EXAM PREP ATI RN FUNDAMENTALS 2026
PROCTORED NGN QUESTIONS, VERIFIED
ANSWERS & RATIONALES (LEVEL 3 GUIDE)
Question 1
A nurse is reviewing the laboratory results of an older adult client who is
scheduled for an elective surgery. The client's serum potassium level is 3.2
mEq/L. Which of the following actions is the nurse's priority?
A. Document the finding in the electronic health record.
B. Re-evaluate the client’s dietary potassium intake over the past 24 hours.
C. Notify the healthcare provider and surgical team immediately.
D. Administer a scheduled oral potassium supplement with a sip of water.
Verified Answer: C
Explanation: A serum potassium level of 3.2 mEq/L indicates hypokalemia,
which poses a severe risk for cardiac dysrhythmias during anesthesia and
surgery. The priority action under the nursing process framework is to notify
,the healthcare provider and surgical team immediately to correct the
imbalance before the procedure begins. Documenting is necessary but does
not address the immediate safety threat.
Question 2
A nurse is assessing a client who is 12 hours postoperative following an
abdominal hysterectomy. Which of the following clinical findings requires
immediate nursing intervention?
A. Urinary output of 20 mL/hr for 2 consecutive hours.
B. Absent bowel sounds in all four abdominal quadrants.
C. Client reports localized incisional pain as 6 on a 0-to-10 scale.
D. Serosanguineous drainage on the abdominal dressing measuring 2 cm.
Verified Answer: A
Explanation: A urinary output of less than 30 mL/hr (40 mL over 2 hours is
20 mL/hr) indicates inadequate renal perfusion, potential hypovolemia, or
acute kidney injury, demanding immediate intervention. Absent bowel sounds
are an expected finding 12 hours post-abdominal surgery due to paralytic
ileus. Incisional pain and small amounts of serosanguineous drainage are
also expected and do not override the ABC/renal perfusion priority.
Question 3
,A client diagnosed with chronic obstructive pulmonary disease (COPD) is
admitted to the medical unit with acute dyspnea. The nurse notes that the client
is anxious, using accessory muscles to breathe, and has an oxygen saturation
(SpO₂) of 86% on room air. Which of the following oxygen delivery methods
should the nurse initiate first?
A. Simple face mask at 6 L/min
B. Nasal cannula at 2 L/min
C. Non-rebreather mask at 15 L/min
D. Venturi mask at 40% FiO₂
Verified Answer: B
Explanation: For a client with chronic COPD, high concentrations of oxygen
can obliterate their hypoxic drive to breathe. The nurse should initiate oxygen
at a low flow rate via nasal cannula (1 to 2 L/min) to safely raise the oxygen
saturation to a target range of 88% to 92% without causing respiratory
depression. High-flow systems like a non-rebreather or simple mask are
contraindicated unless the client is in full cardiac or respiratory arrest.
Question 4
A nurse is reviewing a client’s medical record and notes a prescription for an
electronic infusion pump to deliver a continuous IV medication. At the start of
the shift, the nurse observes that the pump's inspection sticker is expired. Which
of the following actions should the nurse take?
A. Use the pump anyway and report it to the charge nurse at the end of the shift.
B. Obtain a different, certified infusion pump from the clean utility room and
tag the old pump for repair.
, C. Remove the expired sticker and document that the machine appears to be
working correctly.
D. Calculate the manual drip rate and run the IV fluid by gravity instead.
Verified Answer: B
Explanation: Client safety dictates that any biomedical equipment with an
expired inspection sticker or suspected malfunction must be pulled from
service immediately, tagged to prevent further use, and sent to biomedical
engineering for recertification. Using uncertified equipment increases the risk
of medication errors or injury. Continuous IV medications should not be run
via gravity when an infusion pump is required.
Question 5
A nurse is evaluating a client who has a prescription for automated intermittent
pneumatic compression (IPC) sleeves postoperatively. Which of the following
clinical findings indicates a contraindication to using this device?
A. Bilateral lower extremity +1 pitting edema
B. Reports of localized calf pain and warmth in the left leg
C. Diminished pedal pulses bilaterally
D. Multiple small abrasions on the bilateral anterior shins
Verified Answer: B
Explanation: Localized calf pain, swelling, and warmth are classic indicators
of an active deep vein thrombosis (DVT). Applying intermittent pneumatic
compression sleeves to a limb with an active DVT is strictly contraindicated
because the compression cycles can dislodge the thrombus, causing a life-
PROCTORED NGN QUESTIONS, VERIFIED
ANSWERS & RATIONALES (LEVEL 3 GUIDE)
Question 1
A nurse is reviewing the laboratory results of an older adult client who is
scheduled for an elective surgery. The client's serum potassium level is 3.2
mEq/L. Which of the following actions is the nurse's priority?
