ATI Fundamentals Practice
Assessment A - Version 3.1
well written one year 2025
/2026 updated graded A+
Comprehensive 150-Question Practice Exam
Advanced/Hard Difficulty | Nursing Students &
Professionals
QUESTION 1
A nurse is caring for a client who has a prescription for a 24-hour urine collection to evaluate
creatinine clearance. The client asks why the collection container must be kept on ice. Which of
the following responses should the nurse provide?
A) "Ice prevents the growth of bacteria that could alter the test results"
B) "Ice prevents the breakdown of creatinine and other chemical components in the urine"
C) "Ice reduces the volume of urine through evaporation to concentrate the specimen"
D) "Ice maintains the urine at a temperature that prevents cellular lysis"
,Correct Answer: B
Rationale: Refrigeration or keeping the urine on ice prevents the breakdown of creatinine and
other chemical components in the urine, which is essential for accurate test results. While ice
does slow bacterial growth, the primary purpose is to preserve the chemical integrity of the
urine. Ice does not cause evaporation, and cellular lysis is not the primary concern in a routine
24-hour urine collection.
QUESTION 2
A nurse is preparing to administer a blood transfusion to a client who has anemia. The client
has a history of multiple blood transfusions. Which of the following actions should the nurse
take to minimize the risk of a transfusion reaction?
A) Premedicate the client with diphenhydramine and acetaminophen
B) Infuse the blood product over 4 hours
C) Verify the client's blood type and crossmatch with two licensed personnel
D) Administer the blood through a microaggregate filter
Correct Answer: C
Rationale: Verifying the client's blood type and crossmatch with two licensed personnel is the
most critical action to prevent a transfusion reaction. Clients with a history of multiple
transfusions are at increased risk for alloimmunization and transfusion reactions, making
accurate verification even more essential. Premedication may be indicated for clients with a
history of febrile non-hemolytic reactions, but this is not the primary prevention strategy.
QUESTION 3
A nurse is assessing a client who has an indwelling urinary catheter and notes that the urine
output has decreased from 60 mL/hr to 20 mL/hr over the past 2 hours. The client's blood
pressure is 90/60 mm Hg, and heart rate is 110/min. Which of the following actions should the
nurse take first?
A) Irrigate the urinary catheter with sterile normal saline
B) Notify the provider of the decreased urine output
C) Assess the client for signs of hypovolemia
,D) Check the urine for sediment and cloudiness
Correct Answer: C
Rationale: The nurse should first assess the client for signs of hypovolemia, as the decreased
urine output and vital signs indicate possible fluid volume deficit. While the provider should be
notified, assessment is the priority. Catheter irrigation may be needed if obstruction is
suspected, but this should not be the first action without ruling out other causes.
QUESTION 4
A nurse is providing teaching to a client who has hypertension and is starting a DASH diet.
Which of the following statements by the client indicates a need for further teaching?
A) "I will choose whole grains instead of refined grains"
B) "I will include at least 4 to 5 servings of fruits and vegetables daily"
C) "I will limit my sodium intake to 1,500 mg per day"
D) "I will increase my intake of red meat for protein"
Correct Answer: D
Rationale: The DASH diet recommends limiting red meat intake and choosing fish, poultry, or
plant-based proteins instead. The other statements are correct: whole grains are preferred over
refined grains, 4-5 servings of fruits and vegetables are recommended, and sodium should be
limited to 1,500-2,300 mg per day.
QUESTION 5
A nurse is caring for a client who is receiving oxygen via a non-rebreather mask at 15 L/min.
The nurse notes that the reservoir bag is deflating during inspiration. Which of the following
actions should the nurse take?
A) Decrease the oxygen flow rate to 10 L/min
B) Increase the oxygen flow rate to maintain bag inflation
C) Change to a simple face mask
D) Remove the mask and apply a nasal cannula
, Correct Answer: B
Rationale: The reservoir bag should remain inflated during both inspiration and expiration to
ensure the client receives the prescribed oxygen concentration. The nurse should increase the
oxygen flow rate to maintain bag inflation. Decreasing the flow rate would worsen the
problem. Changing masks or removing the mask without assessment is not appropriate.
QUESTION 6
A nurse is assessing a client's cranial nerve function. Which of the following actions should the
nurse take to assess cranial nerve IX (glossopharyngeal) and X (vagus) nerves?
A) Ask the client to smile and raise the eyebrows
B) Ask the client to shrug the shoulders and turn the head
C) Ask the client to say "ah" and observe the uvula movement
D) Ask the client to identify different tastes on the anterior tongue
Correct Answer: C
Rationale: Cranial nerve IX (glossopharyngeal) and X (vagus) are assessed together by having
the client say "ah" and observing for symmetrical elevation of the soft palate and uvula.
Smiling and raising eyebrows assess cranial nerve VII. Shrugging shoulders assesses cranial
nerve XI.
Taste on the anterior tongue assesses cranial nerve VII.
QUESTION 7
A nurse is preparing to administer 250 mg of amoxicillin. The medication is available as a liquid
suspension with a concentration of 125 mg/5 mL. How many milliliters should the nurse
administer?
