ATI PN EXIT Exam ACTUAL EXAM – Complete 80
Questions & Verified Answers Latest
Update – Already Graded A
Fundamentals of Nursing (Questions 1-10)
1. A postoperative client suddenly reports a “pop” in the incision and evisceration is
noted. The nurse should first
A. Apply sterile saline-soaked gauze and cover
B. Gently replace the organs with gloved hand
C. Remove all dressings to assess extent
D. Offer sips of water to calm the client
Correct Answer: A
Rationale: Sterile, moist dressing (A) prevents tissue drying and infection. Re-inserting
organs (B) causes trauma; removing dressings (C) increases exposure; oral intake (D) is
contraindicated pending surgical repair.
2. While transferring a client with left-sided weakness, the nurse notes the client
becomes dead weight and speech becomes slurred. Priority action is
A. Continue transfer to chair and then call for help
B. Lower client to bed and activate stroke alert
C. Take blood pressure in both arms
D. Administer oxygen via nasal cannula at 2 L/min
,Correct Answer: B
Rationale: Signs indicate acute stroke; stopping transfer and activating alert (B) ensures
rapid intervention. Continuing (A) risks injury; BP (C) and O₂ (D) are secondary to timely
stroke-team activation.
3. A client’s morning oral temperature is 35.8 °C (96.4 °F). The PN should
A. Record the finding and continue to monitor
B. Immediately place warming blanket
C. Recheck temperature rectally
D. Notify provider of severe hypothermia
Correct Answer: A
Rationale: 35.8 °C is low-normal and may reflect environmental cooling; monitoring (A)
suffices. Warming (B) and rectal recheck (C) are unnecessary; severe hypothermia is <
32 °C (D).
4. The nurse notes bright-red blood in the suction tubing of a client with a
nasogastric tube. Which action is appropriate?
A. Irrigate the tube with ice water
B. Immediately remove the NG tube
C. Slow the suction and notify the provider
D. Document and reassess in 1 hour
Correct Answer: C
Rationale: Fresh blood suggests gastric irritation or bleeding; slowing suction (C)
reduces mucosal trauma while awaiting provider evaluation. Ice water (A) can worsen
mucosal damage; removing tube (B) loses access; delaying (D) is unsafe.
, 5. A client on contact precautions asks to attend a group physical-therapy session.
The appropriate response is
A. “You may go if you wear a mask.”
B. “Let me check your vital signs first.”
C. “You must remain in your room to prevent spread.”
D. “I will ask the therapist to come here.”
Correct Answer: C
Rationale: Contact precautions require room confinement to prevent pathogen
transmission; no mask requirement (A) suffices for contact spread; vital signs (B)
irrelevant; in-room therapy (D) still risks contaminating equipment.
6. The nurse delegates vital-sign measurement to assistive personnel (AP) for
which client?
A. Post–total laryngectomy 4 hours ago
B. New admission with chest pain
C. Stable client 2 days post-appendectomy
D. Client with new-onset confusion
Correct Answer: C
Rationale: Stable post-op client (C) is appropriate for AP. New surgery (A), chest pain
(B), and acute change in neuro status (D) require licensed assessment.
7. A client complains of dizziness when standing. The nurse suspects orthostatic
hypotension and should
A. Measure BP supine, sitting, and standing
B. Encourage rapid position changes to build tolerance
, C. Offer orange juice with sugar
D. Apply compression stockings before rising
Correct Answer: A
Rationale: Orthostatic vitals (A) confirm diagnosis. Rapid changes (B) risk falls; orange
juice (C) addresses hypoglycemia, not hypotension; stockings (D) are preventive but
measurement precedes intervention.
8. The nurse prepares to insert an indwelling urinary catheter. Which step ensures
sterility?
A. Cleanse the meatus with same swab three times
B. Place the sterile drape with top edge touching bed
C. Keep the drainage bag port above bladder level during insertion
D. Maintain the catheter tip in sterile field until insertion
Correct Answer: D
Rationale: Tip sterility (D) prevents UTI. Re-using swab (A) contaminates; drape edge (B)
is unsterile; bag below bladder (C) prevents reflux but is post-insertion.
