ATI PN FUNDAMENTALS PROCTORED
EXAM 2023 Questions and Verified Answers
with Rationales Comprehensive Review |
2026 Edition
CORE DOMAINS
1. Basic Nursing Concepts and Theories
2. Safety and Infection Control
3. Basic Care and Comfort
4. Pharmacology and Medication Administration
5. Nutrition and Elimination
6. Mobility and Immobility
7. Therapeutic Communication
8. Legal and Ethical Issues
9. Client Education and Advocacy
10.Nursing Process and Priority Setting
Question 1
A 52-year-old patient presents with a complaint of "dizziness" that has been
ongoing for several days. Which history question best distinguishes vertigo from
pre-syncope?
A) "Does the dizziness occur when you stand up too quickly?"
B) "Do you feel like the room is spinning around you?"
C) "Do you have any headaches with the dizziness?"
D) "Do you feel unsteady when walking?"
,Answer: B) "Do you feel like the room is spinning around you?"
Rationale: Vertigo is a specific illusion of motion, often rotational, caused by
vestibular dysfunction. Asking if the room spins or if the patient feels spinning
directly captures this phenomenon. Pre-syncope, by contrast, is a lightheadedness
or impending faint, usually due to cerebral hypoperfusion. Orthostatic triggers
(Option A) are relevant to pre-syncope but do not define the quality of symptoms.
Headaches (Option C) may accompany central causes of vertigo but are not
discriminative. Unsteadiness (Option D) is vague and may occur with both
conditions. The single most distinct historical feature is the subjective experience
of rotational movement.
Question 2
During cardiac auscultation, a murmur is heard best at the apex, is blowing and
high-pitched, and radiates to the axilla. The nurse should recognize this as
characteristic of:
A) Aortic stenosis
B) Mitral regurgitation
C) Tricuspid regurgitation
D) Pulmonic stenosis
Answer: B) Mitral regurgitation
Rationale: Mitral regurgitation produces a holosystolic murmur heard best at the
apex with radiation to the axilla. It is described as blowing and high-pitched. The
murmur begins with S1 and continues through S2, reflecting retrograde flow from
the left ventricle into the left atrium. Aortic stenosis (Option A) presents with a
systolic ejection murmur at the right upper sternal border. Tricuspid regurgitation
(Option C) is best heard at the left lower sternal border and increases with
inspiration. Pulmonic stenosis (Option D) is best heard at the left upper sternal
border.
Question 3
,A patient is admitted with a diagnosis of pneumonia. The nurse notes that the
patient has a productive cough with green sputum. Which nursing diagnosis takes
priority?
A) Ineffective Airway Clearance
B) Impaired Gas Exchange
C) Risk for Infection
D) Activity Intolerance
Answer: B) Impaired Gas Exchange
Rationale: In a patient with pneumonia, Impaired Gas Exchange is the priority
nursing diagnosis as it addresses the underlying pathophysiology of the condition.
While Ineffective Airway Clearance (Option A) is also relevant, gas exchange
impairment can lead to life-threatening hypoxia and is the higher priority. Risk for
Infection (Option C) is less relevant as the patient already has an infection.
Activity Intolerance (Option D) is a secondary concern.
Question 4
A patient with diabetes mellitus is experiencing hypoglycemia. What is the priority
nursing intervention?
A) Administer insulin
B) Administer 15 grams of a fast-acting carbohydrate
C) Check blood glucose in 2 hours
D) Encourage fluids
Answer: B) Administer 15 grams of a fast-acting carbohydrate
Rationale: For hypoglycemia (blood glucose <70 mg/dL), the priority intervention
is to administer 15 grams of a fast-acting carbohydrate (such as juice, glucose
tablets, or hard candy). Insulin (Option A) would further lower blood glucose and
is contraindicated. Checking blood glucose in 2 hours (Option C) is delayed; blood
glucose should be rechecked in 15 minutes. Encouraging fluids (Option D) does
not address the immediate need for glucose.
, Question 5
A patient is receiving continuous enteral tube feeding. How should the nurse assess
for residual volume?
A) Aspirate all contents and discard
B) Aspirate and measure residual, then return it to the stomach unless it
exceeds the facility's policy
C) Aspirate and discard contents if residual is >200 mL
D) Do not check residual with continuous feedings
Answer: B) Aspirate and measure residual, then return it to the stomach
unless it exceeds the facility's policy
Rationale: Gastric residual volume should be aspirated and measured to assess for
delayed gastric emptying. The residual is typically returned to the stomach to
prevent electrolyte loss and reduce the risk of gastric decompensation. Discarding
the residual (Option A) can lead to fluid and electrolyte imbalances. There is no
universal threshold for when to discard; this varies by facility policy (Option C).
Checking residual is recommended for continuous feedings (Option D).
Question 6
A patient is receiving oxygen via nasal cannula at 2 L/min. Which of the following
is the correct flow rate for a nasal cannula?