A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL
Assessment A - Version 3.1
well written one year 2025
/2026 updated graded A+
Comprehensive 150-Question Practice Exam
Advanced/Hard Difficulty | Nursing Students &
Professionals
QUESTION 1
A nurse is caring for a client who has a prescription for a 24-hour urine collection to evaluate
creatinine clearance. The client asks why the collection container must be kept on ice. Which of
the following responses should the nurse provide?
A) "Ice prevents the growth of bacteria that could alter the test results"
B) "Ice prevents the breakdown of creatinine and other chemical components in the urine"
C) "Ice reduces the volume of urine through evaporation to concentrate the specimen"
D) "Ice maintains the urine at a temperature that prevents cellular lysis"
,Correct Answer: B
Rationale: Refrigeration or keeping the urine on ice prevents the breakdown of creatinine and
other chemical components in the urine, which is essential for accurate test results. While ice
does slow bacterial growth, the primary purpose is to preserve the chemical integrity of the
urine. Ice does not cause evaporation, and cellular lysis is not the primary concern in a routine
24-hour urine collection.
QUESTION 2
A nurse is preparing to administer a blood transfusion to a client who has anemia. The client
has a history of multiple blood transfusions. Which of the following actions should the nurse
take to minimize the risk of a transfusion reaction?
A) Premedicate the client with diphenhydramine and acetaminophen
B) Infuse the blood product over 4 hours
C) Verify the client's blood type and crossmatch with two licensed personnel
D) Administer the blood through a microaggregate filter
Correct Answer: C
Rationale: Verifying the client's blood type and crossmatch with two licensed personnel is the
most critical action to prevent a transfusion reaction. Clients with a history of multiple
transfusions are at increased risk for alloimmunization and transfusion reactions, making
accurate verification even more essential. Premedication may be indicated for clients with a
history of febrile non-hemolytic reactions, but this is not the primary prevention strategy.
QUESTION 3
A nurse is assessing a client who has an indwelling urinary catheter and notes that the urine
output has decreased from 60 mL/hr to 20 mL/hr over the past 2 hours. The client's blood
pressure is 90/60 mm Hg, and heart rate is 110/min. Which of the following actions should the
nurse take first?
A) Irrigate the urinary catheter with sterile normal saline
B) Notify the provider of the decreased urine output
C) Assess the client for signs of hypovolemia
,D) Check the urine for sediment and cloudiness
Correct Answer: C
Rationale: The nurse should first assess the client for signs of hypovolemia, as the decreased
urine output and vital signs indicate possible fluid volume deficit. While the provider should be
notified, assessment is the priority. Catheter irrigation may be needed if obstruction is
suspected, but this should not be the first action without ruling out other causes.
QUESTION 4
A nurse is providing teaching to a client who has hypertension and is starting a DASH diet.
Which of the following statements by the client indicates a need for further teaching?
A) "I will choose whole grains instead of refined grains"
B) "I will include at least 4 to 5 servings of fruits and vegetables daily"
C) "I will limit my sodium intake to 1,500 mg per day"
D) "I will increase my intake of red meat for protein"
Correct Answer: D
Rationale: The DASH diet recommends limiting red meat intake and choosing fish, poultry, or
plant-based proteins instead. The other statements are correct: whole grains are preferred over
refined grains, 4-5 servings of fruits and vegetables are recommended, and sodium should be
limited to 1,500-2,300 mg per day.
QUESTION 5
A nurse is caring for a client who is receiving oxygen via a non-rebreather mask at 15 L/min.
The nurse notes that the reservoir bag is deflating during inspiration. Which of the following
actions should the nurse take?
A) Decrease the oxygen flow rate to 10 L/min
B) Increase the oxygen flow rate to maintain bag inflation
C) Change to a simple face mask
D) Remove the mask and apply a nasal cannula
, Correct Answer: B
Rationale: The reservoir bag should remain inflated during both inspiration and expiration to
ensure the client receives the prescribed oxygen concentration. The nurse should increase the
oxygen flow rate to maintain bag inflation. Decreasing the flow rate would worsen the
problem. Changing masks or removing the mask without assessment is not appropriate.
QUESTION 6
A nurse is assessing a client's cranial nerve function. Which of the following actions should the
nurse take to assess cranial nerve IX (glossopharyngeal) and X (vagus) nerves?
A) Ask the client to smile and raise the eyebrows
B) Ask the client to shrug the shoulders and turn the head
C) Ask the client to say "ah" and observe the uvula movement
D) Ask the client to identify different tastes on the anterior tongue
Correct Answer: C
Rationale: Cranial nerve IX (glossopharyngeal) and X (vagus) are assessed together by having
the client say "ah" and observing for symmetrical elevation of the soft palate and uvula.
Smiling and raising eyebrows assess cranial nerve VII. Shrugging shoulders assesses cranial
nerve XI.
Taste on the anterior tongue assesses cranial nerve VII.
QUESTION 7
A nurse is preparing to administer 250 mg of amoxicillin. The medication is available as a liquid
suspension with a concentration of 125 mg/5 mL. How many milliliters should the nurse
administer?
A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL
