ATI / NGN / HESI RN EXIT EXAM
2025/2026 — MOST TESTED
QUESTIONS & ANSWERS —
COMPLETE 150-QUESTION STUDY
BUNDLE — A+ GUARANTEED
QUESTION 1
A client with heart failure is prescribed furosemide (Lasix) 40 mg IV.
Which laboratory value should the nurse assess FIRST before
administering this medication?
A) Sodium level
B) Potassium level
C) Creatinine level
D) Magnesium level
ANSWER: B) Potassium level
RATIONALE: Furosemide is a loop diuretic that causes significant
potassium loss through the kidneys. Hypokalemia is a serious and
common side effect that can lead to life-threatening cardiac
dysrhythmias. The nurse must assess the potassium level before
administration. If potassium is below 3.5 mEq/L, the nurse should hold
the medication and notify the healthcare provider.
QUESTION 2
A nurse is caring for a client who is 2 hours post-myocardial infarction
(MI). Which finding requires IMMEDIATE intervention?
A) Blood pressure of 130/80 mmHg
,B) Heart rate of 58 beats per minute
C) Chest pain rated 8/10 on pain scale
D) Temperature of 99.2°F (37.3°C)
ANSWER: C) Chest pain rated 8/10 on pain scale
RATIONALE: Chest pain post-MI indicates ongoing myocardial
ischemia and possible extension of the infarction. This is a medical
emergency requiring immediate intervention including oxygen
administration, nitroglycerin, morphine, and notification of the
healthcare provider. A slight bradycardia (58 bpm) may be normal post-
MI, especially with beta-blocker therapy.
QUESTION 3
A client is receiving a continuous heparin infusion for deep vein
thrombosis (DVT). The aPTT result is 120 seconds (therapeutic range
60-100 seconds). What action should the nurse take?
A) Increase the infusion rate by 2 units/kg/hr
B) Decrease the infusion rate and notify the healthcare provider
C) Discontinue the infusion immediately
D) Continue the infusion at the current rate
ANSWER: B) Decrease the infusion rate and notify the healthcare
provider
RATIONALE: An aPTT of 120 seconds is above the therapeutic range
of 60-100 seconds, indicating the client is over-anticoagulated and at
increased risk for bleeding. The nurse should decrease the infusion rate
according to the established protocol and notify the healthcare provider.
QUESTION 4
A client with a permanent pacemaker reports dizziness and syncope. The
ECG shows a rate of 38 beats per minute with spike artifacts present.
What is the nurse's interpretation of this finding?
A) Normal pacemaker function
,B) Failure to capture
C) Failure to sense
D) Low battery depletion
ANSWER: B) Failure to capture
RATIONALE: Failure to capture occurs when the pacemaker fires (spike
artifact present) but the myocardium does not depolarize, resulting in no
QRS complex following the spike. The slow ventricular rate of 38
represents the underlying escape rhythm. This is a medical emergency
requiring immediate intervention and possible pacemaker
reprogramming or magnet application.
QUESTION 5
A client with cirrhosis develops confusion, asterixis, and a serum
ammonia level of 150 mcg/dL (normal 15-60). Which prescribed
medication should the nurse administer FIRST?
A) Lactulose 30 mL orally
B) Furosemide 40 mg IV
C) Spironolactone 50 mg orally
D) Pantoprazole 40 mg IV
ANSWER: A) Lactulose 30 mL orally
RATIONALE: Lactulose is the first-line treatment for hepatic
encephalopathy. It works by acidifying the colon, converting ammonia
to ammonium ion, which is then excreted in the stool. Reducing
ammonia levels is the priority to prevent worsening encephalopathy and
coma.
QUESTION 6
A nurse is assessing a client with diabetic ketoacidosis (DKA). Which
finding indicates a complication requiring immediate intervention?
A) Blood glucose 320 mg/dL
B) Serum potassium 2.9 mEq/L
, C) Serum bicarbonate 16 mEq/L
D) Urine ketones 4+
ANSWER: B) Serum potassium 2.9 mEq/L
RATIONALE: Severe hypokalemia (potassium <3.0 mEq/L) is a
medical emergency in DKA because insulin therapy will further drive
potassium into cells, worsening hypokalemia and potentially causing
cardiac dysrhythmias, respiratory muscle paralysis, and cardiac arrest.
Potassium must be replaced before initiating insulin infusion if
potassium is <3.3 mEq/L.
QUESTION 7
A client is admitted with suspected pulmonary embolism (PE). Which
diagnostic test is the MOST definitive for confirming this diagnosis?
A) D-dimer
B) Chest x-ray
C) CT pulmonary angiography
D) Ventilation-perfusion (V/Q) scan
ANSWER: C) CT pulmonary angiography
RATIONALE: CT pulmonary angiography (CTPA) is the gold standard
for diagnosing pulmonary embolism. It provides direct visualization of
clots in the pulmonary arteries with high sensitivity and specificity.
While D-dimer is a useful screening test, it is not definitive due to false
positives. V/Q scans are used when CTPA is contraindicated.
QUESTION 8
A nurse is teaching a client with newly diagnosed type 2 diabetes about
metformin. Which statement by the client indicates understanding?
