ATI PN Fundamentals. Study Practical Nursing
(PN/LPN) Verified Questions and Answers
2026/2027
Elaborate Rationales GRADE A+
1. A patient recovering from total hip replacement reports sudden swelling, redness,
and tenderness in the left calf, accompanied by mild shortness of breath and anxiety.
Which action should the nurse take first?
A. Encourage ambulation and leg exercises
B. Apply warm compress and monitor
C. Document findings and reassess in 4 hours
D. Notify provider immediately for suspected deep vein thrombosis (DVT)
Rationale:
Postoperative immobility increases the risk for DVT. Swelling, redness, tenderness, and
dyspnea may indicate clot formation with potential pulmonary embolism. Immediate
notification of the provider allows for diagnostic testing and anticoagulation therapy to
prevent life-threatening complications.
2. During a home visit, an adult with type 1 diabetes reports nausea, vomiting, and
rapid, deep breathing. Blood glucose is 460 mg/dL. What complication should the nurse
suspect?
A. Diabetic ketoacidosis (DKA)
B. Hyperosmolar hyperglycemic state
C. Hypoglycemia
D. Hyponatremia
Rationale:
DKA arises from insulin deficiency, causing hyperglycemia, ketone accumulation, and
metabolic acidosis. Kussmaul respirations, fruity-smelling breath, nausea, and vomiting are
hallmark signs. Rapid initiation of IV fluids and insulin therapy prevents shock, cerebral
edema, and death.
3. A patient with chronic kidney disease presents with fatigue, palpitations, and
generalized weakness. Lab results show potassium 7.2 mEq/L. What is the priority
nursing action?
A. Encourage high-potassium foods
B. Notify provider immediately and prepare for hyperkalemia management
,C. Restrict fluids
D. Administer diuretics without provider order
Rationale:
Severe hyperkalemia can cause life-threatening cardiac arrhythmias. Prompt notification of
the provider allows interventions such as IV calcium gluconate, insulin with glucose, or
dialysis, preventing sudden cardiac arrest and ensuring patient safety.
4. A resident with a urinary catheter reports cloudy urine, burning, and increased
frequency. Which nursing action is most appropriate?
A. Notify provider and maintain a closed drainage system
B. Change the catheter daily
C. Administer antibiotics without provider order
D. Restrict fluids
Rationale:
These symptoms indicate a catheter-associated urinary tract infection. Maintaining a closed
drainage system reduces bacterial entry, and timely provider notification ensures proper
treatment to prevent progression to sepsis or kidney damage.
5. A patient recovering from abdominal surgery reports nausea, vomiting, and a firm,
distended abdomen with absent bowel sounds. What complication should the nurse
suspect?
A. Gastroenteritis
B. Constipation
C. Paralytic ileus
D. Appendicitis
Rationale:
Paralytic ileus is a temporary cessation of bowel motility often caused by anesthesia,
inflammation, or electrolyte imbalance. Early recognition allows interventions such as NPO
status, NG tube decompression, and close monitoring to prevent vomiting, aspiration, and
further gastrointestinal complications.
6. A resident on prolonged bed rest develops a red area over the sacrum that does not
blanch when pressure is applied. Which stage is this pressure injury?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Rationale:
Stage I pressure injury presents as non-blanchable erythema over bony prominences. Early
,interventions, including repositioning, pressure-relieving devices, and meticulous skin care,
prevent progression to deeper tissue damage or ulceration.
7. A patient receiving IV potassium complains of pain, redness, and swelling at the
infusion site. What is the first nursing action?
A. Assess for infiltration or phlebitis and adjust the rate per protocol
B. Increase the infusion rate to finish faster
C. Discontinue IV without replacement
D. Ignore the complaint if vital signs are stable
Rationale:
IV potassium is highly irritating to tissues. Redness and swelling may indicate infiltration or
phlebitis, which can cause tissue injury. Immediate assessment ensures safe administration,
prevents tissue damage, and maintains proper electrolyte balance.
8. A resident with COPD reports worsening dyspnea and audible wheezing despite
using a prescribed inhaler. Oxygen saturation is 81%. Which intervention is most
appropriate?
A. Delay treatment until provider visit
B. Administer prescribed short-acting bronchodilator immediately and monitor
C. Encourage slow deep breathing only
D. Discontinue inhaler
Rationale:
Persistent respiratory distress despite inhaler use indicates a severe exacerbation. Rapid
bronchodilator therapy improves airway patency and oxygenation, preventing progression to
respiratory failure. Continuous monitoring ensures patient safety.
9. During a home visit, a patient with type 2 diabetes reports extreme thirst, polyuria,
and fatigue. Blood glucose is 395 mg/dL. Which complication should the nurse suspect?
A. Hyperosmolar hyperglycemic state
B. Hypoglycemia
C. Hypokalemia
D. Hyponatremia
Rationale:
HHS is a hyperglycemic emergency marked by severe dehydration and altered mental status.
