ATI PN Fundamentals Proctored Exam – Study Guide, Practice
Questions & Answer Rationales 2026
This document is a comprehensive study resource for the ATI PN Fundamentals Proctored
Exam. It covers core nursing fundamentals, including patient safety, infection control, basic
nursing skills, therapeutic communication, documentation, mobility, hygiene, nutrition,
medication administration, and evidence-based nursing care. The guide includes practice
questions, answer rationales, and concept reviews designed to help practical nursing students
strengthen foundational knowledge and prepare for ATI assessments and nursing coursework.
1. A nurse is reinforcing teaching with a client who is scheduled for an ambulatory
electrocardiogram using a Holter monitor. Which of the following instructions
should the nurse include?
A) Avoid taking a bath or shower while wearing the monitor.
B) Restrict physical activity while the monitor is in place.
C) Leave the monitor chest electrodes off during sleep hours.
D) Avoid using a mobile phone while the monitor is recording.
Correct Answer: A) Avoid taking a bath or shower while wearing the monitor.
Rationale: The monitor must stay completely dry to avoid damaging the electrical
components and skin leads; sponge baths are required instead. Daily activities should
be maintained normally to accurately evaluate heart function during regular routines,
including during sleep. Mobile phones do not interfere with modern monitors.
2. A nurse is collecting data from an older adult client who is being admitted with
dehydration. Which of the following findings should the nurse expect?
A) Elevated blood pressure
B) Distended neck veins
C) Furrows in the tongue
D) Brisk capillary refill
Correct Answer: C) Furrows in the tongue
Rationale: Dehydration causes a severe loss of intracellular fluid, which manifests as
dry mucous membranes and deep furrows or lines in the tongue. Blood pressure drops,
neck veins become flat, and capillary refill time is delayed beyond 2 to 3 seconds due to
poor peripheral perfusion.
3. A nurse is assisting with the care of a client who has a prescription for a 24-hour
urine collection. Which of the following interventions should the nurse perform?
A) Keep the collection container at room temperature.
B) Discard the very first morning void when starting the collection window.
,C) Cleanse the perineal area with antiseptic wipes before each void.
D) Save the final void that occurs right after the 24-hour mark.
Correct Answer: B) Discard the very first morning void when starting the
collection window.
Rationale: The first morning void is discarded because it has pooled in the bladder
overnight and does not reflect a true 24-hour cycle; the timing begins exactly at this
point. The container must be kept cold on ice or refrigerated. Antiseptic wipes are for
clean-catch midstream specimens, not 24-hour collections.
4. A nurse is preparing to administer an intramuscular (IM) injection to an adult
client who has a cachectic or heavily wasted body mass. Which of the following
injection sites should the nurse choose?
A) Dorsogluteal
B) Ventrogluteal
C) Deltoid
D) Vastus lateralis
Correct Answer: B) Ventrogluteal
Rationale: The ventrogluteal site is the safest and preferred muscle mass for IM
injections in adults because it contains a thick muscle layer, lacks major nerves or blood
vessels, and contains minimal subcutaneous fat even in wasted or cachectic clients.
The dorsogluteal site should be avoided due to the proximity of the sciatic nerve.
5. A nurse is caring for a client who is diagnosed with a Clostridioides difficile (C.
diff) infection. Which of the following personal protective equipment (PPE) should
the nurse put on before entering the room?
A) N95 respirator and gloves
B) Surgical mask and gown
C) Gown and gloves
D) Face shield and gloves
Correct Answer: C) Gown and gloves
Rationale: C. diff is transmitted via direct and indirect contact with contaminated
surfaces, necessitating strict contact isolation precautions. A clean gown and clean
gloves must be worn for all interactions inside the room. Air transmission does not
occur, so N95 or surgical masks are not standard requirements.
6. A nurse is reviewing proper lifting techniques with a group of assistive personnel
(AP). Which of the following instructions should the nurse include?
A) Bend at the waist when picking up a heavy object.
B) Hold the object at arm's length away from the body.
C) Keep the feet close together to create a solid pivot point.
D) Tighten the abdominal muscles when preparing to lift.
Correct Answer: D) Tighten the abdominal muscles when preparing to lift.
