ATI RN CONCEPT-BASED ASSESSMENT LEVEL 1
COMPLETE PRACTICE QUESTIONS WITH CORRECT
ANSWERS AND RATIONALES
Question 1:
A nurse is caring for a patient who is postoperative day 2 following a
bowel resection. The patient reports sudden onset of sharp abdominal
pain and nausea. What is the nurse's priority action?
A. Administer prescribed pain medication
B. Assess the surgical incision for dehiscence
C. Reposition the patient to the left side
D. Encourage deep breathing exercises
Correct answer: B. Assess the surgical incision for dehiscence
Rationale: Sudden sharp pain and nausea in a postoperative patient
may indicate wound dehiscence or evisceration. The nurse must first
assess the incision site to identify any complications, as this is a surgical
emergency requiring immediate intervention.
Question 2:
A patient with pneumonia has a prescription for oxygen at 2 L/min via
nasal cannula. The patient's oxygen saturation is 88% on room air. What
is the priority nursing action?
,A. Apply the oxygen as prescribed
B. Notify the healthcare provider immediately
C. Encourage the patient to cough and deep breathe
D. Place the patient in a high Fowler's position
Correct answer: A. Apply the oxygen as prescribed
Rationale: With an oxygen saturation of 88%, the patient requires
immediate supplemental oxygen. Applying oxygen is the priority
intervention before implementing other measures or notifying the
provider.
Question 3:
A nurse is providing discharge teaching to a patient with a new
colostomy. Which statement by the patient indicates a need for further
teaching?
A. "I will change the pouch when it is one-third full"
B. "I should clean the skin around the stoma with mild soap and water"
C. "I will monitor the stoma for color changes"
D. "I can irrigate the colostomy daily to regulate bowel movements"
Correct answer: A. "I will change the pouch when it is one-third full"
Rationale: Colostomy pouches should be changed when they are one-
third to one-half full to prevent leakage and skin breakdown. Waiting
until the pouch is completely full increases the risk of leakage and skin
irritation.
Question 4:
,A patient with end-stage renal disease is receiving hemodialysis three
times per week. Which laboratory value should the nurse monitor most
closely?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum glucose
Correct answer: A. Serum potassium
Rationale: Patients with end-stage renal disease are at high risk for
hyperkalemia due to impaired excretion of potassium. Elevated
potassium levels can lead to life-threatening cardiac arrhythmias,
making this the most critical lab value to monitor.
Question 5:
A nurse is caring for a patient with a chest tube following a
pneumothorax. Which finding should prompt immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Intermittent bubbling in the water seal chamber
C. Gentle bubbling in the suction control chamber
D. Tidaling in the water seal chamber with respirations
Correct answer: A. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an
air leak in the system. This requires immediate assessment of the
system for disconnections, loose connections, or cracks in the tubing.
Intermittent bubbling and tidaling are expected findings.
, Question 6:
A patient with type 2 diabetes is prescribed insulin glargine. Which
statement indicates the patient understands the medication?
A. "I will take this insulin before meals"
B. "I can mix this insulin with regular insulin in the same syringe"
C. "This insulin provides a steady release of insulin throughout the day"
D. "I should expect this insulin to peak in 2-4 hours"
Correct answer: C. "This insulin provides a steady release of insulin
throughout the day"
Rationale: Insulin glargine is a long-acting insulin that provides a steady,
peakless release of insulin for approximately 24 hours. It should not be
mixed with other insulins and is typically given at the same time each
day.
Question 7:
A nurse is assessing a patient who is 24 hours post-total hip
replacement. Which assessment finding requires immediate notification
of the healthcare provider?
A. Pain rated 4 on a scale of 0-10
B. Surgical incision with minimal serosanguineous drainage
C. Unilateral calf swelling and pain
D. Temperature of 99.2°F (37.3°C)
Correct answer: C. Unilateral calf swelling and pain
Rationale: Unilateral calf swelling and pain are signs of a deep vein
COMPLETE PRACTICE QUESTIONS WITH CORRECT
ANSWERS AND RATIONALES
Question 1:
A nurse is caring for a patient who is postoperative day 2 following a
bowel resection. The patient reports sudden onset of sharp abdominal
pain and nausea. What is the nurse's priority action?
