ATI COMPREHENSIVE EXIT EXAM 2026 WITH
NGN
NSG 4800
A home health nurse is caring for a child who has Lyme disease. Which of the following is an appropriate
action for the nurse to take?
Ensure the state health department has been notified.
Administer antitetoxin.
Educate the family to avoid sharing personal belongings.
Assess for skin necrosis.
ANSWER: Ensure the state health department has been notified
Rationale:
Option A (Correct): Lyme disease is a nationally notifiable disease. The nurse is responsible for reporting
confirmed cases to the state health department to assist with surveillance and public health
interventions. This is a legal requirement in most states.
Option B (Incorrect): Antitetoxin is administered for tetanus, not Lyme disease. Lyme disease is caused
by the bacterium Borrelia burgdorferi and is treated with antibiotics such as doxycycline or amoxicillin.
Option C (Incorrect): Lyme disease is not transmitted through casual contact or sharing personal
belongings. It is transmitted through the bite of an infected Ixodes tick. Education should focus on tick
avoidance and prompt removal.
,Option D (Incorrect): Skin necrosis is not a characteristic finding of Lyme disease. The hallmark
manifestation is erythema migrans, a bull's-eye rash. Skin necrosis may occur with other conditions such
as spider bites or necrotizing fasciitis.
Question: 2 of 180
Time Remaining: 03:58:55
Pause Remaining: 00:05:00
A nurse is caring for a client who has been admitted to the hospital.
Exhibit 1 (Nurses' Notes):
0900: The client reports experiencing a loss of appetite and shortness of breath within the last month or
so. The client reports experiencing weakness, abdominal pain, severe itching, and mood changes. The
client has had alcohol use disorder for the past 10 years and sometimes drinks alcohol uncontrollably.
The client is alert but disoriented to time. Their abdomen is bloated and they have redness of the palms
of the hands. Excoriated areas on the upper thorax and shoulders are present. Sclera are yellow.
1230: Administered antacids, spironolactone, and colchicine per provider's prescription.
Exhibit 2 (Laboratory Results):
1200:
High 9.5 g/dL (14 to 18 g/dL)
Hct 38% (42% to 52%)
Bilirubin 5.3 mg/dL (0.3 to 1.0 mg/dL)
,Creatinine 1.8 mg/dL (0.6 to 1.3 mg/dL)
Platelet count 100,000/mm³ (150,000 to 400,000/mm³)
1800:
Alanine aminotransferase ALT 51 units/L (4 to 36 units/L)
Aspartate aminotransferase AST 48 units/L (0 to 35 units/L)
Alkaline phosphatase ALP 151 units/L (30 to 120 units/L)
Blood total protein 15 g/dL (6.4 to 8.3 g/dL)
Select the 5 actions the nurse should take.
Provide frequent rest periods for the client.
Restrict the client's sodium intake.
Advise the client to avoid the use of soap and alcohol-based lotions.
Place the client on a low-carbohydrate diet.
Place the client under contact isolation.
Instruct the client to avoid blowing their nose forcefully.
, Assess the client's level of orientation.
ANSWERs: Provide frequent rest periods for the client; Restrict the client's sodium intake; Advise the
client to avoid the use of soap and alcohol-based lotions; Instruct the client to avoid blowing their nose
forcefully; Assess the client's level of orientation
Rationale:
Option A (Correct): The client has manifestations of hepatic encephalopathy and liver disease (jaundice,
confusion, elevated liver enzymes). Frequent rest periods help conserve energy and reduce metabolic
demands on the liver.
Option B (Correct): Sodium restriction is essential for clients with liver disease and ascites (bloated
abdomen) to reduce fluid retention and prevent worsening of edema and ascites.
Option C (Correct): Clients with liver disease often experience pruritus (severe itching) due to bile salt
accumulation. Soap and alcohol-based lotions can dry the skin and worsen itching. The nurse should
recommend lukewarm water bathing and emollient lotions.
Option D (Incorrect): A low-carbohydrate diet is not indicated for liver disease. Clients with liver disease
may require increased caloric intake with adequate carbohydrates to prevent protein breakdown.
Option E (Incorrect): Contact isolation is not indicated for liver disease unless the client has a co-existing
infection. Liver disease itself is not transmitted through contact.
Option F (Correct): The client has thrombocytopenia (platelet count 100,000/mm³) which increases
bleeding risk. Forceful nose blowing can cause epistaxis and should be avoided.
Option G (Correct): The client is disoriented to time, indicating hepatic encephalopathy. Frequent
assessment of orientation is necessary to monitor neurological status and response to treatment.
