ATI ProcTored exAm 283 (NUr 283)
comPreheNsIve sTUdy GUIde &
QUesTIoN BANk (WITh vAlIdATed
ANsWers & rATIoNAles)UPdATed 2026-
2027
Pass your ATI Proctored Exam 283 (NUR 283) on the first attempt with this comprehensive high-
yield question bank. Features 100+ realistic multiple-choice questions mapped directly to the
official ATI Transition to RN Practice curriculum. Includes exact bolded answers and targeted,
single-concept rationales emphasizing the ABC framework, safety priorities, maternal-newborn,
dosage calculations, and critical pharmacology toxicity. Perfect for achieving an ATI Level 3.
1. Which of the following client assignments should a charge nurse assign to an assistive
personnel (AP)?
A. Feeding a client who has dysphagia following a stroke
B. Transporting a client who is stable to the radiology department
C. Teaching a client how to perform post-operative deep breathing exercises
D. Re-evaluating a client's pain scale after pain medication administration
Rationale
• Transporting a stable client to a diagnostic test is within the standard scope of practice
for an assistive personnel because it involves a routine, predictable task that requires no
clinical judgment or specialized nursing assessment.
2. A nurse is caring for a client who is post-operative following an abdominal surgery.
Which of the following findings is the priority for the nurse to report to the provider?
A. Incisional pain rated as 6 on a scale of 0 to 10
B. A sudden, sharp cough followed by a gush of serosanguineous fluid from the wound
C. Absence of bowel sounds in all four quadrants
D. A capillary refill time of 2 seconds
Rationale
• A sudden gush of serosanguineous fluid coupled with a sharp cough indicates wound
dehiscence or evisceraion, which is a surgical emergency that requires immediate
provider notification and emergency nursing intervention to protect exposed organs.
, 3. A nurse is caring for a client who is receiving a continuous intravenous infusion of
heparin. Which of the following laboratory values should the nurse monitor to evaluate
the effectiveness of this medication?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Rationale
• The activated partial thromboplastin time is the standard therapeutic laboratory
parameter used to monitor and adjust unfractionated heparin infusions to ensure the
client remains within a safe anticoagulation range.
4. A nurse is preparing to administer digoxin to a client. Which of the following actions
must the nurse take prior to administering the medication?
A. Assess the client's deep tendon reflexes
B. Auscultate the apical pulse for 1 full minute
C. Check the client's blood glucose level
D. Measure the client's urine output for the past shift
Rationale
• Digoxin decreases the heart rate via vagal stimulation; therefore, the nurse must count
the apical pulse for a full 60 seconds and withhold the medication if the heart rate is
below the designated threshold, which is typically 60 beats per minute for an adult.
5. A nurse is reviewing the arterial blood gas (ABG) results for a client who has been
vomiting for 24 hours. The results are: pH 7.48, PaCO2 40 mmHg, HCO3 30 mEq/L.
Which of the following acid-base imbalances is the client experiencing?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Rationale
• An elevated pH above 7.45 indicates alkalosis, and an elevated HCO3 above 26 mEq/L
indicates a metabolic origin, which is consistent with the loss of gastric acid through
prolonged vomiting.
6. A nurse is caring for a client who has a deep vein thrombosis (DVT) in the left lower
extremity. Which of the following interventions should the nurse implement?
, A. Massage the affected calf muscle daily
B. Apply cold compresses to the left leg twice daily
C. Elevate the affected leg above the level of the heart
D. Restrict the client's oral fluid intake to 1 liter per day
Rationale
• Elevating the affected extremity above the heart level promotes venous return,
decreases local venous hydrostatic pressure, and significantly reduces the edema and
discomfort associated with a deep vein thrombosis.
7. A nurse is caring for a client who has a prescription for a premium total parenteral
nutrition (TPN) solution. The current TPN bag is empty, and the next bag is not yet
available from the pharmacy. Which of the following actions should the nurse take?
A. Flush the central line with heparinized saline and clamp it
B. Hang a bag of lactated Ringer's solution at the same rate
C. Infuse 10% dextrose in water at the same infusion rate
D. Discontinue the intravenous access site entirely
Rationale
• Abruptly stopping a high-concentration dextrose TPN solution can cause severe rebound
hypoglycemia; infusing 10% dextrose in water at the prescribed rate maintains
circulating blood glucose levels until the new TPN solution arrives.
8. A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. Which of the
following situations does this finding indicate?