A. Administer prescribed pain medication
B. Assess the surgical incision for dehiscence
C. Reposition the patient to the left side
D. Encourage deep breathing exercises
Correct answer: B. Assess the surgical incision for dehiscence
Rationale: Sudden sharp pain and nausea in a postoperative patient
may indicate wound dehiscence or evisceration. The nurse must first
assess the incision site to identify any complications, as this is a surgical
emergency requiring immediate intervention.
Question 2:
A patient with pneumonia has a prescription for oxygen at 2 L/min via
nasal cannula. The patient's oxygen saturation is 88% on room air. What
is the priority nursing action?
,A. Apply the oxygen as prescribed
B. Notify the healthcare provider immediately
C. Encourage the patient to cough and deep breathe
D. Place the patient in a high Fowler's position
Correct answer: A. Apply the oxygen as prescribed
Rationale: With an oxygen saturation of 88%, the patient requires
immediate supplemental oxygen. Applying oxygen is the priority
intervention before implementing other measures or notifying the
provider.
Question 3:
A nurse is providing discharge teaching to a patient with a new
colostomy. Which statement by the patient indicates a need for further
teaching?
A. "I will change the pouch when it is one-third full"
B. "I should clean the skin around the stoma with mild soap and water"
C. "I will monitor the stoma for color changes"
D. "I can irrigate the colostomy daily to regulate bowel movements"
Correct answer: A. "I will change the pouch when it is one-third full"
Rationale: Colostomy pouches should be changed when they are one-
third to one-half full to prevent leakage and skin breakdown. Waiting
until the pouch is completely full increases the risk of leakage and skin
irritation.
Question 4:
,A patient with end-stage renal disease is receiving hemodialysis three
times per week. Which laboratory value should the nurse monitor most
closely?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum glucose
Correct answer: A. Serum potassium
Rationale: Patients with end-stage renal disease are at high risk for
hyperkalemia due to impaired excretion of potassium. Elevated
potassium levels can lead to life-threatening cardiac arrhythmias,
making this the most critical lab value to monitor.
Question 5:
A nurse is caring for a patient with a chest tube following a
pneumothorax. Which finding should prompt immediate intervention?
A. Continuous bubbling in the water seal chamber
B. Intermittent bubbling in the water seal chamber
C. Gentle bubbling in the suction control chamber
D. Tidaling in the water seal chamber with respirations
Correct answer: A. Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an
air leak in the system. This requires immediate assessment of the
system for disconnections, loose connections, or cracks in the tubing.
Intermittent bubbling and tidaling are expected findings.
, Question 6:
A patient with type 2 diabetes is prescribed insulin glargine. Which
statement indicates the patient understands the medication?
A. "I will take this insulin before meals"
B. "I can mix this insulin with regular insulin in the same syringe"
C. "This insulin provides a steady release of insulin throughout the day"
D. "I should expect this insulin to peak in 2-4 hours"
Correct answer: C. "This insulin provides a steady release of insulin
throughout the day"
Rationale: Insulin glargine is a long-acting insulin that provides a steady,
peakless release of insulin for approximately 24 hours. It should not be
mixed with other insulins and is typically given at the same time each
day.
Question 7:
A nurse is assessing a patient who is 24 hours post-total hip
replacement. Which assessment finding requires immediate notification
of the healthcare provider?
A. Pain rated 4 on a scale of 0-10
B. Surgical incision with minimal serosanguineous drainage
C. Unilateral calf swelling and pain
D. Temperature of 99.2°F (37.3°C)
Correct answer: C. Unilateral calf swelling and pain
Rationale: Unilateral calf swelling and pain are signs of a deep vein
