ATI PN FUNDAMENTALS Actual PROCTORED
EXAM 2026 | Comprehensive Simulation |
Detailed Rationales
SECTION A: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-30)
A1. Safety & Infection Control (Questions 1-15)
Q1: A nurse is preparing to insert an indwelling urinary catheter for a female client. After
opening the sterile kit and donning sterile gloves, the nurse accidentally touches the
edge of the sterile field with a non-sterile wrist. What is the correct action by the nurse?
A. Continue with the procedure, as the edge of the field is considered clean
B. Remove the contaminated glove, reapply hand sanitizer, and don a new sterile glove
C. Discard the entire sterile kit and start over with new supplies
D. Cover the contaminated area with a sterile towel from the kit
Answer: C
Rationale: Surgical asepsis requires that the entire sterile field remain uncontaminated.
Once any portion is touched by non-sterile objects, the field is compromised. The nurse
must discard all supplies and establish a new sterile field to prevent introducing
pathogens into the client's urinary tract. Changing gloves (B) does not address field
contamination. Continuing (A) or covering (D) violates sterile technique principles.
Q2 (Select All That Apply): A nurse is implementing fall prevention strategies for an
older adult client with osteoporosis. Which interventions should the included?
, 1. Place the client in a room close to the nurses' station
2. Keep the bed in the lowest position with wheels locked
3. Apply a vest restraint when the client is alone in the room
4. Ensure the call light is within reach at all times
5. Provide non-skid footwear
Answers: 1, 2, 4, 5
Rationale: Fall prevention focuses on environmental safety and client empowerment
without restraints. Proximity to nurses' station (1) enables rapid response. Low bed
position (2) reduces fall distance. Call light access (4) promotes help-seeking. Non-skid
footwear (5) prevents slips. Restraints (3) are last-resort interventions due to risks of
injury, agitation, and loss of dignity; they require specific orders and continuous
monitoring.
Q3: A nurse enters a client's room and finds the client on the floor next to the bed. The
client states, "I tried to get up by myself." What is the priority nursing action?
A. Complete an incident report
B. Assess the client for injuries
C. Help the client back into bed immediately
D. Notify the physician
Answer: B
Rationale: Nursing process priority: Assessment comes first. The nurse must assess for
injuries (head trauma, fractures, bleeding) before moving the client to prevent
exacerbating potential spinal or orthopedic injuries. Moving the client (C) could cause
harm. Documentation (A) and notification (D) follow assessment and stabilization.
,Q4: A nurse is caring for a client with Clostridioides difficile (C. diff) infection. Which
personal protective equipment (PPE) is required when entering the room?
A. Gloves only
B. Gown and gloves
C. Mask, gown, and gloves
D. N95 respirator, gown, and gloves
Answer: B
Rationale: C. diff requires Contact Precautions (gown and gloves) due to fecal-oral
transmission via contaminated surfaces. Droplet or airborne precautions requiring
masks (C, D) are unnecessary unless the client has concurrent respiratory infections.
Gloves alone (A) inadequately protect clothing from environmental contamination.
Q5 (Select All That Apply): Which actions demonstrate proper medication safety
principles?
1. Checking the medication label against the MAR three times
2. Leaving medications at the bedside for the client to take later
3. Verifying client identity using two identifiers
4. Crushing extended-release tablets for easier administration
5. Documenting medication administration immediately after giving
Answers: 1, 3, 5
Rationale: The "five rights" include verification: three label checks (1), two-identifier
client verification (3), and timely documentation (5). Leaving medications (2) violates
the right client/right time principles. Crushing extended-release formulations (4) alters
, pharmacokinetics and can cause toxicity—never crush enteric-coated or
extended-release medications.
Q6: A nurse discovers a medication error involving the wrong dose being administered.
What is the appropriate first action?
A. Complete an incident report
B. Assess the client for adverse effects
C. Notify the nursing supervisor
D. Call the physician
Answer: B
Rationale: Client safety is the priority. The nurse must immediately assess the client for
potential adverse effects from the incorrect dose. After ensuring client stability, the
nurse notifies the physician (D) and supervisor (C), then completes the incident report
(A) per facility policy. Assessment always precedes reporting in adverse events.
Q7: A nurse is preparing to administer an intramuscular injection using the Z-track
method. What is the primary purpose of this technique?
