ATI RN COMPREHENSIVE PREDICTOR
EXIT EXAM 2026 – NGN STYLE (100
QUESTIONS)
QUESTIONS 1–80: MULTIPLE CHOICE & SATA
1. A nurse is caring for a client with heart failure who has crackles in lung bases, +3 edema, and
dyspnea on exertion. Which dietary instruction is most important?
A) Increase fluid intake to 3 L/day
B) Restrict sodium to 2 g/day
C) Increase potassium-rich foods
D) Limit carbohydrates to 50 g/day
Answer Answer: B
• Rationale answer: Sodium restriction reduces fluid retention.
• Why A is wrong: Fluid overload worsens HF.
• Why C is wrong: Potassium may be needed with diuretics but not priority.
• Why D is wrong: No indication for carb restriction.
2. A client on haloperidol develops a temperature of 104°F, muscle rigidity, and confusion. What is the
priority action?
A) Administer acetaminophen
B) Give diphenhydramine
C) Discontinue haloperidol
D) Apply cooling blanket
Answer Answer: C
• Rationale: Suspect neuroleptic malignant syndrome; stop the offending agent.
, • Why A/D are wrong: Symptomatic treatment but not priority.
• Why B is wrong: Diphenhydramine treats dystonia, not NMS.
3. Select all that apply: A nurse is providing discharge teaching to a client with a new colostomy.
Which statements indicate understanding?
A) “I will cut the wafer opening slightly larger than my stoma.”
B) “I should expect the stoma to be shiny and moist.”
C) “I will change the pouch every day.”
D) “I can take a bath without the pouch on.”
E) “Dark red stoma color is normal.”
Answer Answers: B, D
• Rationale B: Stoma should be moist and pink/red.
• Rationale D: Bathing without pouch is fine.
• Why A is wrong: Opening should be exact, not larger (leakage risk).
• Why C is wrong: Change every 3–7 days unless leaking.
• Why E is wrong: Dark red indicates ischemia.
4. A nurse is assessing a newborn with respiratory distress. Which finding suggests choanal atresia?
A) Apnea with feeding
B) Asymmetric chest movement
C) Barking cough
D) Grunting at end of expiration
Answer Answer: A
• Rationale: Choanal atresia causes respiratory distress worse with feeding when mouth is closed.
• Why B is wrong: Asymmetric movement suggests pneumothorax.
• Why C is wrong: Barking cough is croup.
• Why D is wrong: Grunting is RDS or TTN.
5. A client with cirrhosis has an ammonia level of 180 mcg/dL. Which medication should the nurse
prepare?
A) Naloxone
B) Lactulose
C) Protamine sulfate
D) Vitamin K
, Answer Answer: B
• Rationale: Lactulose reduces ammonia by increasing excretion.
• Why A is wrong: Naloxone is for opioid overdose.
• Why C is wrong: Protamine reverses heparin.
• Why D is wrong: Vitamin K for coagulopathy but not high ammonia.
6. Ordered response: Place the steps for using a metered-dose inhaler (MDI) in answer order.
___ Activate the inhaler while breathing in slowly
___ Shake the inhaler for 5 seconds
___ Exhale completely
___ Hold breath for 10 seconds
Answer order:
1. Shake the inhaler
2. Exhale completely
3. Activate while breathing in
4. Hold breath 10 seconds
• Rationale: Shaking first, exhale to empty lungs, inhale med, hold for deposition.
7. A client with bipolar disorder taking lithium has a level of 1.8 mEq/L. Which finding is most
concerning?
A) Polyuria
B) Fine tremor
C) Nausea
D) Slurred speech
Answer Answer: D
• Rationale: Slurred speech indicates moderate toxicity (1.5–2.0).
• Why A/B/C are wrong: Polyuria and fine tremor can occur at therapeutic levels; nausea is early
toxicity but less urgent than neurological signs.