A) 1-6 L/min (with FiO2 of 24-44%)
B) 1-6 L/min (with FiO2 of 24-44%)
C) 8-10 L/min (with FiO2 of 35-50%)
D) 10-15 L/min (with FiO2 of 40-60%)
Answer: B) 1-6 L/min (with FiO2 of 24-44%)
Rationale: A nasal cannula is used for low-flow oxygen delivery at 1-6 L/min,
providing a FiO2 of approximately 24-44% (each liter increases FiO2 by about
4%). Option A is the correct range. Options C and D describe higher flow rates
EXAM 2023 Questions and Verified Answers
with Rationales Comprehensive Review |
2026 Edition
CORE DOMAINS
1. Basic Nursing Concepts and Theories
2. Safety and Infection Control
3. Basic Care and Comfort
4. Pharmacology and Medication Administration
5. Nutrition and Elimination
6. Mobility and Immobility
7. Therapeutic Communication
8. Legal and Ethical Issues
9. Client Education and Advocacy
10.Nursing Process and Priority Setting
Question 1
A 52-year-old patient presents with a complaint of "dizziness" that has been
ongoing for several days. Which history question best distinguishes vertigo from
pre-syncope?
A) "Does the dizziness occur when you stand up too quickly?"
B) "Do you feel like the room is spinning around you?"
C) "Do you have any headaches with the dizziness?"
D) "Do you feel unsteady when walking?"
,Answer: B) "Do you feel like the room is spinning around you?"
Rationale: Vertigo is a specific illusion of motion, often rotational, caused by
vestibular dysfunction. Asking if the room spins or if the patient feels spinning
directly captures this phenomenon. Pre-syncope, by contrast, is a lightheadedness
or impending faint, usually due to cerebral hypoperfusion. Orthostatic triggers
(Option A) are relevant to pre-syncope but do not define the quality of symptoms.
Headaches (Option C) may accompany central causes of vertigo but are not
discriminative. Unsteadiness (Option D) is vague and may occur with both
conditions. The single most distinct historical feature is the subjective experience
of rotational movement.
Question 2
During cardiac auscultation, a murmur is heard best at the apex, is blowing and
high-pitched, and radiates to the axilla. The nurse should recognize this as
characteristic of:
A) Aortic stenosis
B) Mitral regurgitation
C) Tricuspid regurgitation
D) Pulmonic stenosis
Answer: B) Mitral regurgitation
Rationale: Mitral regurgitation produces a holosystolic murmur heard best at the
apex with radiation to the axilla. It is described as blowing and high-pitched. The
murmur begins with S1 and continues through S2, reflecting retrograde flow from
the left ventricle into the left atrium. Aortic stenosis (Option A) presents with a
systolic ejection murmur at the right upper sternal border. Tricuspid regurgitation
(Option C) is best heard at the left lower sternal border and increases with
inspiration. Pulmonic stenosis (Option D) is best heard at the left upper sternal
border.
Question 3
,A patient is admitted with a diagnosis of pneumonia. The nurse notes that the
patient has a productive cough with green sputum. Which nursing diagnosis takes
priority?
A) Ineffective Airway Clearance
B) Impaired Gas Exchange
C) Risk for Infection
D) Activity Intolerance
Answer: B) Impaired Gas Exchange
Rationale: In a patient with pneumonia, Impaired Gas Exchange is the priority
nursing diagnosis as it addresses the underlying pathophysiology of the condition.
While Ineffective Airway Clearance (Option A) is also relevant, gas exchange
impairment can lead to life-threatening hypoxia and is the higher priority. Risk for
Infection (Option C) is less relevant as the patient already has an infection.
Activity Intolerance (Option D) is a secondary concern.
Question 4
A patient with diabetes mellitus is experiencing hypoglycemia. What is the priority
nursing intervention?
A) Administer insulin
B) Administer 15 grams of a fast-acting carbohydrate
C) Check blood glucose in 2 hours
D) Encourage fluids
Answer: B) Administer 15 grams of a fast-acting carbohydrate
Rationale: For hypoglycemia (blood glucose <70 mg/dL), the priority intervention
is to administer 15 grams of a fast-acting carbohydrate (such as juice, glucose
tablets, or hard candy). Insulin (Option A) would further lower blood glucose and
is contraindicated. Checking blood glucose in 2 hours (Option C) is delayed; blood
glucose should be rechecked in 15 minutes. Encouraging fluids (Option D) does
not address the immediate need for glucose.
, Question 5
A patient is receiving continuous enteral tube feeding. How should the nurse assess
for residual volume?
A) Aspirate all contents and discard
B) Aspirate and measure residual, then return it to the stomach unless it
exceeds the facility's policy
C) Aspirate and discard contents if residual is >200 mL
D) Do not check residual with continuous feedings
Answer: B) Aspirate and measure residual, then return it to the stomach
unless it exceeds the facility's policy
Rationale: Gastric residual volume should be aspirated and measured to assess for
delayed gastric emptying. The residual is typically returned to the stomach to
prevent electrolyte loss and reduce the risk of gastric decompensation. Discarding
the residual (Option A) can lead to fluid and electrolyte imbalances. There is no
universal threshold for when to discard; this varies by facility policy (Option C).
Checking residual is recommended for continuous feedings (Option D).
Question 6
A patient is receiving oxygen via nasal cannula at 2 L/min. Which of the following
is the correct flow rate for a nasal cannula?
A) 1-6 L/min (with FiO2 of 24-44%)
B) 1-6 L/min (with FiO2 of 24-44%)
C) 8-10 L/min (with FiO2 of 35-50%)
D) 10-15 L/min (with FiO2 of 40-60%)
Answer: B) 1-6 L/min (with FiO2 of 24-44%)
Rationale: A nasal cannula is used for low-flow oxygen delivery at 1-6 L/min,
providing a FiO2 of approximately 24-44% (each liter increases FiO2 by about
4%). Option A is the correct range. Options C and D describe higher flow rates