A. Reduce injection pain
B. Prevent medication leakage into subcutaneous tissue
C. Facilitate faster medication absorption
D. Prevent needlestick injuries
Answer: B
EXAM 2026 | Comprehensive Simulation |
Detailed Rationales
SECTION A: SAFE & EFFECTIVE CARE ENVIRONMENT (Questions 1-30)
A1. Safety & Infection Control (Questions 1-15)
Q1: A nurse is preparing to insert an indwelling urinary catheter for a female client. After
opening the sterile kit and donning sterile gloves, the nurse accidentally touches the
edge of the sterile field with a non-sterile wrist. What is the correct action by the nurse?
A. Continue with the procedure, as the edge of the field is considered clean
B. Remove the contaminated glove, reapply hand sanitizer, and don a new sterile glove
C. Discard the entire sterile kit and start over with new supplies
D. Cover the contaminated area with a sterile towel from the kit
Answer: C
Rationale: Surgical asepsis requires that the entire sterile field remain uncontaminated.
Once any portion is touched by non-sterile objects, the field is compromised. The nurse
must discard all supplies and establish a new sterile field to prevent introducing
pathogens into the client's urinary tract. Changing gloves (B) does not address field
contamination. Continuing (A) or covering (D) violates sterile technique principles.
Q2 (Select All That Apply): A nurse is implementing fall prevention strategies for an
older adult client with osteoporosis. Which interventions should the included?
, 1. Place the client in a room close to the nurses' station
2. Keep the bed in the lowest position with wheels locked
3. Apply a vest restraint when the client is alone in the room
4. Ensure the call light is within reach at all times
5. Provide non-skid footwear
Answers: 1, 2, 4, 5
Rationale: Fall prevention focuses on environmental safety and client empowerment
without restraints. Proximity to nurses' station (1) enables rapid response. Low bed
position (2) reduces fall distance. Call light access (4) promotes help-seeking. Non-skid
footwear (5) prevents slips. Restraints (3) are last-resort interventions due to risks of
injury, agitation, and loss of dignity; they require specific orders and continuous
monitoring.
Q3: A nurse enters a client's room and finds the client on the floor next to the bed. The
client states, "I tried to get up by myself." What is the priority nursing action?
A. Complete an incident report
B. Assess the client for injuries
C. Help the client back into bed immediately
D. Notify the physician
Answer: B
Rationale: Nursing process priority: Assessment comes first. The nurse must assess for
injuries (head trauma, fractures, bleeding) before moving the client to prevent
exacerbating potential spinal or orthopedic injuries. Moving the client (C) could cause
harm. Documentation (A) and notification (D) follow assessment and stabilization.
,Q4: A nurse is caring for a client with Clostridioides difficile (C. diff) infection. Which
personal protective equipment (PPE) is required when entering the room?
A. Gloves only
B. Gown and gloves
C. Mask, gown, and gloves
D. N95 respirator, gown, and gloves
Answer: B
Rationale: C. diff requires Contact Precautions (gown and gloves) due to fecal-oral
transmission via contaminated surfaces. Droplet or airborne precautions requiring
masks (C, D) are unnecessary unless the client has concurrent respiratory infections.
Gloves alone (A) inadequately protect clothing from environmental contamination.
Q5 (Select All That Apply): Which actions demonstrate proper medication safety
principles?
1. Checking the medication label against the MAR three times
2. Leaving medications at the bedside for the client to take later
3. Verifying client identity using two identifiers
4. Crushing extended-release tablets for easier administration
5. Documenting medication administration immediately after giving
Answers: 1, 3, 5
Rationale: The "five rights" include verification: three label checks (1), two-identifier
client verification (3), and timely documentation (5). Leaving medications (2) violates
the right client/right time principles. Crushing extended-release formulations (4) alters
, pharmacokinetics and can cause toxicity—never crush enteric-coated or
extended-release medications.
Q6: A nurse discovers a medication error involving the wrong dose being administered.
What is the appropriate first action?
A. Complete an incident report
B. Assess the client for adverse effects
C. Notify the nursing supervisor
D. Call the physician
Answer: B
Rationale: Client safety is the priority. The nurse must immediately assess the client for
potential adverse effects from the incorrect dose. After ensuring client stability, the
nurse notifies the physician (D) and supervisor (C), then completes the incident report
(A) per facility policy. Assessment always precedes reporting in adverse events.
Q7: A nurse is preparing to administer an intramuscular injection using the Z-track
method. What is the primary purpose of this technique?
A. Reduce injection pain
B. Prevent medication leakage into subcutaneous tissue
C. Facilitate faster medication absorption
D. Prevent needlestick injuries
Answer: B
