ATI RN COMPREHENSIVE EXIT EXAM – PRACTICE QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Management of Care
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Psychosocial Integrity
Safety and Infection Control
Health Promotion and Maintenance
Legal and Ethical Nursing Practice
Introduction
This comprehensive assessment is designed to evaluate the clinical readiness of nursing students
nearing the completion of their pre-licensure programs. The primary purpose of this exam is to
ensure the candidate possesses the essential knowledge and critical thinking skills required to
provide safe, effective care as an entry-level registered nurse. The assessment features a diverse
range of multiple-choice and scenario-based questions that mirror the complexity of modern
healthcare environments. It places significant emphasis on real-world application, prioritization,
and clinical decision-making across the lifespan. Candidates are expected to demonstrate
proficiency in nursing theory, regulatory compliance, and the delivery of evidence-based
interventions within the interdisciplinary team.
1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
,A. Maintain the affected leg in an adducted position.
B. Encourage the client to lean forward when sitting in a chair.
C. Place an abductor pillow between the client's legs when turning.
D. Keep the head of the bed at a 90-degree angle.
🟢 C. Place an abductor pillow between the client's legs when turning.
🔴 RATIONALE: To prevent dislocation of the new prosthesis, the nurse should ensure the hip is
maintained in an abducted position. Using an abductor pillow or wedge prevents the legs from
crossing the midline (adduction), which is a high-risk movement for dislocation.
2. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should lead the nurse to withhold the medication?
A. Blood pressure 140/90 mmHg.
B. Potassium level 4.2 mEq/L.
C. Apical heart rate 52/min.
D. Respiratory rate 22/min.
🟢 C. Apical heart rate 52/min.
🔴 RATIONALE: Digoxin is a cardiac glycoside that slows the heart rate. For an adult, the
medication should be withheld and the provider notified if the apical heart rate is less than
60/min to prevent bradycardia and potential toxicity.
3. A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. Which of the
following actions should the nurse take first?
A. Check the system for an air leak.
B. Increase the suction pressure.
C. Clamp the chest tube close to the insertion site.
D. Replace the drainage system unit.
,🟢 A. Check the system for an air leak.
🔴 RATIONALE: Continuous bubbling in the water-seal chamber indicates an air leak. The nurse's
first action should be to systematically check the connections and the insertion site to locate the
source of the leak before intervening further.
4. A nurse is reviewing the lab results of a client receiving heparin via continuous IV infusion.
Which of the following results should the nurse report to the provider?
A. Platelets 160,000/mm3.
B. aPTT 90 seconds.
C. Prothrombin time 12 seconds.
D. Hemoglobin 14 g/dL.
🟢 B. aPTT 90 seconds.
🔴 RATIONALE: The therapeutic range for aPTT during heparin therapy is typically 1.5 to 2 times
the normal reference range (usually 60 to 80 seconds). An aPTT of 90 seconds is excessively high
and increases the risk of bleeding, requiring a dose adjustment.
5. A nurse is caring for a client with end-stage renal disease. The client's potassium level is
6.8 mEq/L. Which of the following cardiac changes should the nurse expect to see on the
ECG?
A. Prominent U waves.
B. ST-segment depression.
C. Peaked T waves.
D. Shortened PR interval.
🟢 C. Peaked T waves.
🔴 RATIONALE: Hyperkalemia (potassium > 5.0 mEq/L) commonly causes tall, peaked T waves,
widened QRS complexes, and prolonged PR intervals. Prominent U waves are associated with
hypokalemia.
, 6. A nurse is teaching a client about the use of a spacer with a metered-dose inhaler (MDI).
Which of the following statements by the client indicates an understanding of the
teaching?
A. "The spacer will make the medicine taste better."
B. "The spacer helps more of the medicine reach my lungs."
C. "I should breathe out as fast as I can into the spacer."
D. "I need to wait 10 seconds after taking the medicine before using the spacer."
🟢 B. "The spacer helps more of the medicine reach my lungs."
🔴 RATIONALE: A spacer holds the medication in a chamber after it is released from the MDI,
allowing the client to inhale more effectively and ensuring more medication reaches the lower
airways rather than being trapped in the back of the throat.
7. A nurse is assessing a client who is 12 hours postpartum. Which of the following findings
should the nurse report to the provider?
A. Fundus firm and at the level of the umbilicus.
B. Lochia rubra with small clots.
C. Heart rate 110/min.
D. Urinary output 3,000 mL in 24 hours.
🟢 C. Heart rate 110/min.
🔴 RATIONALE: Tachycardia in the postpartum period (HR > 100/min) can be a sign of excessive
blood loss, dehydration, or infection. The other findings are within expected normal limits for 12
hours postpartum.
8. A nurse is caring for a client who is on a mechanical ventilator. The low-pressure alarm
sounds. Which of the following actions should the nurse take first?
