GALEN COLLEGE OF NURSING
FUNDAMENTALS OF NURSING (NSG 4800) — ATI RN COMPREHENSIVE
PRACTICE ASSESSMENT A & B
OFFICIAL EXAMINATION PAPER — FALL 2026
Student Name: ___________________________ Student ID: ____________ Date: Fall 2026
Score: ______ / 100% Time Allowed: 180 Minutes Format: Multiple Choice with Rationales
EXAMINATION INSTRUCTIONS: Select the best response for each item. Every item includes the correct answer
marked with a green tick (✔) and an evidence-based clinical rationale highlighted in yellow (■). Option positions (A,
B, C, D) have been randomized across all questions.
Question 1: A nurse is caring for a client who has hearing loss. Which of the following actions
should the nurse take to improve communication?
A. Cover your mouth while speaking to the client
B. Speak loudly and slowly from a distance
C. Use complex medical terminology to ensure accuracy
D. Face the client directly when speaking
✔ Correct Answer: Option D — Face the client directly when speaking
Rationale: Facing the client directly allows them to see facial expressions, lip movements, and improves sound
direction and clarity for clients with hearing impairment.
Question 2: A nurse is caring for a client who is 4 hr postpartum and has a boggy uterus with
heavy lochia. Which of the following actions should the nurse take?
A. Massage uterus and expel clots
B. Administer oxytocin immediately and apply ice packs
C. Assess for signs of hemorrhage and notify the provider immediately
D. Encourage the client to ambulate and drink fluids
✔ Correct Answer: Option A — Massage uterus and expel clots
Rationale: Uterine atony is the primary cause of early postpartum hemorrhage; massaging the uterine fundus
stimulates muscle contraction to firm the uterus and expel pooled blood and clots.
,Question 3: A nurse administers an incorrect dose of medication to a client. The nurse
recognizes the error immediately and completes an incident report. Which of the following
facts related to the incident should the nurse document in the client's medical record?
A. The client's reaction to the medication
B. The completion and filing of the incident report
C. The personal opinion of the nurse regarding why the error occurred
D. The administrative disciplinary actions taken against the nurse
✔ Correct Answer: Option A — The client's reaction to the medication
Rationale: Clinical documentation must include objective clinical facts such as medication given, time, and
client response. Incident reports are internal risk management documents and should never be mentioned in the
medical record.
Question 4: An assistive personnel (AP) and a nurse are turning a client onto the right side.
Which of the following actions by the AP requires the nurse to intervene?
A. Raises the side rail on the side opposite the turn
B. Places a pillow under the client's right arm and between knees after turning
C. Places the client in a semi-Fowler's position before turning
D. Uses a draw sheet to assist in moving the client
✔ Correct Answer: Option C — Places the client in a semi-Fowler's position before turning
Rationale: Turning a client while the head of the bed is elevated increases shearing forces and friction on the
skin; the bed should be flat or minimally elevated during positioning turns.
Question 5: A nurse is providing discharge teaching to a client who has been prescribed
warfarin. Which of the following client statements should the nurse recognize as a need for
further teaching?
A. I will use a soft-bristle toothbrush to prevent oral injury.
B. I will maintain a consistent intake of leafy green vegetables.
C. I will report any bleeding gums to the doctor.
D. I'll take aspirin if I develop a headache.
✔ Correct Answer: Option D — I'll take aspirin if I develop a headache.
Rationale: Aspirin is an antiplatelet agent that significantly increases the risk of bleeding when combined with
oral anticoagulants like warfarin.
Question 6: A charge nurse overhears two staff nurses in the hallway discussing the
nutritional status of a client who has anorexia nervosa. Which of the following actions should
the charge nurse take?
A. Ignore the conversation since no visitors are currently present
B. Report the nurses directly to the state board of nursing
C. Tell the nurses to stop the conversation immediately
D. Wait until the shift report to address the issue with all staff
✔ Correct Answer: Option C — Tell the nurses to stop the conversation immediately
Rationale: Discussing protected health information in public hallways violates HIPAA and client confidentiality
rights; the charge nurse must immediately halt the breach.
, Question 7: A nurse is teaching a client who is to start taking misoprostol and is currently on
long-term therapy with NSAIDs for arthritis. The nurse should provide the client with which
of the following information?
