The airport has an exchange kiosk, although the exchange rate is not good. There is a yellow 5B ATM machine downstairs, on the left.
The ATM will suggest a high exchange rate, and ask if you accept that rate. Say NO. You will then get a much better exchange rate.
Good hotels in Zone 10 have reliable ATM machines, as does the new Walmart in Guatemala City.
There are four reliable ATM machines in Santiago Atitlan and three banks. Dollars and Euros are more difficult to change. Only PRISTENE $50 and $100 bills are accepted in the banks (no tears or pen marks of any kind), other bills can be changed at a lower rate on the black market.
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What to expect
