ATI Fundamentals Proctored Exam New
Test Bank 2020/2021
Q1. A nurse is caring for a client who has stage IV pancreatic cancer. The client tells the nurse, "I
don't want any more chemotherapy. I'm tired of being sick." The client's adult children are
insisting that the client continue treatment. Which action by the nurse best demonstrates
advocacy?
A. Tell the family that the client has the right to refuse treatment.
B. Facilitate a meeting with the provider, client, and family to clarify the client's wishes and
explore options.
C. Encourage the client to reconsider for the sake of the family.
D. Document the client's statement and inform the provider.
Correct Answer: B
Rationale: Advocacy involves supporting the client's autonomy and facilitating
communication among the client, family, and healthcare team. While the client has the right to
refuse treatment (A), simply telling the family this does not actively advocate. Facilitating a
family meeting ensures the client's wishes are heard and respected while addressing family
concerns. Encouraging the client to reconsider (C) undermines autonomy. Documentation (D) is
important but not the priority advocacy action.
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate for the nurse to delegate?
A. Evaluating a client's response to pain medication
B. Ambulating a stable postoperative client who had surgery 3 days ago
C. Teaching a client how to use an incentive spirometer
D. Assessing a client's surgical incision for signs of infection
Correct Answer: B
Rationale: Ambulating a stable postoperative client is within UAP scope. UAPs may perform
ADLs, vital signs on stable clients, and ambulation of stable clients. Evaluation (A), teaching (C),
and assessment (D) require RN-level clinical judgment and cannot be delegated to UAP.
,Q3. A nurse is preparing a client for a colonoscopy. The client asks, "What are the risks of this
procedure?" Which response by the nurse is appropriate?
A. "I can explain the risks to you before you sign the consent."
B. "Your provider will explain the risks and benefits before you sign."
C. "You don't need to worry; this is a very safe procedure."
D. "The consent form lists all the risks in detail."
Correct Answer: B
Rationale: Informed consent is the provider's responsibility. The nurse's role is to witness
the signature and ensure the client understands. The nurse should not explain risks (A) or
provide false reassurance (C). The consent form (D) does not substitute for the provider's
explanation.
Q4. A nurse is caring for a client who has a DNR order. The client's heart stops. Which action
should the nurse take?
A. Begin CPR immediately.
B. Call a code blue and initiate resuscitation.
C. Withhold CPR and follow the DNR order.
D. Ask the family for permission to withhold CPR.
Correct Answer: C
Rationale: A DNR order is a provider's order directing healthcare personnel not to perform
CPR. The nurse must honor the DNR. Starting CPR (A, B) would violate the order. The family's
permission is not needed once a valid DNR order exists (D).
Q5. A nurse is reviewing a client's advance directives. Which document expresses the client's
wishes regarding future medical treatment but requires a provider's order to be actionable?
A. Living will
B. Durable power of attorney for healthcare
C. DNR order
D. HIPAA authorization
Correct Answer: A
, Rationale: A living will expresses the client's wishes but must be translated into a provider's
order (such as a DNR) to direct nursing action. Durable power of attorney (B) designates a
surrogate decision-maker. A DNR order (C) is the actionable provider order. HIPAA (D) addresses
privacy.
Q6. A nurse is making assignments for the shift. Which client should the nurse assign to the
most experienced RN?
A. A stable client admitted 2 days ago with pneumonia receiving oral antibiotics
B. A client admitted 1 hour ago with an acute GI bleed, BP 90/58, HR 112
C. A client postoperative day 3 with a healing incision requesting pain medication
D. A client with chronic back pain requesting assistance to the bathroom
Correct Answer: B
Rationale: Using acute vs. chronic and unstable vs. stable prioritization, the unstable GI
bleed client with hemodynamic compromise requires the most experienced RN for ongoing
assessment, IV titration, and preparation for emergent intervention. The other clients are stable
and can be cared for by less experienced staff.
Q7. A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. The
client's family insists the transfusion be given. Which action should the nurse take?
