Page | 1
ATI RN Comprehensive Exit Exam
2025/2026 | 300 Questions & Answers with
Rationales | 100% Correct | NCLEX-Style
Practice
Question #1 – Clinical Judgment / Prioritization
A nurse is caring for a 72-year-old client admitted with community-acquired pneumonia. The
client has a history of type 2 diabetes mellitus, hypertension, and chronic obstructive pulmonary
disease (COPD). Upon assessment, the nurse notes the client is alert but slightly confused, has a
respiratory rate of 30/min, oxygen saturation of 88% on room air, blood pressure of 138/84 mm
Hg, and temperature of 38.3°C (100.9°F). The client is coughing frequently and producing thick
yellow sputum. The healthcare provider has prescribed IV fluids, supplemental oxygen via nasal
cannula, sputum culture, and empirical IV antibiotics.
, Which of the following actions should the nurse take first?
A. Initiate oxygen therapy via nasal cannula at 2 L/min
Page | 2 B. Obtain a sputum sample for culture and sensitivity
C. Start the IV fluids to maintain hydration
D. Administer the first dose of IV antibiotics
✅ Correct Answer: A. Initiate oxygen therapy via nasal cannula at 2 L/min
🧠 Rationale:
According to the ABC (Airway, Breathing, Circulation) priority framework, the nurse should
address breathing problems first. The client’s respiratory rate is elevated (tachypnea), and the
oxygen saturation is critically low (88% on room air), indicating impaired gas exchange likely
due to pneumonia. Initiating oxygen therapy will improve tissue oxygenation and reduce the risk
of hypoxia-related complications.
While obtaining a sputum sample (Option B) is important before starting antibiotics, and both
IV fluids (C) and antibiotics (D) are necessary interventions, oxygenation is the most urgent
priority to stabilize the client. ATI and NCLEX both emphasize addressing life-threatening
problems first.
Question #2 – Safety & Infection Control
, A nurse is preparing to administer medications to a client with Clostridioides difficile (C. diff)
infection. The client is in a private room with contact precautions. As the nurse enters the room,
she notes that the client’s blood pressure cuff and stethoscope are placed on the bedside table.
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The nurse brings in the medication tray and prepares to administer oral metronidazole and
potassium chloride.
Which of the following actions should the nurse take to prevent the spread of infection?
A. Use alcohol-based hand sanitizer before and after entering the room
B. Wear a surgical mask and face shield when administering medications
C. Place disposable gown and gloves before medication administration
D. Use the same stethoscope for other clients after wiping it with alcohol
✅ Correct Answer: C. Place disposable gown and gloves before medication administration
🧠 Rationale:
Clients with C. difficile require contact precautions, including the use of gown and gloves
whenever entering the room or providing care. This prevents the transmission of the spore-
forming bacteria, which spreads via the fecal-oral route.
Option A is incorrect because alcohol-based hand sanitizer is not effective against C. diff
spores; handwashing with soap and water is required after client contact. Option B is
, unnecessary unless there’s a risk of splashes. Option D is unsafe; equipment used in isolation
rooms should be either disposable or dedicated to that client.
Page | 4 Question #3 – Pharmacology / Medication Administration
A nurse is caring for a client who has atrial fibrillation and is prescribed warfarin. During the
morning assessment, the client reports using herbal supplements, including garlic and ginkgo
biloba, to manage blood pressure. The client also complains of bleeding gums when brushing
teeth and has several bruises on their forearms.
Which of the following actions should the nurse take first?
