ATI Exit Retake NGN Exam Prep 2026/2027
ATI Comprehensive Exit Examination
Next Generation NCLEX (NGN) Retake
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Comprehensive Exam Prep Guide 2026/2027
180 Questions, Correct Answers & Clinical Judgment Rationales
PART 1: Questions 1 – 90
April 2026
1
, ATI Exit Retake NGN Exam Prep 2026/2027
Table of Contents
Section: Management of Care (Q1–Q12)
Section: Safety & Infection Control (Q13–Q24)
Section: Health Promotion & Maintenance (Q25–Q36)
Section: Psychosocial Integrity (Q37–Q48)
Section: Basic Care & Comfort (Q49–Q58)
Section: Pharmacological & Parenteral Therapies (Q59–Q70)
Section: Reduction of Risk Potential (Q71–Q82)
Section: Physiological Adaptation – Part A (Q83–Q90)
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, ATI Exit Retake NGN Exam Prep 2026/2027
Section 1: Management of Care (Q1–Q12)
Advance Directives · Delegation · Client Rights · HIPAA · Ethics · QI/Root Cause Analysis · Case Management · Discharge Planning
· Information Technology
Q1. A nurse is caring for a client who has just been admitted to the hospital. The client states, "I
do not want any blood products, even if it means I might die." Which of the following actions
should the nurse take first?
A. Document the client's refusal in the medical record and notify the healthcare provider.
B. Ask the client to sign a refusal-of-treatment form.
C. Ensure the client understands the consequences of refusing blood products.
D. Notify the facility's ethics committee.
✓ Correct Answer: C. Ensure the client understands the consequences of refusing blood
products.
Rationale: Clinical Judgment: Analyze Cues. Framework: ABCs (Safety first). The correct answer is C. The nurse
must first ensure the client fully understands the consequences of refusing treatment (informed consent/refusal).
The client has the right to autonomy and to refuse treatment, but the nurse must verify that the refusal is informed.
After confirming understanding, the nurse documents the refusal (A), has the client sign a form (B), and involves the
ethics committee only if a conflict arises (D). Distractor A is premature before verifying informed refusal. Distractor
B is a subsequent step. Distractor D is unnecessary unless an ethical dilemma requires committee review.
────────────────────────────────────────────────────────────────────────────────
Q2. A nurse on a medical-surgical unit is delegating tasks to a licensed practical nurse (LPN)
and an unlicensed assistive personnel (UAP). Which of the following tasks should the nurse
delegate to the UAP?
A. Measuring the client's intake and output.
B. Administering a prescribed enema to a client.
C. Assessing a client's postoperative incision site.
D. Teaching a client how to use an incentive spirometer.
✓ Correct Answer: A. Measuring the client's intake and output.
Rationale: Clinical Judgment: Generate Solutions. Framework: 5 Rights of Delegation (Right Task, Right
Circumstance, Right Person, Right Direction, Right Supervision). The correct answer is A. Measuring intake and
output is a routine, repetitive task that does not require nursing judgment and falls within the UAP scope of practice.
Distractor B (administering an enema) requires nursing knowledge and should be delegated to the LPN. Distractor
C (assessing an incision) requires RN-level clinical judgment and cannot be delegated. Distractor D (teaching) is an
RN responsibility and cannot be delegated to any assistive personnel.
────────────────────────────────────────────────────────────────────────────────
Q3. [Select All That Apply] [NGN: Select All That Apply]
A nurse is reviewing the medical record of a client who has a do-not-resuscitate (DNR) order.
Which of the following interventions should the nurse implement for this client? (Select all that
apply.)
A. Initiate cardiopulmonary resuscitation if the client experiences cardiac arrest.
B. Administer prescribed antibiotics for a urinary tract infection.
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, ATI Exit Retake NGN Exam Prep 2026/2027
C. Provide comfort measures such as oral care and repositioning.
D. Continue to monitor vital signs and report changes to the provider.
E. Withhold all medications and treatments as part of the DNR order.
F. Consult the palliative care team for symptom management.
✓ Correct Answer: B. Administer prescribed antibiotics for a urinary tract infection., C. Provide
comfort measures such as oral care and repositioning., D. Continue to monitor vital signs and
report changes to the provider., F. Consult the palliative care team for symptom management.
Rationale: Clinical Judgment: Generate Solutions. Framework: Least Restrictive / Autonomy. The correct answers
are B, C, D, and F. A DNR order specifically addresses resuscitation in the event of cardiac or respiratory arrest; it
does not mean withholding all treatment. The nurse should continue to provide routine care, administer
medications for comfort and treatable conditions, monitor the client, and consult palliative care. Option A is
incorrect because the DNR specifically prohibits CPR. Option E is incorrect because a DNR applies only to
resuscitation, not to all medical treatments.
