ATI RN Fundamentals Proctored Exam with NGN-
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Questions And Correct Answers With Rationales
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1. A nurse is preparing to administer an intramuscular injection to an
adult client. Which of the following actions should the nurse take to
minimize discomfort?
A) Administer the injection rapidly without aspiration.
B) Use the Z-track method for all IM injections.
C) Apply a cold compress to the site before injection.
D) Massage the site vigorously after injection.
Answer: B
Rationale: The Z-track method is recommended for IM injections to
prevent medication leakage into subcutaneous tissue and to minimize
discomfort by displacing the skin and subcutaneous tissue laterally
before injection. Rapid administration (A) can increase discomfort; cold
compresses (C) are not standard for minimizing injection pain; and
vigorous massage (D) can damage tissue and increase medication
absorption too quickly.
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2. A nurse is caring for a client who has a prescription for a 24-hour
urine collection. Which of the following actions should the nurse take?
A) Discard the first voiding of the collection period.
B) Keep the collection container at room temperature.
C) Instruct the client to avoid all fluid intake during the collection.
D) Collect all urine in a single container without a preservative.
Answer: A
Rationale: The first voiding of the collection period should be discarded
because it represents urine produced before the collection start time.
The container should be refrigerated or kept on ice (B) to prevent
bacterial growth; fluids should not be restricted (C); and preservatives
may be required depending on the test (D).
3. A nurse is assessing a client who has a nasogastric tube for enteral
feedings. Which of the following findings should the nurse report to the
provider?
A) Gastric residual volume of 150 mL.
B) pH of gastric aspirate of 4.0.
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C) Client reports mild nausea.
D) Tube is taped securely to the nose.
Answer: C
Rationale: Nausea can indicate intolerance to the feeding, delayed
gastric emptying, or tube displacement. While a residual of 150 mL (A)
may be within acceptable limits depending on policy, a pH of 4.0 (B) is
consistent with gastric placement, and secure taping (D) is expected.
4. A nurse is planning care for a client who is postoperative following a
hip arthroplasty. Which of the following interventions should the nurse
include to prevent venous thromboembolism?
A) Apply sequential compression devices.
B) Maintain the client in a supine position.
C) Encourage range-of-motion exercises every 8 hours.
D) Administer aspirin as needed for pain.
Answer: A
Rationale: Sequential compression devices promote venous return and
reduce stasis, thereby decreasing the risk of deep vein thrombosis.
Supine positioning (B) does not prevent thromboembolism; range-of-
motion exercises should be performed more frequently than every 8
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hours (C); and aspirin is not the standard prophylactic agent for VTE
prevention in this context (D).
5. A nurse is providing teaching to a client who has a new prescription
for a metered-dose inhaler. Which of the following statements by the
client indicates an understanding of the teaching?
A) "I will shake the inhaler well before each use."
B) "I will hold my breath for 5 seconds after inhaling."
C) "I will inhale quickly and deeply when I press the canister."
D) "I will rinse my mouth after using a corticosteroid inhaler."
Answer: D
Rationale: Rinsing the mouth after using a corticosteroid inhaler helps
prevent oral candidiasis (thrush). Shaking the inhaler (A) is correct, but
it is not the best indicator of understanding; breath-holding should be
for 10 seconds (B); inhalation should be slow and deep (C).
6. A nurse is caring for a client who is receiving continuous enteral
feedings via a gastrostomy tube. Which of the following actions should
the nurse take to prevent aspiration?