ATI Nursing Skills 2026/2027 | ATI Skills Modules
Nursing Skills Study Guide & Practice Questions, ATI
Nursing Skills Exam Review, Essential Nursing
Procedures & Clinical Skills, Patient Assessment, Vital
Signs, Infection Control, Surgical Asepsis, Medication
Administration, IV Therapy, Peripheral & Central
Venous Access, Blood Administration, Oxygen Therapy,
Airway Management, NG Tubes, Urinary & Bowel
Elimination, Ostomy Care, Mobility, Nutrition & Enteral
Feeding, Pain Management, Wound Care, Specimen
Collection, Maternal-Newborn & Pediatric Assessment,
Clinical Judgment, Patient Safety & Detailed Rationales
Question 1: A nurse is preparing to administer a medication via
nasogastric tube. Which action best ensures accurate dosing and
prevents tube occlusion?
A. Crush a sustained-release tablet and mix with 30 mL sterile water.
B. Administer each medication separately and flush with 15 mL water
between each.
C. Mix all crushed medications together in 60 mL of warm water.
D. Use the plunger of the syringe to push medication through the tube
rapidly.
CORRECT ANSWER: B. Administer each medication separately and
flush with 15 mL water between each.
Rationale: Administering each medication separately with a water flush
prevents drug-drug interactions and tube clogging. Sustained-release
tablets should never be crushed (A). Mixing multiple drugs increases risk of
incompatibility (C). Rapid pushing can cause tube rupture or aspiration (D).
Question 2: A nurse is assessing a patient with chest tubes
connected to a dry suction water seal system. Which finding
requires immediate intervention?
A. Intermittent bubbling in the water seal chamber during exhalation.
B. Continuous bubbling in the suction control chamber at -20 cm H2O.
C. Tidaling in the water seal chamber with respirations.
D. No fluctuation in the water seal chamber for 4 hours post-insertion.
,CORRECT ANSWER: D. No fluctuation in the water seal chamber for
4 hours post-insertion.
Rationale: Absence of fluctuation (tidaling) for 4 hours may indicate a
blocked or kinked tube, or lung re-expansion; but if it persists suddenly, it
suggests occlusion or disconnection. Intermittent bubbling on exhalation
(A) is normal air leak. Continuous bubbling in suction chamber (B) indicates
proper suction. Tidaling (C) is expected.
Question 3: A nurse is caring for a patient with a pressure injury on
the sacrum. The wound bed is covered with yellow slough and has
moderate serosanguinous drainage. Which dressing should the
nurse select?
A. Hydrocolloid dressing.
B. Alginate dressing.
C. Transparent film dressing.
D. Hydrogel dressing.
CORRECT ANSWER: B. Alginate dressing.
Rationale: Alginate dressings are highly absorbent and appropriate for
wounds with moderate to heavy exudate and slough. Hydrocolloid (A) is for
light exudate. Transparent film (C) is for dry wounds or protection.
Hydrogel (D) is for dry wounds with slough but not for moderate drainage.
Question 4: A nurse is teaching a patient with a new colostomy
about dietary management. Which statement by the patient
indicates understanding?
A. I will avoid foods like yogurt and buttermilk to prevent odor.
B. I should eat more high-fiber foods like nuts and seeds to thicken stool.
C. I need to chew food thoroughly and eat at regular intervals.
D. I can use a stool softener daily to prevent constipation.
CORRECT ANSWER: C. I need to chew food thoroughly and eat at
regular intervals.
Rationale: Chewing food thoroughly and eating at regular intervals reduces
gas and blockage risk. Yogurt and buttermilk actually help reduce odor (A).
High-fiber foods like nuts can cause blockage (B). Stool softeners are not
routinely recommended (D).
,Question 5: A nurse is preparing to administer a blood transfusion.
The patient's vital signs are: BP 98/60, HR 110, RR 22, temp 37.1°C.
Which action should the nurse take first?
A. Start the transfusion slowly at 2 mL/min.
B. Notify the provider of the low blood pressure.
C. Obtain a baseline set of vital signs.
D. Administer 0.9% sodium chloride with the blood.
CORRECT ANSWER: C. Obtain a baseline set of vital signs.
Rationale: Obtaining baseline vital signs is essential before any transfusion
to compare during and after. Starting the transfusion (A) without baseline is
unsafe. The BP is within acceptable range for transfusion (B is not needed).
Saline is used but not the first action (D).
Question 6: A nurse is assessing a patient receiving a continuous IV
infusion of heparin. The aPTT is 90 seconds. The infusion rate is 14
units/kg/hr. The patient weighs 70 kg. The available concentration
is 25,000 units in 500 mL D5W. What action should the nurse take?
A. Increase the infusion rate to 18 units/kg/hr.
B. Decrease the infusion rate to 12 units/kg/hr.
C. Maintain the current infusion rate.
D. Stop the infusion and notify the provider.
CORRECT ANSWER: B. Decrease the infusion rate to 12
units/kg/hr.
