ATI FUNDAMENTALS EXAM MASTER
PACK 2026 2027 QUESTIONS
ANSWERS AND RATIONALES
ATI PN Fundamentals Practice Exam
1. A licensed practical nurse (LPN) is reviewing tasks to delegate to an assistive
personnel (AP). Which of the following client assignments should the nurse delegate
to the AP?
A. Reinforcing teaching with a client on how to use an incentive spirometer.
B. Performing a sterile dressing change on a client’s stage 3 pressure injury.
C. Obtaining a routine, non-fasting blood glucose measurement for a stable client.
D. Completing the initial head-to-toe physical assessment on a newly admitted
client.
CORRECT ANSWER: C
RATiONAlE: Obtaining a routine capillary blood glucose reading on a
stable client is a standardized, non-invasive procedural task that falls within the
established scope of training for assistive personnel. Task delegation must follow
safe nursing practice guidelines. Assessment (D), sterile wound care procedures (B),
and client teaching or reinforcement of care instructions (A) all require higher-level
clinical evaluation, interpretation, and judgment, which are strictly reserved for
licensed nursing professionals.
2. A nurse is caring for an older adult client who has developed fecal incontinence.
Which of the following interventions should the nurse implement first to maintain
skin integrity?
A. Apply a thick layer of oil-based zinc oxide ointment to the perineal area.
B. Cleanse the perineal skin with warm water and a mild, non-soap surfactant
, immediately after each episode.
C. Insert an indwelling fecal management system to collect loose stools.
D. Request a prescription from the provider for an oral antidiarrheal medication.
CORRECT ANSWER: B
RATiONAlE: The primary action in preventing skin breakdown due to fecal
incontinence is the rapid and gentle removal of stool. Fecal matter contains
enzymes that quickly break down the stratum corneum, so immediately cleansing
the skin with warm water and a soap-free cleanser is the priority. Applying barrier
creams (A) is beneficial but should only happen after the skin is clean and dry.
Incontinence devices (C) present serious structural risks and are not a first-line
preventive measure, and antidiarrheals (D) require a provider's diagnosis.
3. A nurse is preparing to administer an intramuscular (IM) injection to an adult client
who weighs 142 lb (64.4 kg). Which of the following combinations of needle gauge,
needle length, and anatomical site represents the safest practice?
A. 25-gauge, 5/8-inch needle injected into the deltoid muscle.
B. 22-gauge, 1.5-inch needle injected into the ventrogluteal muscle.
C. 18-gauge, 1-inch needle injected into the vastus lateralis muscle.
D. 23-gauge, 1-inch needle injected into the dorsogluteal muscle.
CORRECT ANSWER: B
RATiONAlE: The ventrogluteal site is the safest and preferred anatomical
choice for deep intramuscular injections in adults because it lacks major blood
vessels and significant nerves, and has a deep muscle layer. For a standard adult
client, a 21- to 23-gauge, 1.5-inch needle ensures the medication goes deep into the
ventrogluteal muscle matrix rather than subcutaneous tissue. A 5/8-inch needle (A)
is too short for deep IM delivery in the deltoid unless the client is emaciated. An 18-
gauge needle (C) is too large and causes unnecessary tissue damage. The
dorsogluteal site (D) is highly discouraged due to its close proximity to the sciatic
nerve.
4. A nurse is reviewing a client's advance directives. The client states, "I want my
daughter to make all healthcare decisions for me if I become too weak to speak for
myself." The nurse should recognize that the client is referring to which of the
following legal documents?
A. A Living Will
, B. An Informed Consent Waiver
C. A Durable Power of Attorney for Healthcare
D. A Provider's Do Not Resuscitate (DNR) Order
CORRECT ANSWER: C
RATiONAlE: A Durable Power of Attorney for Healthcare (also known as a
healthcare proxy or surrogate designation) is a legal document that designates a
specific individual to make medical treatment decisions on a client's behalf if they
lose decision-making capacity. A living will (A) specifies a client's concrete choices
regarding future life-prolonging treatments but does not appoint a person to speak
for them. Informed consent (B) validates understanding of a specific procedure, and
a DNR order (D) is a provider's directive regarding cardiopulmonary resuscitation.
5. A nurse is planning care for a client who is at risk for developing deep vein
thrombosis (DVT) postoperatively. Which of the following nursing interventions
should the nurse include in the plan of care?
A. Massage the client's calves daily to stimulate localized venous blood flow.
B. Instruct the client to sit with their knees crossed while resting in a chair.
C. Place a pillow directly behind the client's knees when resting in bed.
D. Encourage frequent, regular ankle pumping and foot circles while in bed.
CORRECT ANSWER: D
RATiONAlE: Active calf muscle contractions via ankle pumping,
dorsiflexion, and foot circles mimic the natural venous pump mechanism, which
increases venous return and prevents the blood stasis that leads to DVT. Massaging
the lower extremities (A) is contraindicated because it can dislodge an existing,
undetected thrombus. Crossing the knees (B) or putting a pillow directly behind the
knees (C) compresses the popliteal vessels, restricts venous flow, and increases
thromboembolism risks.
