ATI RN Comprehensive Exit Exam NSG 4800 Prep-
Comprehensive Nursing Practice Questions & Clinical
Rationales 3 VERSIONS
This specialized clinical preparation resource provides targeted practice questions,
verified answers, and comprehensive clinical rationales designed explicitly for the ATI
Comprehensive Exit Examination within NSG 4800 senior capstone courses. It
systematically breaks down major NCLEX-RN test plan categories, including safe and
effective care environments, pharmacological therapeutics, and advanced physiological
adaptation parameters. Pre-licensure nursing students will master critical client care
prioritization strategies, multi-system nursing interventions, and clinical judgment
models to ensure a passing predictability score.
1. A nurse is interpreting an ABG: pH 7.28, PaCO2 55, HCO3 24. Which acid-base
imbalance is present?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Rationale: pH <7.35 with elevated PaCO2 indicates respiratory acidosis.
2. A client with hyperkalemia. Which ECG finding is expected?
A) U waves
B) Peaked T waves
C) Prolonged QT
D) ST depression
Rationale: Hyperkalemia causes tall, peaked T waves and widened QRS.
,3. A client with hypocalcemia. Which finding is expected?
A) Chvostek's sign
B) Muscle weakness
C) Constipation
D) Hypertension
Rationale: Hypocalcemia causes neuromuscular irritability, Chvostek's and Trousseau's
signs.
4. A nurse is calculating a medication dose. Order: 500 mg. Available: 250 mg/5
mL. How many mL?
A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL
Rationale: (500 ÷ 250) × 5 = 10 mL.
5. A client has a stage 3 pressure ulcer. Which finding is expected?
A) Redness
B) Blister
C) Full-thickness tissue loss with visible fat
D) Bone exposure
Rationale: Stage 3 involves full-thickness loss with visible subcutaneous fat, no
bone/tendon.
6. A client with tuberculosis. Which isolation precaution is required?
A) Contact
B) Droplet
C) Airborne
D) Standard
,Rationale: TB requires airborne precautions with N95 respirator and negative-pressure
room.
7. A client with influenza. Which isolation precaution is required?
A) Contact
B) Droplet
C) Airborne
D) Standard
Rationale: Influenza requires droplet precautions; mask within 3 feet.
8. A client with MRSA. Which isolation precaution is required?
A) Contact
B) Droplet
C) Airborne
D) Standard
Rationale: MRSA requires contact precautions with gown and gloves.
9. A nurse is teaching about RhoGAM. When is it administered?
A) At 28 weeks and within 72 hours postpartum
B) Only after delivery
C) At 12 weeks
D) Only during first trimester
Rationale: RhoGAM prevents Rh sensitization; given at 28 weeks and within 72 hours of
delivery.
, 10. A client with gestational diabetes. Which finding is expected?
A) Elevated glucose on glucose tolerance test
B) Hypoglycemia
C) Weight loss
D) Polycythemia
Rationale: Gestational diabetes is diagnosed by elevated glucose on GTT.
11. A client in the first stage of labor. Which finding indicates transition?
A) Contractions every 5 minutes
B) Contractions every 2 minutes lasting 60–90 seconds
C) Cervical dilation 4 cm
D) Mild discomfort
Rationale: Transition phase: contractions every 2–3 minutes, strong, lasting 60–90 seconds.
12. A client postpartum with DVT. Which finding is expected?
A) Unilateral calf pain and swelling
B) Bilateral edema
C) Pallor
D) Warmth in both legs
Rationale: DVT causes unilateral calf pain, swelling, warmth, and redness.
13. A newborn with jaundice. Which finding indicates pathologic jaundice?
A) Jaundice at 3 days
B) Jaundice within 24 hours of birth
C) Mild jaundice
D) Resolving jaundice
Rationale: Jaundice within 24 hours is pathologic and requires immediate evaluation.
Comprehensive Nursing Practice Questions & Clinical
Rationales 3 VERSIONS
This specialized clinical preparation resource provides targeted practice questions,
verified answers, and comprehensive clinical rationales designed explicitly for the ATI
Comprehensive Exit Examination within NSG 4800 senior capstone courses. It
systematically breaks down major NCLEX-RN test plan categories, including safe and
effective care environments, pharmacological therapeutics, and advanced physiological
adaptation parameters. Pre-licensure nursing students will master critical client care
prioritization strategies, multi-system nursing interventions, and clinical judgment
models to ensure a passing predictability score.
1. A nurse is interpreting an ABG: pH 7.28, PaCO2 55, HCO3 24. Which acid-base
imbalance is present?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Rationale: pH <7.35 with elevated PaCO2 indicates respiratory acidosis.
2. A client with hyperkalemia. Which ECG finding is expected?
A) U waves
B) Peaked T waves
C) Prolonged QT
D) ST depression
Rationale: Hyperkalemia causes tall, peaked T waves and widened QRS.
,3. A client with hypocalcemia. Which finding is expected?
A) Chvostek's sign
B) Muscle weakness
C) Constipation
D) Hypertension
Rationale: Hypocalcemia causes neuromuscular irritability, Chvostek's and Trousseau's
signs.
4. A nurse is calculating a medication dose. Order: 500 mg. Available: 250 mg/5
mL. How many mL?
A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL
Rationale: (500 ÷ 250) × 5 = 10 mL.
5. A client has a stage 3 pressure ulcer. Which finding is expected?
A) Redness
B) Blister
C) Full-thickness tissue loss with visible fat
D) Bone exposure
Rationale: Stage 3 involves full-thickness loss with visible subcutaneous fat, no
bone/tendon.
6. A client with tuberculosis. Which isolation precaution is required?
A) Contact
B) Droplet
C) Airborne
D) Standard
,Rationale: TB requires airborne precautions with N95 respirator and negative-pressure
room.
7. A client with influenza. Which isolation precaution is required?
A) Contact
B) Droplet
C) Airborne
D) Standard
Rationale: Influenza requires droplet precautions; mask within 3 feet.
8. A client with MRSA. Which isolation precaution is required?
A) Contact
B) Droplet
C) Airborne
D) Standard
Rationale: MRSA requires contact precautions with gown and gloves.
9. A nurse is teaching about RhoGAM. When is it administered?
A) At 28 weeks and within 72 hours postpartum
B) Only after delivery
C) At 12 weeks
D) Only during first trimester
Rationale: RhoGAM prevents Rh sensitization; given at 28 weeks and within 72 hours of
delivery.
, 10. A client with gestational diabetes. Which finding is expected?
A) Elevated glucose on glucose tolerance test
B) Hypoglycemia
C) Weight loss
D) Polycythemia
Rationale: Gestational diabetes is diagnosed by elevated glucose on GTT.
11. A client in the first stage of labor. Which finding indicates transition?
A) Contractions every 5 minutes
B) Contractions every 2 minutes lasting 60–90 seconds
C) Cervical dilation 4 cm
D) Mild discomfort
Rationale: Transition phase: contractions every 2–3 minutes, strong, lasting 60–90 seconds.
12. A client postpartum with DVT. Which finding is expected?
A) Unilateral calf pain and swelling
B) Bilateral edema
C) Pallor
D) Warmth in both legs
Rationale: DVT causes unilateral calf pain, swelling, warmth, and redness.
13. A newborn with jaundice. Which finding indicates pathologic jaundice?
A) Jaundice at 3 days
B) Jaundice within 24 hours of birth
C) Mild jaundice
D) Resolving jaundice
Rationale: Jaundice within 24 hours is pathologic and requires immediate evaluation.