8. A nurse is preparing to transfuse packed RBCs. Which IV fluid is compatible?
A) Lactated Ringer’s
B) 0.9% sodium chloride
C) 5% dextrose in water
D) 0.45% sodium chloride
EXIT EXAM 2026 – NGN STYLE (100
QUESTIONS)
QUESTIONS 1–80: MULTIPLE CHOICE & SATA
1. A nurse is caring for a client with heart failure who has crackles in lung bases, +3 edema, and
dyspnea on exertion. Which dietary instruction is most important?
A) Increase fluid intake to 3 L/day
B) Restrict sodium to 2 g/day
C) Increase potassium-rich foods
D) Limit carbohydrates to 50 g/day
Answer Answer: B
• Rationale answer: Sodium restriction reduces fluid retention.
• Why A is wrong: Fluid overload worsens HF.
• Why C is wrong: Potassium may be needed with diuretics but not priority.
• Why D is wrong: No indication for carb restriction.
2. A client on haloperidol develops a temperature of 104°F, muscle rigidity, and confusion. What is the
priority action?
A) Administer acetaminophen
B) Give diphenhydramine
C) Discontinue haloperidol
D) Apply cooling blanket
Answer Answer: C
• Rationale: Suspect neuroleptic malignant syndrome; stop the offending agent.
, • Why A/D are wrong: Symptomatic treatment but not priority.
• Why B is wrong: Diphenhydramine treats dystonia, not NMS.
3. Select all that apply: A nurse is providing discharge teaching to a client with a new colostomy.
Which statements indicate understanding?
A) “I will cut the wafer opening slightly larger than my stoma.”
B) “I should expect the stoma to be shiny and moist.”
C) “I will change the pouch every day.”
D) “I can take a bath without the pouch on.”
E) “Dark red stoma color is normal.”
Answer Answers: B, D
• Rationale B: Stoma should be moist and pink/red.
• Rationale D: Bathing without pouch is fine.
• Why A is wrong: Opening should be exact, not larger (leakage risk).
• Why C is wrong: Change every 3–7 days unless leaking.
• Why E is wrong: Dark red indicates ischemia.
4. A nurse is assessing a newborn with respiratory distress. Which finding suggests choanal atresia?
A) Apnea with feeding
B) Asymmetric chest movement
C) Barking cough
D) Grunting at end of expiration
Answer Answer: A
• Rationale: Choanal atresia causes respiratory distress worse with feeding when mouth is closed.
• Why B is wrong: Asymmetric movement suggests pneumothorax.
• Why C is wrong: Barking cough is croup.
• Why D is wrong: Grunting is RDS or TTN.
5. A client with cirrhosis has an ammonia level of 180 mcg/dL. Which medication should the nurse
prepare?
A) Naloxone
B) Lactulose
C) Protamine sulfate
D) Vitamin K
, Answer Answer: B
• Rationale: Lactulose reduces ammonia by increasing excretion.
• Why A is wrong: Naloxone is for opioid overdose.
• Why C is wrong: Protamine reverses heparin.
• Why D is wrong: Vitamin K for coagulopathy but not high ammonia.
6. Ordered response: Place the steps for using a metered-dose inhaler (MDI) in answer order.
___ Activate the inhaler while breathing in slowly
___ Shake the inhaler for 5 seconds
___ Exhale completely
___ Hold breath for 10 seconds
Answer order:
1. Shake the inhaler
2. Exhale completely
3. Activate while breathing in
4. Hold breath 10 seconds
• Rationale: Shaking first, exhale to empty lungs, inhale med, hold for deposition.
7. A client with bipolar disorder taking lithium has a level of 1.8 mEq/L. Which finding is most
concerning?
A) Polyuria
B) Fine tremor
C) Nausea
D) Slurred speech
Answer Answer: D
• Rationale: Slurred speech indicates moderate toxicity (1.5–2.0).
• Why A/B/C are wrong: Polyuria and fine tremor can occur at therapeutic levels; nausea is early
toxicity but less urgent than neurological signs.
8. A nurse is preparing to transfuse packed RBCs. Which IV fluid is compatible?
A) Lactated Ringer’s
B) 0.9% sodium chloride
C) 5% dextrose in water
D) 0.45% sodium chloride
