HESI PN FUNDAMENTALS PROCTORED EXAM
(9 LATEST VERSION)
ATI PN FUNDAMENTALS PROCTERED EXAM 2021
(Detailed Solutions)
1. A practical nurse (PN) is caring for a patient who is 2 days post-operative
following abdominal surgery. The PN observes that the patient’s surgical incision
has started to separate at one end, with a small amount of clear, pink-tinged fluid
draining. What is the PN’s priority action?
a. Document the finding and continue to monitor.
b. Place a sterile gauze over the area and notify the registered nurse (RN) or healthcare
provider.
c. Apply an abdominal binder to provide support to the incision.
d. Irrigate the wound with normal saline as ordered.
ANS: B
Wound dehiscence (separation of wound edges) is a serious complication. The priority is
to protect the wound and prevent further damage or infection by covering it with a
sterile, moistened gauze. The PN must immediately report this finding to the supervising
RN or healthcare provider for further evaluation and orders. Option A is incorrect
because this is not a finding that should simply be monitored; it requires immediate
action. Option C is incorrect because applying a binder could put pressure on the
wound and is not the priority. Option D is incorrect because irrigation requires a specific
order and is not the immediate priority action.
,2. A PN is reinforcing teaching with a client who has a new diagnosis of
hypertension. The client asks, "Why do I need to cut down on salt?" Which of the
following responses by the PN is most appropriate?
a. "Salt causes your kidneys to hold onto water, which can raise your blood pressure."
b. "Salt can make your blood vessels constrict, leading to higher pressure."
c. "Your body will use salt to create cholesterol, which blocks your arteries."
d. "Reducing salt helps your heart pump more slowly."
ANS: A
Sodium (salt) acts like a sponge in the body. High sodium intake leads to fluid retention
(increased intravascular volume). This increased volume of fluid in the blood vessels
directly increases blood pressure, making it harder for the heart to pump. Option B is
incorrect because sodium does not directly cause vasoconstriction. Option C is incorrect
because sodium is not directly used to create cholesterol. Option D is incorrect because
while a lower BP may affect heart rate over time, the primary mechanism is fluid volume,
not a direct slowing of the heart.
3. A PN is assisting with the care of a patient who is receiving a continuous enteral
feeding via a nasogastric (NG) tube. To reduce the patient's risk of aspiration,
which of the following actions should the PN take?
a. Flush the tube with 30 mL of water every 4 hours.
b. Check the residual volume every 4 hours.
c. Keep the head of the bed elevated to at least 30 degrees.
d. Warm the feeding to room temperature before administration.
, ANS: C
Keeping the head of the bed elevated to a minimum of 30 degrees (and ideally 45
degrees) during and for 30-60 minutes after a continuous feeding is a critical
intervention to prevent aspiration. Gravity helps keep the feeding in the stomach and
prevents it from refluxing into the esophagus and being aspirated into the lungs. Option
A is important for tube patency but does not directly prevent aspiration. Option B is
important for monitoring gastric tolerance and the risk of dumping syndrome or reflux,
but the most direct and primary preventative measure for aspiration is elevation. Option
D can improve comfort but does not reduce the risk of aspiration.
4. A PN is reinforcing instructions with a client who will be using a cane for the
first time. Which of the following statements by the client indicates an
understanding of the correct use of the cane?
a. "I will hold the cane on the same side as my weak leg."
b. "I will move the cane forward at the same time as my strong leg."
c. "I will hold the cane on the side opposite my weak leg."
d. "I will keep the cane placed 12 inches to the side of my foot."
ANS: C
The correct technique for cane use is to hold the cane on the opposite side of the weak
or injured leg. The cane and the weak leg should move forward together, providing a
wide base of support and reducing the weight-bearing load on the affected side. Option
A is incorrect. Option B is incorrect; the cane moves with the weak leg, not the strong
leg. Option D is incorrect; the cane should be placed about 6 inches to the side of the
foot, not 12 inches.