A. Document the findings and monitor for further signs of bleeding
B. Notify the healthcare provider about the client’s herbal supplement use
C. Withhold the next scheduled dose of warfarin
D. Teach the client about avoiding herbal supplements while on anticoagulants
✅ Correct Answer: B. Notify the healthcare provider about the client’s herbal supplement
use
🧠 Rationale:
The priority action is to notify the provider because the combination of warfarin and herbal
supplements like garlic and ginkgo can significantly increase the risk of bleeding. The client is
ATI RN Comprehensive Exit Exam
2025/2026 | 300 Questions & Answers with
Rationales | 100% Correct | NCLEX-Style
Practice
Question #1 – Clinical Judgment / Prioritization
A nurse is caring for a 72-year-old client admitted with community-acquired pneumonia. The
client has a history of type 2 diabetes mellitus, hypertension, and chronic obstructive pulmonary
disease (COPD). Upon assessment, the nurse notes the client is alert but slightly confused, has a
respiratory rate of 30/min, oxygen saturation of 88% on room air, blood pressure of 138/84 mm
Hg, and temperature of 38.3°C (100.9°F). The client is coughing frequently and producing thick
yellow sputum. The healthcare provider has prescribed IV fluids, supplemental oxygen via nasal
cannula, sputum culture, and empirical IV antibiotics.
, Which of the following actions should the nurse take first?
A. Initiate oxygen therapy via nasal cannula at 2 L/min
Page | 2 B. Obtain a sputum sample for culture and sensitivity
C. Start the IV fluids to maintain hydration
D. Administer the first dose of IV antibiotics
✅ Correct Answer: A. Initiate oxygen therapy via nasal cannula at 2 L/min
🧠 Rationale:
According to the ABC (Airway, Breathing, Circulation) priority framework, the nurse should
address breathing problems first. The client’s respiratory rate is elevated (tachypnea), and the
oxygen saturation is critically low (88% on room air), indicating impaired gas exchange likely
due to pneumonia. Initiating oxygen therapy will improve tissue oxygenation and reduce the risk
of hypoxia-related complications.
While obtaining a sputum sample (Option B) is important before starting antibiotics, and both
IV fluids (C) and antibiotics (D) are necessary interventions, oxygenation is the most urgent
priority to stabilize the client. ATI and NCLEX both emphasize addressing life-threatening
problems first.
Question #2 – Safety & Infection Control
, A nurse is preparing to administer medications to a client with Clostridioides difficile (C. diff)
infection. The client is in a private room with contact precautions. As the nurse enters the room,
she notes that the client’s blood pressure cuff and stethoscope are placed on the bedside table.
Page | 3
The nurse brings in the medication tray and prepares to administer oral metronidazole and
potassium chloride.
Which of the following actions should the nurse take to prevent the spread of infection?
A. Use alcohol-based hand sanitizer before and after entering the room
B. Wear a surgical mask and face shield when administering medications
C. Place disposable gown and gloves before medication administration
D. Use the same stethoscope for other clients after wiping it with alcohol
✅ Correct Answer: C. Place disposable gown and gloves before medication administration
🧠 Rationale:
Clients with C. difficile require contact precautions, including the use of gown and gloves
whenever entering the room or providing care. This prevents the transmission of the spore-
forming bacteria, which spreads via the fecal-oral route.
Option A is incorrect because alcohol-based hand sanitizer is not effective against C. diff
spores; handwashing with soap and water is required after client contact. Option B is
, unnecessary unless there’s a risk of splashes. Option D is unsafe; equipment used in isolation
rooms should be either disposable or dedicated to that client.
Page | 4 Question #3 – Pharmacology / Medication Administration
A nurse is caring for a client who has atrial fibrillation and is prescribed warfarin. During the
morning assessment, the client reports using herbal supplements, including garlic and ginkgo
biloba, to manage blood pressure. The client also complains of bleeding gums when brushing
teeth and has several bruises on their forearms.
Which of the following actions should the nurse take first?
A. Document the findings and monitor for further signs of bleeding
B. Notify the healthcare provider about the client’s herbal supplement use
C. Withhold the next scheduled dose of warfarin
D. Teach the client about avoiding herbal supplements while on anticoagulants
✅ Correct Answer: B. Notify the healthcare provider about the client’s herbal supplement
use
🧠 Rationale:
The priority action is to notify the provider because the combination of warfarin and herbal
supplements like garlic and ginkgo can significantly increase the risk of bleeding. The client is
