L is
hypokalemic and increases the risk of digoxin toxicity and life-threatening cardiac dysrhythmias.
Question 2: A nurse is assessing a client with left-sided heart failure. Which of the following findings
should the nurse expect?
A) Jugular vein distension
B) Dependent peripheral edema
C) Exertional dyspnea and crackles in lung bases
D) Right upper quadrant abdominal tenderness
Correct Answer: C — Left-sided heart failure results in pulmonary congestion, leading to dyspnea, orthopnea, and
crackles in the lung bases. Right-sided failure causes peripheral edema and JVD.
Question 3: A nurse is providing discharge teaching to a client with a new prescription for warfarin.
Which of the following statements by the client indicates an understanding of the teaching?
A) 'I will increase my intake of dark green leafy vegetables.'
B) 'I will use a soft-bristled toothbrush and an electric razor.'
C) 'I can take aspirin for headaches while on warfarin.'
D) 'My INR therapeutic range will be checked once a year.'
Correct Answer: B — A soft-bristled toothbrush and electric razor minimize bleeding risks. Green leafy vegetables
contain vitamin K, which antagonizes warfarin, and must be consumed consistently rather than increased. Aspirin
increases bleeding risk and should be avoided unless prescribed.
Question 4: A nurse is caring for a client who has a suspected myocardial infarction. Which of the
following diagnostic tests is the priority indicator of acute myocardial injury?
A) Complete blood count
B) Serum cardiac troponin T and I
C) Serum electrolytes
D) Chest x-ray
Correct Answer: B — Cardiac troponin is highly specific for myocardial injury and is the gold-standard biomarker for
diagnosing a myocardial infarction.
,Question 5: A nurse is assessing a client following a thyroidectomy. Which of the following findings is
indicative of hypocalcemia resulting from inadvertent parathyroid gland damage?
A) Trousseau's sign
B) Bradycardia
C) Hyperactive bowel sounds
D) Polyuria
Correct Answer: A — Inadvertent damage to the parathyroid glands during thyroid surgery leads to hypocalcemia,
manifested by positive Chvostek's and Trousseau's signs, muscle tremors, and tetany.
Question 6: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 7: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 8: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 9: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
,Question 10: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 11: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 12: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 13: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 14: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
, Question 15: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 16: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 17: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 18: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
Question 19: A nurse in a clinical setting is evaluating a client regarding medical-surgical nursing
management (Item 1). Which of the following nursing actions is appropriate?
A) Implement evidence-based nursing interventions according to client acuity.
B) Delay necessary assessments until the end of the shift.
C) Delegate clinical evaluations to unlicensed assistive personnel.
D) Withhold documentation of abnormal vital signs.
Correct Answer: A — Rationale: Implementing evidence-based nursing interventions appropriate to client acuity ensures
safe, high-quality care within the Medical-Surgical Nursing domain.