6. A nurse is preparing to insert an indwelling urinary catheter for a female client.
Which of the following actions must the nurse perform to maintain strict surgical
asepsis?
A. Use clean diagnostic examination gloves during the peri-care and insertion
process.
B. Cleanse the labia using a back-and-forth scrubbing motion with the antiseptic
swabs.
, C. Open the outer wrapper of the sterile catheter kit package away from the body
first.
D. Keep the catheter drainage bag resting securely on the floor alongside the bed
framework.
CORRECT ANSWER: C
RATiONAlE: When opening a sterile field or kit, the top flap of the outer
wrapper must always be opened away from the body first to prevent the nurse's
unsterile arms from crossing directly over the sterile contents. Sterile gloves are
mandatory for catheter insertion (A). The perineal area must be cleansed from front
to back (anterior to posterior) using a single downward stroke per swab to avoid
introducing rectal bacteria into the urethra (B). The drainage bag must never touch
the floor (D) because this introduces severe cross-contamination risks.
7. A nurse is caring for an older adult client who is experiencing generalized pruritus
and dry skin. Which of the following actions should the nurse take?
A. Bathe the client daily with hot water and antibacterial soap.
B. Apply alcohol-based lotions generously to the skin surfaces immediately after a
shower.
C. Add moisturizing oil directly into a warm bath before the client steps inside.
D. Use a non-soap, hydrating cleanser and apply an emollient cream within 3
minutes of drying.
CORRECT ANSWER: D
RATiONAlE: Older adults have reduced sebum production and thin, fragile
skin. Using a mild, non-soap hydrating cleanser prevents stripping the natural lipid
barrier. Applying an emollient cream within 3 minutes after bathing seals in residual
surface moisture before it evaporates. Hot water and harsh antibacterial soaps (A)
worsen xerosis. Alcohol-based lotions (B) dry out the skin tissue. Adding bath oils
directly to water (C) creates a major fall hazard on slick tub surfaces.
8. A nurse is assessing a client who has a prescription for mechanical wrist restraints.
Which of the following findings indicates a complication of the restraint device?
A. A capillary refill time of 4 seconds in the client's fingers.
B. The ability to insert two fingers easily between the restraint strap and the wrist.
C. Radial pulses that are palpable and regular at 72/min.
D. Smooth skin temperature that is warm and symmetric bilaterally.
PACK 2026 2027 QUESTIONS
ANSWERS AND RATIONALES
ATI PN Fundamentals Practice Exam
1. A licensed practical nurse (LPN) is reviewing tasks to delegate to an assistive
personnel (AP). Which of the following client assignments should the nurse delegate
to the AP?
A. Reinforcing teaching with a client on how to use an incentive spirometer.
B. Performing a sterile dressing change on a client’s stage 3 pressure injury.
C. Obtaining a routine, non-fasting blood glucose measurement for a stable client.
D. Completing the initial head-to-toe physical assessment on a newly admitted
client.
CORRECT ANSWER: C
RATiONAlE: Obtaining a routine capillary blood glucose reading on a
stable client is a standardized, non-invasive procedural task that falls within the
established scope of training for assistive personnel. Task delegation must follow
safe nursing practice guidelines. Assessment (D), sterile wound care procedures (B),
and client teaching or reinforcement of care instructions (A) all require higher-level
clinical evaluation, interpretation, and judgment, which are strictly reserved for
licensed nursing professionals.
2. A nurse is caring for an older adult client who has developed fecal incontinence.
Which of the following interventions should the nurse implement first to maintain
skin integrity?
A. Apply a thick layer of oil-based zinc oxide ointment to the perineal area.
B. Cleanse the perineal skin with warm water and a mild, non-soap surfactant
, immediately after each episode.
C. Insert an indwelling fecal management system to collect loose stools.
D. Request a prescription from the provider for an oral antidiarrheal medication.
CORRECT ANSWER: B
RATiONAlE: The primary action in preventing skin breakdown due to fecal
incontinence is the rapid and gentle removal of stool. Fecal matter contains
enzymes that quickly break down the stratum corneum, so immediately cleansing
the skin with warm water and a soap-free cleanser is the priority. Applying barrier
creams (A) is beneficial but should only happen after the skin is clean and dry.
Incontinence devices (C) present serious structural risks and are not a first-line
preventive measure, and antidiarrheals (D) require a provider's diagnosis.
3. A nurse is preparing to administer an intramuscular (IM) injection to an adult client
who weighs 142 lb (64.4 kg). Which of the following combinations of needle gauge,
needle length, and anatomical site represents the safest practice?