A. Take the medication with a full glass of milk at bedtime only.
B. Avoid taking the medication with food to increase absorption.
C. Complete a serum pregnancy test before taking the medication.
D. Discontinue the medication if mild diarrhea occurs.
✔ Correct Answer: Option C — Complete a serum pregnancy test before taking the medication.
Rationale: Misoprostol is a synthetic prostaglandin that protects gastric mucosa but causes uterine
contractions; it is contraindicated in pregnancy and pregnancy must be ruled out before initiation.
Question 8: A nurse is caring for a 16-year-old female in the ED who presents with dark
yellow urine, capillary refill greater than 3 seconds, and poor skin turgor. Which of the
following conditions should the nurse suspect?
A. Fluid volume deficit / Dehydration
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Fluid volume overload / Hypervolemia
D. Acute renal failure with oliguria
✔ Correct Answer: Option A — Fluid volume deficit / Dehydration
Rationale: Concentrated dark yellow urine, prolonged capillary refill (>3 seconds), and poor skin turgor are
hallmark clinical indicators of fluid volume deficit and dehydration.
Question 9: A nurse is evaluating a client following a respiratory intervention. Which of the
following findings indicates that the client is progressing as expected?
A. Mild wheezing bilaterally on inspiration
B. Ambulating in the hall with decreased shortness of breath
C. Rapid weight gain of 2 kg over 24 hours
D. Respiratory rate of 28 breaths/min with accessory muscle use
✔ Correct Answer: Option B — Ambulating in the hall with decreased shortness of breath
Rationale: Increased activity tolerance demonstrated by ambulation with diminished dyspnea indicates
improved respiratory function and positive progress.
Question 10: A nurse in an emergency department is assessing a preschooler who has a
facial laceration. The nurse should identify which of the following findings as a potential
indication of child sexual maltreatment?
A. The client is able to accurately describe the upcoming procedure
B. The child exhibits fear of the medical equipment
C. The child exhibits discomfort or difficulty while walking or sitting
D. The time of the client's last dose of pain medication is unknown
✔ Correct Answer: Option C — The child exhibits discomfort or difficulty while walking or sitting
Rationale: Physical signs such as unexplained genital/anal soreness, discomfort when sitting or walking, or
recurrent urinary tract infections can indicate child sexual abuse.
FUNDAMENTALS OF NURSING (NSG 4800) — ATI RN COMPREHENSIVE
PRACTICE ASSESSMENT A & B
OFFICIAL EXAMINATION PAPER — FALL 2026
Student Name: ___________________________ Student ID: ____________ Date: Fall 2026
Score: ______ / 100% Time Allowed: 180 Minutes Format: Multiple Choice with Rationales
EXAMINATION INSTRUCTIONS: Select the best response for each item. Every item includes the correct answer
marked with a green tick (✔) and an evidence-based clinical rationale highlighted in yellow (■). Option positions (A,
B, C, D) have been randomized across all questions.
Question 1: A nurse is caring for a client who has hearing loss. Which of the following actions
should the nurse take to improve communication?
A. Cover your mouth while speaking to the client
B. Speak loudly and slowly from a distance
C. Use complex medical terminology to ensure accuracy
D. Face the client directly when speaking
✔ Correct Answer: Option D — Face the client directly when speaking
Rationale: Facing the client directly allows them to see facial expressions, lip movements, and improves sound
direction and clarity for clients with hearing impairment.
Question 2: A nurse is caring for a client who is 4 hr postpartum and has a boggy uterus with
heavy lochia. Which of the following actions should the nurse take?
A. Massage uterus and expel clots
B. Administer oxytocin immediately and apply ice packs
C. Assess for signs of hemorrhage and notify the provider immediately
D. Encourage the client to ambulate and drink fluids
✔ Correct Answer: Option A — Massage uterus and expel clots
Rationale: Uterine atony is the primary cause of early postpartum hemorrhage; massaging the uterine fundus
stimulates muscle contraction to firm the uterus and expel pooled blood and clots.
,Question 3: A nurse administers an incorrect dose of medication to a client. The nurse
recognizes the error immediately and completes an incident report. Which of the following
facts related to the incident should the nurse document in the client's medical record?
A. The client's reaction to the medication
B. The completion and filing of the incident report
C. The personal opinion of the nurse regarding why the error occurred
D. The administrative disciplinary actions taken against the nurse
✔ Correct Answer: Option A — The client's reaction to the medication
Rationale: Clinical documentation must include objective clinical facts such as medication given, time, and
client response. Incident reports are internal risk management documents and should never be mentioned in the
medical record.
