ATI Fundamentals Proctored Exam 2019
& Retake: Practice Questions with
Rationales & High-Yield Study Guide.
1. Delegation & Nursing Process
**1. A nurse is planning care for a group of clients. Which of the
following tasks should the nurse delegate to an assistive personnel
(AP)?**
- A. Changing the dressing for a client who has a stage 3 pressure injury
- B. Determining a client's response to a diuretic
- C. Comparing radial pulses for a client who is postoperative
- **D. Providing postmortem care to a client**
**Rationale:** Postmortem care is within the scope of practice for AP.
Dressing changes for stage 3 pressure injuries, evaluating response to
medications, and comparing pulses require nursing judgment and
should be performed by licensed nurses.
**2. Which statement is an example of a correctly written nursing
diagnosis statement?**
- A. Altered tissue perfusion related to congestive heart failure
- B. Altered urinary elimination related to urinary tract infection
, - C. Risk for impaired tissue integrity related to client's refusal to turn
- **D. Ineffective coping related to response to positive biopsy test
results**
**Rationale:** The nursing diagnosis should describe the client's
response to a health problem, not a medical diagnosis. Option D
focuses on the client's psychological response, which the nurse can
address with appropriate interventions. Options A and B contain
medical diagnoses. Option C includes an observable cause but does not
reflect a nursing-focused response.
**3. What activity should the nurse use in the evaluation phase of the
nursing process?**
- A. Ask a client to evaluate the nursing care provided
- B. Document the nursing care plan in the progress notes
- C. Determine whether a client's health problems have been alleviated
- **D. Examine the effectiveness of nursing interventions toward
meeting client outcomes**
**Rationale:** The evaluation phase involves measuring whether
nursing interventions achieved the desired client outcomes. While
client satisfaction (A) is important, it is not the primary measure of
evaluation. Documenting the care plan (B) occurs during the planning
phase.
& Retake: Practice Questions with
Rationales & High-Yield Study Guide.
1. Delegation & Nursing Process
**1. A nurse is planning care for a group of clients. Which of the
following tasks should the nurse delegate to an assistive personnel
(AP)?**
- A. Changing the dressing for a client who has a stage 3 pressure injury
- B. Determining a client's response to a diuretic
- C. Comparing radial pulses for a client who is postoperative
- **D. Providing postmortem care to a client**
**Rationale:** Postmortem care is within the scope of practice for AP.
Dressing changes for stage 3 pressure injuries, evaluating response to
medications, and comparing pulses require nursing judgment and
should be performed by licensed nurses.
**2. Which statement is an example of a correctly written nursing
diagnosis statement?**
- A. Altered tissue perfusion related to congestive heart failure
- B. Altered urinary elimination related to urinary tract infection
, - C. Risk for impaired tissue integrity related to client's refusal to turn
- **D. Ineffective coping related to response to positive biopsy test
results**
**Rationale:** The nursing diagnosis should describe the client's
response to a health problem, not a medical diagnosis. Option D
focuses on the client's psychological response, which the nurse can
address with appropriate interventions. Options A and B contain
medical diagnoses. Option C includes an observable cause but does not
reflect a nursing-focused response.
**3. What activity should the nurse use in the evaluation phase of the
nursing process?**
- A. Ask a client to evaluate the nursing care provided
- B. Document the nursing care plan in the progress notes
- C. Determine whether a client's health problems have been alleviated
- **D. Examine the effectiveness of nursing interventions toward
meeting client outcomes**
**Rationale:** The evaluation phase involves measuring whether
nursing interventions achieved the desired client outcomes. While
client satisfaction (A) is important, it is not the primary measure of
evaluation. Documenting the care plan (B) occurs during the planning
phase.