Prompt IV fluids and insulin therapy prevent organ failure, seizures, and death. Early
recognition allows timely intervention to reduce morbidity.
10. A patient recovering from surgery suddenly becomes pale, diaphoretic, and
hypotensive with a saturated surgical dressing. What is the priority nursing action?
A. Document findings
B. Reinforce dressing only
, C. Offer fluids
D. Apply pressure and call emergency response
Rationale:
Acute postoperative hemorrhage is life-threatening. Immediate application of pressure and
activation of emergency protocols prevents hypovolemic shock, organ failure, and death.
Delays can result in fatal outcomes.
11. A patient recovering from total knee replacement reports sudden swelling and
warmth in the left calf, along with shortness of breath and mild chest discomfort while
ambulating in the hallway. Which nursing action should be prioritized?
A. Encourage gentle ankle pumps and ambulation
B. Apply warm compress to the leg and monitor
C. Notify provider immediately for suspected deep vein thrombosis with possible
pulmonary embolism
D. Document findings and reassess in 4 hours
Rationale:
Postoperative immobility and orthopedic surgery increase DVT risk. Swelling, warmth, and
chest discomfort suggest a potential embolic event. Immediate provider notification ensures
rapid diagnostic testing and anticoagulation therapy, preventing life-threatening
complications like pulmonary embolism.
12. During a home visit, a patient with type 1 diabetes reports nausea, vomiting, fruity-
smelling breath, and rapid, deep breathing. Blood glucose is 480 mg/dL, and ketones
are present in urine. Which complication should the nurse suspect?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemia
D. Hyponatremia
Rationale:
DKA is caused by insulin deficiency leading to hyperglycemia, ketone accumulation, and
metabolic acidosis. Kussmaul respirations, fruity breath, and vomiting are classic signs.
Immediate intervention with IV fluids, insulin, and electrolyte replacement is essential to
prevent shock, cerebral edema, and death.
13. A patient with chronic kidney disease reports generalized weakness, palpitations,
and fatigue. Lab results reveal potassium 7.4 mEq/L, ECG shows peaked T-waves, and
blood pressure is 88/56 mmHg. What is the nurse’s priority action?
A. Encourage high-potassium foods
B. Notify provider immediately and prepare for hyperkalemia management
C. Restrict fluids
D. Administer diuretics without provider order
(PN/LPN) Verified Questions and Answers
2026/2027
Elaborate Rationales GRADE A+
1. A patient recovering from total hip replacement reports sudden swelling, redness,
and tenderness in the left calf, accompanied by mild shortness of breath and anxiety.
Which action should the nurse take first?
A. Encourage ambulation and leg exercises
B. Apply warm compress and monitor
C. Document findings and reassess in 4 hours
D. Notify provider immediately for suspected deep vein thrombosis (DVT)
Rationale:
Postoperative immobility increases the risk for DVT. Swelling, redness, tenderness, and
dyspnea may indicate clot formation with potential pulmonary embolism. Immediate
notification of the provider allows for diagnostic testing and anticoagulation therapy to
prevent life-threatening complications.
2. During a home visit, an adult with type 1 diabetes reports nausea, vomiting, and
rapid, deep breathing. Blood glucose is 460 mg/dL. What complication should the nurse
suspect?
A. Diabetic ketoacidosis (DKA)
B. Hyperosmolar hyperglycemic state
C. Hypoglycemia
D. Hyponatremia
Rationale:
DKA arises from insulin deficiency, causing hyperglycemia, ketone accumulation, and
metabolic acidosis. Kussmaul respirations, fruity-smelling breath, nausea, and vomiting are
hallmark signs. Rapid initiation of IV fluids and insulin therapy prevents shock, cerebral
edema, and death.
3. A patient with chronic kidney disease presents with fatigue, palpitations, and
generalized weakness. Lab results show potassium 7.2 mEq/L. What is the priority
nursing action?
A. Encourage high-potassium foods
B. Notify provider immediately and prepare for hyperkalemia management
,C. Restrict fluids
D. Administer diuretics without provider order
Rationale:
Severe hyperkalemia can cause life-threatening cardiac arrhythmias. Prompt notification of
the provider allows interventions such as IV calcium gluconate, insulin with glucose, or
dialysis, preventing sudden cardiac arrest and ensuring patient safety.
4. A resident with a urinary catheter reports cloudy urine, burning, and increased
frequency. Which nursing action is most appropriate?
A. Notify provider and maintain a closed drainage system
B. Change the catheter daily
C. Administer antibiotics without provider order
D. Restrict fluids
Rationale:
These symptoms indicate a catheter-associated urinary tract infection. Maintaining a closed
drainage system reduces bacterial entry, and timely provider notification ensures proper
treatment to prevent progression to sepsis or kidney damage.
