2026 PN ATI Comprehensive Predictor Exit
Exam: Level 3 Mastery Guide With
100 Questions, Answers & Rationales for
Success
### FUNDAMENTALS OF NURSING
**Question 1:**
A client with a new colostomy is concerned about odour. Which intervention should the practical
nurse recommend?
A) Place an aspirin tablet in the pouch
B) Use a charcoal filter pouch
C) Increase dietary intake of eggs
D) Empty the pouch every 2 hours
**Answer: B) Use a charcoal filter pouch**
**Rationale:** Charcoal filters help absorb and neutralize odour from the ostomy pouch. Aspirin
should never be placed in the pouch as it can cause mucosal irritation. Eggs and other sulfur-
containing foods can actually increase odour. Emptying the pouch frequently helps with leakage
prevention but does not specifically address odour control.
---
**Question 2:**
A client is receiving enteral feedings via a nasogastric tube. Which action should the PN take to verify
tube placement before administering the feeding?
,A) Aspirate gastric contents and check pH
B) Inject 30 mL of air and auscultate over the stomach
C) Measure the length of the exposed tubing
D) Check the client's respiratory rate
**Answer: A) Aspirate gastric contents and check pH**
**Rationale:** The most reliable method to verify NG tube placement is by checking the pH of
aspirated contents (gastric pH is typically 0-4). The "whoosh test" (auscultating air) is no longer
recommended as it is unreliable. Measuring tubing length and checking respiratory rate do not
confirm placement.
---
**Question 3:**
A client with a pressure injury has a wound with black, dry tissue. The PN should document this
finding as:
A) Slough
B) Eschar
C) Granulation tissue
D) Epithelialization
**Answer: B) Eschar**
**Rationale:** Eschar is black, brown, or tan necrotic tissue that is dry and leathery. Slough is
yellow/white stringy tissue. Granulation tissue appears red and beefy. Epithelialization is pink tissue
forming at wound edges.
---
**Question 4:**
,A client is prescribed enoxaparin (Lovenox) 40 mg subcutaneously. Which site is most appropriate for
injection?
A) Ventrogluteal
B) Abdomen
C) Dorsogluteal
D) Deltoid
**Answer: B) Abdomen**
**Rationale:** Enoxaparin should be administered subcutaneously in the abdomen, at least 2 inches
from the umbilicus, alternating sides. The ventrogluteal and dorsogluteal sites are used for
intramuscular injections, and the deltoid is not appropriate for this medication.
---
**Question 5:**
Which client is at highest risk for falls?
A) 45-year-old with hypertension
B) 72-year-old with Parkinson's disease and orthostatic hypotension
C) 60-year-old with diabetes
D) 55-year-old with arthritis
**Answer: B) 72-year-old with Parkinson's disease and orthostatic hypotension**
**Rationale:** This client has multiple fall risk factors: advanced age, Parkinson's disease (gait
instability, tremors), and orthostatic hypotension (dizziness upon position changes). While all clients
have some risk, this combination presents the highest fall risk.
---
**Question 6:**
, The PN is caring for a client with a saline lock. Which action ensures patency?
A) Flush with 10 mL of sterile water
B) Flush with normal saline using a pulsatile motion
C) Apply pressure immediately after flushing
D) Flush with heparin solution
**Answer: B) Flush with normal saline using a pulsatile motion**
**Rationale:** Flushing with normal saline using a pulsatile motion (push-pause technique) creates
turbulence that helps clear the catheter of blood and debris. Sterile water is not used for flushing.
Heparin flushes may be ordered but normal saline is the standard for maintaining patency. Pressure
is applied when removing the syringe.
---
**Question 7:**
A client is on strict I&O monitoring. Which item should be excluded from the intake record?
A) Clear broth
B) Ice chips
C) Jello
D) IV fluids
**Answer: C) Jello**
**Rationale:** Jello is considered a solid food and is not counted as fluid intake. Clear broth, ice
chips (recorded as half the volume), and IV fluids are all counted as intake. At room temperature,
Jello is a semi-solid food and not fluid.
