ATI PN FUNDAMENTALS
PROCTORED EXAM 2023 ASSESSMENT
180 Questions | Comprehensive NCLEX-PN Aligned Assessment
Safe, Effective Care Environment | Safety and Infection Control | Health Promotion and
Maintenance
Psychosocial Integrity | Basic Care and Comfort | Pharmacological and Parenteral Therapies
Reduction of Risk Potential | Physiological Adaptation
Total Questions Sections Format
180 8 Multiple Choice
ATI PN Fundamentals Proctored Exam 2023 Assessment | Page 1
,SECTION 1: SAFE, EFFECTIVE CARE ENVIRONMENT
Management of Care, Client Rights, Advocacy, Delegation, Legal/Ethical Issues, and
Informed Consent (Q1-Q40)
Q1: A PN is caring for a group of clients on a medical-surgical unit. Which of the following tasks should the PN
delegate to a UAP?
A. Performing an initial admission assessment on a newly assigned client
B. Obtaining a bedside blood glucose level using a glucometer [CORRECT]
C. Administering an oral analgesic to a client reporting pain
D. Providing wound care instruction to a client prior to discharge
Correct Answer: B
Rationale: Obtaining a bedside blood glucose using a glucometer is a routine, standardized procedure that falls within the UAP
scope of practice for vital sign and specimen collection assistance. The PN remains responsible for interpreting results and taking
follow-up actions. Options A, C, and D require nursing assessment, clinical judgment, medication administration, and client
education, which are beyond the UAP scope and must be performed by the PN or RN per the Five Rights of Delegation.
Q2: A client who is scheduled for a colonoscopy has signed the informed consent form. The client tells the PN, 'I
don't really understand what the doctor is going to do during the procedure.' What is the PN's best action?
A. Explain the colonoscopy procedure in detail to the client
B. Notify the provider who will perform the procedure immediately [CORRECT]
C. Document the client's statement in the medical record and proceed
D. Have the client sign a new consent form after the nurse explains the procedure
Correct Answer: B
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and alternatives. The provider
performing the procedure is responsible for obtaining informed consent, and the nurse acts as a witness. If the client expresses
lack of understanding, the PN must stop and notify the provider so the provider can re-explain. The nurse should not
independently explain the procedure or have the client re-sign without the provider's involvement, as this does not fulfill the legal
requirements of informed consent.
Q3: A PN receives a telephone order from a provider for a new medication. Which of the following actions should
the PN take first?
A. Administer the medication immediately and document the telephone order
B. Read back the order to the provider for verification before documenting [CORRECT]
C. Ask the RN to verify the order before it is implemented
D. Document the order in the client's medical record and have a second nurse co-sign
Correct Answer: B
Rationale: When receiving a telephone order, the PN must read back the complete order to the prescribing provider for
verification. This is a critical safety step to prevent medication errors and ensure accuracy. After read-back verification, the order
must be documented promptly and co-signed by a second licensed nurse per facility policy. The PN should not administer the
medication before verifying the order, and while RN collaboration may be appropriate in some settings, the first action is always
the read-back verification directly with the provider.
Q4: Which of the following clients should the PN assess first when receiving morning shift report?
ATI PN Fundamentals Proctored Exam 2023 Assessment | Page 2
, A. A client who is 2 days post-operative following a cholecystectomy with a T-tube in place, reporting minimal
incisional pain
B. A client admitted yesterday with heart failure who has gained 2 kg overnight and has new crackles in the
lung bases [CORRECT]
C. A client with type 2 diabetes mellitus who has a fasting blood glucose of 178 mg/dL and is awaiting
breakfast
D. A client who is scheduled for discharge today after a 3-day hospitalization for community-acquired
pneumonia
Correct Answer: B
Rationale: The client with heart failure who gained 2 kg overnight and has new crackles in the lung bases is exhibiting signs of
fluid volume excess and possible pulmonary edema, which is an acute and potentially life-threatening complication requiring
immediate assessment and intervention. Using the ABCs priority framework and the acute-versus-chronic prioritization principle,
this unstable client takes priority over the stable post-operative client, the client with elevated but manageable blood glucose, and
the client awaiting routine discharge.
Q5: A PN is reviewing the assignment for the shift. Which of the following clients is most appropriate for the PN to
assign to a UAP?