5. A patient recovering from abdominal surgery reports nausea, vomiting, and a firm,
distended abdomen with absent bowel sounds. What complication should the nurse
suspect?
A. Gastroenteritis
B. Constipation
C. Paralytic ileus
D. Appendicitis
Rationale:
Paralytic ileus is a temporary cessation of bowel motility often caused by anesthesia,
inflammation, or electrolyte imbalance. Early recognition allows interventions such as NPO
status, NG tube decompression, and close monitoring to prevent vomiting, aspiration, and
further gastrointestinal complications.
6. A resident on prolonged bed rest develops a red area over the sacrum that does not
blanch when pressure is applied. Which stage is this pressure injury?
A. Stage I
B. Stage II
C. Stage III
D. Stage IV
Rationale:
Stage I pressure injury presents as non-blanchable erythema over bony prominences. Early
,interventions, including repositioning, pressure-relieving devices, and meticulous skin care,
prevent progression to deeper tissue damage or ulceration.
7. A patient receiving IV potassium complains of pain, redness, and swelling at the
infusion site. What is the first nursing action?
A. Assess for infiltration or phlebitis and adjust the rate per protocol
B. Increase the infusion rate to finish faster
C. Discontinue IV without replacement
D. Ignore the complaint if vital signs are stable
Rationale:
IV potassium is highly irritating to tissues. Redness and swelling may indicate infiltration or
phlebitis, which can cause tissue injury. Immediate assessment ensures safe administration,
prevents tissue damage, and maintains proper electrolyte balance.
8. A resident with COPD reports worsening dyspnea and audible wheezing despite
using a prescribed inhaler. Oxygen saturation is 81%. Which intervention is most
appropriate?
A. Delay treatment until provider visit
B. Administer prescribed short-acting bronchodilator immediately and monitor
C. Encourage slow deep breathing only
D. Discontinue inhaler
Rationale:
Persistent respiratory distress despite inhaler use indicates a severe exacerbation. Rapid
bronchodilator therapy improves airway patency and oxygenation, preventing progression to
respiratory failure. Continuous monitoring ensures patient safety.
9. During a home visit, a patient with type 2 diabetes reports extreme thirst, polyuria,
and fatigue. Blood glucose is 395 mg/dL. Which complication should the nurse suspect?
A. Hyperosmolar hyperglycemic state
B. Hypoglycemia
C. Hypokalemia
D. Hyponatremia
Rationale:
HHS is a hyperglycemic emergency marked by severe dehydration and altered mental status.
Prompt IV fluids and insulin therapy prevent organ failure, seizures, and death. Early
recognition allows timely intervention to reduce morbidity.
10. A patient recovering from surgery suddenly becomes pale, diaphoretic, and
hypotensive with a saturated surgical dressing. What is the priority nursing action?
A. Document findings
B. Reinforce dressing only
, C. Offer fluids
D. Apply pressure and call emergency response
Rationale:
Acute postoperative hemorrhage is life-threatening. Immediate application of pressure and
activation of emergency protocols prevents hypovolemic shock, organ failure, and death.
Delays can result in fatal outcomes.
11. A patient recovering from total knee replacement reports sudden swelling and
warmth in the left calf, along with shortness of breath and mild chest discomfort while
ambulating in the hallway. Which nursing action should be prioritized?
A. Encourage gentle ankle pumps and ambulation
B. Apply warm compress to the leg and monitor
C. Notify provider immediately for suspected deep vein thrombosis with possible
pulmonary embolism
D. Document findings and reassess in 4 hours
Rationale:
Postoperative immobility and orthopedic surgery increase DVT risk. Swelling, warmth, and
chest discomfort suggest a potential embolic event. Immediate provider notification ensures
rapid diagnostic testing and anticoagulation therapy, preventing life-threatening
complications like pulmonary embolism.
12. During a home visit, a patient with type 1 diabetes reports nausea, vomiting, fruity-
smelling breath, and rapid, deep breathing. Blood glucose is 480 mg/dL, and ketones
are present in urine. Which complication should the nurse suspect?
A. Hyperosmolar hyperglycemic state
B. Diabetic ketoacidosis (DKA)
C. Hypoglycemia
D. Hyponatremia
Rationale:
DKA is caused by insulin deficiency leading to hyperglycemia, ketone accumulation, and
metabolic acidosis. Kussmaul respirations, fruity breath, and vomiting are classic signs.
Immediate intervention with IV fluids, insulin, and electrolyte replacement is essential to
prevent shock, cerebral edema, and death.
13. A patient with chronic kidney disease reports generalized weakness, palpitations,
and fatigue. Lab results reveal potassium 7.4 mEq/L, ECG shows peaked T-waves, and
blood pressure is 88/56 mmHg. What is the nurse’s priority action?
A. Encourage high-potassium foods
B. Notify provider immediately and prepare for hyperkalemia management
C. Restrict fluids
D. Administer diuretics without provider order
