ATI PN Fundamentals CMS: Question
Section 1: Safe & Effective Care Environment (Q1–Q20)
Q1. A nurse is caring for a client who has dysphagia following a
cerebrovascular accident. During breakfast, the client begins
coughing and develops a wet, gurgling voice. Which action should
the nurse take first?
A. Offer the client small sips of water to clear the airway
B. Encourage the client to continue swallowing slowly
C. Stop the feeding and assess the client's airway and respiratory status
D. Place the client in a supine position
Answer: C
Rationale: Coughing and a wet, gurgling voice during oral intake are signs
of possible aspiration. The nurse should immediately stop feeding and
assess airway and respiratory status. Continuing oral intake may increase
aspiration risk. The client should not be placed supine because this
increases aspiration risk.
Q2. A nurse is preparing to administer medications through a
gastrostomy tube. Which action is most appropriate?
A. Mix all medications together before administration
B. Crush enteric-coated tablets thoroughly
C. Flush the tube according to facility protocol between medications
D. Add medications directly to the enteral feeding formula
Answer: C
Rationale: Flushing the tube between medications prevents clogging and
drug interactions. Medications should not be mixed together, enteric-coated
tablets should not be crushed, and medications should not be added
directly to the feeding formula.
Q3. A client has a prescription for strict intake and output. Which
finding should the nurse recognize as requiring accurate
,measurement and documentation?
A. Moisture from a client's bath towel
B. Ice chips consumed by the client
C. Water used to rinse the client's toothbrush
D. Perspiration noted during ambulation
Answer: B
Rationale: Ice chips count toward intake because they melt and provide
fluid. Oral liquids and measurable output such as urine, emesis, and liquid
stool should be documented according to agency policy.
Q4. A nurse is caring for a client who is scheduled for a
cholecystectomy. The client signs the surgical consent form but then
tells the practical nurse (PN), "I'm not really sure what the doctor is
going to do." What is the PN's MOST appropriate action?
A. Reassure the client that the surgeon will explain everything in the
morning
B. Notify the registered nurse (RN) and document the client's statement so
consent can be re-evaluated
C. Explain the surgical procedure to the client using simple language
D. Cancel the surgery because the client's signature is invalid
Answer: B
Rationale: The PN should notify the RN so that the provider can be
contacted and informed consent can be re-validated, because valid
consent requires that the client understands the procedure, risks, benefits,
and alternatives. The PN should not explain the procedure because that is
the provider's responsibility. Canceling surgery is beyond the PN's scope.
Q5. An RN is planning care for a group of clients and must delegate
tasks. Which client care task is MOST appropriate to delegate to an
unlicensed assistive personnel (UAP)?
A. Assessing a new admission's vital signs
B. Teaching a client about a low-sodium diet
,C. Ambulating a stable client who had an uneventful knee replacement 3
days ago
D. Evaluating a client's response to a new pain medication
Answer: C
Rationale: Ambulating a stable postoperative client is within the UAP
scope of practice because it is a routine, predictable task with a stable
client. Assessments and teaching require licensed nursing scope.
Q6. A client is admitted with active pulmonary tuberculosis. Which
type of isolation precautions should the nurse implement?
A. Contact precautions only
B. Droplet precautions
C. Airborne precautions in a negative-pressure room with an N95 respirator
D. Standard precautions only
Answer: C
Rationale: Pulmonary tuberculosis requires airborne precautions in a
negative-pressure room with HEPA filtration and N95 respirator masks
because the bacteria are transmitted via airborne particles.
Q7. A nurse is preparing to administer medication to a client. Which
action should the nurse take FIRST to ensure client safety?
A. Check the medication against the MAR
B. Verify the client's identity using two identifiers
C. Assess the client's vital signs
D. Document the medication administration
Answer: B
Rationale: The nurse must first verify the client's identity using two
identifiers (e.g., name and date of birth) before administering any
medication. This is a critical safety step.
, Q8. A nurse is caring for a client on contact precautions for MRSA.
Which PPE should the nurse wear when entering the room?
A. N95 respirator and goggles
B. Gloves and gown
C. Surgical mask and gloves
D. Face shield and mask
Answer: B
Rationale: Contact precautions require gloves and gown when entering the
room or when contact with the client or contaminated surfaces is
anticipated.
Q9. Which action is the MOST effective way to prevent the spread of
infection?
A. Wearing gloves for every client interaction
B. Performing hand hygiene
C. Administering prophylactic antibiotics
D. Wearing a surgical mask at all times
Answer: B
Rationale: Hand hygiene is the single most important measure for
preventing the transmission of microorganisms in healthcare settings.
Q10. A nurse is caring for a client with Clostridium difficile infection.
Which action should the nurse take?
A. Use alcohol-based hand sanitizer after care
B. Wash hands with soap and water
C. Wear a surgical mask only
D. Place the client in a negative-pressure room
Answer: B
Rationale: C. difficile spores are resistant to alcohol. Soap and water must
be used for hand hygiene. Contact precautions are required.
