ATI PN FUNDAMENTALS 2023 CMS EXAM PREP 200 SOLVED MCQS & RATIONALES

ATI PN FUNDAMENTALS 2023 CMS EXAM
PREP 200 SOLVED MCQS & RATIONALES

ATI PN Fundamentals Practice Exam
1. A nurse is caring for a client who is at risk for falls. Which of the
following actions should the nurse take?
A. Keep all four side rails raised on the bed.
B. Place the bedside table close to the client.
C. Instruct the client to wear smooth socks when ambulating.
D. Set the bed to its highest position to facilitate transfer.
Rationale: Placing personal items and the bedside table near the
client prevents them from overreaching and falling. Raising four
side rails is considered a physical restraint, socks should have
non-skid tread, and the bed must always be in its lowest position.
2. A nurse is preparing to perform hand hygiene using an alcohol-
based hand rub. Which of the following actions should the nurse
perform?
A. Rinse hands with warm water first.
B. Rub hands together until the alcohol is completely dry.
C. Use a paper towel to dry the hands afterward.
D. Apply at least 15 mL of the product to the palm.
Rationale: To ensure maximum antimicrobial effectiveness,
alcohol-based hand rubs must be rubbed over all surfaces of the
hands until they are completely dry. Water is not used, towels are
unnecessary, and 3 to 5 mL is the standard volume required.
3. A nurse is moving a heavy box of supplies from the floor to a
counter. Which of the following mechanical principles should the
nurse use?
A. Hold the box at arm's length away from the body.
B. Bend at the waist to lift the weight.
C. Bend at the knees and keep the back straight.
D. Keep the feet close together to establish stability.
Rationale: Proper body mechanics dictate bending at the knees
and utilizing the strong gluteal and femoral muscles rather than
the back. The object should be held close to the body's center of
gravity, and the feet should be spread wide to provide a broad
base of support.

,4. A nurse is reviewing a client's electronic health record and notes an
entry that requires correction. Which of the following actions
should the nurse take?
A. Delete the original text from the system entirely.
B. Follow facility policy to append or correct the entry
while maintaining the original audit trail.
C. Use a coworker's login credentials to modify the note.
D. Erase the error using digital white-out options if available.
Rationale: Electronic records must maintain a strict, unalterable
legal audit trail. Making an amendment or correction under
facility guidelines preserves the original note while clearly
identifying the correction made by the nurse.
5. A nurse is assessing a client's radial pulse and notes that the
rhythm is irregular. Which of the following actions should the
nurse take next?
A. Re-assess the radial pulse for 15 seconds and multiply by 4.
B. Record the findings as normal variations.
C. Auscultate the apical pulse for 1 full minute.
D. Immediately administer a PRN dose of digoxin.
Rationale: When a peripheral pulse is found to be irregular, the
nurse must assess the apical pulse at the fifth intercostal space at
the midclavicular line for a full 60 seconds to accurately
determine the heart rate and pattern.
6. A nurse is preparing to insert an indwelling urinary catheter for a
female client. Which of the following safety measures represents
proper surgical asepsis?
A. Keeping the sterile field below the nurse's waist level.
B. Acknowledge that a sterile object becomes
contaminated if it touches a clean object.
C. Reaching over the sterile field to adjust the client's position.
D. Re-sterilizing dropped items by wiping them with an alcohol
pad.
Rationale: Surgical asepsis requires that sterile items only touch
other sterile items. Items placed below the waist are considered
contaminated, reaching over a sterile field violates sterility, and
dropped items must be discarded.
7. A nurse is caring for a client who is on airborne precautions. Which
of the following personal protective equipment (PPE) is required to
enter the room?

, A. A standard surgical mask
B. An N95 respirator
C. A fluid-resistant isolation gown
D. Double sterile gloves
Rationale: Airborne precautions (e.g., for tuberculosis, varicella,
or measles) require the use of a particulate respirator, such as an
N95, to filter out microscopic airborne nuclei. A standard mask
does not provide sufficient filtration.
8. A nurse is preparing to measure a client's blood pressure. Which of
the following factors can cause a falsely high reading?
A. Using a cuff that is too wide for the arm.
B. Positioning the client's arm above the level of the heart.
C. Deflating the blood pressure cuff too slowly.
D. Allowing the client to rest quietly for 5 minutes before the
reading.
Rationale: Deflating the cuff too slowly can cause venous
congestion in the arm, artificially elevating the diastolic or
systolic readings. A cuff that is too wide or an arm positioned too
high will yield a falsely low reading.
9. A nurse enters a client's room and notices a small fire burning in
the trash can. Which of the following actions should the nurse take
first according to the RACE mnemonic?
A. Pull the pin on the fire extinguisher.
B. Rescue and remove the client from the room.
C. Close the door to confine the fire.
D. Activate the facility fire alarm system.
Rationale: The RACE protocol stands for Rescue, Alarm, Confine,
and Extinguish. The absolute first priority in a fire scenario is to
rescue any clients in immediate danger.
10. A nurse is assisting with the admission of a client who has a
living will. Which of the following statements by the nurse is
appropriate?
A. "Your living will means the doctor can decide when to stop
treatments."
B. "A living will cannot be changed once it is signed and
witnessed."
C. "A living will outlines your specific choices for medical
care if you become unable to speak for yourself."
D. "Your family will need to vote on whether to honor your living

, will."
Rationale: A living will is an advance directive that states a
client's specific wishes regarding medical treatments (like
mechanical ventilation or tube feeding) if they become
incapacitated. It can be changed at any time by the client.
11. A nurse is documenting care in a client's medical record. Which of
the following entries demonstrates the objective documentation
standard?
A. "The client is being uncooperative and acting very stubborn
today."
B. "Client refused to ambulate this morning, stating, 'My
left knee is throbbing.'"
C. "The client seems depressed because they didn't eat their lunch."
D. "Administered pain medication because the client looked
uncomfortable."
Rationale: Objective documentation describes clear, observable
behaviors or quotes the client's exact words. Biased adjectives like
"uncooperative" or guesses like "seems depressed" and "looked
uncomfortable" are inappropriate.
12.A nurse is preparing to perform a sterile dressing change. Which of
the following actions should the nurse take when opening the
sterile kit?
A. Open the first flap toward the body.
B. Open the first flap away from the body.
C. Touch the inside surface of the kit flaps with bare hands.
D. Open the side flaps before opening the top flap.
Rationale: To avoid contaminating the sterile field by reaching
over it, the nurse must open the outermost flap of the sterile
package away from the body first, followed by the side flaps, and
the closest flap last.
13.A nurse is assessing a client's skin and notes an area of intact skin
over the sacrum with non-blanchable redness. How should the
nurse classify this pressure injury?
A. Stage 1
B. Stage 2
C. Stage 3
D. Unstageable
Rationale: A Stage 1 pressure injury is characterized by localized,
intact skin featuring non-blanchable erythema (redness that does