ATI FundAmenTAls exAm lATTesT
mAsTeRed exAm CORReCT GRAded
AlReAdY GRAded A+
1. The nurse is caring for a client with Clostridioides difficile. Which precautions should the
nurse implement?
A) Standard precautions only
B) Contact precautions with gown and gloves
C) Airborne precautions with N95 mask
D) Droplet precautions with surgical mask
Answer: B
Rationale: C. difficile spreads via contact with spores. Contact precautions require gown and
gloves. Alcohol-based hand sanitizers are not effective against C. difficile spores; soap and water
handwashing is essential .
2. A nurse is caring for a client who has influenza and is on isolation precautions. Which action
should the nurse take to prevent the spread of infection?
A) Wear a mask when working within 3 feet of the client
B) Administer metronidazole
C) Don protective eyewear before entering the room
D) Place the client in a negative airflow room
Answer: A
Rationale: Influenza requires droplet precautions. A mask should be worn when within 3 feet of
the client. Negative airflow rooms are for airborne precautions (TB, measles). Metronidazole
treats bacterial infections, not viral influenza .
1
, 3. Which client requires airborne precautions?
A) Influenza
B) Tuberculosis
C) MRSA
D) Rotavirus
Answer: B
Rationale: Tuberculosis spreads via airborne droplet nuclei. Airborne precautions require an
N95 respirator and a negative-pressure room .
4. The nurse is preparing to use a fire extinguisher. Which actions should the nurse take?
(Select all that apply)
A) Pull the pin
B) Aim at the base of the fire
C) Squeeze the handle
D) Sweep from side to side
E) Aim at the top of the fire
Answer: A, B, C, D
Rationale: The PASS technique is: Pull the pin, Aim at the base of the fire, Squeeze the
handle, Sweep from side to side. Aiming at the top of the fire is ineffective .
5. A nurse obtains a prescription for wrist restraints for a client who is trying to pull out his NG
tube. Which action should the nurse take?
A) Attach the restraints securely to the side rails of the client's bed
B) Tie restraints with a quick-release knot to the bed frame
C) Remove restraints every 4 hours
D) Apply restraints tightly to prevent movement
Answer: B
Rationale: Restraints must be tied to the bed frame (not side rails) with a quick-release knot to
allow rapid removal in an emergency. Restraints should be removed every 2 hours for range of
motion and circulation checks, not every 4 hours .
6. A nurse finds a wet floor in a patient room. What is the first action?
A) Warn patients verbally
B) Place a wet floor sign
2
, C) Clean up immediately and then place a sign
D) Report to housekeeping
Answer: C
Rationale: Immediate cleanup prevents accidents. A sign is then placed to alert others to the
potential hazard .
7. Which PPE should the nurse remove first?
A) Mask
B) Gloves
C) Gown
D) Goggles
Answer: B
Rationale: Gloves are the most contaminated PPE and should be removed first to avoid
contaminating other PPE or the skin. The order of removal is: gloves, goggles/face shield, gown,
mask .
8. A client suddenly develops chest pain and shortness of breath. What is the nurse's first
action?
A) Document the findings
B) Administer oxygen
C) Call the family
D) Offer fluids
Answer: B
Rationale: The ABCs (Airway, Breathing, Circulation) are always the priority. Chest pain with
shortness of breath suggests a potential cardiac or respiratory emergency; administering oxygen
addresses the breathing component .
9. Which factors increase a client's risk for falls? (Select all that apply)
A) Decreased visual acuity
B) Generalized weakness
C) Urinary frequency
D) Regular exercise
E) Cognitive dysfunction
3
, Answer: A, B, C, E
Rationale: Fall risks include decreased vision, weakness, urinary frequency, gait problems,
cognitive impairment, and medication side effects. Regular exercise reduces fall risk .
10. A nurse is caring for a client who has orthostatic hypotension. Which action should the
nurse take to prevent falls?
A) Have the client sit on the side of the bed for a few seconds before standing
B) Assist the client to stand up quickly
C) Encourage the client to walk without assistance
D) Keep the bed in high position
Answer: A
Rationale: Clients with orthostatic hypotension should change positions slowly. Having the
client sit on the side of the bed for a few seconds before standing allows blood pressure to
adjust and prevents dizziness that could lead to falls .
11. A nurse is caring for a client who has a seizure disorder. Which seizure precautions should
the nurse implement?
A) Place the client in a supine position during a seizure
B) Restrain the client to prevent injury
C) Place a padded tongue blade in the client's mouth
D) Keep oxygen and suction equipment at the bedside
Answer: D
Rationale: Seizure precautions include having oxygen and suction at the bedside. During a
seizure, the client should be lowered to the floor, the head protected, and never restrained.
Nothing should be placed in the client's mouth .
12. A nurse is caring for a client receiving oxygen therapy via nasal cannula. Which action
should the nurse take?
A) Apply petroleum jelly to the client's nares
B) Remove the nasal cannula during meals
C) Check the oxygen delivery rate at least once per shift
D) Avoid using wool blankets near the client
Answer: D
Rationale: Oxygen supports combustion; wool blankets can create static electricity. Water-
4
mAsTeRed exAm CORReCT GRAded
AlReAdY GRAded A+
1. The nurse is caring for a client with Clostridioides difficile. Which precautions should the
nurse implement?