A. The system is functioning normally
B. The client's lung has fully re-expanded
C. There is an air leak in the system
D. The suction pressure is set too low
Rationale
• Continuous bubbling in the water-seal chamber indicates that atmospheric air is entering
the closed system, signaling a leak along the chest tube connections or at the insertion
site that requires immediate troubleshooting.
9. A nurse is preparing to perform tracheostomy care for a client. Which of the following
actions should the nurse plan to take?
A. Wash the inner cannula with hot tap water
B. Secure the new ties before removing the old ties
, C. Hyperoxygenate the client with 100% oxygen prior to suctioning
D. Cleanse the stoma site using a firm, circular scrubbing motion
Rationale
• Suctioning transiently removes oxygen from the respiratory tract; hyperoxygenating the
client with 100% oxygen before beginning the procedure prevents hypoxemia and
associated cardiac dysrhythmias.
10. A nurse is assessing a client who has left-sided heart failure. Which of the following
clinical manifestations should the nurse expect?
A. Jugular venous distention
B. Dependent edema in the lower extremities
C. Crackles upon pulmonary auscultation
D. Hepatomegaly
Rationale
• Left-sided heart failure causes blood to back up into the pulmonary veins and capillaries,
raising hydrostatic pressure and forcing fluid into the alveoli, which produces
adventitious crackles during auscultation.
11. A nurse is caring for a client who has a new prescription for lithium carbonate to treat
bipolar disorder. Which of the following dietary instructions should the nurse provide to
the client?
A. Limit sodium intake to less than 1 gram per day
B. Maintain a consistent intake of dietary sodium
C. Restrict fluid intake to 1.5 liters per day
D. Avoid foods high in potassium
Rationale
• Lithium is a salt that is processed by the kidneys in a manner identical to sodium;
lowering sodium intake or becoming dehydrated causes the kidneys to retain lithium,
rapidly leading to toxicity.
12. A nurse is planning care for a client who is on airborne precautions. Which of the
following personal protective equipment (PPE) must the nurse don prior to entering the
client's room?
A. A standard surgical mask
B. An N95 respirator
C. A fluid-resistant gown
D. Face shield or goggles
comPreheNsIve sTUdy GUIde &
QUesTIoN BANk (WITh vAlIdATed
ANsWers & rATIoNAles)UPdATed 2026-
2027
Pass your ATI Proctored Exam 283 (NUR 283) on the first attempt with this comprehensive high-
yield question bank. Features 100+ realistic multiple-choice questions mapped directly to the
official ATI Transition to RN Practice curriculum. Includes exact bolded answers and targeted,
single-concept rationales emphasizing the ABC framework, safety priorities, maternal-newborn,
dosage calculations, and critical pharmacology toxicity. Perfect for achieving an ATI Level 3.
1. Which of the following client assignments should a charge nurse assign to an assistive
personnel (AP)?
A. Feeding a client who has dysphagia following a stroke
B. Transporting a client who is stable to the radiology department
C. Teaching a client how to perform post-operative deep breathing exercises
D. Re-evaluating a client's pain scale after pain medication administration
Rationale
• Transporting a stable client to a diagnostic test is within the standard scope of practice
for an assistive personnel because it involves a routine, predictable task that requires no
clinical judgment or specialized nursing assessment.
2. A nurse is caring for a client who is post-operative following an abdominal surgery.
Which of the following findings is the priority for the nurse to report to the provider?
A. Incisional pain rated as 6 on a scale of 0 to 10
B. A sudden, sharp cough followed by a gush of serosanguineous fluid from the wound
C. Absence of bowel sounds in all four quadrants
D. A capillary refill time of 2 seconds
Rationale
• A sudden gush of serosanguineous fluid coupled with a sharp cough indicates wound
dehiscence or evisceraion, which is a surgical emergency that requires immediate
provider notification and emergency nursing intervention to protect exposed organs.
, 3. A nurse is caring for a client who is receiving a continuous intravenous infusion of
heparin. Which of the following laboratory values should the nurse monitor to evaluate
the effectiveness of this medication?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Rationale
• The activated partial thromboplastin time is the standard therapeutic laboratory
parameter used to monitor and adjust unfractionated heparin infusions to ensure the
client remains within a safe anticoagulation range.
4. A nurse is preparing to administer digoxin to a client. Which of the following actions
must the nurse take prior to administering the medication?
