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RN ATI COMPREHENSIVE EXIT ACTUAL EXAM
PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED
1. A nurse is caring for a client with heart failure who has a new
prescription for furosemide. Which laboratory value requires
notification of the provider before administering the first dose?
A) Sodium 138 mEq/L
B) Potassium 2.9 mEq/L
C) Creatinine 0.8 mg/dL
D) Hemoglobin 13 g/dL
*Rationale: Hypokalemia (K <3.5) increases risk of
arrhythmias and digoxin toxicity. Furosemide causes further
potassium loss. Correct potassium before administration or use
potassium-sparing diuretic.*
2. A nurse is preparing to administer a blood transfusion to a
client. Which IV solution should be used to prime the blood
tubing?
A) Lactated Ringer’s solution
B) 5% dextrose in water
C) 0.9% sodium chloride (normal saline)
D) 0.45% sodium chloride
Rationale: Only normal saline is compatible with blood
products. Dextrose solutions cause hemolysis; lactated
Ringer’s contains calcium which can cause clotting.
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3. A nurse is assessing a client who is receiving a continuous
morphine infusion via patient-controlled analgesia (PCA). The
client has a respiratory rate of 8 breaths/min and is difficult to
arouse. Which medication should the nurse administer first?
A) Flumazenil
B) Naloxone
C) Activated charcoal
D) Methylnaltrexone
Rationale: Naloxone is an opioid antagonist that reverses
respiratory depression. Flumazenil reverses benzodiazepines.
Methylnaltrexone treats opioid-induced constipation.
4. A nurse is teaching a client with type 1 diabetes about sick-
day management. Which statement by the client indicates
understanding?
A) "I will stop my insulin if I cannot eat."
B) "I will check my blood glucose every 4 hours and drink
sugar-free liquids."
C) "I will take twice as much insulin to prevent ketoacidosis."
D) "I will only drink water and avoid all carbohydrates."
*Rationale: During illness, blood glucose often rises; never
stop insulin. Check glucose q4h, stay hydrated with sugar-free
or regular fluids if able, and continue insulin with dose
adjustments.*
5. A nurse is caring for a client with a nasogastric tube set to low
intermittent suction. Which electrolyte imbalance is the client at
greatest risk for?
A) Hyperkalemia
B) Hypokalemia
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C) Hypernatremia
D) Hypercalcemia
Rationale: Gastric suction removes gastric acid (HCl) and
potassium, leading to metabolic alkalosis and hypokalemia.
Monitor potassium and replace as needed.
6. A nurse is assessing a postpartum client who delivered
vaginally 2 hours ago. The fundus is boggy and displaced to the
right. What is the priority nursing action?
A) Document the finding
B) Assist the client to void
C) Administer oxytocin
D) Perform fundal massage
Rationale: A displaced, boggy uterus indicates a full bladder.
The priority is to have the client void, which allows the uterus
to contract. After voiding, reassess and then massage if still
boggy.
7. A client with cirrhosis has an order for lactulose. Which
assessment finding indicates the medication is effective?
A) Decreased abdominal girth
B) Decreased serum ammonia level
C) Increased serum bilirubin
D) Increased bowel sounds
Rationale: Lactulose reduces serum ammonia by acidifying
the colon, trapping ammonium ion, and promoting excretion.
Effectiveness is measured by decreased ammonia and
improved mental status.
8. A nurse is caring for a client with major depressive disorder
who started taking phenelzine (MAOI). Which food item on the
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client’s tray should the nurse remove?
A) Aged cheddar cheese
B) Applesauce
C) White rice
D) Green beans
Rationale: MAOIs require a low-tyramine diet. Aged cheese,
cured meats, fermented foods, and some wines can cause
hypertensive crisis.
9. A nurse is providing discharge teaching to a client with a new
prescription for warfarin. Which over-the-counter medication
should the client avoid?
A) Acetaminophen
B) Ibuprofen
C) Loratadine
D) Diphenhydramine
Rationale: NSAIDs (ibuprofen, naproxen, aspirin) increase
bleeding risk when taken with warfarin. Acetaminophen is
safer but monitor INR with chronic use.
10. A nurse is assessing a client who is receiving a packed red
blood cell transfusion. Fifteen minutes after initiation, the client
reports low back pain and chills. What is the priority action?
A) Slow the infusion rate
B) Stop the transfusion
C) Administer acetaminophen
D) Notify the provider after the infusion
Rationale: Back pain and chills suggest acute hemolytic
reaction. Stop transfusion immediately, keep IV line open with
saline, and notify provider. Return blood unit to lab.
