ATI RN Fundamentals 2026 | Fundamentals of Nursing Review & Exam Prep | ATI
Fundamentals Study Guide | RN Fundamentals Practice Questions, Answers & Detailed
Rationales | Nursing Foundations, Basic Nursing Care, Health Assessment,
Psychosocial & Physiologic Needs, Infection Control, Safety, Communication, Clinical
Judgment, Patient-Centered Care & NCLEX-RN Preparation
Question 1: A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus.
Which of the following findings indicates a therapeutic response to insulin therapy?
A. Serum glucose level of 210 mg/dL
B. Presence of ketone bodies in the urine
C. Glycosylated hemoglobin (HbA1c) of 6.8%
D. Random serum glucose of 160 mg/dL
CORRECT ANSWER: C. Glycosylated hemoglobin (HbA1c) of 6.8%
Rationale: HbA1c reflects average blood glucose levels over the past 2-3 months. A level below
7% indicates good glycemic control and a therapeutic response to insulin therapy.
Question 2: A client is prescribed enoxaparin for deep vein thrombosis prophylaxis. Which of
the following actions should the nurse take prior to administering the medication?
A. Assess the client's partial thromboplastin time (PTT).
B. Verify the client's platelet count.
C. Ensure the client is NPO for 2 hours.
D. Administer a test dose intradermally.
CORRECT ANSWER: B. Verify the client's platelet count.
Rationale: Heparin-induced thrombocytopenia (HIT) is a risk with low-molecular-weight
heparins like enoxaparin. Monitoring platelet counts is essential to detect this adverse reaction
before and during therapy.
Question 3: A nurse is providing discharge teaching to a client with heart failure. Which of the
following client statements indicates an understanding of daily weight monitoring?
A. "I should weigh myself immediately after eating breakfast."
B. "I will use a different scale each time to ensure accuracy."
C. "I need to weigh myself at the same time every day."
D. "A weight gain of 1 pound in a week is normal."
CORRECT ANSWER: C. "I need to weigh myself at the same time every day."
Rationale: Weighing at the same time each day, typically in the morning after voiding and
before breakfast, provides the most accurate comparison and early detection of fluid retention.
,Question 4: A nurse is reviewing a client's laboratory results. Which of the following values
indicates that a client with chronic kidney disease is adhering to a dietary restriction?
A. Serum phosphorus 5.8 mg/dL
B. Serum potassium 5.0 mEq/L
C. Serum calcium 9.5 mg/dL
D. Serum phosphorus 4.2 mg/dL
CORRECT ANSWER: D. Serum phosphorus 4.2 mg/dL
Rationale: Clients with chronic kidney disease must restrict dietary phosphorus. Normal
phosphorus levels are 2.5-4.5 mg/dL; therefore, 4.2 mg/dL is within the expected range and
suggests adherence to dietary restrictions.
Question 5: A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions should be the priority?
A. Obtain a baseline blood pressure.
B. Assess for a history of allergic reactions.
C. Verify the client's identity with two identifiers.
D. Ensure the client has signed a consent form.
CORRECT ANSWER: C. Verify the client's identity with two identifiers.
Rationale: Patient safety is the priority. Verifying the client's identity with two identifiers (e.g.,
name and date of birth) ensures the correct blood product is administered to the correct
patient, preventing a potentially fatal transfusion error.
Question 6: A client receiving total parenteral nutrition (TPN) complains of a headache and
appears lethargic. Which of the following is the nurse's priority action?
A. Check the client's blood glucose level.
B. Slow the infusion rate of the TPN.
C. Assess the client's blood pressure.
D. Discontinue the TPN infusion immediately.
CORRECT ANSWER: A. Check the client's blood glucose level.
Rationale: Hyperglycemia is a common complication of TPN due to the high glucose
concentration. Headache and lethargy are early signs of hyperglycemia; checking the blood
glucose level is the priority to guide immediate intervention.
,Question 7: A nurse is teaching a client with a new colostomy about stoma care. Which of the
following statements indicates the client understands the teaching?
A. "I should clean the stoma with alcohol to prevent infection."
B. "I will use a wet-to-dry dressing to cover the stoma."
C. "I should avoid eating foods that cause gas."
D. "I expect the stoma to be purple and dry initially."
CORRECT ANSWER: C. "I should avoid eating foods that cause gas."
Rationale: Certain foods (e.g., beans, broccoli, carbonated beverages) can increase gas
production, causing discomfort and bloating. Avoiding these foods is a practical self-care
strategy for clients with a colostomy.
Question 8: A nurse is assessing a client who has a chest tube. Which of the following findings
indicates a potential complication?
A. Continuous bubbling in the water seal chamber.
B. Tidaling in the water seal chamber with respiration.
C. Drainage of 50 mL in the first hour.
D. A small amount of air leak noted on initial insertion.
CORRECT ANSWER: A. Continuous bubbling in the water seal chamber.
Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which could be
from the patient, the equipment, or a disconnection. This is a complication that requires
immediate assessment and intervention.
Question 9: A nurse is preparing to administer metoprolol to a client with hypertension.
Which of the following findings should cause the nurse to hold the medication?
A. Apical heart rate of 62/min
B. Blood pressure 118/68 mm Hg
C. Apical heart rate of 52/min
D. Respiratory rate of 18/min
CORRECT ANSWER: C. Apical heart rate of 52/min
Rationale: Metoprolol is a beta-blocker that slows the heart rate. A heart rate below 60/min is a
common contraindication for administration, as it could lead to symptomatic bradycardia.
, Question 10: A nurse is providing teaching to a client about the use of a metered-dose inhaler
(MDI). Which of the following instructions should the nurse include?
A. Hold the breath for 1-2 seconds after inhalation.
B. Inhale rapidly and deeply through the mouth.
C. Activate the MDI at the beginning of inspiration.
D. Exhale completely before placing the mouthpiece in the mouth.
CORRECT ANSWER: D. Exhale completely before placing the mouthpiece in the mouth.
Rationale: Exhaling completely before placing the mouthpiece in the mouth ensures the lungs
are empty and allows for a deeper inspiration, promoting better medication deposition in the
lungs.
Question 11: A client is prescribed a low-sodium diet. Which of the following food choices by
the client indicates a need for further teaching?
A. Broiled fish with lemon juice.
B. A baked potato with margarine.
C. A turkey sandwich with cheese.
D. Fresh fruit salad.
CORRECT ANSWER: C. A turkey sandwich with cheese.
Rationale: Processed meats like turkey and cheese are high in sodium. The client should avoid
these foods on a low-sodium diet, indicating a need for further teaching.
Question 12: A nurse is caring for a client who has a nasogastric (NG) tube attached to
continuous suction. The nurse observes that the tube is not draining. Which of the following
actions should the nurse take first?
A. Advance the NG tube 2-3 cm.
B. Irrigate the tube with 30 mL of sterile water.
C. Reposition the client to the left side.
D. Verify the placement of the NG tube.
CORRECT ANSWER: D. Verify the placement of the NG tube.
Rationale: Before manipulating a non-functioning NG tube, the nurse must first verify its
placement to ensure it is still in the stomach and not in the lungs or coiled.
Fundamentals Study Guide | RN Fundamentals Practice Questions, Answers & Detailed
Rationales | Nursing Foundations, Basic Nursing Care, Health Assessment,
Psychosocial & Physiologic Needs, Infection Control, Safety, Communication, Clinical
Judgment, Patient-Centered Care & NCLEX-RN Preparation
Question 1: A nurse is caring for a client who has a new diagnosis of type 1 diabetes mellitus.
Which of the following findings indicates a therapeutic response to insulin therapy?
A. Serum glucose level of 210 mg/dL
B. Presence of ketone bodies in the urine
C. Glycosylated hemoglobin (HbA1c) of 6.8%
D. Random serum glucose of 160 mg/dL
CORRECT ANSWER: C. Glycosylated hemoglobin (HbA1c) of 6.8%
Rationale: HbA1c reflects average blood glucose levels over the past 2-3 months. A level below
7% indicates good glycemic control and a therapeutic response to insulin therapy.
Question 2: A client is prescribed enoxaparin for deep vein thrombosis prophylaxis. Which of
the following actions should the nurse take prior to administering the medication?
A. Assess the client's partial thromboplastin time (PTT).
B. Verify the client's platelet count.
C. Ensure the client is NPO for 2 hours.
D. Administer a test dose intradermally.
CORRECT ANSWER: B. Verify the client's platelet count.
Rationale: Heparin-induced thrombocytopenia (HIT) is a risk with low-molecular-weight
heparins like enoxaparin. Monitoring platelet counts is essential to detect this adverse reaction
before and during therapy.
Question 3: A nurse is providing discharge teaching to a client with heart failure. Which of the
following client statements indicates an understanding of daily weight monitoring?
A. "I should weigh myself immediately after eating breakfast."
B. "I will use a different scale each time to ensure accuracy."
C. "I need to weigh myself at the same time every day."
D. "A weight gain of 1 pound in a week is normal."
CORRECT ANSWER: C. "I need to weigh myself at the same time every day."
Rationale: Weighing at the same time each day, typically in the morning after voiding and
before breakfast, provides the most accurate comparison and early detection of fluid retention.
,Question 4: A nurse is reviewing a client's laboratory results. Which of the following values
indicates that a client with chronic kidney disease is adhering to a dietary restriction?