────────────────────────────────────────────────────────────────────────────────
Q4. A nurse manager is conducting a root cause analysis (RCA) after a client received the wrong
medication. Which of the following steps should the nurse manager take first?
A. Disciplining the nurse who administered the incorrect medication.
B. Identifying the factors that contributed to the error.
C. Implementing a new medication administration policy.
D. Notifying the client and family of the error.
✓ Correct Answer: B. Identifying the factors that contributed to the error.
Rationale: Clinical Judgment: Analyze Cues. Framework: Quality Improvement (Root Cause Analysis). The correct
answer is B. The purpose of RCA is to identify the underlying system failures and contributing factors that led to the
adverse event—not to assign blame. Distractor A violates the just culture approach; individual punishment does not
address system issues. Distractor C (implementing a new policy) comes after identifying the root cause. Distractor D
(notifying the client) is ethically important but is not the first step in RCA; notification occurs as part of disclosure
but the analytical process begins with identifying contributing factors.
────────────────────────────────────────────────────────────────────────────────
Q5. A nurse is caring for a client who requires informed consent for a surgical procedure. The
client has signed the consent form, but the nurse observes that the client appears confused
about the procedure. Which of the following actions should the nurse take?
A. Proceed with the preoperative preparations since the client has signed the form.
B. Ask the client to describe the procedure to assess understanding.
C. Contact the surgeon to return and reinforce the explanation.
D. Have the client's family member explain the procedure to the client.
✓ Correct Answer: B. Ask the client to describe the procedure to assess understanding.
Rationale: Clinical Judgment: Evaluate Outcomes. Framework: Autonomy / Informed Consent. The correct answer
is B. The nurse should first assess the client's level of understanding by asking the client to describe the procedure in
their own words. If the client cannot adequately describe the procedure, the nurse must notify the surgeon (C) to
return and provide additional explanation. Distractor A is unsafe—consent is not valid if the client does not
understand the procedure. Distractor D is inappropriate; it is the surgeon's and provider's responsibility to explain
the procedure, not the family's.
4
ATI Comprehensive Exit Examination
Next Generation NCLEX (NGN) Retake
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━
Comprehensive Exam Prep Guide 2026/2027
180 Questions, Correct Answers & Clinical Judgment Rationales
PART 1: Questions 1 – 90
April 2026
1
, ATI Exit Retake NGN Exam Prep 2026/2027
Table of Contents
Section: Management of Care (Q1–Q12)
Section: Safety & Infection Control (Q13–Q24)
Section: Health Promotion & Maintenance (Q25–Q36)
Section: Psychosocial Integrity (Q37–Q48)
Section: Basic Care & Comfort (Q49–Q58)
Section: Pharmacological & Parenteral Therapies (Q59–Q70)
Section: Reduction of Risk Potential (Q71–Q82)
Section: Physiological Adaptation – Part A (Q83–Q90)
2
, ATI Exit Retake NGN Exam Prep 2026/2027
Section 1: Management of Care (Q1–Q12)
Advance Directives · Delegation · Client Rights · HIPAA · Ethics · QI/Root Cause Analysis · Case Management · Discharge Planning
· Information Technology
Q1. A nurse is caring for a client who has just been admitted to the hospital. The client states, "I
do not want any blood products, even if it means I might die." Which of the following actions
should the nurse take first?
A. Document the client's refusal in the medical record and notify the healthcare provider.
B. Ask the client to sign a refusal-of-treatment form.
C. Ensure the client understands the consequences of refusing blood products.
D. Notify the facility's ethics committee.
✓ Correct Answer: C. Ensure the client understands the consequences of refusing blood
products.
Rationale: Clinical Judgment: Analyze Cues. Framework: ABCs (Safety first). The correct answer is C. The nurse
must first ensure the client fully understands the consequences of refusing treatment (informed consent/refusal).
The client has the right to autonomy and to refuse treatment, but the nurse must verify that the refusal is informed.
After confirming understanding, the nurse documents the refusal (A), has the client sign a form (B), and involves the
ethics committee only if a conflict arises (D). Distractor A is premature before verifying informed refusal. Distractor
B is a subsequent step. Distractor D is unnecessary unless an ethical dilemma requires committee review.
