ATI Comprehensive Exit Exam 2026 with NGN – Complete
Exam-Style Questions with Detailed Rationales | 100% Verified –
Pass Guaranteed – A+ Graded
CANDIDATE INSTRUCTIONS
Select the best answer. For NGN questions, follow format instructions. Use clinical
judgment, ABCs, Maslow, and safety principles. Suggested time: 150–180 minutes.
SECTION A: TRADITIONAL MULTIPLE CHOICE (Questions 1–60)
1. A nurse is reviewing the adult immunization schedule for a 65-year-old client. Which
vaccine is routinely recommended at this age?
A. Human papillomavirus (HPV)
B. Herpes zoster (Shingrix)
C. Varicella
D. Meningococcal
Correct Answer: B
Rationale: The CDC recommends two doses of Shingrix for adults 50 years and older to
prevent shingles. The primary distractor is D; meningococcal vaccine is indicated for
specific risk groups, not routine age-based recommendation at 65.
2. A nurse applies restraints to an adult client who is at risk for self-harm. How
frequently must the nurse obtain a new physician’s order for continued restraint use?
A. Every 1 hour
B. Every 2 hours
C. Every 4 hours
D. Every 24 hours
Correct Answer: C
,Rationale: Federal regulations require a new order every 4 hours for adults ages 18 and
older, every 2 hours for ages 9–17, and every 1 hour for children under 9. The primary
distractor is D; although reassessment is ongoing, the order itself expires at shorter
intervals.
3. According to the Denver II developmental screening test, which fine motor milestone
should a 12-month-old infant typically demonstrate?
A. Transferring objects hand to hand
B. Using a mature pincer grasp
C. Building a tower of two cubes
D. Scribbling spontaneously
Correct Answer: B
Rationale: A mature pincer grasp using thumb and forefinger is expected by 12 months.
The primary distractor is A; transferring objects hand to hand is typically achieved by
6–7 months.
4. Which laboratory value falls within the expected reference range for a healthy adult?
A. Serum potassium 2.8 mEq/L
B. Serum sodium 148 mEq/L
C. Blood urea nitrogen (BUN) 15 mg/dL
D. International normalized ratio (INR) 3.5
Correct Answer: C
Rationale: Normal BUN is approximately 7–20 mg/dL, making 15 mg/dL within
expected limits. The primary distractor is A; potassium 2.8 mEq/L indicates
hypokalemia, which can precipitate life-threatening cardiac dysrhythmias.
5. A client with suspected tuberculosis is admitted to the hospital. Which personal
protective equipment is required for the nurse entering the room?
A. Gown and gloves
B. Surgical mask within 3 feet
C. N95 respirator
D. Face shield only
,Correct Answer: C
Rationale: Tuberculosis requires airborne precautions, which mandate an N95 respirator
or higher-level protection and a negative-pressure room. The primary distractor is B;
surgical masks within 3 feet are used for droplet precautions, not airborne pathogens.
6. A client with type 1 diabetes is prescribed insulin lispro before meals. The nurse
understands that the peak action of this medication occurs at which time?
A. 15–30 minutes
B. 1–2 hours
C. 4–8 hours
D. 12–16 hours
Correct Answer: B
Rationale: Rapid-acting insulin lispro has an onset of approximately 15 minutes, a peak
of 1–2 hours, and a duration of 3–5 hours. The primary distractor is C; 4–8 hours
represents the peak of intermediate-acting NPH insulin.
7. A client diagnosed with major depressive disorder states, “I don’t see any reason to
keep trying.” Which response by the nurse demonstrates therapeutic communication?
A. “You have so much to live for; think about your family.”
B. “Tell me more about what makes you feel that way.”
C. “Why do you feel like giving up now?”
D. “Let’s talk about something more positive.”
Correct Answer: B
Rationale: Open-ended questions encourage the client to express feelings and promote
a therapeutic relationship. The primary distractor is A; false reassurance minimizes the
client’s feelings and is non-therapeutic.
8. A nurse in the emergency department receives a phone call from a local news
reporter asking about a celebrity client’s condition. Which action by the nurse
demonstrates appropriate understanding of HIPAA?
A. Confirm the client is receiving care but provide no details
B. Refer the reporter to the hospital public relations department
C. State that the client is in stable condition
D. Ask the reporter to submit a written request
, Correct Answer: B
Rationale: HIPAA mandates that protected health information cannot be disclosed
without client authorization; all media inquiries must be directed to the designated
public relations representative. The primary distractor is A; confirming admission status
without client consent still violates privacy protections.
9. A pregnant client at 28 weeks gestation calls the clinic reporting sudden onset of
severe headache and visual changes. The nurse recognizes these symptoms as
potential indicators of which complication?
A. Gestational diabetes
B. Preeclampsia
C. Placenta previa
D. Round ligament pain
Correct Answer: B
Rationale: Severe headache and visual disturbances in the third trimester are classic
warning signs of preeclampsia, a hypertensive disorder of pregnancy. The primary
distractor is D; round ligament pain presents as sharp lower abdominal discomfort and
does not involve neurological symptoms.
10. A client receiving intravenous heparin therapy has an aPTT drawn. Which aPTT
value indicates the client is within the therapeutic range?
A. 25 seconds
B. 45 seconds
C. 65 seconds
D. 100 seconds
Correct Answer: C
Rationale: Therapeutic aPTT for unfractionated heparin is typically 1.5–2.5 times the
control value, generally 60–80 seconds. The primary distractor is A; 25 seconds is
below the normal baseline and indicates subtherapeutic anticoagulation with increased
clot risk.
