ATI RN Comprehensive Exit Exam NSG 4800 Prep-
Comprehensive Nursing Practice Questions & Clinical
Rationales 2 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 assessing a client in labor with an epidural. Which finding requires
immediate intervention?
A) Blood pressure 100/60
B) Respiratory rate 10
C) Mild itching
D) Urinary retention
Rationale: Respiratory depression can occur with epidural opioids; RR <12 requires
immediate intervention.
2. A client is receiving oxytocin for induction. Which finding indicates
hyperstimulation?
A) Contractions every 3 minutes
B) Contractions lasting 90 seconds
C) Fetal heart rate 140
D) Mild discomfort
Rationale: Contractions >90 seconds or <2 minutes apart indicate hyperstimulation; stop
oxytocin.
,3. A nurse is caring for a client after cesarean delivery. Which finding indicates
infection?
A) Temperature 100.4°F on day 1
B) Foul-smelling lochia
C) Mild incisional pain
D) Lochia rubra
Rationale: Foul-smelling lochia indicates endometritis; requires antibiotics.
4. A newborn is 1 hour old. Which finding requires immediate intervention?
A) Acrocyanosis
B) Respiratory rate 70
C) Heart rate 130
D) Moro reflex present
Rationale: RR >60 indicates respiratory distress; needs evaluation.
5. A nurse is teaching a new mother about umbilical cord care. Which instruction is
correct?
A) Clean with alcohol at each diaper change
B) Cover with plastic wrap
C) Apply ointment
D) Soak in water
Rationale: Keep cord clean and dry; alcohol or soap and water.
6. A child with croup. Which finding is expected?
A) Barking cough
B) Drooling
C) Trismus
D) Kussmaul respirations
,Rationale: Croup causes barking cough, stridor, and hoarseness.
7. A child with bronchiolitis. Which finding is expected?
A) Wheezing
B) Barking cough
C) Drooling
D) Trismus
Rationale: Bronchiolitis causes wheezing, tachypnea, and retractions.
8. A child with pyloric stenosis. Which finding is expected?
A) Projectile vomiting
B) Currant jelly stools
C) Ribbon-like stools
D) Clay-colored stools
Rationale: Pyloric stenosis causes projectile vomiting after feeding.
9. A child with Hirschsprung disease. Which finding is expected?
A) Ribbon-like stools
B) Projectile vomiting
C) Currant jelly stools
D) Clay-colored stools
Rationale: Hirschsprung causes ribbon-like stools, constipation, and abdominal distension.
10. A child with celiac disease. Which food should be avoided?
A) Rice
B) Wheat
, C) Corn
D) Potatoes
Rationale: Celiac disease requires a gluten-free diet; avoid wheat, barley, rye.
11. A child with acute glomerulonephritis. Which finding is expected?
A) Tea-colored urine
B) Polyuria
C) Hyperkalemia
D) Weight loss
Rationale: Glomerulonephritis causes hematuria, edema, and hypertension.
12. A child with nephrotic syndrome. Which finding is expected?
A) Proteinuria
B) Hematuria
C) Hypertension
D) Weight loss
Rationale: Nephrotic syndrome causes massive proteinuria, hypoalbuminemia, and
edema.
13. A child with hypospadias. Which intervention is priority?
A) Do not circumcise
B) Circumcise immediately
C) Catheterize
D) Apply ice
Rationale: Circumcision is contraindicated because the foreskin may be needed for repair.
Comprehensive Nursing Practice Questions & Clinical
Rationales 2 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 assessing a client in labor with an epidural. Which finding requires
immediate intervention?
A) Blood pressure 100/60
B) Respiratory rate 10
C) Mild itching
D) Urinary retention
Rationale: Respiratory depression can occur with epidural opioids; RR <12 requires
immediate intervention.
2. A client is receiving oxytocin for induction. Which finding indicates
hyperstimulation?
A) Contractions every 3 minutes
B) Contractions lasting 90 seconds
C) Fetal heart rate 140
D) Mild discomfort
Rationale: Contractions >90 seconds or <2 minutes apart indicate hyperstimulation; stop
oxytocin.
,3. A nurse is caring for a client after cesarean delivery. Which finding indicates
infection?
A) Temperature 100.4°F on day 1
B) Foul-smelling lochia
C) Mild incisional pain
D) Lochia rubra
Rationale: Foul-smelling lochia indicates endometritis; requires antibiotics.
4. A newborn is 1 hour old. Which finding requires immediate intervention?
A) Acrocyanosis
B) Respiratory rate 70
C) Heart rate 130
D) Moro reflex present
Rationale: RR >60 indicates respiratory distress; needs evaluation.
5. A nurse is teaching a new mother about umbilical cord care. Which instruction is
correct?
A) Clean with alcohol at each diaper change
B) Cover with plastic wrap
C) Apply ointment
D) Soak in water
Rationale: Keep cord clean and dry; alcohol or soap and water.
6. A child with croup. Which finding is expected?
A) Barking cough
B) Drooling
C) Trismus
D) Kussmaul respirations
,Rationale: Croup causes barking cough, stridor, and hoarseness.
7. A child with bronchiolitis. Which finding is expected?
A) Wheezing
B) Barking cough
C) Drooling
D) Trismus
Rationale: Bronchiolitis causes wheezing, tachypnea, and retractions.
8. A child with pyloric stenosis. Which finding is expected?
A) Projectile vomiting
B) Currant jelly stools
C) Ribbon-like stools
D) Clay-colored stools
Rationale: Pyloric stenosis causes projectile vomiting after feeding.
9. A child with Hirschsprung disease. Which finding is expected?
A) Ribbon-like stools
B) Projectile vomiting
C) Currant jelly stools
D) Clay-colored stools
Rationale: Hirschsprung causes ribbon-like stools, constipation, and abdominal distension.
10. A child with celiac disease. Which food should be avoided?
A) Rice
B) Wheat
, C) Corn
D) Potatoes
Rationale: Celiac disease requires a gluten-free diet; avoid wheat, barley, rye.
11. A child with acute glomerulonephritis. Which finding is expected?
A) Tea-colored urine
B) Polyuria
C) Hyperkalemia
D) Weight loss
Rationale: Glomerulonephritis causes hematuria, edema, and hypertension.
12. A child with nephrotic syndrome. Which finding is expected?
A) Proteinuria
B) Hematuria
C) Hypertension
D) Weight loss
Rationale: Nephrotic syndrome causes massive proteinuria, hypoalbuminemia, and
edema.
13. A child with hypospadias. Which intervention is priority?
A) Do not circumcise
B) Circumcise immediately
C) Catheterize
D) Apply ice
Rationale: Circumcision is contraindicated because the foreskin may be needed for repair.