A. Document the finding in the electronic health record.
B. Re-evaluate the client’s dietary potassium intake over the past 24 hours.
C. Notify the healthcare provider and surgical team immediately.
D. Administer a scheduled oral potassium supplement with a sip of water.
Verified Answer: C
Explanation: A serum potassium level of 3.2 mEq/L indicates hypokalemia,
which poses a severe risk for cardiac dysrhythmias during anesthesia and
surgery. The priority action under the nursing process framework is to notify
,the healthcare provider and surgical team immediately to correct the
imbalance before the procedure begins. Documenting is necessary but does
not address the immediate safety threat.
Question 2
A nurse is assessing a client who is 12 hours postoperative following an
abdominal hysterectomy. Which of the following clinical findings requires
immediate nursing intervention?
A. Urinary output of 20 mL/hr for 2 consecutive hours.
B. Absent bowel sounds in all four abdominal quadrants.
C. Client reports localized incisional pain as 6 on a 0-to-10 scale.
D. Serosanguineous drainage on the abdominal dressing measuring 2 cm.
Verified Answer: A
Explanation: A urinary output of less than 30 mL/hr (40 mL over 2 hours is
20 mL/hr) indicates inadequate renal perfusion, potential hypovolemia, or
acute kidney injury, demanding immediate intervention. Absent bowel sounds
are an expected finding 12 hours post-abdominal surgery due to paralytic
ileus. Incisional pain and small amounts of serosanguineous drainage are
also expected and do not override the ABC/renal perfusion priority.
Question 3
,A client diagnosed with chronic obstructive pulmonary disease (COPD) is
admitted to the medical unit with acute dyspnea. The nurse notes that the client
is anxious, using accessory muscles to breathe, and has an oxygen saturation
(SpO₂) of 86% on room air. Which of the following oxygen delivery methods
should the nurse initiate first?
A. Simple face mask at 6 L/min
B. Nasal cannula at 2 L/min
C. Non-rebreather mask at 15 L/min
D. Venturi mask at 40% FiO₂
Verified Answer: B
Explanation: For a client with chronic COPD, high concentrations of oxygen
can obliterate their hypoxic drive to breathe. The nurse should initiate oxygen
at a low flow rate via nasal cannula (1 to 2 L/min) to safely raise the oxygen
saturation to a target range of 88% to 92% without causing respiratory
depression. High-flow systems like a non-rebreather or simple mask are
contraindicated unless the client is in full cardiac or respiratory arrest.
Question 4
A nurse is reviewing a client’s medical record and notes a prescription for an
electronic infusion pump to deliver a continuous IV medication. At the start of
the shift, the nurse observes that the pump's inspection sticker is expired. Which
of the following actions should the nurse take?
A. Use the pump anyway and report it to the charge nurse at the end of the shift.
B. Obtain a different, certified infusion pump from the clean utility room and
tag the old pump for repair.
, C. Remove the expired sticker and document that the machine appears to be
working correctly.
D. Calculate the manual drip rate and run the IV fluid by gravity instead.
Verified Answer: B
Explanation: Client safety dictates that any biomedical equipment with an
expired inspection sticker or suspected malfunction must be pulled from
service immediately, tagged to prevent further use, and sent to biomedical
engineering for recertification. Using uncertified equipment increases the risk
of medication errors or injury. Continuous IV medications should not be run
via gravity when an infusion pump is required.
Question 5
A nurse is evaluating a client who has a prescription for automated intermittent
pneumatic compression (IPC) sleeves postoperatively. Which of the following
clinical findings indicates a contraindication to using this device?
A. Bilateral lower extremity +1 pitting edema
B. Reports of localized calf pain and warmth in the left leg
C. Diminished pedal pulses bilaterally
D. Multiple small abrasions on the bilateral anterior shins
Verified Answer: B
Explanation: Localized calf pain, swelling, and warmth are classic indicators
of an active deep vein thrombosis (DVT). Applying intermittent pneumatic
compression sleeves to a limb with an active DVT is strictly contraindicated
because the compression cycles can dislodge the thrombus, causing a life-