9. A client with dysphagia is prescribed thickened liquids. The nurse notes slight
cough after swallow test. Next action is
A. Advance to thin liquids to confirm aspiration
B. Keep head-of-bed flat to prevent reflux
C. Reassess swallowing before each meal
D. Offer ice chips to soothe throat
Correct Answer: C
Questions & Verified Answers Latest
Update – Already Graded A
Fundamentals of Nursing (Questions 1-10)
1. A postoperative client suddenly reports a “pop” in the incision and evisceration is
noted. The nurse should first
A. Apply sterile saline-soaked gauze and cover
B. Gently replace the organs with gloved hand
C. Remove all dressings to assess extent
D. Offer sips of water to calm the client
Correct Answer: A
Rationale: Sterile, moist dressing (A) prevents tissue drying and infection. Re-inserting
organs (B) causes trauma; removing dressings (C) increases exposure; oral intake (D) is
contraindicated pending surgical repair.
2. While transferring a client with left-sided weakness, the nurse notes the client
becomes dead weight and speech becomes slurred. Priority action is
A. Continue transfer to chair and then call for help
B. Lower client to bed and activate stroke alert
C. Take blood pressure in both arms
D. Administer oxygen via nasal cannula at 2 L/min
,Correct Answer: B
Rationale: Signs indicate acute stroke; stopping transfer and activating alert (B) ensures
rapid intervention. Continuing (A) risks injury; BP (C) and O₂ (D) are secondary to timely
stroke-team activation.
3. A client’s morning oral temperature is 35.8 °C (96.4 °F). The PN should
A. Record the finding and continue to monitor
B. Immediately place warming blanket
C. Recheck temperature rectally
D. Notify provider of severe hypothermia
Correct Answer: A
Rationale: 35.8 °C is low-normal and may reflect environmental cooling; monitoring (A)
suffices. Warming (B) and rectal recheck (C) are unnecessary; severe hypothermia is <
32 °C (D).
4. The nurse notes bright-red blood in the suction tubing of a client with a
nasogastric tube. Which action is appropriate?
A. Irrigate the tube with ice water
B. Immediately remove the NG tube
C. Slow the suction and notify the provider
D. Document and reassess in 1 hour
Correct Answer: C
Rationale: Fresh blood suggests gastric irritation or bleeding; slowing suction (C)
reduces mucosal trauma while awaiting provider evaluation. Ice water (A) can worsen
mucosal damage; removing tube (B) loses access; delaying (D) is unsafe.
, 5. A client on contact precautions asks to attend a group physical-therapy session.
The appropriate response is
A. “You may go if you wear a mask.”
B. “Let me check your vital signs first.”
C. “You must remain in your room to prevent spread.”
D. “I will ask the therapist to come here.”
Correct Answer: C
Rationale: Contact precautions require room confinement to prevent pathogen
transmission; no mask requirement (A) suffices for contact spread; vital signs (B)
irrelevant; in-room therapy (D) still risks contaminating equipment.
6. The nurse delegates vital-sign measurement to assistive personnel (AP) for
which client?
A. Post–total laryngectomy 4 hours ago
B. New admission with chest pain
C. Stable client 2 days post-appendectomy
D. Client with new-onset confusion
Correct Answer: C
Rationale: Stable post-op client (C) is appropriate for AP. New surgery (A), chest pain
(B), and acute change in neuro status (D) require licensed assessment.
7. A client complains of dizziness when standing. The nurse suspects orthostatic
hypotension and should
A. Measure BP supine, sitting, and standing
B. Encourage rapid position changes to build tolerance
, C. Offer orange juice with sugar
D. Apply compression stockings before rising
Correct Answer: A
Rationale: Orthostatic vitals (A) confirm diagnosis. Rapid changes (B) risk falls; orange
juice (C) addresses hypoglycemia, not hypotension; stockings (D) are preventive but
measurement precedes intervention.
8. The nurse prepares to insert an indwelling urinary catheter. Which step ensures
sterility?
A. Cleanse the meatus with same swab three times
B. Place the sterile drape with top edge touching bed
C. Keep the drainage bag port above bladder level during insertion
D. Maintain the catheter tip in sterile field until insertion
Correct Answer: D
Rationale: Tip sterility (D) prevents UTI. Re-using swab (A) contaminates; drape edge (B)
is unsterile; bag below bladder (C) prevents reflux but is post-insertion.
9. A client with dysphagia is prescribed thickened liquids. The nurse notes slight
cough after swallow test. Next action is
A. Advance to thin liquids to confirm aspiration
B. Keep head-of-bed flat to prevent reflux
C. Reassess swallowing before each meal
D. Offer ice chips to soothe throat
Correct Answer: C