Rationale: A therapeutic aPTT for heparin is typically 1.5 to 2.5 times the
control value (approximately 60-80 seconds). An aPTT of 90 seconds is
elevated, indicating a risk of bleeding, so the rate should be decreased per
protocol. Increasing (A) would worsen the risk. Maintaining (C) does not
address the supratherapeutic level. Stopping (D) is too extreme unless there
is active bleeding.
Question 7: A nurse is caring for a patient who has a suspected
urinary tract infection. Which urinalysis result should indicate to
the nurse the presence of a UTI?
A. WBC count of 8,000/mm³.
B. Trace amount of protein.
, C. Specific gravity of 1.010.
D. pH of 6.0.
CORRECT ANSWER: A. WBC count of 8,000/mm³.
Rationale: A white blood cell count above the expected reference range of 0
to 4,000/mm³ indicates urinary tract infection. A trace amount of protein
(B) is an expected finding. Specific gravity of 1.010 (C) is within normal
range. pH of 6.0 (D) is within the expected reference range of 4.6 to 8.0.
Question 8: A nurse is caring for a female patient who needs to
collect a midstream urine specimen. Which action should the nurse
take?
A. Give the patient a clean urine cup from the laboratory.
B. Instruct the patient to cleanse the perineal area from back to front.
C. Have the patient urinate a small amount of urine before starting the
collection.
D. Tell the patient to collect about 10 mL of urine.
CORRECT ANSWER: C. Have the patient urinate a small amount of
urine before starting the collection.
Rationale: Urinating a small amount before the collection helps cleanse the
urethral meatus of any bacteria that may be present. Cleansing should be
front to back (B is incorrect). The specimen container must be sterile (A is
incorrect). The patient should collect at least 10-15 mL, but the priority
action is the pre-void (D is not the best answer).
Question 9: A nurse is teaching a patient about home collection of a
stool specimen for fecal occult blood testing. Which instruction
should the nurse provide?
A. Obtain specimens from three different stools.
B. Eat a diet low in fiber and residue.
C. Avoid foods that are high in fat.
D. Refrigerate the specimen card after obtaining the first sample.
CORRECT ANSWER: A. Obtain specimens from three different
stools.
Rationale: The three specimens must be taken from three separate,
consecutive bowel movements. A low-fiber diet (B) is not required. Avoiding
high-fat foods (C) is not necessary. The card should not be refrigerated (D).
Nursing Skills Study Guide & Practice Questions, ATI
Nursing Skills Exam Review, Essential Nursing
Procedures & Clinical Skills, Patient Assessment, Vital
Signs, Infection Control, Surgical Asepsis, Medication
Administration, IV Therapy, Peripheral & Central
Venous Access, Blood Administration, Oxygen Therapy,
Airway Management, NG Tubes, Urinary & Bowel
Elimination, Ostomy Care, Mobility, Nutrition & Enteral
Feeding, Pain Management, Wound Care, Specimen
Collection, Maternal-Newborn & Pediatric Assessment,
Clinical Judgment, Patient Safety & Detailed Rationales
Question 1: A nurse is preparing to administer a medication via
nasogastric tube. Which action best ensures accurate dosing and
prevents tube occlusion?
A. Crush a sustained-release tablet and mix with 30 mL sterile water.
B. Administer each medication separately and flush with 15 mL water
between each.
C. Mix all crushed medications together in 60 mL of warm water.
D. Use the plunger of the syringe to push medication through the tube
rapidly.
CORRECT ANSWER: B. Administer each medication separately and
flush with 15 mL water between each.
Rationale: Administering each medication separately with a water flush
prevents drug-drug interactions and tube clogging. Sustained-release
tablets should never be crushed (A). Mixing multiple drugs increases risk of
incompatibility (C). Rapid pushing can cause tube rupture or aspiration (D).
Question 2: A nurse is assessing a patient with chest tubes
connected to a dry suction water seal system. Which finding
requires immediate intervention?
A. Intermittent bubbling in the water seal chamber during exhalation.
B. Continuous bubbling in the suction control chamber at -20 cm H2O.
C. Tidaling in the water seal chamber with respirations.
D. No fluctuation in the water seal chamber for 4 hours post-insertion.
,CORRECT ANSWER: D. No fluctuation in the water seal chamber for
4 hours post-insertion.
Rationale: Absence of fluctuation (tidaling) for 4 hours may indicate a
blocked or kinked tube, or lung re-expansion; but if it persists suddenly, it
suggests occlusion or disconnection. Intermittent bubbling on exhalation
(A) is normal air leak. Continuous bubbling in suction chamber (B) indicates
proper suction. Tidaling (C) is expected.
Question 3: A nurse is caring for a patient with a pressure injury on
the sacrum. The wound bed is covered with yellow slough and has
moderate serosanguinous drainage. Which dressing should the
nurse select?
