ATI PN Fundamentals Proctored Exam 2025 – NGN-
Style Questions & Case Scenarios 300 Verified Questions
with Answers & Detailed Rationales
Question 1: A nurse is preparing to administer a cleansing enema to a client. The client
reports abdominal cramping during the procedure. Which action should the nurse take?
A) Stop the infusion and remove the tubing
B) Lower the enema bag to slow the flow rate
C) Increase the flow rate to complete the procedure quickly
D) Instruct the client to take deep breaths and continue
Answer: B) Lower the enema bag to slow the flow rate
Rationale: Abdominal cramping during enema administration typically indicates that the
solution is flowing too quickly. Lowering the enema bag slows the flow and reduces
cramping. Stopping the procedure is premature unless cramping is severe. Increasing the
rate would worsen cramping. Deep breathing may help but does not address the cause .
Question 2: A nurse is reinforcing teaching with a client who has a new prescription for
a transdermal nitroglycerin patch. Which statement by the client indicates
understanding?
A) "I will apply the patch to the same site each day."
B) "I will remove the patch at bedtime and apply a new one in the morning."
C) "I will cut the patch in half if I need a lower dose."
D) "I will wear the patch continuously for 24 hours each day."
Answer: B) "I will remove the patch at bedtime and apply a new one in the
morning."
Rationale: Transdermal nitroglycerin patches are typically worn for 12-14 hours and
removed at night to prevent tolerance. Sites should be rotated to prevent skin irritation.
Patches should not be cut as this alters the delivery system. Continuous wear leads to
tolerance .
,Question 3: A nurse is caring for a client who has a new colostomy. The stoma appears
dark purple in color. Which action should the nurse take?
A) Document the finding as expected
B) Apply a warm compress to the stoma
C) Notify the healthcare provider immediately
D) Gently massage the stoma to restore circulation
Answer: C) Notify the healthcare provider immediately
Rationale: A dark purple or black stoma indicates compromised blood supply (ischemia)
and is a surgical emergency. A healthy stoma should be pink and moist. Applying heat or
massaging will not resolve ischemia and may cause further damage .
Question 4: A nurse is preparing to administer an enteral feeding via a nasogastric tube.
The nurse aspirates 150 mL of gastric residual. Which action should the nurse take?
A) Discard the residual and administer the feeding
B) Reinstill the residual and hold the feeding
C) Administer the feeding at a slower rate
D) Notify the healthcare provider
Answer: B) Reinstill the residual and hold the feeding
Rationale: Gastric residual volumes greater than 100-150 mL indicate delayed gastric
emptying. The residual should be reinstilled to prevent electrolyte loss, and the feeding
should be held. The provider should be notified if residuals remain elevated. Discarding the
residual is not recommended .
Question 5: A nurse is reinforcing teaching with a client who has a new hearing aid.
Which instruction should the nurse include?
A) "Store the hearing aid in a warm, dry place."
B) "Clean the hearing aid with alcohol wipes."
,C) "Turn off the hearing aid when not in use."
D) "Keep the hearing aid in direct sunlight to dry."
Answer: C) "Turn off the hearing aid when not in use."
Rationale: Hearing aids should be turned off when not in use to conserve battery life. They
should be stored in a cool, dry place. Alcohol can damage the hearing aid. Direct sunlight
can cause damage .
Question 6: A nurse is caring for a client who has a wound with a Penrose drain. Which
action should the nurse take?
A) Connect the drain to continuous suction
B) Empty the drain when it is half full
C) Secure the drain with a safety pin to the dressing
D) Advance the drain daily as prescribed
Answer: C) Secure the drain with a safety pin to the dressing
Rationale: A Penrose drain is a flat, flexible drain that is secured to the skin with a safety
pin to prevent it from retracting into the wound. It is not connected to suction. It is not
emptied (passive drainage). It may be advanced daily but this is not always the case .
Question 7: A nurse is preparing to administer a medication via a metered-dose inhaler
(MDI). The nurse should instruct the client to perform which action after inhaling the
medication?
A) Exhale forcefully immediately
B) Hold the breath for 10 seconds
C) Rinse the mouth with water
D) Cough vigorously
Answer: B) Hold the breath for 10 seconds
Rationale: After inhaling medication from an MDI, the client should hold their breath for
10 seconds to allow the medication to deposit in the airways. Exhaling immediately loses
, medication. Rinsing the mouth is done after corticosteroid inhalers. Coughing may occur
but is not the intended action .
Question 8: A nurse is assisting with the admission of a client who is on contact
precautions. Which item should the nurse ensure is placed in the client's room?
A) N95 respirator mask
B) Gown and gloves
C) Surgical mask
D) Eye protection
Answer: B) Gown and gloves
Rationale: Contact precautions require the use of gown and gloves for all contact with the
client or their environment. N95 respirators are for airborne precautions. Surgical masks
are for droplet precautions. Eye protection is used when splashing is anticipated .
Question 9: A nurse is caring for a client who is receiving oxygen via a non-rebreather
mask. Which finding indicates the mask is functioning correctly?
A) The reservoir bag is deflated during inspiration
B) The reservoir bag is partially inflated during inspiration
C) The reservoir bag remains inflated during inspiration
D) The reservoir bag is completely deflated at all times
Answer: C) The reservoir bag remains inflated during inspiration
Rationale: With a non-rebreather mask, the reservoir bag should remain inflated during
inspiration to deliver the highest oxygen concentration (up to 90-100%). If the bag
deflates, the oxygen flow rate is insufficient. The bag should be fully inflated .
Question 10: A nurse is reinforcing teaching with a client about a low-sodium diet.