Section 1: Safe & Effective Care Environment (Q1–Q20)
Q1. A nurse is caring for a client who has dysphagia following a
cerebrovascular accident. During breakfast, the client begins
coughing and develops a wet, gurgling voice. Which action should
the nurse take first?
A. Offer the client small sips of water to clear the airway
B. Encourage the client to continue swallowing slowly
C. Stop the feeding and assess the client's airway and respiratory status
D. Place the client in a supine position
Answer: C
Rationale: Coughing and a wet, gurgling voice during oral intake are signs
of possible aspiration. The nurse should immediately stop feeding and
assess airway and respiratory status. Continuing oral intake may increase
aspiration risk. The client should not be placed supine because this
increases aspiration risk.
Q2. A nurse is preparing to administer medications through a
gastrostomy tube. Which action is most appropriate?
A. Mix all medications together before administration
B. Crush enteric-coated tablets thoroughly
C. Flush the tube according to facility protocol between medications
D. Add medications directly to the enteral feeding formula
Answer: C
Rationale: Flushing the tube between medications prevents clogging and
drug interactions. Medications should not be mixed together, enteric-coated
tablets should not be crushed, and medications should not be added
directly to the feeding formula.
Q3. A client has a prescription for strict intake and output. Which
finding should the nurse recognize as requiring accurate
,measurement and documentation?
A. Moisture from a client's bath towel
B. Ice chips consumed by the client
C. Water used to rinse the client's toothbrush
D. Perspiration noted during ambulation
Answer: B
Rationale: Ice chips count toward intake because they melt and provide
fluid. Oral liquids and measurable output such as urine, emesis, and liquid
stool should be documented according to agency policy.
Q4. A nurse is caring for a client who is scheduled for a
cholecystectomy. The client signs the surgical consent form but then
tells the practical nurse (PN), "I'm not really sure what the doctor is
going to do." What is the PN's MOST appropriate action?
A. Reassure the client that the surgeon will explain everything in the
morning
B. Notify the registered nurse (RN) and document the client's statement so
consent can be re-evaluated
C. Explain the surgical procedure to the client using simple language
D. Cancel the surgery because the client's signature is invalid
Answer: B
Rationale: The PN should notify the RN so that the provider can be
contacted and informed consent can be re-validated, because valid
consent requires that the client understands the procedure, risks, benefits,
and alternatives. The PN should not explain the procedure because that is
the provider's responsibility. Canceling surgery is beyond the PN's scope.
Q5. An RN is planning care for a group of clients and must delegate
tasks. Which client care task is MOST appropriate to delegate to an
unlicensed assistive personnel (UAP)?
A. Assessing a new admission's vital signs
B. Teaching a client about a low-sodium diet
,C. Ambulating a stable client who had an uneventful knee replacement 3
days ago
D. Evaluating a client's response to a new pain medication
Answer: C
Rationale: Ambulating a stable postoperative client is within the UAP
scope of practice because it is a routine, predictable task with a stable
client. Assessments and teaching require licensed nursing scope.
Q6. A client is admitted with active pulmonary tuberculosis. Which
type of isolation precautions should the nurse implement?
A. Contact precautions only
B. Droplet precautions
C. Airborne precautions in a negative-pressure room with an N95 respirator
D. Standard precautions only
Answer: C
Rationale: Pulmonary tuberculosis requires airborne precautions in a
negative-pressure room with HEPA filtration and N95 respirator masks
because the bacteria are transmitted via airborne particles.
Q7. A nurse is preparing to administer medication to a client. Which
action should the nurse take FIRST to ensure client safety?
A. Check the medication against the MAR
B. Verify the client's identity using two identifiers
C. Assess the client's vital signs
D. Document the medication administration
Answer: B
Rationale: The nurse must first verify the client's identity using two
identifiers (e.g., name and date of birth) before administering any
medication. This is a critical safety step.
, Q8. A nurse is caring for a client on contact precautions for MRSA.
Which PPE should the nurse wear when entering the room?
A. N95 respirator and goggles
B. Gloves and gown
C. Surgical mask and gloves
D. Face shield and mask
Answer: B
Rationale: Contact precautions require gloves and gown when entering the
room or when contact with the client or contaminated surfaces is
anticipated.
Q9. Which action is the MOST effective way to prevent the spread of
infection?
A. Wearing gloves for every client interaction
B. Performing hand hygiene
C. Administering prophylactic antibiotics
D. Wearing a surgical mask at all times
Answer: B
Rationale: Hand hygiene is the single most important measure for
preventing the transmission of microorganisms in healthcare settings.
Q10. A nurse is caring for a client with Clostridium difficile infection.
Which action should the nurse take?
A. Use alcohol-based hand sanitizer after care
B. Wash hands with soap and water
C. Wear a surgical mask only
D. Place the client in a negative-pressure room
Answer: B
Rationale: C. difficile spores are resistant to alcohol. Soap and water must
be used for hand hygiene. Contact precautions are required.