A. Suction the client's airway.
B. Check the tubing for a disconnection.
(VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Management of Care
Pharmacological and Parenteral Therapies
Reduction of Risk Potential
Physiological Adaptation
Psychosocial Integrity
Safety and Infection Control
Health Promotion and Maintenance
Legal and Ethical Nursing Practice
Introduction
This comprehensive assessment is designed to evaluate the clinical readiness of nursing students
nearing the completion of their pre-licensure programs. The primary purpose of this exam is to
ensure the candidate possesses the essential knowledge and critical thinking skills required to
provide safe, effective care as an entry-level registered nurse. The assessment features a diverse
range of multiple-choice and scenario-based questions that mirror the complexity of modern
healthcare environments. It places significant emphasis on real-world application, prioritization,
and clinical decision-making across the lifespan. Candidates are expected to demonstrate
proficiency in nursing theory, regulatory compliance, and the delivery of evidence-based
interventions within the interdisciplinary team.
1. A nurse is caring for a client who is 24 hours postoperative following a total hip
arthroplasty. Which of the following actions should the nurse take?
,A. Maintain the affected leg in an adducted position.
B. Encourage the client to lean forward when sitting in a chair.
C. Place an abductor pillow between the client's legs when turning.
D. Keep the head of the bed at a 90-degree angle.
🟢 C. Place an abductor pillow between the client's legs when turning.
🔴 RATIONALE: To prevent dislocation of the new prosthesis, the nurse should ensure the hip is
maintained in an abducted position. Using an abductor pillow or wedge prevents the legs from
crossing the midline (adduction), which is a high-risk movement for dislocation.
2. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following findings should lead the nurse to withhold the medication?
A. Blood pressure 140/90 mmHg.
B. Potassium level 4.2 mEq/L.
C. Apical heart rate 52/min.
D. Respiratory rate 22/min.
🟢 C. Apical heart rate 52/min.
🔴 RATIONALE: Digoxin is a cardiac glycoside that slows the heart rate. For an adult, the
medication should be withheld and the provider notified if the apical heart rate is less than
60/min to prevent bradycardia and potential toxicity.
3. A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. Which of the
following actions should the nurse take first?
A. Check the system for an air leak.
B. Increase the suction pressure.
C. Clamp the chest tube close to the insertion site.
D. Replace the drainage system unit.
,🟢 A. Check the system for an air leak.
🔴 RATIONALE: Continuous bubbling in the water-seal chamber indicates an air leak. The nurse's
first action should be to systematically check the connections and the insertion site to locate the
source of the leak before intervening further.
4. A nurse is reviewing the lab results of a client receiving heparin via continuous IV infusion.
Which of the following results should the nurse report to the provider?
A. Platelets 160,000/mm3.
B. aPTT 90 seconds.
C. Prothrombin time 12 seconds.
D. Hemoglobin 14 g/dL.
🟢 B. aPTT 90 seconds.
🔴 RATIONALE: The therapeutic range for aPTT during heparin therapy is typically 1.5 to 2 times
the normal reference range (usually 60 to 80 seconds). An aPTT of 90 seconds is excessively high
and increases the risk of bleeding, requiring a dose adjustment.
5. A nurse is caring for a client with end-stage renal disease. The client's potassium level is
6.8 mEq/L. Which of the following cardiac changes should the nurse expect to see on the
ECG?
A. Prominent U waves.
B. ST-segment depression.
C. Peaked T waves.
D. Shortened PR interval.
🟢 C. Peaked T waves.
🔴 RATIONALE: Hyperkalemia (potassium > 5.0 mEq/L) commonly causes tall, peaked T waves,
widened QRS complexes, and prolonged PR intervals. Prominent U waves are associated with
hypokalemia.
, 6. A nurse is teaching a client about the use of a spacer with a metered-dose inhaler (MDI).
Which of the following statements by the client indicates an understanding of the
teaching?
A. "The spacer will make the medicine taste better."
B. "The spacer helps more of the medicine reach my lungs."
C. "I should breathe out as fast as I can into the spacer."
D. "I need to wait 10 seconds after taking the medicine before using the spacer."
🟢 B. "The spacer helps more of the medicine reach my lungs."
🔴 RATIONALE: A spacer holds the medication in a chamber after it is released from the MDI,
allowing the client to inhale more effectively and ensuring more medication reaches the lower
airways rather than being trapped in the back of the throat.
7. A nurse is assessing a client who is 12 hours postpartum. Which of the following findings
should the nurse report to the provider?
A. Fundus firm and at the level of the umbilicus.
B. Lochia rubra with small clots.
C. Heart rate 110/min.
D. Urinary output 3,000 mL in 24 hours.
🟢 C. Heart rate 110/min.
🔴 RATIONALE: Tachycardia in the postpartum period (HR > 100/min) can be a sign of excessive
blood loss, dehydration, or infection. The other findings are within expected normal limits for 12
hours postpartum.
8. A nurse is caring for a client who is on a mechanical ventilator. The low-pressure alarm
sounds. Which of the following actions should the nurse take first?
A. Suction the client's airway.
B. Check the tubing for a disconnection.
