ATI PN Comprehensive Exit Exam 2024/2025
– NGN Format | 180 Authentic Questions
with 100% Verified Answers & Detailed
Rationales | A+ Graded
SECTION I: FUNDAMENTALS OF NURSING & SAFETY
1. A nurse is caring for a client with a new prescription for oxygen therapy at 4 L/min via nasal
cannula. Which action should the nurse take first?
A. Apply the cannula and set the flow rate
B. Verify the prescription and assess the client's respiratory status
C. Document the intervention
D. Teach the client about fire safety
B— The nurse must first verify the prescription and assess respiratory status (rate,
rhythm, oxygen saturation) to establish a baseline and ensure the therapy is appropriate.
Applying oxygen without assessment can mask deterioration. Documentation and teaching
follow the intervention.
2. A nurse is performing a sterile dressing change. Which action indicates a break in sterile
technique?
A. Holding sterile gloves above waist level
B. Turning away from the sterile field to sneeze
C. Placing sterile supplies on the sterile field
D. Keeping the sterile field in view at all times
B— Turning away or sneezing toward the sterile field contaminates it. The nurse should
step away from the field and turn the head. All other options demonstrate correct sterile
technique.
3. A client is at risk for falls. Which interventions should the nurse include in the plan of care?
(SATA)
A. Keep the bed in the lowest position
B. Use a bed exit alarm
C. Keep side rails up on all four sides
,D. Ensure call light is within reach
E. Apply physical restraints prophylactically
A, B, D — Low bed position, bed exit alarms, and accessible call lights are evidence-
based fall precautions. Full side rails are considered restraints and increase injury risk. Restraints
require a specific prescription and are never prophylactic.
4. A nurse is teaching a client about hand hygiene. Which statement by the client indicates
understanding?
A. "I should wash my hands for 5 seconds with warm water."
B. "Alcohol-based rub is effective when hands are visibly soiled."
C. "I should wash my hands for at least 20 seconds with soap and water."
D. "I only need to wash my hands after using the bathroom."
C— Soap and water for at least 20 seconds is the CDC standard. Alcohol rub is
ineffective on visibly soiled hands. Hand hygiene is required before and after many contacts, not
just after toileting.
5. A nurse is caring for a client with an indwelling urinary catheter. Which finding requires
immediate intervention?
A. Urine output of 40 mL/hr
B. Dependent loop in the tubing
C. Cloudy urine with a strong odor
D. Catheter secured to the thigh
C— Cloudy, malodorous urine suggests catheter-associated urinary tract infection
(CAUTI) and requires prompt assessment and notification of the provider. Dependent loops
should be corrected but are not emergent. Output of 40 mL/hr is adequate.
6. A nurse is preparing to move a client up in bed. Which action protects the nurse from injury?
A. Keep feet close together
B. Bend at the waist and twist
C. Raise the bed to a comfortable working height and use a gait belt
D. Pull the client toward the nurse using arm strength
C— Raising the bed to working height and using assistive devices protects the nurse's
back. Feet should be shoulder-width apart, knees bent, and the client moved with coordinated
effort—not by twisting or arm strength alone.
,7. A nurse is assessing a client's skin for pressure injury risk. Which finding is a stage 1 pressure
injury?
A. Full-thickness loss with visible bone
B. Nonblanchable erythema of intact skin
C. Partial-thickness loss with a blister
D. Slough covering the wound bed
B— Stage 1 is nonblanchable erythema of intact skin. Stage 2 is partial-thickness loss
(blister). Stage 3 is full-thickness loss with slough. Stage 4 exposes bone, tendon, or muscle.
8. A nurse is caring for a client on contact precautions. Which personal protective equipment
should the nurse remove first?
A. Gloves
B. Gown
C. Mask
D. Goggles
A— Gloves are the most contaminated and are removed first, followed by goggles,
gown, then mask (removed last, after leaving the room). This sequence minimizes self-
contamination.