Which food should the nurse recommend?
Style Questions & Case Scenarios 300 Verified Questions
with Answers & Detailed Rationales
Question 1: A nurse is preparing to administer a cleansing enema to a client. The client
reports abdominal cramping during the procedure. Which action should the nurse take?
A) Stop the infusion and remove the tubing
B) Lower the enema bag to slow the flow rate
C) Increase the flow rate to complete the procedure quickly
D) Instruct the client to take deep breaths and continue
Answer: B) Lower the enema bag to slow the flow rate
Rationale: Abdominal cramping during enema administration typically indicates that the
solution is flowing too quickly. Lowering the enema bag slows the flow and reduces
cramping. Stopping the procedure is premature unless cramping is severe. Increasing the
rate would worsen cramping. Deep breathing may help but does not address the cause .
Question 2: A nurse is reinforcing teaching with a client who has a new prescription for
a transdermal nitroglycerin patch. Which statement by the client indicates
understanding?
A) "I will apply the patch to the same site each day."
B) "I will remove the patch at bedtime and apply a new one in the morning."
C) "I will cut the patch in half if I need a lower dose."
D) "I will wear the patch continuously for 24 hours each day."
Answer: B) "I will remove the patch at bedtime and apply a new one in the
morning."
Rationale: Transdermal nitroglycerin patches are typically worn for 12-14 hours and
removed at night to prevent tolerance. Sites should be rotated to prevent skin irritation.
Patches should not be cut as this alters the delivery system. Continuous wear leads to
tolerance .
,Question 3: A nurse is caring for a client who has a new colostomy. The stoma appears
dark purple in color. Which action should the nurse take?
A) Document the finding as expected
B) Apply a warm compress to the stoma
C) Notify the healthcare provider immediately
D) Gently massage the stoma to restore circulation
Answer: C) Notify the healthcare provider immediately
Rationale: A dark purple or black stoma indicates compromised blood supply (ischemia)
and is a surgical emergency. A healthy stoma should be pink and moist. Applying heat or
massaging will not resolve ischemia and may cause further damage .
Question 4: A nurse is preparing to administer an enteral feeding via a nasogastric tube.
The nurse aspirates 150 mL of gastric residual. Which action should the nurse take?
A) Discard the residual and administer the feeding
B) Reinstill the residual and hold the feeding
C) Administer the feeding at a slower rate
D) Notify the healthcare provider
Answer: B) Reinstill the residual and hold the feeding
Rationale: Gastric residual volumes greater than 100-150 mL indicate delayed gastric
emptying. The residual should be reinstilled to prevent electrolyte loss, and the feeding
should be held. The provider should be notified if residuals remain elevated. Discarding the
residual is not recommended .
Question 5: A nurse is reinforcing teaching with a client who has a new hearing aid.
Which instruction should the nurse include?
A) "Store the hearing aid in a warm, dry place."
B) "Clean the hearing aid with alcohol wipes."
,C) "Turn off the hearing aid when not in use."
D) "Keep the hearing aid in direct sunlight to dry."
Answer: C) "Turn off the hearing aid when not in use."
Rationale: Hearing aids should be turned off when not in use to conserve battery life. They
should be stored in a cool, dry place. Alcohol can damage the hearing aid. Direct sunlight
can cause damage .
Question 6: A nurse is caring for a client who has a wound with a Penrose drain. Which
action should the nurse take?
A) Connect the drain to continuous suction
B) Empty the drain when it is half full
C) Secure the drain with a safety pin to the dressing
D) Advance the drain daily as prescribed
Answer: C) Secure the drain with a safety pin to the dressing
Rationale: A Penrose drain is a flat, flexible drain that is secured to the skin with a safety
pin to prevent it from retracting into the wound. It is not connected to suction. It is not
emptied (passive drainage). It may be advanced daily but this is not always the case .
Question 7: A nurse is preparing to administer a medication via a metered-dose inhaler
(MDI). The nurse should instruct the client to perform which action after inhaling the
medication?
A) Exhale forcefully immediately
B) Hold the breath for 10 seconds
C) Rinse the mouth with water
D) Cough vigorously
Answer: B) Hold the breath for 10 seconds
Rationale: After inhaling medication from an MDI, the client should hold their breath for
10 seconds to allow the medication to deposit in the airways. Exhaling immediately loses
, medication. Rinsing the mouth is done after corticosteroid inhalers. Coughing may occur
but is not the intended action .
Question 8: A nurse is assisting with the admission of a client who is on contact
precautions. Which item should the nurse ensure is placed in the client's room?
A) N95 respirator mask
B) Gown and gloves
C) Surgical mask
D) Eye protection
Answer: B) Gown and gloves
Rationale: Contact precautions require the use of gown and gloves for all contact with the
client or their environment. N95 respirators are for airborne precautions. Surgical masks
are for droplet precautions. Eye protection is used when splashing is anticipated .
Question 9: A nurse is caring for a client who is receiving oxygen via a non-rebreather
mask. Which finding indicates the mask is functioning correctly?
A) The reservoir bag is deflated during inspiration
B) The reservoir bag is partially inflated during inspiration
C) The reservoir bag remains inflated during inspiration
D) The reservoir bag is completely deflated at all times
Answer: C) The reservoir bag remains inflated during inspiration
Rationale: With a non-rebreather mask, the reservoir bag should remain inflated during
inspiration to deliver the highest oxygen concentration (up to 90-100%). If the bag
deflates, the oxygen flow rate is insufficient. The bag should be fully inflated .
Question 10: A nurse is reinforcing teaching with a client about a low-sodium diet.
Which food should the nurse recommend?