,Rationale: Contracting the abdominal muscles provides core internal support for the
lumbar spine during a lift, preventing back strain. Staff should bend at the knees, keep a
wide base of support by spreading the feet apart, and hold heavy objects close to the
body’s center of gravity.
7. A nurse is checking a client's tympanic temperature. Which of the following
actions should the nurse take to ensure an accurate reading for an adult client?
A) Pull the pinna down and back.
B) Pull the pinna straight back.
C) Pull the pinna up and back.
D) Direct the probe toward the lower wall of the ear canal.
Correct Answer: C) Pull the pinna up and back.
Rationale: Pulling the pinna up and back for an adult straightens the ear canal, allowing
the infrared probe beam to point directly at the tympanic membrane. Pulling down and
back is the proper technique for infants and children under 3 years old.
8. A nurse is preparing to change a sterile dressing for a client who has a central
venous catheter. Which of the following actions should the nurse perform first?
A) Open the sterile dressing pack on the overbed table.
B) Apply sterile gloves to remove the old dressing.
C) Instruct the client to turn their head away from the insertion site.
D) Cleanse the catheter insertion site with an alcohol wipe.
Correct Answer: C) Instruct the client to turn their head away from the insertion
site.
Rationale: Instructing the client to turn their head away prevents respiratory droplets
from contaminating the sterile site while the dressing is changed. The old dressing is
removed using clean gloves, not sterile gloves. Equipment setup occurs afterward.
9. A nurse is documenting care in a client's medical record. Which of the following
entries represents an example of subjective data?
A) "The client's surgical incision is clean, intact, and free of redness."
B) "The client reports a sharp, burning pain in the lower abdomen."
C) "The client vomited 150 mL of clear green fluid."
D) "The client's blood pressure increased from 120/80 to 142/90 mm Hg."
Correct Answer: B) "The client reports a sharp, burning pain in the lower
abdomen."
Rationale: Subjective data consists of information that can only be felt, verified, and
reported directly by the client (such as pain, nausea, or anxiety). Wound appearance,
emesis volume, and vital signs are objective measurements because they are visibly
observable or quantifiable.
10. A nurse is reinforced with teaching about a low-residue diet for a client who has
acute diverticulitis. Which of the following food choices should the nurse
recommend?
, A) Whole-wheat bread
B) Poached eggs
C) Raw broccoli salad
D) Oatmeal with raisins
Correct Answer: B) Poached eggs
Rationale: A low-residue (low-fiber) diet reduces the amount of undigested food moving
through the intestinal tract, allowing the bowel to heal. Eggs, dairy, and refined white
grains are low in residue. Whole wheat, raw vegetables, and dried fruits are high in fiber
and residue.
11. A nurse is measuring a client's blood pressure and notes that the cuff is too wide
for the client’s arm. Which of the following outcomes should the nurse expect?
A) A falsely high reading
B) A falsely low reading
C) An accurate reading with a delayed pulse wave
D) An inability to auscultate the Korotkoff sounds
Correct Answer: B) A falsely low reading
Rationale: A blood pressure cuff that is too wide or too large will distribute bladder
pressure over a larger surface area, resulting in a falsely low blood pressure reading.
Conversely, a cuff that is too narrow or wrapped too loosely produces a falsely elevated
reading.
12. A nurse is caring for a client who is unresponsive and requires frequent mouth
care. Which of the following safety actions should the nurse take?
A) Position the client supine with the head flat.
B) Place the client in a lateral side-lying position.
C) Use a large volume of water to rinse the oral cavity.
D) Cleanse the mouth using the nurse's gloved fingers to hold the tongue down.
Correct Answer: B) Place the client in a lateral side-lying position.
Rationale: A lateral side-lying position allows secretions and fluids to drain out of the
side of the mouth via gravity, preventing pulmonary aspiration. Suppressed reflexes put
the client at high risk; fluids must be kept to a minimum, and a padded tongue blade or
bite block should be used instead of fingers.
13. A nurse is assisting with a mechanical lift transfer for a client who is non-weight-
bearing. Which of the following actions should the nurse prioritize to maintain
safety?
A) Keep the lift base legs closed tightly during the transfer.
B) Ensure that at least two staff members assist with the transfer.
C) Hook the short chains to the top of the sling fabric first.
D) Elevate the client as high as possible before moving the lift.
Correct Answer: B) Ensure that at least two staff members assist with the
transfer.