A) Standard precautions only
B) Contact precautions with gown and gloves
C) Airborne precautions with N95 mask
D) Droplet precautions with surgical mask
Answer: B
Rationale: C. difficile spreads via contact with spores. Contact precautions require gown and
gloves. Alcohol-based hand sanitizers are not effective against C. difficile spores; soap and water
handwashing is essential .
2. A nurse is caring for a client who has influenza and is on isolation precautions. Which action
should the nurse take to prevent the spread of infection?
A) Wear a mask when working within 3 feet of the client
B) Administer metronidazole
C) Don protective eyewear before entering the room
D) Place the client in a negative airflow room
Answer: A
Rationale: Influenza requires droplet precautions. A mask should be worn when within 3 feet of
the client. Negative airflow rooms are for airborne precautions (TB, measles). Metronidazole
treats bacterial infections, not viral influenza .
1
, 3. Which client requires airborne precautions?
A) Influenza
B) Tuberculosis
C) MRSA
D) Rotavirus
Answer: B
Rationale: Tuberculosis spreads via airborne droplet nuclei. Airborne precautions require an
N95 respirator and a negative-pressure room .
4. The nurse is preparing to use a fire extinguisher. Which actions should the nurse take?
(Select all that apply)
A) Pull the pin
B) Aim at the base of the fire
C) Squeeze the handle
D) Sweep from side to side
E) Aim at the top of the fire
Answer: A, B, C, D
Rationale: The PASS technique is: Pull the pin, Aim at the base of the fire, Squeeze the
handle, Sweep from side to side. Aiming at the top of the fire is ineffective .
5. A nurse obtains a prescription for wrist restraints for a client who is trying to pull out his NG
tube. Which action should the nurse take?
A) Attach the restraints securely to the side rails of the client's bed
B) Tie restraints with a quick-release knot to the bed frame
C) Remove restraints every 4 hours
D) Apply restraints tightly to prevent movement
Answer: B
Rationale: Restraints must be tied to the bed frame (not side rails) with a quick-release knot to
allow rapid removal in an emergency. Restraints should be removed every 2 hours for range of
motion and circulation checks, not every 4 hours .
6. A nurse finds a wet floor in a patient room. What is the first action?
A) Warn patients verbally
B) Place a wet floor sign
2
, C) Clean up immediately and then place a sign
D) Report to housekeeping
Answer: C
Rationale: Immediate cleanup prevents accidents. A sign is then placed to alert others to the
potential hazard .
7. Which PPE should the nurse remove first?
A) Mask
B) Gloves
C) Gown
D) Goggles
Answer: B
Rationale: Gloves are the most contaminated PPE and should be removed first to avoid
contaminating other PPE or the skin. The order of removal is: gloves, goggles/face shield, gown,
mask .
8. A client suddenly develops chest pain and shortness of breath. What is the nurse's first
action?
A) Document the findings
B) Administer oxygen
C) Call the family
D) Offer fluids
Answer: B
Rationale: The ABCs (Airway, Breathing, Circulation) are always the priority. Chest pain with
shortness of breath suggests a potential cardiac or respiratory emergency; administering oxygen
addresses the breathing component .
9. Which factors increase a client's risk for falls? (Select all that apply)
A) Decreased visual acuity
B) Generalized weakness
C) Urinary frequency
D) Regular exercise
E) Cognitive dysfunction
3
, Answer: A, B, C, E
Rationale: Fall risks include decreased vision, weakness, urinary frequency, gait problems,
cognitive impairment, and medication side effects. Regular exercise reduces fall risk .
10. A nurse is caring for a client who has orthostatic hypotension. Which action should the
nurse take to prevent falls?
A) Have the client sit on the side of the bed for a few seconds before standing
B) Assist the client to stand up quickly
C) Encourage the client to walk without assistance
D) Keep the bed in high position
Answer: A
Rationale: Clients with orthostatic hypotension should change positions slowly. Having the
client sit on the side of the bed for a few seconds before standing allows blood pressure to
adjust and prevents dizziness that could lead to falls .
11. A nurse is caring for a client who has a seizure disorder. Which seizure precautions should
the nurse implement?
A) Place the client in a supine position during a seizure
B) Restrain the client to prevent injury
C) Place a padded tongue blade in the client's mouth
D) Keep oxygen and suction equipment at the bedside
Answer: D
Rationale: Seizure precautions include having oxygen and suction at the bedside. During a
seizure, the client should be lowered to the floor, the head protected, and never restrained.
Nothing should be placed in the client's mouth .
12. A nurse is caring for a client receiving oxygen therapy via nasal cannula. Which action
should the nurse take?
A) Apply petroleum jelly to the client's nares
B) Remove the nasal cannula during meals
C) Check the oxygen delivery rate at least once per shift
D) Avoid using wool blankets near the client
Answer: D
Rationale: Oxygen supports combustion; wool blankets can create static electricity. Water-
4
