ATI Fundamentals Practice
Assessment B: Comprehensive
150-
Question Exam Bank for
Advanced Nursing
Competency well written one
year 2025 /2026 updated
graded A+
,Instructions
This examination consists of 150 multiple-choice questions designed to assess advanced-level
nursing fundamentals knowledge consistent with ATI Fundamentals Practice Assessment B standards.
Each question contains one correct answer and includes a detailed rationale explaining the clinical
reasoning behind the correct response. Questions encompass conceptual understanding, clinical
application, and complex scenario-based reasoning across the full spectrum of foundational
nursing practice.
Target Audience: Nursing students preparing for ATI proctored assessments and NCLEX-RN
examination
Difficulty Level: Advanced/Hard – requires synthesis of multiple concepts and prioritization skills
Questions 1–50: Safety, Infection Control, and Legal/Ethical Practice
Question 1
A nurse is caring for a client who has a new diagnosis of methicillin-resistant Staphylococcus aureus
(MRSA) in a surgical wound. Which of the following precautions should the nurse implement?
A) Standard precautions only
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
- detailed answer 100 % correct :-B) Contact precautions
Rationale: MRSA requires contact precautions, which include the use of a gown and gloves when
entering the client's room. Contact precautions are indicated for organisms that are spread by direct
or indirect contact. Standard precautions alone are insufficient for MRSA. Droplet precautions are for
pathogens spread via respiratory droplets (e.g., influenza), and airborne precautions are for pathogens
transmitted via airborne nuclei (e.g., tuberculosis).
Question 2
A nurse is preparing to administer a client's morning medications. The client states, "I don't want to
take that purple pill today." Which of the following actions should the nurse take?
A) Crush the medication and mix it with applesauce
B) Withhold the medication and document the client's refusal
C) Place the medication in the client's food without telling them
,D) Tell the client that the provider prescribed it and they must take it
- detailed answer 100 % correct :-B) Withhold the medication and document the client's refusal
Rationale: Clients have the right to refuse treatment, including medications. The nurse should respect
the client's autonomy, withhold the medication, document the refusal, and notify the provider.
Crushing medication without authorization, hiding it in food, or coercing the client violates ethical
principles and legal standards.
Question 3
A nurse is performing a Romberg test during a physical assessment. Which of the following techniques
should the nurse use?
A) Ask the client to stand with feet together and arms at sides while closing their eyes
B) Ask the client to walk heel-to-toe in a straight line
C) Ask the client to stand on one foot with eyes open
D) Ask the client to touch their nose with alternating fingers
- detailed answer 100 % correct :-A) Ask the client to stand with feet together and arms at sides
while closing their eyes
Rationale: The Romberg test assesses balance and proprioception. The client stands with feet
together, arms at sides, first with eyes open and then closed. A positive Romberg test (swaying or loss
of balance with eyes closed) indicates a proprioceptive or vestibular dysfunction. The other options
assess different aspects of neurological function.
Question 4
A nurse in a medical-surgical unit is caring for six clients. Which of the following clients should the
nurse assess first?
A) A client who has pneumonia and an oxygen saturation of 92%
B) A client who is postoperative day 1 and reports incisional pain of 6 on a 0–10 scale
C) A client who has diabetes mellitus and a blood glucose of 180 mg/dL
D) A client who has a new tracheostomy and is experiencing difficulty breathing
- detailed answer 100 % correct :-D) A client who has a new tracheostomy and is experiencing
difficulty breathing Rationale: Difficulty breathing in a client with a new tracheostomy indicates a
potentially lifethreatening airway obstruction and requires immediate assessment and intervention.
Airway is always the priority in the ABCs (Airway, Breathing, Circulation). The other clients have findings
that require attention but are not immediately life-threatening.
, Question 5
A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of
the following statements by the client indicates a need for further teaching?
A) "I will avoid eating large amounts of leafy green vegetables."
B) "I will take ibuprofen if I have a headache."
C) "I will report any unusual bleeding to my provider."
D) "I will have my blood tested regularly as scheduled."
- detailed answer 100 % correct :-B) "I will take ibuprofen if I have a headache."
Rationale: Ibuprofen is an NSAID that increases the risk of bleeding when taken with warfarin. The
client should avoid NSAIDs and use alternative pain relief (e.g., acetaminophen). The other statements
demonstrate correct understanding of warfarin therapy.
Question 6
A nurse is preparing to insert an indwelling urinary catheter for a female client. Which of the following
actions should the nurse take to maintain surgical aseptic technique?
A) Place the sterile field on the overbed table at waist level
B) Open the sterile kit toward the nurse's body
C) Use clean gloves for the procedure
D) Allow the sterile drape to touch the client's legs
- detailed answer 100 % correct :-A) Place the sterile field on the overbed table at waist level
Rationale: The sterile field should be placed on a surface at or above waist level to prevent
contamination. Opening the kit away from the body prevents contamination. Sterile gloves, not clean
gloves, are required for urinary catheter insertion. The sterile drape should not touch unsterile
surfaces.
Question 7
A nurse is caring for a client who has a prescription for restraints. Which of the following actions
should the nurse take?
A) Apply restraints tightly to ensure the client cannot remove them
B) Tie restraints to the bed frame using a quick-release knot
C) Document the client's behavior every 4 hours
D) Remove restraints every 4 hours for range-of-motion exercises
Assessment B: Comprehensive
150-
Question Exam Bank for
Advanced Nursing
Competency well written one
year 2025 /2026 updated
graded A+
,Instructions
This examination consists of 150 multiple-choice questions designed to assess advanced-level
nursing fundamentals knowledge consistent with ATI Fundamentals Practice Assessment B standards.