Questions & Answer Rationales 2026
This document is a comprehensive study resource for the ATI PN Fundamentals Proctored
Exam. It covers core nursing fundamentals, including patient safety, infection control, basic
nursing skills, therapeutic communication, documentation, mobility, hygiene, nutrition,
medication administration, and evidence-based nursing care. The guide includes practice
questions, answer rationales, and concept reviews designed to help practical nursing students
strengthen foundational knowledge and prepare for ATI assessments and nursing coursework.
1. A nurse is reinforcing teaching with a client who is scheduled for an ambulatory
electrocardiogram using a Holter monitor. Which of the following instructions
should the nurse include?
A) Avoid taking a bath or shower while wearing the monitor.
B) Restrict physical activity while the monitor is in place.
C) Leave the monitor chest electrodes off during sleep hours.
D) Avoid using a mobile phone while the monitor is recording.
Correct Answer: A) Avoid taking a bath or shower while wearing the monitor.
Rationale: The monitor must stay completely dry to avoid damaging the electrical
components and skin leads; sponge baths are required instead. Daily activities should
be maintained normally to accurately evaluate heart function during regular routines,
including during sleep. Mobile phones do not interfere with modern monitors.
2. A nurse is collecting data from an older adult client who is being admitted with
dehydration. Which of the following findings should the nurse expect?
A) Elevated blood pressure
B) Distended neck veins
C) Furrows in the tongue
D) Brisk capillary refill
Correct Answer: C) Furrows in the tongue
Rationale: Dehydration causes a severe loss of intracellular fluid, which manifests as
dry mucous membranes and deep furrows or lines in the tongue. Blood pressure drops,
neck veins become flat, and capillary refill time is delayed beyond 2 to 3 seconds due to
poor peripheral perfusion.
3. A nurse is assisting with the care of a client who has a prescription for a 24-hour
urine collection. Which of the following interventions should the nurse perform?
A) Keep the collection container at room temperature.
B) Discard the very first morning void when starting the collection window.
,C) Cleanse the perineal area with antiseptic wipes before each void.
D) Save the final void that occurs right after the 24-hour mark.
Correct Answer: B) Discard the very first morning void when starting the
collection window.
Rationale: The first morning void is discarded because it has pooled in the bladder
overnight and does not reflect a true 24-hour cycle; the timing begins exactly at this
point. The container must be kept cold on ice or refrigerated. Antiseptic wipes are for
clean-catch midstream specimens, not 24-hour collections.
4. A nurse is preparing to administer an intramuscular (IM) injection to an adult
client who has a cachectic or heavily wasted body mass. Which of the following
injection sites should the nurse choose?
A) Dorsogluteal
B) Ventrogluteal
C) Deltoid
D) Vastus lateralis
Correct Answer: B) Ventrogluteal
Rationale: The ventrogluteal site is the safest and preferred muscle mass for IM
injections in adults because it contains a thick muscle layer, lacks major nerves or blood
vessels, and contains minimal subcutaneous fat even in wasted or cachectic clients.
The dorsogluteal site should be avoided due to the proximity of the sciatic nerve.
5. A nurse is caring for a client who is diagnosed with a Clostridioides difficile (C.
diff) infection. Which of the following personal protective equipment (PPE) should
the nurse put on before entering the room?
A) N95 respirator and gloves
B) Surgical mask and gown
C) Gown and gloves
D) Face shield and gloves
Correct Answer: C) Gown and gloves
Rationale: C. diff is transmitted via direct and indirect contact with contaminated
surfaces, necessitating strict contact isolation precautions. A clean gown and clean
gloves must be worn for all interactions inside the room. Air transmission does not
occur, so N95 or surgical masks are not standard requirements.
6. A nurse is reviewing proper lifting techniques with a group of assistive personnel
(AP). Which of the following instructions should the nurse include?
A) Bend at the waist when picking up a heavy object.
B) Hold the object at arm's length away from the body.
C) Keep the feet close together to create a solid pivot point.
D) Tighten the abdominal muscles when preparing to lift.
Correct Answer: D) Tighten the abdominal muscles when preparing to lift.
,Rationale: Contracting the abdominal muscles provides core internal support for the
lumbar spine during a lift, preventing back strain. Staff should bend at the knees, keep a
wide base of support by spreading the feet apart, and hold heavy objects close to the
body’s center of gravity.
