ATI RN Comprehensive Exit Exam 2025 2026

ATI RN Comprehensive Exit Exam | 2025 –2026 Edition 180 NGN Questions with Verified Answers & In-Depth Rationales | Aligned with NCLEX- RN Standards | Graded A+ Introduction This expertly crafted study resource contains 180 Next Generation NCLEX (NGN)-formatted questions from the ATI RN Comprehensive Exit Exam, fully updated for the 2025–2026 testing cycle. Each question is verified for accuracy and clinical relevance, with well- rationalized answers to promote deep understanding and real-world application of nursing concepts essential for NCLEX success.

Topics Covered:

• Clinical Judgment & Case Studies (NGN Format) • Pharmacological & Parenteral Therapies • Management of Care & Prioritization • Safety & Infection Control • Physiological Adaptation • Psychosocial Integrity & Mental Health • Health Promotion & Maintenance • Basic Care & Comfort • Maternal-Newborn, Pediatric, and Geriatric Nursing • Professional Standards, Ethics, and Legal Issues Correct answers are marked in bold and green. Each is paired with a detailed rationale that explains the reasoning behind the correct choice and why alternative answers are incorrect— ideal for mastering NCLEX-style clinical judgment.Exam Questions and Answers

Case Study 1: Acute Myocardial Infarction

Scenario: A 55-year-old male presents to the ED with chest pain, diaphoresis, and nausea for

• hour. ECG shows ST elevation in leads V1–V4. BP is 140/90 mmHg, HR 100 bpm, RR 20

breaths/min, SpO2 94%.

Question 1 (Multiple Choice): What is the priority nursing action?

• Administer sublingual nitroglycerin
• Perform a 12-lead ECG and notify the physician
• Start an IV line with normal saline
• Administer morphine IV

Rationale: ST elevation indicates an acute MI, requiring immediate ECG confirmation and physician notification to initiate reperfusion therapy. Nitroglycerin, IV fluids, and morphine are secondary actions after physician consultation.Question 2 (Select All That Apply): Which interventions should the nurse implement?(Select all that apply) 1 / 4

• Administer oxygen at 2 L/min via nasal cannula
• Obtain cardiac biomarkers
• Prepare for possible catheterization
• Encourage ambulation to reduce anxiety
• Administer aspirin per protocol

Rationale: Cardiac biomarkers confirm MI, catheterization may be needed for reperfusion, and aspirin reduces clot progression. Oxygen is only needed if SpO2 < 90%. Ambulation is contraindicated in acute MI.Question 3 (Drag-and-Drop): Place the steps of MONA protocol in the correct order for this patient.

Options: Administer aspirin, Administer morphine, Administer oxygen, Administer

nitroglycerin

Correct Order:

• Administer oxygen
• Administer aspirin
• Administer nitroglycerin
• Administer morphine

Rationale: The MONA protocol prioritizes oxygen (if hypoxic), aspirin to prevent clot growth, nitroglycerin for vasodilation, and morphine for pain relief, in that order, per protocol.

Question 4

Question: A nurse is delegating tasks to a UAP. Which task is appropriate?

• Administering IV push medication
• Measuring vital signs
• Assessing pain levels
• Developing a care plan

Rationale: Measuring vital signs is within the UAP’s scope, while the others require RN licensure and judgment.Question 5 Question: A patient with anaphylaxis is prescribed epinephrine. What is the priority administration route?

• Oral
• Intramuscular
• Subcutaneous
• Intravenous

Rationale: IM epinephrine is the fastest and safest route for anaphylaxis to reverse symptoms.Question 6 Question: What is the most effective way to prevent central line-associated bloodstream infections?

• Change dressings weekly
• Use sterile technique during insertion and care
• Flush with saline only 2 / 4

• Avoid site inspection

Rationale: Sterile technique during insertion and care minimizes infection risk.

Case Study 2: Postpartum Hemorrhage

Scenario: A 28-year-old female, G2P2, 2 hours postpartum, reports heavy vaginal bleeding.Her uterus is boggy, BP is 100/60 mmHg, HR 110 bpm, RR 22 breaths/min.

Question 7 (Multiple Choice): What is the priority nursing action?

• Administer oxytocin immediately
• Massage the uterus and notify the physician
• Increase IV fluid rate
• Prepare for a blood transfusion

Rationale: Uterine massage addresses atony, the most common cause of postpartum

hemorrhage, and physician notification ensures timely intervention.Question 8 (Matrix): Match the assessment finding to the appropriate intervention.Finding Intervention Boggy uterus Massage uterus Tachycardia Administer IV fluids Heavy bleeding Notify physician Hypotension Prepare for blood transfusion

Rationale: Each finding requires a specific intervention to address

postpartum hemorrhage effectively.

Question 9 (Select All That Apply): Which medications may be prescribed for this patient?(Select all that apply)

• Oxytocin
• Antibiotics
• Methylergonovine
• Misoprostol
• Carboprost

Rationale: Oxytocin, methylergonovine, and carboprost promote uterine contraction to control bleeding. Antibiotics are for infection, and misoprostol is less commonly used in this context.

Question 10 Question: A patient with type 1 diabetes has a blood glucose of 50 mg/dL. What is the priority action?

• Administer insulin
• Give 15 g of fast-acting carbohydrates
• Monitor for 1 hour
• Administer glucagon IV 3 / 4

Rationale: Fast-acting carbohydrates treat hypoglycemia quickly; glucagon is used if the patient is unresponsive.Question 11 Question: A patient with schizophrenia reports auditory hallucinations. What is the best nursing response?

• “Those voices aren’t real.”
• “Tell me more about what you’re hearing.”
• “Ignore them.”
• “I’ll get you medication.”

Rationale: Exploring hallucinations validates the patient’s experience and aids assessment.Question 12 Question: What is the priority health promotion activity for colorectal cancer screening?

• Annual chest X-rays
• Colonoscopy starting at age 45
• Daily aspirin therapy
• Routine ECG monitoring

Rationale: Colonoscopy at age 45 is recommended for average-risk individuals.

Question 13 Question: A patient with heart failure is prescribed furosemide. What lab value should the nurse monitor?

• Blood glucose
• Potassium
• Liver enzymes
• Platelet count

Rationale: Furosemide can cause hypokalemia, requiring electrolyte monitoring.

Question 14 Question: A 6-year-old with asthma is wheezing. What is the priority medication?

• Epinephrine
• Albuterol
• Prednisone
• Montelukast

Rationale: Albuterol is a fast-acting bronchodilator for acute asthma symptoms.

Question 15 Question: A patient in the ICU has a Glasgow Coma Scale score of 6. What does this indicate?

• Mild confusion
• Severe neurological impairment
• Full consciousness
• Normal status

Rationale: A GCS score of 6 indicates a coma, requiring intensive monitoring.

Question 16

Question: Which ethical principle guides informed consent?

• Beneficence
• Autonomy
• / 4