A. Serum phosphorus 5.8 mg/dL
B. Serum potassium 5.0 mEq/L
C. Serum calcium 9.5 mg/dL
D. Serum phosphorus 4.2 mg/dL
CORRECT ANSWER: D. Serum phosphorus 4.2 mg/dL
Rationale: Clients with chronic kidney disease must restrict dietary phosphorus. Normal
phosphorus levels are 2.5-4.5 mg/dL; therefore, 4.2 mg/dL is within the expected range and
suggests adherence to dietary restrictions.
Question 5: A nurse is preparing to administer a blood transfusion to a client. Which of the
following actions should be the priority?
A. Obtain a baseline blood pressure.
B. Assess for a history of allergic reactions.
C. Verify the client's identity with two identifiers.
D. Ensure the client has signed a consent form.
CORRECT ANSWER: C. Verify the client's identity with two identifiers.
Rationale: Patient safety is the priority. Verifying the client's identity with two identifiers (e.g.,
name and date of birth) ensures the correct blood product is administered to the correct
patient, preventing a potentially fatal transfusion error.
Question 6: A client receiving total parenteral nutrition (TPN) complains of a headache and
appears lethargic. Which of the following is the nurse's priority action?
A. Check the client's blood glucose level.
B. Slow the infusion rate of the TPN.
C. Assess the client's blood pressure.
D. Discontinue the TPN infusion immediately.
CORRECT ANSWER: A. Check the client's blood glucose level.
Rationale: Hyperglycemia is a common complication of TPN due to the high glucose
concentration. Headache and lethargy are early signs of hyperglycemia; checking the blood
glucose level is the priority to guide immediate intervention.
,Question 7: A nurse is teaching a client with a new colostomy about stoma care. Which of the
following statements indicates the client understands the teaching?
A. "I should clean the stoma with alcohol to prevent infection."
B. "I will use a wet-to-dry dressing to cover the stoma."
C. "I should avoid eating foods that cause gas."
D. "I expect the stoma to be purple and dry initially."
CORRECT ANSWER: C. "I should avoid eating foods that cause gas."
Rationale: Certain foods (e.g., beans, broccoli, carbonated beverages) can increase gas
production, causing discomfort and bloating. Avoiding these foods is a practical self-care
strategy for clients with a colostomy.
Question 8: A nurse is assessing a client who has a chest tube. Which of the following findings
indicates a potential complication?
A. Continuous bubbling in the water seal chamber.
B. Tidaling in the water seal chamber with respiration.
C. Drainage of 50 mL in the first hour.
D. A small amount of air leak noted on initial insertion.
CORRECT ANSWER: A. Continuous bubbling in the water seal chamber.
Rationale: Continuous bubbling in the water seal chamber indicates an air leak, which could be
from the patient, the equipment, or a disconnection. This is a complication that requires
immediate assessment and intervention.
Question 9: A nurse is preparing to administer metoprolol to a client with hypertension.
Which of the following findings should cause the nurse to hold the medication?
A. Apical heart rate of 62/min
B. Blood pressure 118/68 mm Hg
C. Apical heart rate of 52/min
D. Respiratory rate of 18/min
CORRECT ANSWER: C. Apical heart rate of 52/min
Rationale: Metoprolol is a beta-blocker that slows the heart rate. A heart rate below 60/min is a
common contraindication for administration, as it could lead to symptomatic bradycardia.
, Question 10: A nurse is providing teaching to a client about the use of a metered-dose inhaler
(MDI). Which of the following instructions should the nurse include?
A. Hold the breath for 1-2 seconds after inhalation.
B. Inhale rapidly and deeply through the mouth.
C. Activate the MDI at the beginning of inspiration.
D. Exhale completely before placing the mouthpiece in the mouth.
CORRECT ANSWER: D. Exhale completely before placing the mouthpiece in the mouth.
Rationale: Exhaling completely before placing the mouthpiece in the mouth ensures the lungs
are empty and allows for a deeper inspiration, promoting better medication deposition in the
lungs.
Question 11: A client is prescribed a low-sodium diet. Which of the following food choices by
the client indicates a need for further teaching?
A. Broiled fish with lemon juice.
B. A baked potato with margarine.
C. A turkey sandwich with cheese.
D. Fresh fruit salad.
CORRECT ANSWER: C. A turkey sandwich with cheese.
Rationale: Processed meats like turkey and cheese are high in sodium. The client should avoid
these foods on a low-sodium diet, indicating a need for further teaching.
Question 12: A nurse is caring for a client who has a nasogastric (NG) tube attached to
continuous suction. The nurse observes that the tube is not draining. Which of the following
actions should the nurse take first?
A. Advance the NG tube 2-3 cm.
B. Irrigate the tube with 30 mL of sterile water.
C. Reposition the client to the left side.
D. Verify the placement of the NG tube.
CORRECT ANSWER: D. Verify the placement of the NG tube.
Rationale: Before manipulating a non-functioning NG tube, the nurse must first verify its
placement to ensure it is still in the stomach and not in the lungs or coiled.