Question 4: An assistive personnel (AP) and a nurse are turning a client onto the right side.
Which of the following actions by the AP requires the nurse to intervene?
A. Raises the side rail on the side opposite the turn
B. Places a pillow under the client's right arm and between knees after turning
C. Places the client in a semi-Fowler's position before turning
D. Uses a draw sheet to assist in moving the client
✔ Correct Answer: Option C — Places the client in a semi-Fowler's position before turning
Rationale: Turning a client while the head of the bed is elevated increases shearing forces and friction on the
skin; the bed should be flat or minimally elevated during positioning turns.
Question 5: A nurse is providing discharge teaching to a client who has been prescribed
warfarin. Which of the following client statements should the nurse recognize as a need for
further teaching?
A. I will use a soft-bristle toothbrush to prevent oral injury.
B. I will maintain a consistent intake of leafy green vegetables.
C. I will report any bleeding gums to the doctor.
D. I'll take aspirin if I develop a headache.
✔ Correct Answer: Option D — I'll take aspirin if I develop a headache.
Rationale: Aspirin is an antiplatelet agent that significantly increases the risk of bleeding when combined with
oral anticoagulants like warfarin.
Question 6: A charge nurse overhears two staff nurses in the hallway discussing the
nutritional status of a client who has anorexia nervosa. Which of the following actions should
the charge nurse take?
A. Ignore the conversation since no visitors are currently present
B. Report the nurses directly to the state board of nursing
C. Tell the nurses to stop the conversation immediately
D. Wait until the shift report to address the issue with all staff
✔ Correct Answer: Option C — Tell the nurses to stop the conversation immediately
Rationale: Discussing protected health information in public hallways violates HIPAA and client confidentiality
rights; the charge nurse must immediately halt the breach.
, Question 7: A nurse is teaching a client who is to start taking misoprostol and is currently on
long-term therapy with NSAIDs for arthritis. The nurse should provide the client with which
of the following information?
A. Take the medication with a full glass of milk at bedtime only.
B. Avoid taking the medication with food to increase absorption.
C. Complete a serum pregnancy test before taking the medication.
D. Discontinue the medication if mild diarrhea occurs.
✔ Correct Answer: Option C — Complete a serum pregnancy test before taking the medication.
Rationale: Misoprostol is a synthetic prostaglandin that protects gastric mucosa but causes uterine
contractions; it is contraindicated in pregnancy and pregnancy must be ruled out before initiation.
Question 8: A nurse is caring for a 16-year-old female in the ED who presents with dark
yellow urine, capillary refill greater than 3 seconds, and poor skin turgor. Which of the
following conditions should the nurse suspect?
A. Fluid volume deficit / Dehydration
B. Syndrome of inappropriate antidiuretic hormone (SIADH)
C. Fluid volume overload / Hypervolemia
D. Acute renal failure with oliguria
✔ Correct Answer: Option A — Fluid volume deficit / Dehydration
Rationale: Concentrated dark yellow urine, prolonged capillary refill (>3 seconds), and poor skin turgor are
hallmark clinical indicators of fluid volume deficit and dehydration.
Question 9: A nurse is evaluating a client following a respiratory intervention. Which of the
following findings indicates that the client is progressing as expected?
A. Mild wheezing bilaterally on inspiration
B. Ambulating in the hall with decreased shortness of breath
C. Rapid weight gain of 2 kg over 24 hours
D. Respiratory rate of 28 breaths/min with accessory muscle use
✔ Correct Answer: Option B — Ambulating in the hall with decreased shortness of breath
Rationale: Increased activity tolerance demonstrated by ambulation with diminished dyspnea indicates
improved respiratory function and positive progress.
Question 10: A nurse in an emergency department is assessing a preschooler who has a
facial laceration. The nurse should identify which of the following findings as a potential
indication of child sexual maltreatment?
A. The client is able to accurately describe the upcoming procedure
B. The child exhibits fear of the medical equipment
C. The child exhibits discomfort or difficulty while walking or sitting
D. The time of the client's last dose of pain medication is unknown
✔ Correct Answer: Option C — The child exhibits discomfort or difficulty while walking or sitting
Rationale: Physical signs such as unexplained genital/anal soreness, discomfort when sitting or walking, or
recurrent urinary tract infections can indicate child sexual abuse.
