ATI Fundamentals Proctored Assessment 2026: In-Depth Exam Preparation Guide with Quizzes and Rationales

A nurse is caring for a client following a laparoscopic cholecystectomy. The client has a prescription for ondansetron 4 mg IV bolus every 6 hr PRN for nausea and vomiting. Identify the sequence of steps the nurse should follow to administer the medication. a. Select the injection port of the IV tubing closest to the client b. Cleanse the injection port with an antiseptic swab c. Aspirate for blood return d. Inject the medication e. Perform hand hygiene Correct sequence: e, a, b, c, d Rationale: Hand hygiene is performed first to prevent infection. The port closest to the client is selected, then cleansed to reduce contamination. Aspirating confirms IV patency before safely injecting the medication. A nurse is teaching a client who has diabetes mellitus about mixing regular and NPH insulin. Which statement by the client indicates understanding of the teaching? a. I should wait 3 minutes after mixing the insulin to inject it b. I should draw up the NPH insulin before regular insulin c. I should inject air into the vial of regular insulin first d. I should roll the vial of NPH insulin between my hands before drawing it up Rationale: NPH insulin is cloudy and must be gently rolled to mix it evenly. Regular insulin is drawn up before NPH, and injections should not be delayed after mixing. A nurse is assessing the body temperature of an adult client using a temporal artery thermometer. Which actions should the nurse take? (Select all that apply) a. Slide the probe across the client’s forehead b. Pull the client’s pinna up and back c. Hold the client’s hair aside while performing the procedure d. Document the client’s temperature with “AX” e. Move the probe in a circular motion Rationale: Temporal artery thermometers require sliding the probe across the forehead and ensuring hair does not interfere. Pulling the pinna and circular motion are incorrect techniques. A nurse is preparing to insert a peripheral IV catheter into the client’s arm. Which action should the nurse take to help dilate the vein? a. Stroke the skin near the vein upward b. Dangle the client’s arm over the edge of the bed c. Apply a cool compress d. Instruct the client to flex the arm Rationale: Dangling the arm promotes venous filling by gravity. Cool compresses constrict veins, and flexing increases vein movement. A nurse is preparing to suction a client’s tracheostomy tube. Which action should the nurse plan to take? a. Apply intermittent suction during catheter insertion b. Suction for 20 seconds per pass c. Hyperoxygenate manually for 30–60 seconds d. Decrease suction pressure if oxygen saturation drops Rationale: Intermittent suction prevents mucosal damage. Suction should not exceed 10–15 seconds, and oxygen should be administered before and after suctioning. A nurse is assessing a client who received morphine 30 minutes ago. Which finding is the priority? a. Last bowel movement was 3 days ago b. Reports pain of 8/10 c. Distended bladder d. Respiratory rate of 7/min Rationale: Respiratory depression is a life-threatening adverse effect of opioids and requires immediate intervention. A nurse is caring for a client treated multiple times for STIs. Which response should the nurse take? a. You must have too many sexual partners b. Why do you keep letting this happen? c. Let’s explore why this might be recurring d. Don’t you have access to condoms? Rationale: This response is therapeutic and nonjudgmental, encouraging discussion and education without placing blame. A nurse enters the room of a client with a seizure disorder who begins to seize while seated. Which action should the nurse take first? a. Move objects away b. Turn the client on their side c. Help the client lie on the floor d. Loosen clothing Rationale: Safely lowering the client to the floor prevents injury. Other actions follow once safety is ensured. A nurse is performing Weber’s test to assess conduction deafness. Which action should the nurse take? a. Place the tuning fork near each ear b. Place the tuning fork on the mastoid c. Place the tuning fork on the top of the client’s head d. Measure how long the sound is heard Rationale: Weber’s test requires placing the vibrating tuning fork at the midline of the skull. A nurse is obtaining a medication history. Which medication interacts adversely with ginkgo biloba? a. Warfarin b. Albuterol c. Levothyroxine d. Atorvastatin Rationale: Ginkgo increases bleeding risk and can potentiate anticoagulants like warfarin. A nurse is obtaining informed consent. The client refuses surgery. Which action should the nurse take? a. Discuss alternatives b. Explain risks c. Express approval d. Document the decision in the medical record Rationale: Clients have the right to refuse treatment. The nurse must document the refusal and notify the provider. A nurse is teaching a client how to reduce adverse effects of immobility. Which statement shows understanding? a. Change position every 4 hours b. Remove antiembolic stockings c. Hold breath when standing d. Perform ankle and knee exercises every hour Rationale: Frequent exercises promote circulation and prevent complications such as DVT. A nurse is advancing a postoperative client to a full liquid diet. Which food is appropriate? a. Oatmeal b. Applesauce c. Scrambled eggs d. Plain yogurt Rationale: Full liquids include dairy products like yogurt but exclude solid or semi-solid foods. A nurse is preparing a terminally ill client for discharge. Which question assesses psychosocial coping? a. Current medications b. Pain level c. Family cancer history d. What techniques do you use to cope with stress? Rationale: This question assesses emotional coping mechanisms and support needs. A nurse is performing a skin assessment on an older adult. Which finding is expected? a. Thickened epidermis b. Increased elasticity c. Reduced sweat production d. Increased oil production Rationale: Aging skin produces less sweat and oil, increasing dryness and heat intolerance. A nurse is caring for a client newly diagnosed with cancer who begins crying. Which response is appropriate? a. Get a second opinion b. Things will get better c. It must be difficult to receive this news d. Speak with the chaplain Rationale: This response acknowledges the client’s feelings without minimizing emotions. A nurse is preparing to obtain a health history. Which action should the nurse take? a. Use first name immediately b. Explain the purpose of collecting information c. Demand full disclosure d. Avoid direct quotes Rationale: Explaining purpose builds trust and encourages accurate communication. A nurse is caring for a client transferring to hospice care. Which response to the client’s son is appropriate? a. Let’s talk more about your dad’s condition b. Refer to social worker c. Encourage enjoyment d. Refer to hospice nurse Rationale: This response opens communication and provides emotional support. A nurse is confirming client identity before medication administration. Which data should be used? a. Room number b. Diagnosis c. Next of kin d. Telephone number Rationale: Unique identifiers such as telephone number or date of birth are acceptable identifiers. A nurse is planning care for a client with financial difficulty following a prescribed diet. Who should be notified? a. Social worker b. Occupational therapist c. Dietitian d. Provider Rationale: Social workers assist with financial and community resource needs. A nurse is teaching about MRSA precautions. Which statement shows understanding? a. I will place the client in a private room b. Remove gown before gloves c. Wear N95 respirator d. Visitors wear masks Rationale: Contact precautions and private rooms reduce MRSA transmission. A nurse is planning care for a client with a latex allergy. Which intervention is appropriate? a. Cover BP cuff with stockinette b. Use powdered gloves c. Apply adhesive tape d. Use glass syringes Rationale: Stockinettes create a barrier between latex-containing equipment and the client. A nurse witnesses informed consent. The client does not understand the procedure. What should the nurse do? a. Explain the surgery b. Notify the provider c. Complete incident report d. Provide brochures Rationale: The provider is responsible for explaining procedures and answering questions before consent.