A. Administer the transfusion as the family requests.
B. Respect the client's refusal and document the decision.
C. Ask the provider to obtain a court order.
D. Delay the transfusion until the client is sedated.
Correct Answer: B
Rationale: A competent adult has the right to refuse any treatment, including life-saving
interventions. Administering blood against the client's will constitutes battery (A). A court order
(C) is only appropriate if the client lacks decision-making capacity. Delaying to sedate the client
(D) violates autonomy.
Q8. (SATA) A nurse is teaching a newly licensed nurse about the Five Rights of Delegation.
Which of the following are included? Select all that apply.
, A. Right task
B. Right circumstance
C. Right diagnosis
D. Right person
E. Right direction/communication
F. Right supervision/evaluation
Correct Answers: A, B, D, E, F
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person,
Right Direction/Communication, and Right Supervision/Evaluation. "Right diagnosis" is not part
of delegation; diagnosis is an RN-only responsibility.
Q9. A nurse witnesses a client sign a consent form for surgery. Which action should the nurse
take?
A. Explain the procedure to the client before witnessing.
B. Verify that the provider has explained the procedure and the client understands.
C. Sign the consent form as the person who obtained consent.
D. Obtain consent from the client's spouse if the client is anxious.
Correct Answer: B
Rationale: The nurse's role is to witness the signature and verify that the provider has
explained the procedure and that the client understands. Explaining the procedure (A) is the
provider's responsibility. The nurse signs as a witness, not as the person obtaining consent (C). A
competent adult signs their own consent (D).
Q10. A nurse is preparing to administer a medication via a nasogastric tube. Which action best
ensures accurate dosing and 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 of warm water.
D. Use the plunger of the syringe to push medication rapidly through the tube.
Correct Answer: B
Rationale: Administering each medication separately with a water flush prevents drug-drug
interactions and tube clogging. Sustained-release tablets should never be crushed (A). Mixing
Test Bank 2020/2021
Q1. A nurse is caring for a client who has stage IV pancreatic cancer. The client tells the nurse, "I
don't want any more chemotherapy. I'm tired of being sick." The client's adult children are
insisting that the client continue treatment. Which action by the nurse best demonstrates
advocacy?
A. Tell the family that the client has the right to refuse treatment.
B. Facilitate a meeting with the provider, client, and family to clarify the client's wishes and
explore options.
C. Encourage the client to reconsider for the sake of the family.
D. Document the client's statement and inform the provider.
Correct Answer: B
Rationale: Advocacy involves supporting the client's autonomy and facilitating
communication among the client, family, and healthcare team. While the client has the right to
refuse treatment (A), simply telling the family this does not actively advocate. Facilitating a
family meeting ensures the client's wishes are heard and respected while addressing family
concerns. Encouraging the client to reconsider (C) undermines autonomy. Documentation (D) is
important but not the priority advocacy action.
Q2. A nurse is delegating tasks to unlicensed assistive personnel (UAP). Which task is
appropriate for the nurse to delegate?
A. Evaluating a client's response to pain medication
B. Ambulating a stable postoperative client who had surgery 3 days ago
C. Teaching a client how to use an incentive spirometer
D. Assessing a client's surgical incision for signs of infection
Correct Answer: B
Rationale: Ambulating a stable postoperative client is within UAP scope. UAPs may perform
ADLs, vital signs on stable clients, and ambulation of stable clients. Evaluation (A), teaching (C),
and assessment (D) require RN-level clinical judgment and cannot be delegated to UAP.
,Q3. A nurse is preparing a client for a colonoscopy. The client asks, "What are the risks of this
procedure?" Which response by the nurse is appropriate?
A. "I can explain the risks to you before you sign the consent."
B. "Your provider will explain the risks and benefits before you sign."
C. "You don't need to worry; this is a very safe procedure."
D. "The consent form lists all the risks in detail."
Correct Answer: B
Rationale: Informed consent is the provider's responsibility. The nurse's role is to witness
the signature and ensure the client understands. The nurse should not explain risks (A) or
provide false reassurance (C). The consent form (D) does not substitute for the provider's
explanation.