---
**Question 8:**
Exam: Level 3 Mastery Guide With
100 Questions, Answers & Rationales for
Success
### FUNDAMENTALS OF NURSING
**Question 1:**
A client with a new colostomy is concerned about odour. Which intervention should the practical
nurse recommend?
A) Place an aspirin tablet in the pouch
B) Use a charcoal filter pouch
C) Increase dietary intake of eggs
D) Empty the pouch every 2 hours
**Answer: B) Use a charcoal filter pouch**
**Rationale:** Charcoal filters help absorb and neutralize odour from the ostomy pouch. Aspirin
should never be placed in the pouch as it can cause mucosal irritation. Eggs and other sulfur-
containing foods can actually increase odour. Emptying the pouch frequently helps with leakage
prevention but does not specifically address odour control.
---
**Question 2:**
A client is receiving enteral feedings via a nasogastric tube. Which action should the PN take to verify
tube placement before administering the feeding?
,A) Aspirate gastric contents and check pH
B) Inject 30 mL of air and auscultate over the stomach
C) Measure the length of the exposed tubing
D) Check the client's respiratory rate
**Answer: A) Aspirate gastric contents and check pH**
**Rationale:** The most reliable method to verify NG tube placement is by checking the pH of
aspirated contents (gastric pH is typically 0-4). The "whoosh test" (auscultating air) is no longer
recommended as it is unreliable. Measuring tubing length and checking respiratory rate do not
confirm placement.
---
**Question 3:**
A client with a pressure injury has a wound with black, dry tissue. The PN should document this
finding as:
A) Slough
B) Eschar
C) Granulation tissue
D) Epithelialization
**Answer: B) Eschar**
**Rationale:** Eschar is black, brown, or tan necrotic tissue that is dry and leathery. Slough is
yellow/white stringy tissue. Granulation tissue appears red and beefy. Epithelialization is pink tissue
forming at wound edges.
---
**Question 4:**
,A client is prescribed enoxaparin (Lovenox) 40 mg subcutaneously. Which site is most appropriate for
injection?
A) Ventrogluteal
B) Abdomen
C) Dorsogluteal
D) Deltoid
**Answer: B) Abdomen**
**Rationale:** Enoxaparin should be administered subcutaneously in the abdomen, at least 2 inches
from the umbilicus, alternating sides. The ventrogluteal and dorsogluteal sites are used for
intramuscular injections, and the deltoid is not appropriate for this medication.
---
**Question 5:**
Which client is at highest risk for falls?
A) 45-year-old with hypertension
B) 72-year-old with Parkinson's disease and orthostatic hypotension
C) 60-year-old with diabetes
D) 55-year-old with arthritis
**Answer: B) 72-year-old with Parkinson's disease and orthostatic hypotension**
**Rationale:** This client has multiple fall risk factors: advanced age, Parkinson's disease (gait
instability, tremors), and orthostatic hypotension (dizziness upon position changes). While all clients
have some risk, this combination presents the highest fall risk.
---
**Question 6:**
, The PN is caring for a client with a saline lock. Which action ensures patency?
A) Flush with 10 mL of sterile water
B) Flush with normal saline using a pulsatile motion
C) Apply pressure immediately after flushing
D) Flush with heparin solution
**Answer: B) Flush with normal saline using a pulsatile motion**
**Rationale:** Flushing with normal saline using a pulsatile motion (push-pause technique) creates
turbulence that helps clear the catheter of blood and debris. Sterile water is not used for flushing.
Heparin flushes may be ordered but normal saline is the standard for maintaining patency. Pressure
is applied when removing the syringe.
---
**Question 7:**
A client is on strict I&O monitoring. Which item should be excluded from the intake record?
A) Clear broth
B) Ice chips
C) Jello
D) IV fluids
**Answer: C) Jello**
**Rationale:** Jello is considered a solid food and is not counted as fluid intake. Clear broth, ice
chips (recorded as half the volume), and IV fluids are all counted as intake. At room temperature,
Jello is a semi-solid food and not fluid.
---
**Question 8:**
