ATI Fundamentals 2019 Proctored Exam |
Fundamentals Proctored Exam
1. A nurse is caring for a client who has Clostridioides difficile. Which of the following
precautions should the nurse implement?
A. Standard precautions only
B. Contact precautions with gown and gloves
C. Airborne precautions with an N95 mask
D. Droplet precautions with a surgical mask
Rationale: C. difficile spreads via contact with spores. Contact precautions require gown and
gloves. Alcohol-based hand rub is ineffective against C. difficile spores; soap and water
handwashing is essential.
2. A nurse finds a wet floor in a client's room. Which of the following actions should the nurse
take first?
A. Warn clients verbally as they enter the room
B. Place a wet floor sign
C. Clean up immediately and then place a sign
D. Report to housekeeping
Rationale: Placing a wet floor sign is the immediate first action to alert others of the hazard
and prevent falls. Cleanup follows, but the sign must be placed first to ensure safety.
3. Which of the following clients requires airborne precautions?
A. A client who has influenza
B. A client who has tuberculosis
C. A client who has MRSA
D. A client who has rotavirus
Rationale: Tuberculosis spreads via airborne droplets measuring less than 5 mcg. Airborne
precautions require an N95 respirator or HEPA mask and a negative-pressure airborne infection
isolation room.
,4. A nurse is caring for a client on droplet precautions. Which PPE is required when within 3
feet of the client?
A. Gown and gloves only
B. Mask within 3 feet of the client
C. N95 respirator
D. No PPE needed
Rationale: Droplet precautions require a mask when within 3 feet of the client. Droplets
travel 3–6 feet.
5. A nurse is preparing to leave the room of a client who requires airborne precautions
following a dressing change. Which PPE should the nurse remove first?
A. Gloves
B. Mask
C. Gown
D. Goggles
Rationale: Gloves are the most contaminated item and should be removed first. The mask is
removed last after leaving the room to prevent inhalation of airborne pathogens.
6. A nurse is teaching a newly licensed nurse about the care of a client who has a MRSA
infection. Which statement indicates understanding?
A. "I will use alcohol-based hand rub after removing gloves."
B. "I will place the client in a private room."
C. "I will wear a mask when entering the room."
D. "I will use standard precautions only."
Rationale: MRSA requires contact precautions, including a private room when available.
Alcohol-based hand rub is acceptable after glove removal for MRSA, but private room
placement is a key teaching point.
7. A nurse is preparing to insert an indwelling urinary catheter in a female client. Which action
is correct?
,A. Inflate the balloon before inserting the catheter
B. Insert the catheter 2 to 3 inches until urine flows
C. Use sterile technique throughout the procedure
D. Cleanse the meatus from back to front
Rationale: Insertion of an indwelling urinary catheter requires sterile technique to prevent
CAUTI. The balloon is inflated only after urine return confirms bladder placement.
8. A nurse is caring for a client who has a latex allergy. Which action should the nurse include
in the plan of care?
A. Schedule the client as the first surgical procedure of the day
B. Cleanse medication stoppers with povidone-iodine
C. Remove stopcocks from IV tubing
D. Ensure the gloves in the surgical suite are powdered
Rationale: Scheduling the latex-allergic client as the first surgical procedure reduces
exposure to latex particles in the air from prior procedures.
9. A nurse is preparing to administer a controlled substance to a client for pain management.
Which action should the nurse take?
A. Sign for the medication before administering it
B. Report any discrepancy in the count of the controlled substance after administration
C. Discard unused portions in the trash
D. Have another nurse sign for the medication
Rationale: Any discrepancy in controlled substance counts must be reported immediately
per facility policy and legal requirements.
10. A nurse is preparing to administer an injection to a client. Which action should the nurse
plan to take after administering the injection?
A. Recap the needle immediately
B. Place the needle in a regular trash container
, C. Discard the needle in a puncture-proof container
D. Break the needle off the syringe
Rationale: Needles must be discarded in a puncture-proof sharps container immediately
after use. Recapping and breaking needles increase the risk of needlestick injury.
11. A nurse is reviewing the medical record of a client who asks about magnet therapy for
pain relief. Which finding is a contraindication?
A. The client has osteoarthritis
B. The client has a history of migraines
C. The client has an implanted defibrillator
D. The client has hypertension
Rationale: Magnet therapy is contraindicated for clients with implanted electronic devices
such as defibrillators or pacemakers because magnets can interfere with device function.
12. A nurse is assessing a client who has worked outdoors for the past 20 years. Which finding
should the nurse identify as a priority?
A. Dry, scaly skin on the forearms
B. A change in appearance of a mole on the shoulder
C. Freckles on the face
D. Sunburn on the neck
Rationale: A change in the appearance of a mole is a warning sign for melanoma and
requires immediate evaluation.
13. A nurse is preparing to administer a medication via nasogastric tube. Which action best
prevents tube occlusion?
A. Crush a sustained-release tablet and mix with 30 mL sterile water
B. Administer each medication separately and flush with 15 mL water between each
C. Mix all crushed medications together in 60 mL warm water
D. Use the plunger to push medication rapidly
Fundamentals Proctored Exam
1. A nurse is caring for a client who has Clostridioides difficile. Which of the following
precautions should the nurse implement?