A. Hydrocolloid dressing.
B. Alginate dressing.
C. Transparent film dressing.
D. Hydrogel dressing.
CORRECT ANSWER: B. Alginate dressing.
Rationale: Alginate dressings are highly absorbent and appropriate for
wounds with moderate to heavy exudate and slough. Hydrocolloid (A) is for
light exudate. Transparent film (C) is for dry wounds or protection.
Hydrogel (D) is for dry wounds with slough but not for moderate drainage.
Question 4: A nurse is teaching a patient with a new colostomy
about dietary management. Which statement by the patient
indicates understanding?
A. I will avoid foods like yogurt and buttermilk to prevent odor.
B. I should eat more high-fiber foods like nuts and seeds to thicken stool.
C. I need to chew food thoroughly and eat at regular intervals.
D. I can use a stool softener daily to prevent constipation.
CORRECT ANSWER: C. I need to chew food thoroughly and eat at
regular intervals.
Rationale: Chewing food thoroughly and eating at regular intervals reduces
gas and blockage risk. Yogurt and buttermilk actually help reduce odor (A).
High-fiber foods like nuts can cause blockage (B). Stool softeners are not
routinely recommended (D).
,Question 5: A nurse is preparing to administer a blood transfusion.
The patient's vital signs are: BP 98/60, HR 110, RR 22, temp 37.1°C.
Which action should the nurse take first?
A. Start the transfusion slowly at 2 mL/min.
B. Notify the provider of the low blood pressure.
C. Obtain a baseline set of vital signs.
D. Administer 0.9% sodium chloride with the blood.
CORRECT ANSWER: C. Obtain a baseline set of vital signs.
Rationale: Obtaining baseline vital signs is essential before any transfusion
to compare during and after. Starting the transfusion (A) without baseline is
unsafe. The BP is within acceptable range for transfusion (B is not needed).
Saline is used but not the first action (D).
Question 6: A nurse is assessing a patient receiving a continuous IV
infusion of heparin. The aPTT is 90 seconds. The infusion rate is 14
units/kg/hr. The patient weighs 70 kg. The available concentration
is 25,000 units in 500 mL D5W. What action should the nurse take?
A. Increase the infusion rate to 18 units/kg/hr.
B. Decrease the infusion rate to 12 units/kg/hr.
C. Maintain the current infusion rate.
D. Stop the infusion and notify the provider.
CORRECT ANSWER: B. Decrease the infusion rate to 12
units/kg/hr.
Rationale: A therapeutic aPTT for heparin is typically 1.5 to 2.5 times the
control value (approximately 60-80 seconds). An aPTT of 90 seconds is
elevated, indicating a risk of bleeding, so the rate should be decreased per
protocol. Increasing (A) would worsen the risk. Maintaining (C) does not
address the supratherapeutic level. Stopping (D) is too extreme unless there
is active bleeding.
Question 7: A nurse is caring for a patient who has a suspected
urinary tract infection. Which urinalysis result should indicate to
the nurse the presence of a UTI?
A. WBC count of 8,000/mm³.
B. Trace amount of protein.
, C. Specific gravity of 1.010.
D. pH of 6.0.
CORRECT ANSWER: A. WBC count of 8,000/mm³.
Rationale: A white blood cell count above the expected reference range of 0
to 4,000/mm³ indicates urinary tract infection. A trace amount of protein
(B) is an expected finding. Specific gravity of 1.010 (C) is within normal
range. pH of 6.0 (D) is within the expected reference range of 4.6 to 8.0.
Question 8: A nurse is caring for a female patient who needs to
collect a midstream urine specimen. Which action should the nurse
take?
A. Give the patient a clean urine cup from the laboratory.
B. Instruct the patient to cleanse the perineal area from back to front.
C. Have the patient urinate a small amount of urine before starting the
collection.
D. Tell the patient to collect about 10 mL of urine.
CORRECT ANSWER: C. Have the patient urinate a small amount of
urine before starting the collection.
Rationale: Urinating a small amount before the collection helps cleanse the
urethral meatus of any bacteria that may be present. Cleansing should be
front to back (B is incorrect). The specimen container must be sterile (A is
incorrect). The patient should collect at least 10-15 mL, but the priority
action is the pre-void (D is not the best answer).
Question 9: A nurse is teaching a patient about home collection of a
stool specimen for fecal occult blood testing. Which instruction
should the nurse provide?
A. Obtain specimens from three different stools.
B. Eat a diet low in fiber and residue.
C. Avoid foods that are high in fat.
D. Refrigerate the specimen card after obtaining the first sample.
CORRECT ANSWER: A. Obtain specimens from three different
stools.
Rationale: The three specimens must be taken from three separate,
consecutive bowel movements. A low-fiber diet (B) is not required. Avoiding
high-fat foods (C) is not necessary. The card should not be refrigerated (D).