9. A client reports difficulty swallowing. Which action should the nurse take first?
A. Place the client in a supine position for meals
B. Obtain a swallow evaluation before oral intake
C. Encourage thin liquids
D. Provide a straw for drinking
B— A swallow evaluation (often by speech-language pathology) is required before oral
intake in a client with dysphagia to prevent aspiration. Supine position, thin liquids, and straws
all increase aspiration risk.
10. A nurse is reinforcing teaching about the use of a walker. Which instruction is correct?
A. "Move the walker forward, then step into it."
B. "Lift the walker and take a step at the same time."
C. "Place the walker one arm's length ahead, then step forward."
D. "Use the walker on stairs first."
, A— The correct sequence: advance the walker, then step into it. The client should not
step while lifting the walker. Walkers are used on level surfaces; stairs require specific training.
11. A nurse notes a client has a new onset of confusion. Which action is the priority?
A. Apply wrist restraints
B. Assess for hypoxia, hypoglycemia, and infection
C. Administer a sedative as needed
D. Document the behavior and reassess in 4 hours
B— Acute confusion (delirium) is a medical emergency. Assess for reversible causes—
hypoxia, hypoglycemia, infection, medication effects. Restraints and sedatives can worsen
delirium. Prompt reassessment is essential.
12. A nurse is caring for a client with a nasogastric tube. Which action should the nurse take
before administering a tube feeding?
A. Verify tube placement by auscultating for a whoosh
B. Check gastric residual volume and verify placement with pH
C. Place the client flat
D. Flush with 5 mL of water
B— Verify placement by aspirating gastric contents and checking pH (≤5.5) or by X-ray
per policy. The auscultation "whoosh" method is unreliable. The client should be elevated 30–
45° to prevent aspiration.
13. A nurse is providing wound care. Which finding should be reported to the provider
immediately?
A. Serosanguineous drainage on the dressing
B. Wound edges approximated
C. Sudden increase in bright red drainage with swelling
D. Mild tenderness at the site
C— Sudden bright red drainage with swelling suggests hemorrhage and requires
immediate notification. Serosanguineous drainage and mild tenderness can be expected.
Approximated edges indicate healing.
14. A nurse is caring for a client who is postoperative. Which action prevents atelectasis?
A. Encourage the client to remain on bed rest
– NGN Format | 180 Authentic Questions
with 100% Verified Answers & Detailed
Rationales | A+ Graded
SECTION I: FUNDAMENTALS OF NURSING & SAFETY
1. A nurse is caring for a client with a new prescription for oxygen therapy at 4 L/min via nasal
cannula. Which action should the nurse take first?
A. Apply the cannula and set the flow rate
B. Verify the prescription and assess the client's respiratory status
C. Document the intervention
D. Teach the client about fire safety
B— The nurse must first verify the prescription and assess respiratory status (rate,
rhythm, oxygen saturation) to establish a baseline and ensure the therapy is appropriate.
Applying oxygen without assessment can mask deterioration. Documentation and teaching
follow the intervention.
2. A nurse is performing a sterile dressing change. Which action indicates a break in sterile
technique?
A. Holding sterile gloves above waist level
B. Turning away from the sterile field to sneeze
C. Placing sterile supplies on the sterile field
D. Keeping the sterile field in view at all times
B— Turning away or sneezing toward the sterile field contaminates it. The nurse should
step away from the field and turn the head. All other options demonstrate correct sterile
technique.
3. A client is at risk for falls. Which interventions should the nurse include in the plan of care?
(SATA)
A. Keep the bed in the lowest position
B. Use a bed exit alarm
C. Keep side rails up on all four sides
,D. Ensure call light is within reach
E. Apply physical restraints prophylactically
A, B, D — Low bed position, bed exit alarms, and accessible call lights are evidence-
based fall precautions. Full side rails are considered restraints and increase injury risk. Restraints
require a specific prescription and are never prophylactic.
4. A nurse is teaching a client about hand hygiene. Which statement by the client indicates
understanding?
A. "I should wash my hands for 5 seconds with warm water."
B. "Alcohol-based rub is effective when hands are visibly soiled."
C. "I should wash my hands for at least 20 seconds with soap and water."
D. "I only need to wash my hands after using the bathroom."
C— Soap and water for at least 20 seconds is the CDC standard. Alcohol rub is
ineffective on visibly soiled hands. Hand hygiene is required before and after many contacts, not
just after toileting.
5. A nurse is caring for a client with an indwelling urinary catheter. Which finding requires
immediate intervention?
A. Urine output of 40 mL/hr
B. Dependent loop in the tubing
C. Cloudy urine with a strong odor
D. Catheter secured to the thigh
C— Cloudy, malodorous urine suggests catheter-associated urinary tract infection
(CAUTI) and requires prompt assessment and notification of the provider. Dependent loops
should be corrected but are not emergent. Output of 40 mL/hr is adequate.
6. A nurse is preparing to move a client up in bed. Which action protects the nurse from injury?
A. Keep feet close together
B. Bend at the waist and twist
C. Raise the bed to a comfortable working height and use a gait belt
D. Pull the client toward the nurse using arm strength
C— Raising the bed to working height and using assistive devices protects the nurse's
back. Feet should be shoulder-width apart, knees bent, and the client moved with coordinated
effort—not by twisting or arm strength alone.
,7. A nurse is assessing a client's skin for pressure injury risk. Which finding is a stage 1 pressure
injury?
A. Full-thickness loss with visible bone
B. Nonblanchable erythema of intact skin
C. Partial-thickness loss with a blister
D. Slough covering the wound bed
B— Stage 1 is nonblanchable erythema of intact skin. Stage 2 is partial-thickness loss
(blister). Stage 3 is full-thickness loss with slough. Stage 4 exposes bone, tendon, or muscle.
8. A nurse is caring for a client on contact precautions. Which personal protective equipment
should the nurse remove first?
A. Gloves
B. Gown
C. Mask
D. Goggles
A— Gloves are the most contaminated and are removed first, followed by goggles,
gown, then mask (removed last, after leaving the room). This sequence minimizes self-
contamination.
9. A client reports difficulty swallowing. Which action should the nurse take first?
A. Place the client in a supine position for meals
B. Obtain a swallow evaluation before oral intake
C. Encourage thin liquids
D. Provide a straw for drinking
B— A swallow evaluation (often by speech-language pathology) is required before oral
intake in a client with dysphagia to prevent aspiration. Supine position, thin liquids, and straws
all increase aspiration risk.
10. A nurse is reinforcing teaching about the use of a walker. Which instruction is correct?
A. "Move the walker forward, then step into it."
B. "Lift the walker and take a step at the same time."
C. "Place the walker one arm's length ahead, then step forward."
D. "Use the walker on stairs first."
, A— The correct sequence: advance the walker, then step into it. The client should not
step while lifting the walker. Walkers are used on level surfaces; stairs require specific training.
11. A nurse notes a client has a new onset of confusion. Which action is the priority?
A. Apply wrist restraints
B. Assess for hypoxia, hypoglycemia, and infection
C. Administer a sedative as needed
D. Document the behavior and reassess in 4 hours
B— Acute confusion (delirium) is a medical emergency. Assess for reversible causes—
hypoxia, hypoglycemia, infection, medication effects. Restraints and sedatives can worsen
delirium. Prompt reassessment is essential.
12. A nurse is caring for a client with a nasogastric tube. Which action should the nurse take
before administering a tube feeding?
A. Verify tube placement by auscultating for a whoosh
B. Check gastric residual volume and verify placement with pH
C. Place the client flat
D. Flush with 5 mL of water
B— Verify placement by aspirating gastric contents and checking pH (≤5.5) or by X-ray
per policy. The auscultation "whoosh" method is unreliable. The client should be elevated 30–
45° to prevent aspiration.
13. A nurse is providing wound care. Which finding should be reported to the provider
immediately?
A. Serosanguineous drainage on the dressing
B. Wound edges approximated
C. Sudden increase in bright red drainage with swelling
D. Mild tenderness at the site
C— Sudden bright red drainage with swelling suggests hemorrhage and requires
immediate notification. Serosanguineous drainage and mild tenderness can be expected.
Approximated edges indicate healing.
14. A nurse is caring for a client who is postoperative. Which action prevents atelectasis?
A. Encourage the client to remain on bed rest