(9 LATEST VERSION)
ATI PN FUNDAMENTALS PROCTERED EXAM 2021
(Detailed Solutions)
1. A practical nurse (PN) is caring for a patient who is 2 days post-operative
following abdominal surgery. The PN observes that the patient’s surgical incision
has started to separate at one end, with a small amount of clear, pink-tinged fluid
draining. What is the PN’s priority action?
a. Document the finding and continue to monitor.
b. Place a sterile gauze over the area and notify the registered nurse (RN) or healthcare
provider.
c. Apply an abdominal binder to provide support to the incision.
d. Irrigate the wound with normal saline as ordered.
ANS: B
Wound dehiscence (separation of wound edges) is a serious complication. The priority is
to protect the wound and prevent further damage or infection by covering it with a
sterile, moistened gauze. The PN must immediately report this finding to the supervising
RN or healthcare provider for further evaluation and orders. Option A is incorrect
because this is not a finding that should simply be monitored; it requires immediate
action. Option C is incorrect because applying a binder could put pressure on the
wound and is not the priority. Option D is incorrect because irrigation requires a specific
order and is not the immediate priority action.
,2. A PN is reinforcing teaching with a client who has a new diagnosis of
hypertension. The client asks, "Why do I need to cut down on salt?" Which of the
following responses by the PN is most appropriate?
a. "Salt causes your kidneys to hold onto water, which can raise your blood pressure."
b. "Salt can make your blood vessels constrict, leading to higher pressure."
c. "Your body will use salt to create cholesterol, which blocks your arteries."
d. "Reducing salt helps your heart pump more slowly."
ANS: A
Sodium (salt) acts like a sponge in the body. High sodium intake leads to fluid retention
(increased intravascular volume). This increased volume of fluid in the blood vessels
directly increases blood pressure, making it harder for the heart to pump. Option B is
incorrect because sodium does not directly cause vasoconstriction. Option C is incorrect
because sodium is not directly used to create cholesterol. Option D is incorrect because
while a lower BP may affect heart rate over time, the primary mechanism is fluid volume,
not a direct slowing of the heart.
3. A PN is assisting with the care of a patient who is receiving a continuous enteral
feeding via a nasogastric (NG) tube. To reduce the patient's risk of aspiration,
which of the following actions should the PN take?
a. Flush the tube with 30 mL of water every 4 hours.
b. Check the residual volume every 4 hours.
c. Keep the head of the bed elevated to at least 30 degrees.
d. Warm the feeding to room temperature before administration.
, ANS: C
Keeping the head of the bed elevated to a minimum of 30 degrees (and ideally 45
degrees) during and for 30-60 minutes after a continuous feeding is a critical
intervention to prevent aspiration. Gravity helps keep the feeding in the stomach and
prevents it from refluxing into the esophagus and being aspirated into the lungs. Option
A is important for tube patency but does not directly prevent aspiration. Option B is
important for monitoring gastric tolerance and the risk of dumping syndrome or reflux,
but the most direct and primary preventative measure for aspiration is elevation. Option
D can improve comfort but does not reduce the risk of aspiration.
4. A PN is reinforcing instructions with a client who will be using a cane for the
first time. Which of the following statements by the client indicates an
understanding of the correct use of the cane?
a. "I will hold the cane on the same side as my weak leg."
b. "I will move the cane forward at the same time as my strong leg."
c. "I will hold the cane on the side opposite my weak leg."
d. "I will keep the cane placed 12 inches to the side of my foot."
ANS: C
The correct technique for cane use is to hold the cane on the opposite side of the weak
or injured leg. The cane and the weak leg should move forward together, providing a
wide base of support and reducing the weight-bearing load on the affected side. Option
A is incorrect. Option B is incorrect; the cane moves with the weak leg, not the strong
leg. Option D is incorrect; the cane should be placed about 6 inches to the side of the
foot, not 12 inches.
