ATI PN FUNDAMENTALS NGN-STYLE
PRACTICE QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES |
ORIGINAL EDUCATIONAL CONTENT
CORE DOMAINS
• Nursing Process and Clinical Judgment
• Safety and Infection Control
• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
• Reduction of Risk Potential
• Physiological Adaptation
• Psychosocial Integrity
• Health Promotion and Maintenance
INTRODUCTION
The purpose of this comprehensive practice assessment is to
evaluate the practical nursing student's mastery of fundamental
nursing concepts using Next Generation NCLEX (NGN) style
questioning. This assessment covers the nursing process, safety
and infection control, basic care and comfort, pharmacological
therapies, reduction of risk potential, physiological adaptation,
psychosocial integrity, and health promotion. Questions are
structured as multiple-choice, matrix, and scenario-based items
designed to simulate real-world clinical decision-making.
Emphasis is placed on applied professional knowledge, clinical
judgment, and critical thinking necessary for safe and effective
practical nursing practice.
,SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who has Clostridioides
difficile. Which action should the nurse take?
A. Place the client in a negative-pressure room
B. Wear an N95 respirator when entering the room
C. Perform hand hygiene with soap and water after care
D. Wear a gown and gloves only when soiling is likely
C. Perform hand hygiene with soap and water after care
RATIONALE: C. difficile is transmitted via spores, which are
not killed by alcohol-based hand sanitizer. Contact precautions
require soap-and-water hand hygiene. A negative-pressure room
is for airborne precautions. An N95 is not required for C. diff.
Gowns and gloves are required for all contact with the client and
environment.
2. A nurse is assessing a client who has been receiving
furosemide. Which finding indicates a need for immediate
intervention?
A. Urine output of 50 mL/hr
B. Serum potassium of 2.8 mEq/L
C. Blood pressure of 118/72 mm Hg
D. Weight loss of 0.5 kg in 24 hours
B. Serum potassium of 2.8 mEq/L
RATIONALE: Loop diuretics such as furosemide cause
potassium loss. A serum potassium of 2.8 mEq/L is critically low
and can cause cardiac dysrhythmias. The nurse should notify the
provider immediately and anticipate potassium replacement.
,3. A nurse is preparing to administer medications to a
client who has a new prescription for warfarin. Which
laboratory value should the nurse review before
administration?
A. Serum potassium
B. INR
C. Serum creatinine
D. Hemoglobin A1C
B. INR
RATIONALE: Warfarin therapy requires monitoring of the INR
to ensure therapeutic anticoagulation (typically 2–3 for most
indications) and to prevent bleeding complications. The nurse
should hold the medication and notify the provider if the INR is
supratherapeutic.
4. A nurse is caring for a client who is postoperative and
has not voided for 8 hours. Which action should the nurse
take first?
A. Insert an indwelling urinary catheter
B. Palpate the client's bladder for distention
C. Encourage the client to drink fluids
D. Administer a prescribed diuretic
B. Palpate the client's bladder for distention
RATIONALE: Assessment is the first step. The nurse should
palpate the bladder to determine whether the client has urinary
retention or is not producing urine. This guides the next
intervention.
5. A nurse is teaching a client about crutch walking. Which
statement by the client indicates understanding?
, A. "I will bear weight on my axillae when resting."
B. "I will use a three-point gait for my non-weight-bearing leg."
C. "I will place my crutches 12 inches in front of me."
D. "I will wear slippers when walking with crutches."
B. "I will use a three-point gait for my non-weight-
bearing leg."
RATIONALE: A three-point gait is used when one leg is non-
weight-bearing. The client should not bear weight on the axillae
(risk of nerve damage), crutches should be placed 6–8 inches in
front, and supportive non-skid shoes should be worn.
6. A nurse is caring for a client who has a new colostomy.
Which finding should the nurse report to the provider
immediately?
A. Stoma is red and moist
B. Stoma is pale and dusky
C. Small amount of bleeding at the stoma
D. Output of 100 mL of liquid stool
B. Stoma is pale and dusky
RATIONALE: A healthy stoma should be red and moist. A pale,
dusky, or cyanotic stoma indicates compromised blood flow and
possible necrosis. This requires immediate notification of the
provider.
7. A nurse is preparing to administer insulin to a client.
Which action should the nurse take to ensure client safety?