A. A client with a new tracheostomy who requires suctioning every 2 hours
B. A client who had a total hip replacement yesterday and needs assistance with ambulation using a walker
[CORRECT]
C. A client receiving continuous IV heparin therapy requiring aPTT monitoring every 6 hours
D. A client with acute pancreatitis who is receiving parenteral nutrition via a central line
Correct Answer: B
Rationale: Assisting with ambulation using a walker for a stable post-surgical client falls within the UAP scope of practice. This
involves routine ADL assistance and does not require nursing assessment or clinical judgment. Clients requiring tracheostomy
suctioning, continuous anticoagulant monitoring with lab interpretation, and central line parenteral nutrition management require
the assessment, critical thinking, and clinical skills of a licensed nurse (PN or RN).
Q6: A PN is caring for a client who has a do-not-resuscitate (DNR) order. The client's family member requests that
'everything possible' be done. What is the PN's best response?
A. Explain to the family member that the DNR order means no interventions will be performed
B. Tell the family member that the decision is final and cannot be changed
C. Notify the RN and the provider of the family member's concern [CORRECT]
D. Follow the family member's request and begin full resuscitation interventions
Correct Answer: C
Rationale: The PN must act as a client advocate and facilitate communication between the family and the healthcare team. When
there is a conflict between a DNR order and a family member's request, the PN should notify the RN and provider so they can
address the concern, clarify the DNR order, and determine whether the order needs to be reviewed or revised. The PN should not
independently explain, override, or change the DNR order, as these actions require provider-level communication and legal
documentation.
Q7: A PN is reviewing a client's medical record and notes that the client has an advance directive in place. Which of
the following is the primary purpose of an advance directive?
A. To designate a family member as the primary decision-maker for all healthcare decisions
ATI PN Fundamentals Proctored Exam 2023 Assessment | Page 3
, B. To document the client's wishes regarding medical treatment in the event the client becomes unable to
communicate [CORRECT]
C. To authorize the healthcare team to make treatment decisions based on the client's diagnosis
D. To protect the hospital from legal liability in end-of-life situations
Correct Answer: B
Rationale: An advance directive is a legal document that allows a competent client to document their healthcare treatment
preferences in advance, including the designation of a healthcare proxy through a Durable Power of Attorney for Healthcare or
specific treatment directives through a living will. It becomes effective when the client loses decision-making capacity. It does
not automatically give all decision-making authority to a family member, authorize the healthcare team to decide independently,
or primarily serve to protect institutional liability.
Q8: A PN is assigned to care for four clients. Which of the following tasks is within the PN's scope of practice to
perform independently?
A. Performing the initial comprehensive assessment on a client newly admitted with chest pain
B. Developing the nursing care plan for a client with a newly diagnosed chronic condition
C. Administering oral medications to stable clients with known medication regimens [CORRECT]
D. Providing discharge teaching on a newly prescribed anticoagulant medication to a client
Correct Answer: C
Rationale: Administering oral medications to stable clients is within the PN scope of practice. The PN's role includes medication
administration, routine monitoring, and reinforcing teaching for stable clients. The initial comprehensive assessment,
development of the nursing care plan (diagnosis and planning phases), and initial client education on newly prescribed
medications are within the RN scope, as they require complex clinical judgment, assessment expertise, and the ability to evaluate
client understanding of new information.
Q9: A client tells the PN, 'I want to leave the hospital against medical advice.' Which of the following actions should
the PN take first?
A. Call security to prevent the client from leaving the unit
B. Explain the risks of leaving and have the client sign an AMA (against medical advice) form
C. Notify the RN and the provider of the client's intent to leave [CORRECT]
D. Restrict the client to the room until the provider can be reached
Correct Answer: C
Rationale: Every competent adult has the right to refuse treatment and leave the hospital, even against medical advice. The PN's
first action is to notify the RN and provider so they can discuss the client's concerns, explain the potential risks, and attempt to
address the underlying reasons for wanting to leave. The client should not be physically restrained or confined, as this would
constitute false imprisonment. If the client still chooses to leave after discussion, the provider should be informed and the client
asked to sign an AMA form, but the PN's initial step is notification of the healthcare team.
Q10: A PN is reviewing the plan of care for a client with a pressure injury. Which of the following interventions
should the PN question?
