RN ATI Comprehensive Exit Exam (Version 2 )
Actual exam With Questions And Revised
Correct Answers & Rationales ()
100% Guaranteed Pass
Item ID: V2-001
Item Type: NGN – Extended Multiple Response
Scenario:
A 68-year-old woman is transferred to the post-anesthesia care unit after a laparoscopic
hemicolectomy. She has a history of COPD, hypertension, and CKD stage 3. Vital signs
on arrival: BP 142/88 mm Hg, HR 98 beats/min, RR 24 breaths/min, SpO₂ 91 % on 4 L
nasal cannula, T 36.2 °C. She is drowsy but arousable, reporting incisional pain 7/10.
Question:
Which assessment findings require immediate follow-up by the nurse? (Select all that
apply.)
Options:
A. SpO₂ 91 % on 4 L NC
B. RR 24 breaths/min
C. Pain score 7/10
D. BP 142/88 mm Hg
,E. Patient drowsy but arousable
Correct Choices: A, B, C
Rationale (Revised & Verified):
● Correct Answer: A, B, C
● Analysis: SpO₂ < 92 % in a COPD patient post-op signals hypoxemia requiring
escalation (AARC 2025). RR > 22 suggests respiratory compromise or pending
fatigue (ASPAN). Pain 7/10 impedes deep breathing/coughing, increasing
atelectasis risk (APS 2025).
● Distractor Breakdown: D—Hypertension common post-op; no acute end-organ
symptoms. E—Expected drowsiness within first 30 min of PACU.
Item ID: V2-002
Item Type: Traditional MCQ
Scenario:
A 19-year-old primigravida at 39 weeks is admitted in active labor. Cervix 6 cm, –2
station, intact membranes. FHR baseline 155 with recurrent late decelerations. IV fluid
LR at 125 mL/h. Maternal BP 100/54 mm Hg.
Question:
What is the nurse’s priority action?
Options:
A. Administer 8 L oxygen via non-rebreather
B. Turn patient to left lateral position
,C. Increase IV rate to 500 mL bolus
D. Notify provider for stat cesarean
Rationale (Revised & Verified):
● Correct Answer: B
● Analysis: Left lateral displacement relieves aortocaval compression, improving
uteroplacental perfusion and is first-line for late decels (ACOG 2024).
● Distractor Breakdown: A—Oxygen may help but only after positioning. C—Bolus
useful only if hypotension present; current BP not hypotensive for labor.
D—Premature without corrective measures.
Item ID: V2-003
Item Type: NGN – Matrix
Scenario:
A 55-year-old man post-MI day 2 on heparin 18 units/kg/h. aPTT 96 sec (control 30
sec). Platelet count 198 k. No active bleeding.
Question:
Match the lab value with the appropriate nurse action (select one action per row).
Matrix:
Lab Value → Action
aPTT 96 sec | Hold infusion for 1 h ↓ Reduce rate 2 units/kg/h ↓ No change
Platelets 198 k | Hold infusion ↓ Notify provider ↓ Continue monitoring
, Correct Choices: Reduce rate 2 units/kg/h ; Continue monitoring
Rationale (Revised & Verified):
● Correct Answer: Reduce rate 2 units/kg/h for aPTT 96 sec; Continue monitoring
for platelets.
● Analysis: aPTT 1.5–2.5 × control is target; 96 sec ≈ 3 × → decrease dose (AHA
2025). Platelets > 150 k without 50 % drop rules out HIT.
● Distractor Breakdown: Holding infusion risks rebound clotting; unnecessary
notification delays care.
Item ID: V2-004
Item Type: Traditional MCQ
Scenario:
A 10-year-old with new-onset type 1 DM receives insulin aspart per carbohydrate
counting. Pre-lunch glucose 212 mg/dL, urine negative for ketones. Lunch carb count 65
g. Insulin ratio 1:10, correction 1:50 >150.
Question:
How many units of aspart should the nurse administer?