A. Administer the insulin at the same site each time
B. Verify the insulin dose with a second nurse
C. Use a tuberculin syringe for insulin administration
D. Shake the insulin vial vigorously before drawing up
PRACTICE QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES |
ORIGINAL EDUCATIONAL CONTENT
CORE DOMAINS
• Nursing Process and Clinical Judgment
• Safety and Infection Control
• Basic Care and Comfort
• Pharmacological and Parenteral Therapies
• Reduction of Risk Potential
• Physiological Adaptation
• Psychosocial Integrity
• Health Promotion and Maintenance
INTRODUCTION
The purpose of this comprehensive practice assessment is to
evaluate the practical nursing student's mastery of fundamental
nursing concepts using Next Generation NCLEX (NGN) style
questioning. This assessment covers the nursing process, safety
and infection control, basic care and comfort, pharmacological
therapies, reduction of risk potential, physiological adaptation,
psychosocial integrity, and health promotion. Questions are
structured as multiple-choice, matrix, and scenario-based items
designed to simulate real-world clinical decision-making.
Emphasis is placed on applied professional knowledge, clinical
judgment, and critical thinking necessary for safe and effective
practical nursing practice.
,SECTION ONE: QUESTIONS 1–100
1. A nurse is caring for a client who has Clostridioides
difficile. Which action should the nurse take?
A. Place the client in a negative-pressure room
B. Wear an N95 respirator when entering the room
C. Perform hand hygiene with soap and water after care
D. Wear a gown and gloves only when soiling is likely
C. Perform hand hygiene with soap and water after care
RATIONALE: C. difficile is transmitted via spores, which are
not killed by alcohol-based hand sanitizer. Contact precautions
require soap-and-water hand hygiene. A negative-pressure room
is for airborne precautions. An N95 is not required for C. diff.
Gowns and gloves are required for all contact with the client and
environment.
2. A nurse is assessing a client who has been receiving
furosemide. Which finding indicates a need for immediate
intervention?
A. Urine output of 50 mL/hr
B. Serum potassium of 2.8 mEq/L
C. Blood pressure of 118/72 mm Hg
D. Weight loss of 0.5 kg in 24 hours
B. Serum potassium of 2.8 mEq/L
RATIONALE: Loop diuretics such as furosemide cause
potassium loss. A serum potassium of 2.8 mEq/L is critically low
and can cause cardiac dysrhythmias. The nurse should notify the
provider immediately and anticipate potassium replacement.
,3. A nurse is preparing to administer medications to a
client who has a new prescription for warfarin. Which
laboratory value should the nurse review before
administration?
A. Serum potassium
B. INR
C. Serum creatinine
D. Hemoglobin A1C
B. INR
RATIONALE: Warfarin therapy requires monitoring of the INR
to ensure therapeutic anticoagulation (typically 2–3 for most
indications) and to prevent bleeding complications. The nurse
should hold the medication and notify the provider if the INR is
supratherapeutic.
4. A nurse is caring for a client who is postoperative and
has not voided for 8 hours. Which action should the nurse
take first?
A. Insert an indwelling urinary catheter
B. Palpate the client's bladder for distention
C. Encourage the client to drink fluids
D. Administer a prescribed diuretic
B. Palpate the client's bladder for distention
RATIONALE: Assessment is the first step. The nurse should
palpate the bladder to determine whether the client has urinary
retention or is not producing urine. This guides the next
intervention.
5. A nurse is teaching a client about crutch walking. Which
statement by the client indicates understanding?
, A. "I will bear weight on my axillae when resting."
B. "I will use a three-point gait for my non-weight-bearing leg."
C. "I will place my crutches 12 inches in front of me."
D. "I will wear slippers when walking with crutches."
B. "I will use a three-point gait for my non-weight-
bearing leg."
RATIONALE: A three-point gait is used when one leg is non-
weight-bearing. The client should not bear weight on the axillae
(risk of nerve damage), crutches should be placed 6–8 inches in
front, and supportive non-skid shoes should be worn.
6. A nurse is caring for a client who has a new colostomy.
Which finding should the nurse report to the provider
immediately?
A. Stoma is red and moist
B. Stoma is pale and dusky
C. Small amount of bleeding at the stoma
D. Output of 100 mL of liquid stool
B. Stoma is pale and dusky
RATIONALE: A healthy stoma should be red and moist. A pale,
dusky, or cyanotic stoma indicates compromised blood flow and
possible necrosis. This requires immediate notification of the
provider.
7. A nurse is preparing to administer insulin to a client.
Which action should the nurse take to ensure client safety?
A. Administer the insulin at the same site each time
B. Verify the insulin dose with a second nurse
C. Use a tuberculin syringe for insulin administration
D. Shake the insulin vial vigorously before drawing up