A) I will take this medication on an empty stomach
B) I will stop taking this medication if I have imaging with contrast dye
C) I can expect to gain weight while taking this medication
D) I will take this medication only when my blood sugar is high
2025/2026 — MOST TESTED
QUESTIONS & ANSWERS —
COMPLETE 150-QUESTION STUDY
BUNDLE — A+ GUARANTEED
QUESTION 1
A client with heart failure is prescribed furosemide (Lasix) 40 mg IV.
Which laboratory value should the nurse assess FIRST before
administering this medication?
A) Sodium level
B) Potassium level
C) Creatinine level
D) Magnesium level
ANSWER: B) Potassium level
RATIONALE: Furosemide is a loop diuretic that causes significant
potassium loss through the kidneys. Hypokalemia is a serious and
common side effect that can lead to life-threatening cardiac
dysrhythmias. The nurse must assess the potassium level before
administration. If potassium is below 3.5 mEq/L, the nurse should hold
the medication and notify the healthcare provider.
QUESTION 2
A nurse is caring for a client who is 2 hours post-myocardial infarction
(MI). Which finding requires IMMEDIATE intervention?
A) Blood pressure of 130/80 mmHg
,B) Heart rate of 58 beats per minute
C) Chest pain rated 8/10 on pain scale
D) Temperature of 99.2°F (37.3°C)
ANSWER: C) Chest pain rated 8/10 on pain scale
RATIONALE: Chest pain post-MI indicates ongoing myocardial
ischemia and possible extension of the infarction. This is a medical
emergency requiring immediate intervention including oxygen
administration, nitroglycerin, morphine, and notification of the
healthcare provider. A slight bradycardia (58 bpm) may be normal post-
MI, especially with beta-blocker therapy.
QUESTION 3
A client is receiving a continuous heparin infusion for deep vein
thrombosis (DVT). The aPTT result is 120 seconds (therapeutic range
60-100 seconds). What action should the nurse take?
A) Increase the infusion rate by 2 units/kg/hr
B) Decrease the infusion rate and notify the healthcare provider
C) Discontinue the infusion immediately
D) Continue the infusion at the current rate
ANSWER: B) Decrease the infusion rate and notify the healthcare
provider
RATIONALE: An aPTT of 120 seconds is above the therapeutic range
of 60-100 seconds, indicating the client is over-anticoagulated and at
increased risk for bleeding. The nurse should decrease the infusion rate
according to the established protocol and notify the healthcare provider.
QUESTION 4
A client with a permanent pacemaker reports dizziness and syncope. The
ECG shows a rate of 38 beats per minute with spike artifacts present.
What is the nurse's interpretation of this finding?
A) Normal pacemaker function
,B) Failure to capture
C) Failure to sense
D) Low battery depletion
ANSWER: B) Failure to capture
RATIONALE: Failure to capture occurs when the pacemaker fires (spike
artifact present) but the myocardium does not depolarize, resulting in no
QRS complex following the spike. The slow ventricular rate of 38
represents the underlying escape rhythm. This is a medical emergency
requiring immediate intervention and possible pacemaker
reprogramming or magnet application.
QUESTION 5
A client with cirrhosis develops confusion, asterixis, and a serum
ammonia level of 150 mcg/dL (normal 15-60). Which prescribed
medication should the nurse administer FIRST?
A) Lactulose 30 mL orally
B) Furosemide 40 mg IV
C) Spironolactone 50 mg orally
D) Pantoprazole 40 mg IV
ANSWER: A) Lactulose 30 mL orally
RATIONALE: Lactulose is the first-line treatment for hepatic
encephalopathy. It works by acidifying the colon, converting ammonia
to ammonium ion, which is then excreted in the stool. Reducing
ammonia levels is the priority to prevent worsening encephalopathy and
coma.
QUESTION 6
A nurse is assessing a client with diabetic ketoacidosis (DKA). Which
finding indicates a complication requiring immediate intervention?
A) Blood glucose 320 mg/dL
B) Serum potassium 2.9 mEq/L
, C) Serum bicarbonate 16 mEq/L
D) Urine ketones 4+
ANSWER: B) Serum potassium 2.9 mEq/L
RATIONALE: Severe hypokalemia (potassium <3.0 mEq/L) is a
medical emergency in DKA because insulin therapy will further drive
potassium into cells, worsening hypokalemia and potentially causing
cardiac dysrhythmias, respiratory muscle paralysis, and cardiac arrest.
Potassium must be replaced before initiating insulin infusion if
potassium is <3.3 mEq/L.
QUESTION 7
A client is admitted with suspected pulmonary embolism (PE). Which
diagnostic test is the MOST definitive for confirming this diagnosis?
A) D-dimer
B) Chest x-ray
C) CT pulmonary angiography
D) Ventilation-perfusion (V/Q) scan
ANSWER: C) CT pulmonary angiography
RATIONALE: CT pulmonary angiography (CTPA) is the gold standard
for diagnosing pulmonary embolism. It provides direct visualization of
clots in the pulmonary arteries with high sensitivity and specificity.
While D-dimer is a useful screening test, it is not definitive due to false
positives. V/Q scans are used when CTPA is contraindicated.
QUESTION 8
A nurse is teaching a client with newly diagnosed type 2 diabetes about
metformin. Which statement by the client indicates understanding?
A) I will take this medication on an empty stomach
B) I will stop taking this medication if I have imaging with contrast dye
C) I can expect to gain weight while taking this medication
D) I will take this medication only when my blood sugar is high
