EXIT EXAM WITH NGN QUESTIONS AND
VERIFIED ANSWERS COMPLETE STUDY
GUIDE LATEST ACTUAL EXAM VERSION FOR
PRACTICAL NURSING SUCCESS
ATI PN COMPREHENSIVE PREDICTOR 2023 EXIT EXAM WITH NGN – COMPLETE
STUDY GUIDE
DOCUMENT OVERVIEW
• This comprehensive study guide contains practice questions designed to prepare
you for the ATI PN exit exam with NGN (Next Generation NCLEX) format, covering
all major nursing domains and clinical scenarios you will encounter in practice.
• Study this material by taking practice tests in sections, reviewing EXPERT
RATIONALE for both correct and incorrect answers, and identifying weak areas to
focus your review before the actual exam.
QUESTIONS
1. A practical nurse is caring for a client with hypertension who is prescribed
lisinopril, an ACE inhibitor. What is the primary mechanism of action for this
medication?
A) Blocks beta-adrenergic receptors to decrease heart rate and contractility
B) Inhibits the conversion of angiotensin I to angiotensin II
C) Blocks calcium channels to decrease vascular resistance
D) Increases sodium and water reabsorption in the kidneys
E) Directly relaxes vascular smooth muscle
CORRECT ANSWER: B) Inhibits the conversion of angiotensin I to angiotensin II
,EXPERT RATIONALE: ACE inhibitors work by blocking the angiotensin-converting
enzyme, which prevents the conversion of angiotensin I to angiotensin II. This
reduces vasoconstriction and aldosterone secretion, leading to decreased blood
pressure. Option A describes beta-blockers, Option C describes calcium channel
blockers, Option D describes mechanisms that increase blood pressure, and Option
E describes vasodilators. Understanding medication mechanisms is essential for PN
practice when administering antihypertensive agents.
2. A client is admitted to the unit with a diagnosis of acute myocardial
infarction. Which assessment finding would indicate the client is experiencing
cardiogenic shock?
A) Heart rate of 78 bpm with regular rhythm
B) Systolic blood pressure less than 90 mmHg with cool, clammy skin and
decreased urine output
C) Respiratory rate of 16 breaths per minute
D) Oxygen saturation of 98% on room air
E) Warm, dry skin with adequate perfusion
CORRECT ANSWER: B) Systolic blood pressure less than 90 mmHg with cool,
clammy skin and decreased urine output
EXPERT RATIONALE: Cardiogenic shock results from inadequate cardiac output
and is characterized by hypotension (systolic BP <90 mmHg), poor tissue perfusion
(cool, clammy skin), and decreased end-organ perfusion (oliguria with decreased
urine output). These classic signs indicate inadequate perfusion due to cardiac
dysfunction. The other options represent normal vital signs or adequate perfusion,
which would not indicate shock. PNs must recognize shock states early to initiate
appropriate interventions.
,3. A practical nurse is preparing to administer insulin to a client with diabetes
mellitus. Which sites should the nurse rotate when administering
subcutaneous insulin injections?
A) Only the abdomen to ensure consistent absorption
B) The abdomen, upper arms, thighs, and buttocks
C) Only the thighs to prevent lipodystrophy
D) The same site weekly to maintain consistent blood glucose levels
E) Only areas with visible fat deposits
CORRECT ANSWER: B) The abdomen, upper arms, thighs, and buttocks
EXPERT RATIONALE: Insulin injection sites should be rotated among the abdomen,
upper arms, thighs, and buttocks to prevent lipodystrophy (abnormal fat
distribution), promote consistent absorption, and maintain optimal medication
effectiveness. While the abdomen has the most consistent absorption, using only
one site can lead to tissue damage and poor absorption over time. Rotating sites
ensures even insulin distribution and prevents complications. This is a fundamental
skill in diabetes management for PNs.
4. A mother brings her 18-month-old child to the clinic. The practical nurse is
assessing the child's developmental milestones. Which milestone would be
INAPPROPRIATE for this age?
A) Walking independently without assistance
B) Speaking in 50-word vocabulary
C) Using a cup with some spilling
D) Demonstrating the ability to climb stairs with one hand held
E) Reading simple sentences independently
CORRECT ANSWER: E) Reading simple sentences independently
, EXPERT RATIONALE: An 18-month-old child would not be developmentally capable
of reading simple sentences independently. At 18 months, typical milestones
include walking independently, speaking 10-50 words, using a cup (with some
spilling), and climbing stairs with assistance. Reading typically develops around ages
4-6 years. All other options are appropriate for an 18-month-old. Recognizing
appropriate developmental milestones is crucial for PNs conducting pediatric
assessments and identifying delays.
5. A client with pneumonia is receiving supplemental oxygen via a nasal
cannula at 4 L/min. What is the approximate fraction of inspired oxygen
(FiO2) this client is receiving?
A) 24-28%
B) 32-36%
C) 40-44%
D) 60-65%
E) 80-90%
CORRECT ANSWER: B) 32-36%
EXPERT RATIONALE: A nasal cannula at 4 L/min delivers approximately 32-36%
FiO2. The general formula is that each liter per minute of oxygen increases FiO2 by
approximately 3-4% above room air (21%). Therefore: 4 L/min × 4% = 16% + 21%
(room air) = approximately 37%. A face mask at 5-6 L/min delivers 40-60% FiO2, and
a non-rebreather mask delivers 80-95% FiO2. Understanding oxygen delivery
systems is essential for appropriate respiratory support in nursing practice.
6. A practical nurse is caring for a client who has suffered a stroke affecting
the right hemisphere. Which clinical manifestation would the nurse expect?
A) Expressive aphasia and inability to speak fluently
B) Left-sided hemiparesis and perceptual deficits