────────────────────────────────────────────────────────────────────────────────
Q2. A nurse on a medical-surgical unit is delegating tasks to a licensed practical nurse (LPN)
and an unlicensed assistive personnel (UAP). Which of the following tasks should the nurse
delegate to the UAP?
A. Measuring the client's intake and output.
B. Administering a prescribed enema to a client.
C. Assessing a client's postoperative incision site.
D. Teaching a client how to use an incentive spirometer.
✓ Correct Answer: A. Measuring the client's intake and output.
Rationale: Clinical Judgment: Generate Solutions. Framework: 5 Rights of Delegation (Right Task, Right
Circumstance, Right Person, Right Direction, Right Supervision). The correct answer is A. Measuring intake and
output is a routine, repetitive task that does not require nursing judgment and falls within the UAP scope of practice.
Distractor B (administering an enema) requires nursing knowledge and should be delegated to the LPN. Distractor
C (assessing an incision) requires RN-level clinical judgment and cannot be delegated. Distractor D (teaching) is an
RN responsibility and cannot be delegated to any assistive personnel.
────────────────────────────────────────────────────────────────────────────────
Q3. [Select All That Apply] [NGN: Select All That Apply]
A nurse is reviewing the medical record of a client who has a do-not-resuscitate (DNR) order.
Which of the following interventions should the nurse implement for this client? (Select all that
apply.)
A. Initiate cardiopulmonary resuscitation if the client experiences cardiac arrest.
B. Administer prescribed antibiotics for a urinary tract infection.
3
, ATI Exit Retake NGN Exam Prep 2026/2027
C. Provide comfort measures such as oral care and repositioning.
D. Continue to monitor vital signs and report changes to the provider.
E. Withhold all medications and treatments as part of the DNR order.
F. Consult the palliative care team for symptom management.
✓ Correct Answer: B. Administer prescribed antibiotics for a urinary tract infection., C. Provide
comfort measures such as oral care and repositioning., D. Continue to monitor vital signs and
report changes to the provider., F. Consult the palliative care team for symptom management.
Rationale: Clinical Judgment: Generate Solutions. Framework: Least Restrictive / Autonomy. The correct answers
are B, C, D, and F. A DNR order specifically addresses resuscitation in the event of cardiac or respiratory arrest; it
does not mean withholding all treatment. The nurse should continue to provide routine care, administer
medications for comfort and treatable conditions, monitor the client, and consult palliative care. Option A is
incorrect because the DNR specifically prohibits CPR. Option E is incorrect because a DNR applies only to
resuscitation, not to all medical treatments.
────────────────────────────────────────────────────────────────────────────────
Q4. A nurse manager is conducting a root cause analysis (RCA) after a client received the wrong
medication. Which of the following steps should the nurse manager take first?
A. Disciplining the nurse who administered the incorrect medication.
B. Identifying the factors that contributed to the error.
C. Implementing a new medication administration policy.
D. Notifying the client and family of the error.
✓ Correct Answer: B. Identifying the factors that contributed to the error.
Rationale: Clinical Judgment: Analyze Cues. Framework: Quality Improvement (Root Cause Analysis). The correct
answer is B. The purpose of RCA is to identify the underlying system failures and contributing factors that led to the
adverse event—not to assign blame. Distractor A violates the just culture approach; individual punishment does not
address system issues. Distractor C (implementing a new policy) comes after identifying the root cause. Distractor D
(notifying the client) is ethically important but is not the first step in RCA; notification occurs as part of disclosure
but the analytical process begins with identifying contributing factors.
────────────────────────────────────────────────────────────────────────────────
Q5. A nurse is caring for a client who requires informed consent for a surgical procedure. The
client has signed the consent form, but the nurse observes that the client appears confused
about the procedure. Which of the following actions should the nurse take?
A. Proceed with the preoperative preparations since the client has signed the form.
B. Ask the client to describe the procedure to assess understanding.
C. Contact the surgeon to return and reinforce the explanation.
D. Have the client's family member explain the procedure to the client.
✓ Correct Answer: B. Ask the client to describe the procedure to assess understanding.
Rationale: Clinical Judgment: Evaluate Outcomes. Framework: Autonomy / Informed Consent. The correct answer
is B. The nurse should first assess the client's level of understanding by asking the client to describe the procedure in
their own words. If the client cannot adequately describe the procedure, the nurse must notify the surgeon (C) to
return and provide additional explanation. Distractor A is unsafe—consent is not valid if the client does not
understand the procedure. Distractor D is inappropriate; it is the surgeon's and provider's responsibility to explain
the procedure, not the family's.
4
