ATI PN FUNDAMENTALS PROCTORED EXAM 2023 –
250 PRACTICE QUESTIONS WITH ANSWERS &
RATIONALES
1. A nurse is caring for a client who has a new prescription for a low-sodium diet.
Which of the following foods should the nurse instruct the client to avoid?
A) Fresh broccoli
B) Canned green beans
C) Baked chicken breast
D) Brown rice
*Answer: B) Canned green beans
Rationale: Canned vegetables are high in sodium due to the canning process. Fresh
broccoli, baked chicken breast (without added salt), and brown rice are lower in sodium.
Clients on a low-sodium diet should choose fresh or frozen vegetables without added salt.
2. A nurse is preparing to administer a cleansing enema to a client. Which of the
following is the correct client position for this procedure?
A) Supine
B) Prone
C) Left lateral (Sims') position
D) Dorsal recumbent
*Answer: C) Left lateral (Sims') position
Rationale: The left lateral (Sims') position is the preferred position for enema
administration because it promotes flow of the enema solution into the sigmoid and
descending colon by gravity. The dorsal recumbent position is used for vaginal/rectal
exams. Supine and prone are not appropriate for enema administration.
,3. A nurse is assessing a client's radial pulse. Which of the following is a correct
technique?
A) Use the thumb to palpate the pulse
B) Count the pulse for 15 seconds and multiply by 4
C) Palpate the pulse for a full 60 seconds
D) Assess the pulse on the client's right arm only
*Answer: C) Palpate the pulse for a full 60 seconds
Rationale: The radial pulse should be counted for a full 60 seconds to ensure accuracy,
especially if the rhythm is irregular. The pads of the fingers (not the thumb, which has its
own pulse) should be used to palpate the pulse. Both arms should be assessed for
comparison.
4. A client is receiving oxygen therapy via a nasal cannula at 3 L/min. Which of the
following is a correct nursing action?
A) Apply petroleum jelly to the nares
B) Use a water-soluble lubricant to prevent drying
C) Set the flow rate to 8 L/min
D) Remove the cannula during meals
*Answer: B) Use a water-soluble lubricant to prevent drying
Rationale: Water-soluble lubricant is used to prevent dryness and irritation of the nares
from oxygen therapy. Petroleum jelly is flammable with oxygen and should be avoided.
Nasal cannula is typically used at 1-6 L/min; 3 L/min is appropriate. The cannula can
remain in place during meals; the client can eat with it on.
5. A nurse is performing a sterile dressing change. Which of the following actions
indicates a break in sterile technique?
A) Opening the sterile package away from the body
B) Placing sterile items 2 inches away from the edge of the sterile field
C) Reaching across the sterile field to retrieve an item
D) Using sterile forceps to handle sterile supplies
,*Answer: C) Reaching across the sterile field to retrieve an item
Rationale: Reaching across the sterile field is a break in sterile technique because it
contaminates the field. The nurse should walk around to the other side or ask for
assistance. Opening the package away from the body, placing items 2 inches from the
edge, and using sterile forceps are all correct sterile techniques.
6. A client is prescribed a stool softener (docusate sodium). The nurse understands
that this medication works by which mechanism?
A) Stimulating peristalsis
B) Increasing water and fat penetration into the stool
C) Lubricating the intestinal wall
D) Increasing osmotic pressure in the colon
*Answer: B) Increasing water and fat penetration into the stool
Rationale: Docusate sodium is an emollient stool softener that lowers surface tension,
allowing water and fat to penetrate the stool. This softens the stool, making it easier to
pass. Stimulant laxatives stimulate peristalsis. Lubricant laxatives (mineral oil) lubricate
the intestinal wall. Osmotic laxatives increase osmotic pressure.
7. A nurse is providing teaching to a client who is prescribed warfarin. Which of
the following statements indicates the client understands the teaching?
A) "I should take ibuprofen for my headaches."
B) "I should avoid eating large amounts of leafy green vegetables."
C) "I should expect my urine to turn orange."
D) "I should take my warfarin with milk."
*Answer: B) "I should avoid eating large amounts of leafy green vegetables."
Rationale: Warfarin's effect is antagonized by vitamin K, which is found in leafy green
vegetables (spinach, kale, broccoli). Clients should maintain a consistent vitamin K intake,
not avoid it entirely, but the statement shows understanding that vitamin K affects
warfarin. Ibuprofen increases bleeding risk. Orange urine is not expected with warfarin (it
can occur with rifampin). Warfarin should be taken consistently with or without food, but
not specifically with milk.
, 8. A nurse is assessing a client's pain using the FLACC scale. For which client
population is this scale most appropriate?
A) Older adults
B) Infants and children who cannot self-report
C) Adolescents
D) Adults with chronic pain
*Answer: B) Infants and children who cannot self-report
Rationale: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is used for infants and
children who cannot self-report pain (ages 2 months to 7 years). It is also used for clients
who are unable to communicate. Numeric scales are used for older children and adults.
9. A client is receiving IV fluids and the nurse notes that the IV site is red, warm,
and tender. Which of the following is the priority action?
A) Apply a cold compress
B) Discontinue the IV line
C) Slow the infusion rate
D) Notify the provider
*Answer: B) Discontinue the IV line
Rationale: Redness, warmth, and tenderness at the IV site indicate phlebitis (inflammation
of the vein). The priority is to discontinue the IV and remove the catheter to prevent
further damage. A cold compress can be applied after removal. The provider should be
notified after discontinuing the IV.
10. A nurse is preparing to administer a tuberculin skin test (PPD). Which of the
following is the correct injection route?