A. 25-gauge, 5/8-inch needle injected into the deltoid muscle.
B. 22-gauge, 1.5-inch needle injected into the ventrogluteal muscle.
C. 18-gauge, 1-inch needle injected into the vastus lateralis muscle.
D. 23-gauge, 1-inch needle injected into the dorsogluteal muscle.
CORRECT ANSWER: B
RATiONAlE: The ventrogluteal site is the safest and preferred anatomical
choice for deep intramuscular injections in adults because it lacks major blood
vessels and significant nerves, and has a deep muscle layer. For a standard adult
client, a 21- to 23-gauge, 1.5-inch needle ensures the medication goes deep into the
ventrogluteal muscle matrix rather than subcutaneous tissue. A 5/8-inch needle (A)
is too short for deep IM delivery in the deltoid unless the client is emaciated. An 18-
gauge needle (C) is too large and causes unnecessary tissue damage. The
dorsogluteal site (D) is highly discouraged due to its close proximity to the sciatic
nerve.
4. A nurse is reviewing a client's advance directives. The client states, "I want my
daughter to make all healthcare decisions for me if I become too weak to speak for
myself." The nurse should recognize that the client is referring to which of the
following legal documents?
A. A Living Will
, B. An Informed Consent Waiver
C. A Durable Power of Attorney for Healthcare
D. A Provider's Do Not Resuscitate (DNR) Order
CORRECT ANSWER: C
RATiONAlE: A Durable Power of Attorney for Healthcare (also known as a
healthcare proxy or surrogate designation) is a legal document that designates a
specific individual to make medical treatment decisions on a client's behalf if they
lose decision-making capacity. A living will (A) specifies a client's concrete choices
regarding future life-prolonging treatments but does not appoint a person to speak
for them. Informed consent (B) validates understanding of a specific procedure, and
a DNR order (D) is a provider's directive regarding cardiopulmonary resuscitation.
5. A nurse is planning care for a client who is at risk for developing deep vein
thrombosis (DVT) postoperatively. Which of the following nursing interventions
should the nurse include in the plan of care?
A. Massage the client's calves daily to stimulate localized venous blood flow.
B. Instruct the client to sit with their knees crossed while resting in a chair.
C. Place a pillow directly behind the client's knees when resting in bed.
D. Encourage frequent, regular ankle pumping and foot circles while in bed.
CORRECT ANSWER: D
RATiONAlE: Active calf muscle contractions via ankle pumping,
dorsiflexion, and foot circles mimic the natural venous pump mechanism, which
increases venous return and prevents the blood stasis that leads to DVT. Massaging
the lower extremities (A) is contraindicated because it can dislodge an existing,
undetected thrombus. Crossing the knees (B) or putting a pillow directly behind the
knees (C) compresses the popliteal vessels, restricts venous flow, and increases
thromboembolism risks.
6. A nurse is preparing to insert an indwelling urinary catheter for a female client.
Which of the following actions must the nurse perform to maintain strict surgical
asepsis?
A. Use clean diagnostic examination gloves during the peri-care and insertion
process.
B. Cleanse the labia using a back-and-forth scrubbing motion with the antiseptic
swabs.
, C. Open the outer wrapper of the sterile catheter kit package away from the body
first.
D. Keep the catheter drainage bag resting securely on the floor alongside the bed
framework.
CORRECT ANSWER: C
RATiONAlE: When opening a sterile field or kit, the top flap of the outer
wrapper must always be opened away from the body first to prevent the nurse's
unsterile arms from crossing directly over the sterile contents. Sterile gloves are
mandatory for catheter insertion (A). The perineal area must be cleansed from front
to back (anterior to posterior) using a single downward stroke per swab to avoid
introducing rectal bacteria into the urethra (B). The drainage bag must never touch
the floor (D) because this introduces severe cross-contamination risks.
7. A nurse is caring for an older adult client who is experiencing generalized pruritus
and dry skin. Which of the following actions should the nurse take?
A. Bathe the client daily with hot water and antibacterial soap.
B. Apply alcohol-based lotions generously to the skin surfaces immediately after a
shower.
C. Add moisturizing oil directly into a warm bath before the client steps inside.
D. Use a non-soap, hydrating cleanser and apply an emollient cream within 3
minutes of drying.
CORRECT ANSWER: D
RATiONAlE: Older adults have reduced sebum production and thin, fragile
skin. Using a mild, non-soap hydrating cleanser prevents stripping the natural lipid
barrier. Applying an emollient cream within 3 minutes after bathing seals in residual
surface moisture before it evaporates. Hot water and harsh antibacterial soaps (A)
worsen xerosis. Alcohol-based lotions (B) dry out the skin tissue. Adding bath oils
directly to water (C) creates a major fall hazard on slick tub surfaces.
8. A nurse is assessing a client who has a prescription for mechanical wrist restraints.
Which of the following findings indicates a complication of the restraint device?
A. A capillary refill time of 4 seconds in the client's fingers.
B. The ability to insert two fingers easily between the restraint strap and the wrist.
C. Radial pulses that are palpable and regular at 72/min.
D. Smooth skin temperature that is warm and symmetric bilaterally.
