ATI PN FUNDAMENTALS PROCTORED EXAM 2026 –
300 PRACTICE QUESTIONS WITH ANSWERS &
RATIONALES
1. A nurse is preparing to administer a medication via the subcutaneous route.
Which of the following is the correct needle length for a subcutaneous injection in
an average-sized adult?
A) 1/4 inch
B) 3/8 to 5/8 inch
C) 1 to 1.5 inches
D) 2 inches
*Answer: B) 3/8 to 5/8 inch
Rationale: Subcutaneous injections are administered into the fatty tissue layer just below
the skin. The needle length is typically 3/8 to 5/8 inch (25-27 gauge) for an average-sized
adult. A 1/4 inch is too short. 1 to 1.5 inches are used for intramuscular injections. 2 inches
is too long for any injection.
2. A nurse is assessing a client's surgical wound on the second day post-operative.
Which of the following findings requires immediate intervention?
A) Serosanguineous drainage on the dressing
B) Wound edges that are pink and well-approximated
C) A small amount of bloody drainage on the dressing
D) Purulent drainage with a foul odor
*Answer: D) Purulent drainage with a foul odor
Rationale: Purulent drainage (yellow/green) with a foul odor is a sign of wound infection
and requires immediate intervention. Serosanguineous (pink/watery) drainage is normal
in the early post-operative period. Sanguineous (bloody) drainage is also expected initially.
Pink, well-approximated edges indicate normal healing.
,3. A client is prescribed a sedative-hypnotic for insomnia. Which of the following
is the priority nursing instruction?
A) Take the medication on an empty stomach
B) Avoid alcohol while taking this medication
C) Take the medication with a full glass of milk
D) Expect to feel alert and energetic after taking it
*Answer: B) Avoid alcohol while taking this medication
Rationale: Sedative-hypnotics are central nervous system depressants. Alcohol potentiates
this effect, increasing the risk of respiratory depression, severe drowsiness, and impaired
motor function. The medication should be taken with food if GI upset occurs. The client
should expect drowsiness, not alertness.
4. A nurse is performing a focused assessment on a client who is 1 day post-
operative. Which of the following is the priority assessment?
A) Pain level
B) Bowel sounds
C) Airway and breathing
D) Incision site appearance
*Answer: C) Airway and breathing
Rationale: The priority assessment for any post-operative client is airway, breathing, and
circulation (ABCs). Pain, bowel sounds, and incision assessment are important but
secondary to maintaining a patent airway and adequate oxygenation.
5. A nurse is providing teaching to a client about a low-cholesterol diet. Which of
the following foods should the nurse instruct the client to limit?
A) Egg whites
B) Oatmeal
C) Egg yolks
D) Fresh fish
,*Answer: C) Egg yolks
Rationale: Egg yolks are high in cholesterol. Egg whites, oatmeal, and fresh fish (especially
fatty fish like salmon) are low in cholesterol and are encouraged on a low-cholesterol diet.
Clients should limit foods high in saturated fats and cholesterol.
6. A nurse is caring for a client with an indwelling urinary catheter. Which of the
following is a correct nursing action to prevent infection?
A) Hang the drainage bag on the bed rail
B) Keep the drainage bag below the level of the bladder
C) Empty the drainage bag when it is completely full
D) Irrigate the catheter daily with sterile water
*Answer: B) Keep the drainage bag below the level of the bladder
Rationale: The drainage bag should be kept below the level of the bladder to prevent
backflow of urine, which can introduce bacteria. The drainage bag should not be hung on
the bed rail (it can be knocked over or raised above the bladder). The bag should be
emptied when 1/2 to 2/3 full. Irrigation is not routine and requires an order.
7. A nurse is preparing to administer a topical medication. Which of the following
is a correct nursing action?
A) Apply the medication with a sterile glove
B) Apply the medication with a clean applicator or gloved hand
C) Apply the medication directly with bare hands
D) Apply the medication in a thick layer to ensure absorption
*Answer: B) Apply the medication with a clean applicator or gloved hand
Rationale: Topical medications should be applied with a clean applicator or gloved hand
to prevent contamination. Bare hands should not be used (unless specified). Sterile gloves
are not required for non-sterile topical applications. The medication should be applied in a
thin, even layer (not thick, which can cause irritation).
, 8. A client is prescribed a potassium-sparing diuretic (spironolactone). Which of
the following foods should the nurse instruct the client to limit?
A) Apples
B) Bananas
C) White bread
D) Rice
*Answer: B) Bananas
Rationale: Spironolactone is a potassium-sparing diuretic, meaning it retains potassium.
Clients should limit high-potassium foods such as bananas, oranges, potatoes, and
tomatoes to prevent hyperkalemia. Apples, white bread, and rice are low in potassium.
9. A nurse is assessing a client's capillary refill. Which of the following is a normal
finding?
A) 1 second
B) 3 seconds
C) 4 seconds
D) 5 seconds
*Answer: A) 1 second
Rationale: Normal capillary refill is less than 2 seconds (typically 1-2 seconds). A refill time
of 3 seconds or greater indicates decreased perfusion and is a sign of circulatory
compromise. Capillary refill is assessed by pressing on the nail bed until blanching occurs,
then observing the time for color to return.
10. A client is receiving a tube feeding. The nurse notes that the client's gastric
residual volume (GRV) is 400 mL. Which of the following is the priority action?
A) Continue the tube feeding as ordered
B) Hold the feeding and notify the provider
C) Discard the residual and continue the feeding
D) Increase the rate of the feeding
*Answer: B) Hold the feeding and notify the provider
Rationale: A gastric residual volume (GRV) greater than 250-500 mL (depending on facility
policy) indicates delayed gastric emptying and increased risk of aspiration. The nurse
300 PRACTICE QUESTIONS WITH ANSWERS &
RATIONALES
1. A nurse is preparing to administer a medication via the subcutaneous route.
Which of the following is the correct needle length for a subcutaneous injection in
an average-sized adult?