Q4. A nurse is caring for a client who has a DNR order. The client's heart stops. Which action
should the nurse take?
A. Begin CPR immediately.
B. Call a code blue and initiate resuscitation.
C. Withhold CPR and follow the DNR order.
D. Ask the family for permission to withhold CPR.
Correct Answer: C
Rationale: A DNR order is a provider's order directing healthcare personnel not to perform
CPR. The nurse must honor the DNR. Starting CPR (A, B) would violate the order. The family's
permission is not needed once a valid DNR order exists (D).
Q5. A nurse is reviewing a client's advance directives. Which document expresses the client's
wishes regarding future medical treatment but requires a provider's order to be actionable?
A. Living will
B. Durable power of attorney for healthcare
C. DNR order
D. HIPAA authorization
Correct Answer: A
, Rationale: A living will expresses the client's wishes but must be translated into a provider's
order (such as a DNR) to direct nursing action. Durable power of attorney (B) designates a
surrogate decision-maker. A DNR order (C) is the actionable provider order. HIPAA (D) addresses
privacy.
Q6. A nurse is making assignments for the shift. Which client should the nurse assign to the
most experienced RN?
A. A stable client admitted 2 days ago with pneumonia receiving oral antibiotics
B. A client admitted 1 hour ago with an acute GI bleed, BP 90/58, HR 112
C. A client postoperative day 3 with a healing incision requesting pain medication
D. A client with chronic back pain requesting assistance to the bathroom
Correct Answer: B
Rationale: Using acute vs. chronic and unstable vs. stable prioritization, the unstable GI
bleed client with hemodynamic compromise requires the most experienced RN for ongoing
assessment, IV titration, and preparation for emergent intervention. The other clients are stable
and can be cared for by less experienced staff.
Q7. A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. The
client's family insists the transfusion be given. Which action should the nurse take?
A. Administer the transfusion as the family requests.
B. Respect the client's refusal and document the decision.
C. Ask the provider to obtain a court order.
D. Delay the transfusion until the client is sedated.
Correct Answer: B
Rationale: A competent adult has the right to refuse any treatment, including life-saving
interventions. Administering blood against the client's will constitutes battery (A). A court order
(C) is only appropriate if the client lacks decision-making capacity. Delaying to sedate the client
(D) violates autonomy.
Q8. (SATA) A nurse is teaching a newly licensed nurse about the Five Rights of Delegation.
Which of the following are included? Select all that apply.
, A. Right task
B. Right circumstance
C. Right diagnosis
D. Right person
E. Right direction/communication
F. Right supervision/evaluation
Correct Answers: A, B, D, E, F
Rationale: The Five Rights of Delegation are: Right Task, Right Circumstance, Right Person,
Right Direction/Communication, and Right Supervision/Evaluation. "Right diagnosis" is not part
of delegation; diagnosis is an RN-only responsibility.
Q9. A nurse witnesses a client sign a consent form for surgery. Which action should the nurse
take?
A. Explain the procedure to the client before witnessing.
B. Verify that the provider has explained the procedure and the client understands.
C. Sign the consent form as the person who obtained consent.
D. Obtain consent from the client's spouse if the client is anxious.
Correct Answer: B
Rationale: The nurse's role is to witness the signature and verify that the provider has
explained the procedure and that the client understands. Explaining the procedure (A) is the
provider's responsibility. The nurse signs as a witness, not as the person obtaining consent (C). A
competent adult signs their own consent (D).
Q10. A nurse is preparing to administer a medication via a nasogastric tube. Which action best
ensures accurate dosing and 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 of warm water.
D. Use the plunger of the syringe to push medication rapidly through the tube.
Correct Answer: B
Rationale: Administering each medication separately with a water flush prevents drug-drug
interactions and tube clogging. Sustained-release tablets should never be crushed (A). Mixing