Question: 3 of 180
Time Remaining: 03:56:55
NGN
NSG 4800
A home health nurse is caring for a child who has Lyme disease. Which of the following is an appropriate
action for the nurse to take?
Ensure the state health department has been notified.
Administer antitetoxin.
Educate the family to avoid sharing personal belongings.
Assess for skin necrosis.
ANSWER: Ensure the state health department has been notified
Rationale:
Option A (Correct): Lyme disease is a nationally notifiable disease. The nurse is responsible for reporting
confirmed cases to the state health department to assist with surveillance and public health
interventions. This is a legal requirement in most states.
Option B (Incorrect): Antitetoxin is administered for tetanus, not Lyme disease. Lyme disease is caused
by the bacterium Borrelia burgdorferi and is treated with antibiotics such as doxycycline or amoxicillin.
Option C (Incorrect): Lyme disease is not transmitted through casual contact or sharing personal
belongings. It is transmitted through the bite of an infected Ixodes tick. Education should focus on tick
avoidance and prompt removal.
,Option D (Incorrect): Skin necrosis is not a characteristic finding of Lyme disease. The hallmark
manifestation is erythema migrans, a bull's-eye rash. Skin necrosis may occur with other conditions such
as spider bites or necrotizing fasciitis.
Question: 2 of 180
Time Remaining: 03:58:55
Pause Remaining: 00:05:00
A nurse is caring for a client who has been admitted to the hospital.
Exhibit 1 (Nurses' Notes):
0900: The client reports experiencing a loss of appetite and shortness of breath within the last month or
so. The client reports experiencing weakness, abdominal pain, severe itching, and mood changes. The
client has had alcohol use disorder for the past 10 years and sometimes drinks alcohol uncontrollably.
The client is alert but disoriented to time. Their abdomen is bloated and they have redness of the palms
of the hands. Excoriated areas on the upper thorax and shoulders are present. Sclera are yellow.
1230: Administered antacids, spironolactone, and colchicine per provider's prescription.
Exhibit 2 (Laboratory Results):
1200:
High 9.5 g/dL (14 to 18 g/dL)
Hct 38% (42% to 52%)
Bilirubin 5.3 mg/dL (0.3 to 1.0 mg/dL)
,Creatinine 1.8 mg/dL (0.6 to 1.3 mg/dL)
Platelet count 100,000/mm³ (150,000 to 400,000/mm³)
1800:
Alanine aminotransferase ALT 51 units/L (4 to 36 units/L)
Aspartate aminotransferase AST 48 units/L (0 to 35 units/L)
Alkaline phosphatase ALP 151 units/L (30 to 120 units/L)
Blood total protein 15 g/dL (6.4 to 8.3 g/dL)
Select the 5 actions the nurse should take.
Provide frequent rest periods for the client.
Restrict the client's sodium intake.
Advise the client to avoid the use of soap and alcohol-based lotions.
Place the client on a low-carbohydrate diet.
Place the client under contact isolation.
Instruct the client to avoid blowing their nose forcefully.
, Assess the client's level of orientation.
ANSWERs: Provide frequent rest periods for the client; Restrict the client's sodium intake; Advise the
client to avoid the use of soap and alcohol-based lotions; Instruct the client to avoid blowing their nose
forcefully; Assess the client's level of orientation
Rationale:
Option A (Correct): The client has manifestations of hepatic encephalopathy and liver disease (jaundice,
confusion, elevated liver enzymes). Frequent rest periods help conserve energy and reduce metabolic
demands on the liver.
Option B (Correct): Sodium restriction is essential for clients with liver disease and ascites (bloated
abdomen) to reduce fluid retention and prevent worsening of edema and ascites.
Option C (Correct): Clients with liver disease often experience pruritus (severe itching) due to bile salt
accumulation. Soap and alcohol-based lotions can dry the skin and worsen itching. The nurse should
recommend lukewarm water bathing and emollient lotions.
Option D (Incorrect): A low-carbohydrate diet is not indicated for liver disease. Clients with liver disease
may require increased caloric intake with adequate carbohydrates to prevent protein breakdown.
Option E (Incorrect): Contact isolation is not indicated for liver disease unless the client has a co-existing
infection. Liver disease itself is not transmitted through contact.
Option F (Correct): The client has thrombocytopenia (platelet count 100,000/mm³) which increases
bleeding risk. Forceful nose blowing can cause epistaxis and should be avoided.
Option G (Correct): The client is disoriented to time, indicating hepatic encephalopathy. Frequent
assessment of orientation is necessary to monitor neurological status and response to treatment.
Question: 3 of 180
Time Remaining: 03:56:55