A) 1/4 inch
B) 3/8 to 5/8 inch
C) 1 to 1.5 inches
D) 2 inches
*Answer: B) 3/8 to 5/8 inch
Rationale: Subcutaneous injections are administered into the fatty tissue layer just below
the skin. The needle length is typically 3/8 to 5/8 inch (25-27 gauge) for an average-sized
adult. A 1/4 inch is too short. 1 to 1.5 inches are used for intramuscular injections. 2 inches
is too long for any injection.
2. A nurse is assessing a client's surgical wound on the second day post-operative.
Which of the following findings requires immediate intervention?
A) Serosanguineous drainage on the dressing
B) Wound edges that are pink and well-approximated
C) A small amount of bloody drainage on the dressing
D) Purulent drainage with a foul odor
*Answer: D) Purulent drainage with a foul odor
Rationale: Purulent drainage (yellow/green) with a foul odor is a sign of wound infection
and requires immediate intervention. Serosanguineous (pink/watery) drainage is normal
in the early post-operative period. Sanguineous (bloody) drainage is also expected initially.
Pink, well-approximated edges indicate normal healing.
,3. A client is prescribed a sedative-hypnotic for insomnia. Which of the following
is the priority nursing instruction?
A) Take the medication on an empty stomach
B) Avoid alcohol while taking this medication
C) Take the medication with a full glass of milk
D) Expect to feel alert and energetic after taking it
*Answer: B) Avoid alcohol while taking this medication
Rationale: Sedative-hypnotics are central nervous system depressants. Alcohol potentiates
this effect, increasing the risk of respiratory depression, severe drowsiness, and impaired
motor function. The medication should be taken with food if GI upset occurs. The client
should expect drowsiness, not alertness.
4. A nurse is performing a focused assessment on a client who is 1 day post-
operative. Which of the following is the priority assessment?
A) Pain level
B) Bowel sounds
C) Airway and breathing
D) Incision site appearance
*Answer: C) Airway and breathing
Rationale: The priority assessment for any post-operative client is airway, breathing, and
circulation (ABCs). Pain, bowel sounds, and incision assessment are important but
secondary to maintaining a patent airway and adequate oxygenation.
5. A nurse is providing teaching to a client about a low-cholesterol diet. Which of
the following foods should the nurse instruct the client to limit?
A) Egg whites
B) Oatmeal
C) Egg yolks
D) Fresh fish
,*Answer: C) Egg yolks
Rationale: Egg yolks are high in cholesterol. Egg whites, oatmeal, and fresh fish (especially
fatty fish like salmon) are low in cholesterol and are encouraged on a low-cholesterol diet.
Clients should limit foods high in saturated fats and cholesterol.
6. A nurse is caring for a client with an indwelling urinary catheter. Which of the
following is a correct nursing action to prevent infection?
A) Hang the drainage bag on the bed rail
B) Keep the drainage bag below the level of the bladder
C) Empty the drainage bag when it is completely full
D) Irrigate the catheter daily with sterile water
*Answer: B) Keep the drainage bag below the level of the bladder
Rationale: The drainage bag should be kept below the level of the bladder to prevent
backflow of urine, which can introduce bacteria. The drainage bag should not be hung on
the bed rail (it can be knocked over or raised above the bladder). The bag should be
emptied when 1/2 to 2/3 full. Irrigation is not routine and requires an order.
7. A nurse is preparing to administer a topical medication. Which of the following
is a correct nursing action?
A) Apply the medication with a sterile glove
B) Apply the medication with a clean applicator or gloved hand
C) Apply the medication directly with bare hands
D) Apply the medication in a thick layer to ensure absorption
*Answer: B) Apply the medication with a clean applicator or gloved hand
Rationale: Topical medications should be applied with a clean applicator or gloved hand
to prevent contamination. Bare hands should not be used (unless specified). Sterile gloves
are not required for non-sterile topical applications. The medication should be applied in a
thin, even layer (not thick, which can cause irritation).
, 8. A client is prescribed a potassium-sparing diuretic (spironolactone). Which of
the following foods should the nurse instruct the client to limit?
A) Apples
B) Bananas
C) White bread
D) Rice
*Answer: B) Bananas
Rationale: Spironolactone is a potassium-sparing diuretic, meaning it retains potassium.
Clients should limit high-potassium foods such as bananas, oranges, potatoes, and
tomatoes to prevent hyperkalemia. Apples, white bread, and rice are low in potassium.
9. A nurse is assessing a client's capillary refill. Which of the following is a normal
finding?
A) 1 second
B) 3 seconds
C) 4 seconds
D) 5 seconds
*Answer: A) 1 second
Rationale: Normal capillary refill is less than 2 seconds (typically 1-2 seconds). A refill time
of 3 seconds or greater indicates decreased perfusion and is a sign of circulatory
compromise. Capillary refill is assessed by pressing on the nail bed until blanching occurs,
then observing the time for color to return.
10. A client is receiving a tube feeding. The nurse notes that the client's gastric
residual volume (GRV) is 400 mL. Which of the following is the priority action?
A) Continue the tube feeding as ordered
B) Hold the feeding and notify the provider
C) Discard the residual and continue the feeding
D) Increase the rate of the feeding
*Answer: B) Hold the feeding and notify the provider
Rationale: A gastric residual volume (GRV) greater than 250-500 mL (depending on facility
policy) indicates delayed gastric emptying and increased risk of aspiration. The nurse