A. Repositioning the client every 2 hours
B. Applying a transparent dressing over the wound
C. Massaging the reddened area over the bony prominence [CORRECT]
D. Providing a high-protein diet to promote wound healing
Correct Answer: C
ATI PN Fundamentals Proctored Exam 2023 Assessment | Page 4
PROCTORED EXAM 2023 ASSESSMENT
180 Questions | Comprehensive NCLEX-PN Aligned Assessment
Safe, Effective Care Environment | Safety and Infection Control | Health Promotion and
Maintenance
Psychosocial Integrity | Basic Care and Comfort | Pharmacological and Parenteral Therapies
Reduction of Risk Potential | Physiological Adaptation
Total Questions Sections Format
180 8 Multiple Choice
ATI PN Fundamentals Proctored Exam 2023 Assessment | Page 1
,SECTION 1: SAFE, EFFECTIVE CARE ENVIRONMENT
Management of Care, Client Rights, Advocacy, Delegation, Legal/Ethical Issues, and
Informed Consent (Q1-Q40)
Q1: A PN is caring for a group of clients on a medical-surgical unit. Which of the following tasks should the PN
delegate to a UAP?
A. Performing an initial admission assessment on a newly assigned client
B. Obtaining a bedside blood glucose level using a glucometer [CORRECT]
C. Administering an oral analgesic to a client reporting pain
D. Providing wound care instruction to a client prior to discharge
Correct Answer: B
Rationale: Obtaining a bedside blood glucose using a glucometer is a routine, standardized procedure that falls within the UAP
scope of practice for vital sign and specimen collection assistance. The PN remains responsible for interpreting results and taking
follow-up actions. Options A, C, and D require nursing assessment, clinical judgment, medication administration, and client
education, which are beyond the UAP scope and must be performed by the PN or RN per the Five Rights of Delegation.
Q2: A client who is scheduled for a colonoscopy has signed the informed consent form. The client tells the PN, 'I
don't really understand what the doctor is going to do during the procedure.' What is the PN's best action?
A. Explain the colonoscopy procedure in detail to the client
B. Notify the provider who will perform the procedure immediately [CORRECT]
C. Document the client's statement in the medical record and proceed
D. Have the client sign a new consent form after the nurse explains the procedure
Correct Answer: B
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and alternatives. The provider
performing the procedure is responsible for obtaining informed consent, and the nurse acts as a witness. If the client expresses
lack of understanding, the PN must stop and notify the provider so the provider can re-explain. The nurse should not
independently explain the procedure or have the client re-sign without the provider's involvement, as this does not fulfill the legal
requirements of informed consent.
Q3: A PN receives a telephone order from a provider for a new medication. Which of the following actions should
the PN take first?
A. Administer the medication immediately and document the telephone order
B. Read back the order to the provider for verification before documenting [CORRECT]
C. Ask the RN to verify the order before it is implemented
D. Document the order in the client's medical record and have a second nurse co-sign
Correct Answer: B
Rationale: When receiving a telephone order, the PN must read back the complete order to the prescribing provider for
verification. This is a critical safety step to prevent medication errors and ensure accuracy. After read-back verification, the order
must be documented promptly and co-signed by a second licensed nurse per facility policy. The PN should not administer the
medication before verifying the order, and while RN collaboration may be appropriate in some settings, the first action is always
the read-back verification directly with the provider.
Q4: Which of the following clients should the PN assess first when receiving morning shift report?
ATI PN Fundamentals Proctored Exam 2023 Assessment | Page 2
, A. A client who is 2 days post-operative following a cholecystectomy with a T-tube in place, reporting minimal
incisional pain
B. A client admitted yesterday with heart failure who has gained 2 kg overnight and has new crackles in the
lung bases [CORRECT]
C. A client with type 2 diabetes mellitus who has a fasting blood glucose of 178 mg/dL and is awaiting
breakfast
D. A client who is scheduled for discharge today after a 3-day hospitalization for community-acquired
pneumonia
Correct Answer: B
Rationale: The client with heart failure who gained 2 kg overnight and has new crackles in the lung bases is exhibiting signs of
fluid volume excess and possible pulmonary edema, which is an acute and potentially life-threatening complication requiring
immediate assessment and intervention. Using the ABCs priority framework and the acute-versus-chronic prioritization principle,
this unstable client takes priority over the stable post-operative client, the client with elevated but manageable blood glucose, and
the client awaiting routine discharge.
Q5: A PN is reviewing the assignment for the shift. Which of the following clients is most appropriate for the PN to
assign to a UAP?