Each question contains one correct answer and includes a detailed rationale explaining the clinical
reasoning behind the correct response. Questions encompass conceptual understanding, clinical
application, and complex scenario-based reasoning across the full spectrum of foundational
nursing practice.
Target Audience: Nursing students preparing for ATI proctored assessments and NCLEX-RN
examination
Difficulty Level: Advanced/Hard – requires synthesis of multiple concepts and prioritization skills
Questions 1–50: Safety, Infection Control, and Legal/Ethical Practice
Question 1
A nurse is caring for a client who has a new diagnosis of methicillin-resistant Staphylococcus aureus
(MRSA) in a surgical wound. Which of the following precautions should the nurse implement?
A) Standard precautions only
B) Contact precautions
C) Droplet precautions
D) Airborne precautions
- detailed answer 100 % correct :-B) Contact precautions
Rationale: MRSA requires contact precautions, which include the use of a gown and gloves when
entering the client's room. Contact precautions are indicated for organisms that are spread by direct
or indirect contact. Standard precautions alone are insufficient for MRSA. Droplet precautions are for
pathogens spread via respiratory droplets (e.g., influenza), and airborne precautions are for pathogens
transmitted via airborne nuclei (e.g., tuberculosis).
Question 2
A nurse is preparing to administer a client's morning medications. The client states, "I don't want to
take that purple pill today." Which of the following actions should the nurse take?
A) Crush the medication and mix it with applesauce
B) Withhold the medication and document the client's refusal
C) Place the medication in the client's food without telling them
,D) Tell the client that the provider prescribed it and they must take it
- detailed answer 100 % correct :-B) Withhold the medication and document the client's refusal
Rationale: Clients have the right to refuse treatment, including medications. The nurse should respect
the client's autonomy, withhold the medication, document the refusal, and notify the provider.
Crushing medication without authorization, hiding it in food, or coercing the client violates ethical
principles and legal standards.
Question 3
A nurse is performing a Romberg test during a physical assessment. Which of the following techniques
should the nurse use?
A) Ask the client to stand with feet together and arms at sides while closing their eyes
B) Ask the client to walk heel-to-toe in a straight line
C) Ask the client to stand on one foot with eyes open
D) Ask the client to touch their nose with alternating fingers
- detailed answer 100 % correct :-A) Ask the client to stand with feet together and arms at sides
while closing their eyes
Rationale: The Romberg test assesses balance and proprioception. The client stands with feet
together, arms at sides, first with eyes open and then closed. A positive Romberg test (swaying or loss
of balance with eyes closed) indicates a proprioceptive or vestibular dysfunction. The other options
assess different aspects of neurological function.
Question 4
A nurse in a medical-surgical unit is caring for six clients. Which of the following clients should the
nurse assess first?
A) A client who has pneumonia and an oxygen saturation of 92%
B) A client who is postoperative day 1 and reports incisional pain of 6 on a 0–10 scale
C) A client who has diabetes mellitus and a blood glucose of 180 mg/dL
D) A client who has a new tracheostomy and is experiencing difficulty breathing
- detailed answer 100 % correct :-D) A client who has a new tracheostomy and is experiencing
difficulty breathing Rationale: Difficulty breathing in a client with a new tracheostomy indicates a
potentially lifethreatening airway obstruction and requires immediate assessment and intervention.
Airway is always the priority in the ABCs (Airway, Breathing, Circulation). The other clients have findings
that require attention but are not immediately life-threatening.
, Question 5
A nurse is providing discharge teaching to a client who has a new prescription for warfarin. Which of
the following statements by the client indicates a need for further teaching?
A) "I will avoid eating large amounts of leafy green vegetables."
B) "I will take ibuprofen if I have a headache."
C) "I will report any unusual bleeding to my provider."
D) "I will have my blood tested regularly as scheduled."
- detailed answer 100 % correct :-B) "I will take ibuprofen if I have a headache."
Rationale: Ibuprofen is an NSAID that increases the risk of bleeding when taken with warfarin. The
client should avoid NSAIDs and use alternative pain relief (e.g., acetaminophen). The other statements
demonstrate correct understanding of warfarin therapy.
Question 6
A nurse is preparing to insert an indwelling urinary catheter for a female client. Which of the following
actions should the nurse take to maintain surgical aseptic technique?
A) Place the sterile field on the overbed table at waist level
B) Open the sterile kit toward the nurse's body
C) Use clean gloves for the procedure
D) Allow the sterile drape to touch the client's legs
- detailed answer 100 % correct :-A) Place the sterile field on the overbed table at waist level
Rationale: The sterile field should be placed on a surface at or above waist level to prevent
contamination. Opening the kit away from the body prevents contamination. Sterile gloves, not clean
gloves, are required for urinary catheter insertion. The sterile drape should not touch unsterile
surfaces.
Question 7
A nurse is caring for a client who has a prescription for restraints. Which of the following actions
should the nurse take?
A) Apply restraints tightly to ensure the client cannot remove them
B) Tie restraints to the bed frame using a quick-release knot
C) Document the client's behavior every 4 hours
D) Remove restraints every 4 hours for range-of-motion exercises