Options:
A. 6.5
B. 9.5
C. 10.5
D. 12.5
Actual exam With Questions And Revised
Correct Answers & Rationales ()
100% Guaranteed Pass
Item ID: V2-001
Item Type: NGN – Extended Multiple Response
Scenario:
A 68-year-old woman is transferred to the post-anesthesia care unit after a laparoscopic
hemicolectomy. She has a history of COPD, hypertension, and CKD stage 3. Vital signs
on arrival: BP 142/88 mm Hg, HR 98 beats/min, RR 24 breaths/min, SpO₂ 91 % on 4 L
nasal cannula, T 36.2 °C. She is drowsy but arousable, reporting incisional pain 7/10.
Question:
Which assessment findings require immediate follow-up by the nurse? (Select all that
apply.)
Options:
A. SpO₂ 91 % on 4 L NC
B. RR 24 breaths/min
C. Pain score 7/10
D. BP 142/88 mm Hg
,E. Patient drowsy but arousable
Correct Choices: A, B, C
Rationale (Revised & Verified):
● Correct Answer: A, B, C
● Analysis: SpO₂ < 92 % in a COPD patient post-op signals hypoxemia requiring
escalation (AARC 2025). RR > 22 suggests respiratory compromise or pending
fatigue (ASPAN). Pain 7/10 impedes deep breathing/coughing, increasing
atelectasis risk (APS 2025).
● Distractor Breakdown: D—Hypertension common post-op; no acute end-organ
symptoms. E—Expected drowsiness within first 30 min of PACU.
Item ID: V2-002
Item Type: Traditional MCQ
Scenario:
A 19-year-old primigravida at 39 weeks is admitted in active labor. Cervix 6 cm, –2
station, intact membranes. FHR baseline 155 with recurrent late decelerations. IV fluid
LR at 125 mL/h. Maternal BP 100/54 mm Hg.
Question:
What is the nurse’s priority action?
Options:
A. Administer 8 L oxygen via non-rebreather
B. Turn patient to left lateral position
,C. Increase IV rate to 500 mL bolus
D. Notify provider for stat cesarean
Rationale (Revised & Verified):
● Correct Answer: B
● Analysis: Left lateral displacement relieves aortocaval compression, improving
uteroplacental perfusion and is first-line for late decels (ACOG 2024).
● Distractor Breakdown: A—Oxygen may help but only after positioning. C—Bolus
useful only if hypotension present; current BP not hypotensive for labor.
D—Premature without corrective measures.
Item ID: V2-003
Item Type: NGN – Matrix
Scenario:
A 55-year-old man post-MI day 2 on heparin 18 units/kg/h. aPTT 96 sec (control 30
sec). Platelet count 198 k. No active bleeding.
Question:
Match the lab value with the appropriate nurse action (select one action per row).
Matrix:
Lab Value → Action
aPTT 96 sec | Hold infusion for 1 h ↓ Reduce rate 2 units/kg/h ↓ No change
Platelets 198 k | Hold infusion ↓ Notify provider ↓ Continue monitoring
, Correct Choices: Reduce rate 2 units/kg/h ; Continue monitoring
Rationale (Revised & Verified):
● Correct Answer: Reduce rate 2 units/kg/h for aPTT 96 sec; Continue monitoring
for platelets.
● Analysis: aPTT 1.5–2.5 × control is target; 96 sec ≈ 3 × → decrease dose (AHA
2025). Platelets > 150 k without 50 % drop rules out HIT.
● Distractor Breakdown: Holding infusion risks rebound clotting; unnecessary
notification delays care.
Item ID: V2-004
Item Type: Traditional MCQ
Scenario:
A 10-year-old with new-onset type 1 DM receives insulin aspart per carbohydrate
counting. Pre-lunch glucose 212 mg/dL, urine negative for ketones. Lunch carb count 65
g. Insulin ratio 1:10, correction 1:50 >150.
Question:
How many units of aspart should the nurse administer?
Options:
A. 6.5
B. 9.5
C. 10.5
D. 12.5