A. A client with a new tracheostomy who requires suctioning every 2 hours
B. A client who had a total hip replacement yesterday and needs assistance with ambulation using a walker
[CORRECT]
C. A client receiving continuous IV heparin therapy requiring aPTT monitoring every 6 hours
D. A client with acute pancreatitis who is receiving parenteral nutrition via a central line
Correct Answer: B
Rationale: Assisting with ambulation using a walker for a stable post-surgical client falls within the UAP scope of practice. This
involves routine ADL assistance and does not require nursing assessment or clinical judgment. Clients requiring tracheostomy
suctioning, continuous anticoagulant monitoring with lab interpretation, and central line parenteral nutrition management require
the assessment, critical thinking, and clinical skills of a licensed nurse (PN or RN).
Q6: A PN is caring for a client who has a do-not-resuscitate (DNR) order. The client's family member requests that
'everything possible' be done. What is the PN's best response?
A. Explain to the family member that the DNR order means no interventions will be performed
B. Tell the family member that the decision is final and cannot be changed
C. Notify the RN and the provider of the family member's concern [CORRECT]
D. Follow the family member's request and begin full resuscitation interventions
Correct Answer: C
Rationale: The PN must act as a client advocate and facilitate communication between the family and the healthcare team. When
there is a conflict between a DNR order and a family member's request, the PN should notify the RN and provider so they can
address the concern, clarify the DNR order, and determine whether the order needs to be reviewed or revised. The PN should not
independently explain, override, or change the DNR order, as these actions require provider-level communication and legal
documentation.
Q7: A PN is reviewing a client's medical record and notes that the client has an advance directive in place. Which of
the following is the primary purpose of an advance directive?
A. To designate a family member as the primary decision-maker for all healthcare decisions
ATI PN Fundamentals Proctored Exam 2023 Assessment | Page 3
, B. To document the client's wishes regarding medical treatment in the event the client becomes unable to
communicate [CORRECT]
C. To authorize the healthcare team to make treatment decisions based on the client's diagnosis
D. To protect the hospital from legal liability in end-of-life situations
Correct Answer: B
Rationale: An advance directive is a legal document that allows a competent client to document their healthcare treatment
preferences in advance, including the designation of a healthcare proxy through a Durable Power of Attorney for Healthcare or
specific treatment directives through a living will. It becomes effective when the client loses decision-making capacity. It does
not automatically give all decision-making authority to a family member, authorize the healthcare team to decide independently,
or primarily serve to protect institutional liability.
Q8: A PN is assigned to care for four clients. Which of the following tasks is within the PN's scope of practice to
perform independently?
A. Performing the initial comprehensive assessment on a client newly admitted with chest pain
B. Developing the nursing care plan for a client with a newly diagnosed chronic condition
C. Administering oral medications to stable clients with known medication regimens [CORRECT]
D. Providing discharge teaching on a newly prescribed anticoagulant medication to a client
Correct Answer: C
Rationale: Administering oral medications to stable clients is within the PN scope of practice. The PN's role includes medication
administration, routine monitoring, and reinforcing teaching for stable clients. The initial comprehensive assessment,
development of the nursing care plan (diagnosis and planning phases), and initial client education on newly prescribed
medications are within the RN scope, as they require complex clinical judgment, assessment expertise, and the ability to evaluate
client understanding of new information.
Q9: A client tells the PN, 'I want to leave the hospital against medical advice.' Which of the following actions should
the PN take first?
A. Call security to prevent the client from leaving the unit
B. Explain the risks of leaving and have the client sign an AMA (against medical advice) form
C. Notify the RN and the provider of the client's intent to leave [CORRECT]
D. Restrict the client to the room until the provider can be reached
Correct Answer: C
Rationale: Every competent adult has the right to refuse treatment and leave the hospital, even against medical advice. The PN's
first action is to notify the RN and provider so they can discuss the client's concerns, explain the potential risks, and attempt to
address the underlying reasons for wanting to leave. The client should not be physically restrained or confined, as this would
constitute false imprisonment. If the client still chooses to leave after discussion, the provider should be informed and the client
asked to sign an AMA form, but the PN's initial step is notification of the healthcare team.
Q10: A PN is reviewing the plan of care for a client with a pressure injury. Which of the following interventions
should the PN question?
A. Repositioning the client every 2 hours
B. Applying a transparent dressing over the wound
C. Massaging the reddened area over the bony prominence [CORRECT]
D. Providing a high-protein diet to promote wound healing
Correct Answer: C
ATI PN Fundamentals Proctored Exam 2023 Assessment | Page 4