7. A nurse is checking a client's tympanic temperature. Which of the following
actions should the nurse take to ensure an accurate reading for an adult client?
A) Pull the pinna down and back.
B) Pull the pinna straight back.
C) Pull the pinna up and back.
D) Direct the probe toward the lower wall of the ear canal.
Correct Answer: C) Pull the pinna up and back.
Rationale: Pulling the pinna up and back for an adult straightens the ear canal, allowing
the infrared probe beam to point directly at the tympanic membrane. Pulling down and
back is the proper technique for infants and children under 3 years old.
8. A nurse is preparing to change a sterile dressing for a client who has a central
venous catheter. Which of the following actions should the nurse perform first?
A) Open the sterile dressing pack on the overbed table.
B) Apply sterile gloves to remove the old dressing.
C) Instruct the client to turn their head away from the insertion site.
D) Cleanse the catheter insertion site with an alcohol wipe.
Correct Answer: C) Instruct the client to turn their head away from the insertion
site.
Rationale: Instructing the client to turn their head away prevents respiratory droplets
from contaminating the sterile site while the dressing is changed. The old dressing is
removed using clean gloves, not sterile gloves. Equipment setup occurs afterward.
9. A nurse is documenting care in a client's medical record. Which of the following
entries represents an example of subjective data?
A) "The client's surgical incision is clean, intact, and free of redness."
B) "The client reports a sharp, burning pain in the lower abdomen."
C) "The client vomited 150 mL of clear green fluid."
D) "The client's blood pressure increased from 120/80 to 142/90 mm Hg."
Correct Answer: B) "The client reports a sharp, burning pain in the lower
abdomen."
Rationale: Subjective data consists of information that can only be felt, verified, and
reported directly by the client (such as pain, nausea, or anxiety). Wound appearance,
emesis volume, and vital signs are objective measurements because they are visibly
observable or quantifiable.
10. A nurse is reinforced with teaching about a low-residue diet for a client who has
acute diverticulitis. Which of the following food choices should the nurse
recommend?
, A) Whole-wheat bread
B) Poached eggs
C) Raw broccoli salad
D) Oatmeal with raisins
Correct Answer: B) Poached eggs
Rationale: A low-residue (low-fiber) diet reduces the amount of undigested food moving
through the intestinal tract, allowing the bowel to heal. Eggs, dairy, and refined white
grains are low in residue. Whole wheat, raw vegetables, and dried fruits are high in fiber
and residue.
11. A nurse is measuring a client's blood pressure and notes that the cuff is too wide
for the client’s arm. Which of the following outcomes should the nurse expect?
A) A falsely high reading
B) A falsely low reading
C) An accurate reading with a delayed pulse wave
D) An inability to auscultate the Korotkoff sounds
Correct Answer: B) A falsely low reading
Rationale: A blood pressure cuff that is too wide or too large will distribute bladder
pressure over a larger surface area, resulting in a falsely low blood pressure reading.
Conversely, a cuff that is too narrow or wrapped too loosely produces a falsely elevated
reading.
12. A nurse is caring for a client who is unresponsive and requires frequent mouth
care. Which of the following safety actions should the nurse take?
A) Position the client supine with the head flat.
B) Place the client in a lateral side-lying position.
C) Use a large volume of water to rinse the oral cavity.
D) Cleanse the mouth using the nurse's gloved fingers to hold the tongue down.
Correct Answer: B) Place the client in a lateral side-lying position.
Rationale: A lateral side-lying position allows secretions and fluids to drain out of the
side of the mouth via gravity, preventing pulmonary aspiration. Suppressed reflexes put
the client at high risk; fluids must be kept to a minimum, and a padded tongue blade or
bite block should be used instead of fingers.
13. A nurse is assisting with a mechanical lift transfer for a client who is non-weight-
bearing. Which of the following actions should the nurse prioritize to maintain
safety?
A) Keep the lift base legs closed tightly during the transfer.
B) Ensure that at least two staff members assist with the transfer.
C) Hook the short chains to the top of the sling fabric first.
D) Elevate the client as high as possible before moving the lift.
Correct Answer: B) Ensure that at least two staff members assist with the
transfer.