A. Assess the client's deep tendon reflexes
B. Auscultate the apical pulse for 1 full minute
C. Check the client's blood glucose level
D. Measure the client's urine output for the past shift
Rationale
• Digoxin decreases the heart rate via vagal stimulation; therefore, the nurse must count
the apical pulse for a full 60 seconds and withhold the medication if the heart rate is
below the designated threshold, which is typically 60 beats per minute for an adult.
5. A nurse is reviewing the arterial blood gas (ABG) results for a client who has been
vomiting for 24 hours. The results are: pH 7.48, PaCO2 40 mmHg, HCO3 30 mEq/L.
Which of the following acid-base imbalances is the client experiencing?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Rationale
• An elevated pH above 7.45 indicates alkalosis, and an elevated HCO3 above 26 mEq/L
indicates a metabolic origin, which is consistent with the loss of gastric acid through
prolonged vomiting.
6. A nurse is caring for a client who has a deep vein thrombosis (DVT) in the left lower
extremity. Which of the following interventions should the nurse implement?
, A. Massage the affected calf muscle daily
B. Apply cold compresses to the left leg twice daily
C. Elevate the affected leg above the level of the heart
D. Restrict the client's oral fluid intake to 1 liter per day
Rationale
• Elevating the affected extremity above the heart level promotes venous return,
decreases local venous hydrostatic pressure, and significantly reduces the edema and
discomfort associated with a deep vein thrombosis.
7. A nurse is caring for a client who has a prescription for a premium total parenteral
nutrition (TPN) solution. The current TPN bag is empty, and the next bag is not yet
available from the pharmacy. Which of the following actions should the nurse take?
A. Flush the central line with heparinized saline and clamp it
B. Hang a bag of lactated Ringer's solution at the same rate
C. Infuse 10% dextrose in water at the same infusion rate
D. Discontinue the intravenous access site entirely
Rationale
• Abruptly stopping a high-concentration dextrose TPN solution can cause severe rebound
hypoglycemia; infusing 10% dextrose in water at the prescribed rate maintains
circulating blood glucose levels until the new TPN solution arrives.
8. A nurse is assessing a client who has a chest tube connected to a water-seal drainage
system. The nurse notes continuous bubbling in the water-seal chamber. Which of the
following situations does this finding indicate?
A. The system is functioning normally
B. The client's lung has fully re-expanded
C. There is an air leak in the system
D. The suction pressure is set too low
Rationale
• Continuous bubbling in the water-seal chamber indicates that atmospheric air is entering
the closed system, signaling a leak along the chest tube connections or at the insertion
site that requires immediate troubleshooting.
9. A nurse is preparing to perform tracheostomy care for a client. Which of the following
actions should the nurse plan to take?
A. Wash the inner cannula with hot tap water
B. Secure the new ties before removing the old ties
, C. Hyperoxygenate the client with 100% oxygen prior to suctioning
D. Cleanse the stoma site using a firm, circular scrubbing motion
Rationale
• Suctioning transiently removes oxygen from the respiratory tract; hyperoxygenating the
client with 100% oxygen before beginning the procedure prevents hypoxemia and
associated cardiac dysrhythmias.
10. A nurse is assessing a client who has left-sided heart failure. Which of the following
clinical manifestations should the nurse expect?
A. Jugular venous distention
B. Dependent edema in the lower extremities
C. Crackles upon pulmonary auscultation
D. Hepatomegaly
Rationale
• Left-sided heart failure causes blood to back up into the pulmonary veins and capillaries,
raising hydrostatic pressure and forcing fluid into the alveoli, which produces
adventitious crackles during auscultation.
11. A nurse is caring for a client who has a new prescription for lithium carbonate to treat
bipolar disorder. Which of the following dietary instructions should the nurse provide to
the client?
A. Limit sodium intake to less than 1 gram per day
B. Maintain a consistent intake of dietary sodium
C. Restrict fluid intake to 1.5 liters per day
D. Avoid foods high in potassium
Rationale
• Lithium is a salt that is processed by the kidneys in a manner identical to sodium;
lowering sodium intake or becoming dehydrated causes the kidneys to retain lithium,
rapidly leading to toxicity.
12. A nurse is planning care for a client who is on airborne precautions. Which of the
following personal protective equipment (PPE) must the nurse don prior to entering the
client's room?
A. A standard surgical mask
B. An N95 respirator
C. A fluid-resistant gown
D. Face shield or goggles