A. Standard precautions only
B. Contact precautions with gown and gloves
C. Airborne precautions with an N95 mask
D. Droplet precautions with a surgical mask
Rationale: C. difficile spreads via contact with spores. Contact precautions require gown and
gloves. Alcohol-based hand rub is ineffective against C. difficile spores; soap and water
handwashing is essential.
2. A nurse finds a wet floor in a client's room. Which of the following actions should the nurse
take first?
A. Warn clients verbally as they enter the room
B. Place a wet floor sign
C. Clean up immediately and then place a sign
D. Report to housekeeping
Rationale: Placing a wet floor sign is the immediate first action to alert others of the hazard
and prevent falls. Cleanup follows, but the sign must be placed first to ensure safety.
3. Which of the following clients requires airborne precautions?
A. A client who has influenza
B. A client who has tuberculosis
C. A client who has MRSA
D. A client who has rotavirus
Rationale: Tuberculosis spreads via airborne droplets measuring less than 5 mcg. Airborne
precautions require an N95 respirator or HEPA mask and a negative-pressure airborne infection
isolation room.
,4. A nurse is caring for a client on droplet precautions. Which PPE is required when within 3
feet of the client?
A. Gown and gloves only
B. Mask within 3 feet of the client
C. N95 respirator
D. No PPE needed
Rationale: Droplet precautions require a mask when within 3 feet of the client. Droplets
travel 3–6 feet.
5. A nurse is preparing to leave the room of a client who requires airborne precautions
following a dressing change. Which PPE should the nurse remove first?
A. Gloves
B. Mask
C. Gown
D. Goggles
Rationale: Gloves are the most contaminated item and should be removed first. The mask is
removed last after leaving the room to prevent inhalation of airborne pathogens.
6. A nurse is teaching a newly licensed nurse about the care of a client who has a MRSA
infection. Which statement indicates understanding?
A. "I will use alcohol-based hand rub after removing gloves."
B. "I will place the client in a private room."
C. "I will wear a mask when entering the room."
D. "I will use standard precautions only."
Rationale: MRSA requires contact precautions, including a private room when available.
Alcohol-based hand rub is acceptable after glove removal for MRSA, but private room
placement is a key teaching point.
7. A nurse is preparing to insert an indwelling urinary catheter in a female client. Which action
is correct?
,A. Inflate the balloon before inserting the catheter
B. Insert the catheter 2 to 3 inches until urine flows
C. Use sterile technique throughout the procedure
D. Cleanse the meatus from back to front
Rationale: Insertion of an indwelling urinary catheter requires sterile technique to prevent
CAUTI. The balloon is inflated only after urine return confirms bladder placement.
8. A nurse is caring for a client who has a latex allergy. Which action should the nurse include
in the plan of care?
A. Schedule the client as the first surgical procedure of the day
B. Cleanse medication stoppers with povidone-iodine
C. Remove stopcocks from IV tubing
D. Ensure the gloves in the surgical suite are powdered
Rationale: Scheduling the latex-allergic client as the first surgical procedure reduces
exposure to latex particles in the air from prior procedures.
9. A nurse is preparing to administer a controlled substance to a client for pain management.
Which action should the nurse take?
A. Sign for the medication before administering it
B. Report any discrepancy in the count of the controlled substance after administration
C. Discard unused portions in the trash
D. Have another nurse sign for the medication
Rationale: Any discrepancy in controlled substance counts must be reported immediately
per facility policy and legal requirements.
10. A nurse is preparing to administer an injection to a client. Which action should the nurse
plan to take after administering the injection?
A. Recap the needle immediately
B. Place the needle in a regular trash container
, C. Discard the needle in a puncture-proof container
D. Break the needle off the syringe
Rationale: Needles must be discarded in a puncture-proof sharps container immediately
after use. Recapping and breaking needles increase the risk of needlestick injury.
11. A nurse is reviewing the medical record of a client who asks about magnet therapy for
pain relief. Which finding is a contraindication?
A. The client has osteoarthritis
B. The client has a history of migraines
C. The client has an implanted defibrillator
D. The client has hypertension
Rationale: Magnet therapy is contraindicated for clients with implanted electronic devices
such as defibrillators or pacemakers because magnets can interfere with device function.
12. A nurse is assessing a client who has worked outdoors for the past 20 years. Which finding
should the nurse identify as a priority?
A. Dry, scaly skin on the forearms
B. A change in appearance of a mole on the shoulder
C. Freckles on the face
D. Sunburn on the neck
Rationale: A change in the appearance of a mole is a warning sign for melanoma and
requires immediate evaluation.
13. A nurse is preparing to administer a medication via nasogastric tube. Which action best
prevents tube occlusion?
A. Crush a sustained-release tablet and mix with 30 mL sterile water
B. Administer each medication separately and flush with 15 mL water between each
C. Mix all crushed medications together in 60 mL warm water
D. Use the plunger to push medication rapidly