Exam-Style Questions with Detailed Rationales | 100% Verified –
Pass Guaranteed – A+ Graded
CANDIDATE INSTRUCTIONS
Select the best answer. For NGN questions, follow format instructions. Use clinical
judgment, ABCs, Maslow, and safety principles. Suggested time: 150–180 minutes.
SECTION A: TRADITIONAL MULTIPLE CHOICE (Questions 1–60)
1. A nurse is reviewing the adult immunization schedule for a 65-year-old client. Which
vaccine is routinely recommended at this age?
A. Human papillomavirus (HPV)
B. Herpes zoster (Shingrix)
C. Varicella
D. Meningococcal
Correct Answer: B
Rationale: The CDC recommends two doses of Shingrix for adults 50 years and older to
prevent shingles. The primary distractor is D; meningococcal vaccine is indicated for
specific risk groups, not routine age-based recommendation at 65.
2. A nurse applies restraints to an adult client who is at risk for self-harm. How
frequently must the nurse obtain a new physician’s order for continued restraint use?
A. Every 1 hour
B. Every 2 hours
C. Every 4 hours
D. Every 24 hours
Correct Answer: C
,Rationale: Federal regulations require a new order every 4 hours for adults ages 18 and
older, every 2 hours for ages 9–17, and every 1 hour for children under 9. The primary
distractor is D; although reassessment is ongoing, the order itself expires at shorter
intervals.
3. According to the Denver II developmental screening test, which fine motor milestone
should a 12-month-old infant typically demonstrate?
A. Transferring objects hand to hand
B. Using a mature pincer grasp
C. Building a tower of two cubes
D. Scribbling spontaneously
Correct Answer: B
Rationale: A mature pincer grasp using thumb and forefinger is expected by 12 months.
The primary distractor is A; transferring objects hand to hand is typically achieved by
6–7 months.
4. Which laboratory value falls within the expected reference range for a healthy adult?
A. Serum potassium 2.8 mEq/L
B. Serum sodium 148 mEq/L
C. Blood urea nitrogen (BUN) 15 mg/dL
D. International normalized ratio (INR) 3.5
Correct Answer: C
Rationale: Normal BUN is approximately 7–20 mg/dL, making 15 mg/dL within
expected limits. The primary distractor is A; potassium 2.8 mEq/L indicates
hypokalemia, which can precipitate life-threatening cardiac dysrhythmias.
5. A client with suspected tuberculosis is admitted to the hospital. Which personal
protective equipment is required for the nurse entering the room?
A. Gown and gloves
B. Surgical mask within 3 feet
C. N95 respirator
D. Face shield only
,Correct Answer: C
Rationale: Tuberculosis requires airborne precautions, which mandate an N95 respirator
or higher-level protection and a negative-pressure room. The primary distractor is B;
surgical masks within 3 feet are used for droplet precautions, not airborne pathogens.
6. A client with type 1 diabetes is prescribed insulin lispro before meals. The nurse
understands that the peak action of this medication occurs at which time?
A. 15–30 minutes
B. 1–2 hours
C. 4–8 hours
D. 12–16 hours
Correct Answer: B
Rationale: Rapid-acting insulin lispro has an onset of approximately 15 minutes, a peak
of 1–2 hours, and a duration of 3–5 hours. The primary distractor is C; 4–8 hours
represents the peak of intermediate-acting NPH insulin.
7. A client diagnosed with major depressive disorder states, “I don’t see any reason to
keep trying.” Which response by the nurse demonstrates therapeutic communication?
A. “You have so much to live for; think about your family.”
B. “Tell me more about what makes you feel that way.”
C. “Why do you feel like giving up now?”
D. “Let’s talk about something more positive.”
Correct Answer: B
Rationale: Open-ended questions encourage the client to express feelings and promote
a therapeutic relationship. The primary distractor is A; false reassurance minimizes the
client’s feelings and is non-therapeutic.
8. A nurse in the emergency department receives a phone call from a local news
reporter asking about a celebrity client’s condition. Which action by the nurse
demonstrates appropriate understanding of HIPAA?
A. Confirm the client is receiving care but provide no details
B. Refer the reporter to the hospital public relations department
C. State that the client is in stable condition
D. Ask the reporter to submit a written request
, Correct Answer: B
Rationale: HIPAA mandates that protected health information cannot be disclosed
without client authorization; all media inquiries must be directed to the designated
public relations representative. The primary distractor is A; confirming admission status
without client consent still violates privacy protections.
9. A pregnant client at 28 weeks gestation calls the clinic reporting sudden onset of
severe headache and visual changes. The nurse recognizes these symptoms as
potential indicators of which complication?
A. Gestational diabetes
B. Preeclampsia
C. Placenta previa
D. Round ligament pain
Correct Answer: B
Rationale: Severe headache and visual disturbances in the third trimester are classic
warning signs of preeclampsia, a hypertensive disorder of pregnancy. The primary
distractor is D; round ligament pain presents as sharp lower abdominal discomfort and
does not involve neurological symptoms.
10. A client receiving intravenous heparin therapy has an aPTT drawn. Which aPTT
value indicates the client is within the therapeutic range?
A. 25 seconds
B. 45 seconds
C. 65 seconds
D. 100 seconds
Correct Answer: C
Rationale: Therapeutic aPTT for unfractionated heparin is typically 1.5–2.5 times the
control value, generally 60–80 seconds. The primary distractor is A; 25 seconds is
below the normal baseline and indicates subtherapeutic anticoagulation with increased
clot risk.