RN ATI COMPREHENSIVE EXIT ACTUAL EXAM
PREP 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED
1. A nurse is caring for a client with heart failure who has a new
prescription for furosemide. Which laboratory value requires
notification of the provider before administering the first dose?
A) Sodium 138 mEq/L
B) Potassium 2.9 mEq/L
C) Creatinine 0.8 mg/dL
D) Hemoglobin 13 g/dL
*Rationale: Hypokalemia (K <3.5) increases risk of
arrhythmias and digoxin toxicity. Furosemide causes further
potassium loss. Correct potassium before administration or use
potassium-sparing diuretic.*
2. A nurse is preparing to administer a blood transfusion to a
client. Which IV solution should be used to prime the blood
tubing?
A) Lactated Ringer’s solution
B) 5% dextrose in water
C) 0.9% sodium chloride (normal saline)
D) 0.45% sodium chloride
Rationale: Only normal saline is compatible with blood
products. Dextrose solutions cause hemolysis; lactated
Ringer’s contains calcium which can cause clotting.
,2|Page
3. A nurse is assessing a client who is receiving a continuous
morphine infusion via patient-controlled analgesia (PCA). The
client has a respiratory rate of 8 breaths/min and is difficult to
arouse. Which medication should the nurse administer first?
A) Flumazenil
B) Naloxone
C) Activated charcoal
D) Methylnaltrexone
Rationale: Naloxone is an opioid antagonist that reverses
respiratory depression. Flumazenil reverses benzodiazepines.
Methylnaltrexone treats opioid-induced constipation.
4. A nurse is teaching a client with type 1 diabetes about sick-
day management. Which statement by the client indicates
understanding?
A) "I will stop my insulin if I cannot eat."
B) "I will check my blood glucose every 4 hours and drink
sugar-free liquids."
C) "I will take twice as much insulin to prevent ketoacidosis."
D) "I will only drink water and avoid all carbohydrates."
*Rationale: During illness, blood glucose often rises; never
stop insulin. Check glucose q4h, stay hydrated with sugar-free
or regular fluids if able, and continue insulin with dose
adjustments.*
5. A nurse is caring for a client with a nasogastric tube set to low
intermittent suction. Which electrolyte imbalance is the client at
greatest risk for?
A) Hyperkalemia
B) Hypokalemia
,3|Page
C) Hypernatremia
D) Hypercalcemia
Rationale: Gastric suction removes gastric acid (HCl) and
potassium, leading to metabolic alkalosis and hypokalemia.
Monitor potassium and replace as needed.
6. A nurse is assessing a postpartum client who delivered
vaginally 2 hours ago. The fundus is boggy and displaced to the
right. What is the priority nursing action?
A) Document the finding
B) Assist the client to void
C) Administer oxytocin
D) Perform fundal massage
Rationale: A displaced, boggy uterus indicates a full bladder.
The priority is to have the client void, which allows the uterus
to contract. After voiding, reassess and then massage if still
boggy.
7. A client with cirrhosis has an order for lactulose. Which
assessment finding indicates the medication is effective?
A) Decreased abdominal girth
B) Decreased serum ammonia level
C) Increased serum bilirubin
D) Increased bowel sounds
Rationale: Lactulose reduces serum ammonia by acidifying
the colon, trapping ammonium ion, and promoting excretion.
Effectiveness is measured by decreased ammonia and
improved mental status.
8. A nurse is caring for a client with major depressive disorder
who started taking phenelzine (MAOI). Which food item on the
, 4|Page
client’s tray should the nurse remove?
A) Aged cheddar cheese
B) Applesauce
C) White rice
D) Green beans
Rationale: MAOIs require a low-tyramine diet. Aged cheese,
cured meats, fermented foods, and some wines can cause
hypertensive crisis.
9. A nurse is providing discharge teaching to a client with a new
prescription for warfarin. Which over-the-counter medication
should the client avoid?
A) Acetaminophen
B) Ibuprofen
C) Loratadine
D) Diphenhydramine
Rationale: NSAIDs (ibuprofen, naproxen, aspirin) increase
bleeding risk when taken with warfarin. Acetaminophen is
safer but monitor INR with chronic use.
10. A nurse is assessing a client who is receiving a packed red
blood cell transfusion. Fifteen minutes after initiation, the client
reports low back pain and chills. What is the priority action?
A) Slow the infusion rate
B) Stop the transfusion
C) Administer acetaminophen
D) Notify the provider after the infusion
Rationale: Back pain and chills suggest acute hemolytic
reaction. Stop transfusion immediately, keep IV line open with
saline, and notify provider. Return blood unit to lab.