A) Subcutaneous
B) Intramuscular
C) Intradermal
D) Intravenous
250 PRACTICE QUESTIONS WITH ANSWERS &
RATIONALES
1. A nurse is caring for a client who has a new prescription for a low-sodium diet.
Which of the following foods should the nurse instruct the client to avoid?
A) Fresh broccoli
B) Canned green beans
C) Baked chicken breast
D) Brown rice
*Answer: B) Canned green beans
Rationale: Canned vegetables are high in sodium due to the canning process. Fresh
broccoli, baked chicken breast (without added salt), and brown rice are lower in sodium.
Clients on a low-sodium diet should choose fresh or frozen vegetables without added salt.
2. A nurse is preparing to administer a cleansing enema to a client. Which of the
following is the correct client position for this procedure?
A) Supine
B) Prone
C) Left lateral (Sims') position
D) Dorsal recumbent
*Answer: C) Left lateral (Sims') position
Rationale: The left lateral (Sims') position is the preferred position for enema
administration because it promotes flow of the enema solution into the sigmoid and
descending colon by gravity. The dorsal recumbent position is used for vaginal/rectal
exams. Supine and prone are not appropriate for enema administration.
,3. A nurse is assessing a client's radial pulse. Which of the following is a correct
technique?
A) Use the thumb to palpate the pulse
B) Count the pulse for 15 seconds and multiply by 4
C) Palpate the pulse for a full 60 seconds
D) Assess the pulse on the client's right arm only
*Answer: C) Palpate the pulse for a full 60 seconds
Rationale: The radial pulse should be counted for a full 60 seconds to ensure accuracy,
especially if the rhythm is irregular. The pads of the fingers (not the thumb, which has its
own pulse) should be used to palpate the pulse. Both arms should be assessed for
comparison.
4. A client is receiving oxygen therapy via a nasal cannula at 3 L/min. Which of the
following is a correct nursing action?
A) Apply petroleum jelly to the nares
B) Use a water-soluble lubricant to prevent drying
C) Set the flow rate to 8 L/min
D) Remove the cannula during meals
*Answer: B) Use a water-soluble lubricant to prevent drying
Rationale: Water-soluble lubricant is used to prevent dryness and irritation of the nares
from oxygen therapy. Petroleum jelly is flammable with oxygen and should be avoided.
Nasal cannula is typically used at 1-6 L/min; 3 L/min is appropriate. The cannula can
remain in place during meals; the client can eat with it on.
5. A nurse is performing a sterile dressing change. Which of the following actions
indicates a break in sterile technique?
A) Opening the sterile package away from the body
B) Placing sterile items 2 inches away from the edge of the sterile field
C) Reaching across the sterile field to retrieve an item
D) Using sterile forceps to handle sterile supplies
,*Answer: C) Reaching across the sterile field to retrieve an item
Rationale: Reaching across the sterile field is a break in sterile technique because it
contaminates the field. The nurse should walk around to the other side or ask for
assistance. Opening the package away from the body, placing items 2 inches from the
edge, and using sterile forceps are all correct sterile techniques.
6. A client is prescribed a stool softener (docusate sodium). The nurse understands
that this medication works by which mechanism?
A) Stimulating peristalsis
B) Increasing water and fat penetration into the stool
C) Lubricating the intestinal wall
D) Increasing osmotic pressure in the colon
*Answer: B) Increasing water and fat penetration into the stool
Rationale: Docusate sodium is an emollient stool softener that lowers surface tension,
allowing water and fat to penetrate the stool. This softens the stool, making it easier to
pass. Stimulant laxatives stimulate peristalsis. Lubricant laxatives (mineral oil) lubricate
the intestinal wall. Osmotic laxatives increase osmotic pressure.
7. A nurse is providing teaching to a client who is prescribed warfarin. Which of
the following statements indicates the client understands the teaching?
A) "I should take ibuprofen for my headaches."
B) "I should avoid eating large amounts of leafy green vegetables."
C) "I should expect my urine to turn orange."
D) "I should take my warfarin with milk."
*Answer: B) "I should avoid eating large amounts of leafy green vegetables."
Rationale: Warfarin's effect is antagonized by vitamin K, which is found in leafy green
vegetables (spinach, kale, broccoli). Clients should maintain a consistent vitamin K intake,
not avoid it entirely, but the statement shows understanding that vitamin K affects
warfarin. Ibuprofen increases bleeding risk. Orange urine is not expected with warfarin (it
can occur with rifampin). Warfarin should be taken consistently with or without food, but
not specifically with milk.
, 8. A nurse is assessing a client's pain using the FLACC scale. For which client
population is this scale most appropriate?
A) Older adults
B) Infants and children who cannot self-report
C) Adolescents
D) Adults with chronic pain
*Answer: B) Infants and children who cannot self-report
Rationale: The FLACC scale (Face, Legs, Activity, Cry, Consolability) is used for infants and
children who cannot self-report pain (ages 2 months to 7 years). It is also used for clients
who are unable to communicate. Numeric scales are used for older children and adults.
9. A client is receiving IV fluids and the nurse notes that the IV site is red, warm,
and tender. Which of the following is the priority action?
A) Apply a cold compress
B) Discontinue the IV line
C) Slow the infusion rate
D) Notify the provider
*Answer: B) Discontinue the IV line
Rationale: Redness, warmth, and tenderness at the IV site indicate phlebitis (inflammation
of the vein). The priority is to discontinue the IV and remove the catheter to prevent
further damage. A cold compress can be applied after removal. The provider should be
notified after discontinuing the IV.
10. A nurse is preparing to administer a tuberculin skin test (PPD). Which of the
following is the correct injection route?
A) Subcutaneous
B) Intramuscular
C) Intradermal
D) Intravenous