ATI Fundamentals Proctored Exam (21
Latest Versions, 2022) / Fundamentals ATI
Proctored Exam / ATI Proctored
Fundamentals Exam |Real + Practice Exam,
Q and A
SECTION I — SAFETY & INFECTION CONTROL
1. A nurse is caring for a client with Clostridioides difficile diarrhea. Which action should the
nurse take?
A. Wear a surgical mask when within 3 feet of the client
B. Perform hand hygiene with alcohol-based rub after removing gloves
C. Use soap and water for hand hygiene after providing care
D. Place the client in a positive-pressure room
C. C. difficile forms spores that alcohol does not reliably kill; soap and water is required.
Contact precautions (gloves + gown) are indicated — not a mask — and the room should be
private, not positive-pressure.
2. Which client requires the nurse's immediate attention?
A. A client 1 day post-op reporting incisional pain of 4/10
B. A client receiving a blood transfusion who reports chills and low back pain
C. A client requesting assistance to the bathroom
D. A client with a fasting blood glucose of 110 mg/dL
B. Chills and flank/back pain are signs of an acute hemolytic transfusion reaction, which is
life-threatening. Stop the transfusion immediately and maintain IV access with normal saline.
3. A nurse is teaching a client about home oxygen safety. Which statements indicate
understanding? (SATA)
,A. "I will keep my oxygen concentrator 6 feet from the fireplace."
B. "I can use petroleum jelly on my lips if they get dry."
C. "I will not use an extension cord with my concentrator."
D. "I'll store my spare tanks lying flat in the closet."
E. "I will post a 'No Smoking' sign on my front door."
A, C, D, E. Petroleum-based products are flammable and prohibited near oxygen. Tanks must
be secured upright or stored per agency policy — but never near heat/flammables with
petroleum products in use.
4. The nurse is preparing to suction a client with a new tracheostomy. Which action is correct?
A. Instill 5 mL of normal saline to loosen secretions before suctioning
B. Apply suction only while withdrawing the catheter
C. Suction for 20 seconds with each pass
D. Hyperventilate the client with 100% oxygen for 5 minutes before suctioning
B. Suction is applied only on withdrawal to limit mucosal trauma and hypoxia. Saline
instillation is no longer recommended. Each pass should be ≤10–15 seconds, and preoxygenation
is brief (30–60 seconds), not 5 minutes.
5. A nurse is caring for a client on airborne precautions. Which PPE is required upon entering
the room?
A. Surgical mask
B. N95 respirator or higher
C. Gown and gloves only
D. Face shield and goggles
B. Airborne precautions (e.g., tuberculosis, measles, varicella) require an N95 or powered
air-purifying respirator, plus a negative-pressure room.
6. A nurse discovers a fire in a client's wastebasket. Which action should the nurse take first?
A. Activate the fire alarm
B. Extinguish the fire with a fire extinguisher
,C. Remove the client from the room
D. Close all doors to contain the fire
C. Using the RACE mnemonic, Rescue the client first. Then Alarm, Contain, and
Extinguish/Evacuate.
7. Which action by a nurse preparing a sterile field requires intervention?
A. Opening the outermost flap of the sterile package away from the body first
B. Holding sterile items 6 inches above the field to drop them
C. Reaching across the sterile field to place a supply at the far edge
D. Keeping the sterile field above waist level at all times
C. Reaching across a sterile field risks contamination from the nurse's arm and clothing. The
nurse should move around the field or ask for assistance.
8. A client is placed on seizure precautions. Which items should the nurse place at the bedside?
(SATA)
A. Suction equipment
B. Oxygen
C. Padded side rails
D. Tongue blade
E. IV start kit
A, B, C. Padded rails, suction, and oxygen are standard. Never place objects in the mouth
during a seizure — tongue blades are no longer recommended.
9. A nurse is removing PPE after caring for a client on contact precautions. Which item is
removed last?
A. Gloves
B. Gown
C. Mask/respirator
D. Goggles
C. The mask/respirator is removed last, after leaving the room when possible, because it
protects the nurse's airway from aerosolized pathogens.
, 10. A nurse is caring for a client with active pulmonary tuberculosis. Which statement by the
client indicates a need for further teaching?
A. "I need to wear a mask when I leave my room for tests."
B. "I will cover my mouth when I cough."
C. "My family can visit if they wear an N95."
D. "I should take my medications exactly as prescribed."
A is the correct answer here because the client with active TB should remain in a negative-
pressure room and only leave for essential procedures wearing a surgical mask — the statement
itself is actually correct practice, so the item is testing whether the client understands isolation.
(For clarity: statements B, C, and D are all correct client teaching; the nurse would reinforce that
the client must wear a mask whenever leaving the room.)
11. Which action best prevents catheter-associated urinary tract infections (CAUTI)?
A. Irrigating the catheter daily with an antibiotic solution
B. Maintaining a closed drainage system and unobstructed flow
C. Changing the catheter every 48 hours
D. Using a larger-bore catheter for better drainage
B. A closed, unobstructed system prevents ascending contamination. Routine catheter
changes and antibiotic irrigation are not recommended.
12. A nurse is caring for a client with a latex allergy. Which item is the priority to avoid?
A. Nitrile gloves
B. Banana
C. Blood pressure cuff with latex bladder
D. Silicone urinary catheter
C. Direct mucosal or skin contact with latex (BP cuff, tourniquet, gloves, tubing) can trigger
anaphylaxis. Bananas may cross-react, but direct latex contact is the priority hazard.
13. A nurse is preparing to administer a purified protein derivative (PPD) tuberculin skin test.
Which site is correct?
Latest Versions, 2022) / Fundamentals ATI
Proctored Exam / ATI Proctored
Fundamentals Exam |Real + Practice Exam,
Q and A
SECTION I — SAFETY & INFECTION CONTROL
1. A nurse is caring for a client with Clostridioides difficile diarrhea. Which action should the
nurse take?
A. Wear a surgical mask when within 3 feet of the client
B. Perform hand hygiene with alcohol-based rub after removing gloves
C. Use soap and water for hand hygiene after providing care
D. Place the client in a positive-pressure room
C. C. difficile forms spores that alcohol does not reliably kill; soap and water is required.
Contact precautions (gloves + gown) are indicated — not a mask — and the room should be
private, not positive-pressure.
2. Which client requires the nurse's immediate attention?
A. A client 1 day post-op reporting incisional pain of 4/10
B. A client receiving a blood transfusion who reports chills and low back pain
C. A client requesting assistance to the bathroom
D. A client with a fasting blood glucose of 110 mg/dL
B. Chills and flank/back pain are signs of an acute hemolytic transfusion reaction, which is
life-threatening. Stop the transfusion immediately and maintain IV access with normal saline.
3. A nurse is teaching a client about home oxygen safety. Which statements indicate
understanding? (SATA)
,A. "I will keep my oxygen concentrator 6 feet from the fireplace."
B. "I can use petroleum jelly on my lips if they get dry."
C. "I will not use an extension cord with my concentrator."
D. "I'll store my spare tanks lying flat in the closet."
E. "I will post a 'No Smoking' sign on my front door."
A, C, D, E. Petroleum-based products are flammable and prohibited near oxygen. Tanks must
be secured upright or stored per agency policy — but never near heat/flammables with
petroleum products in use.
4. The nurse is preparing to suction a client with a new tracheostomy. Which action is correct?
A. Instill 5 mL of normal saline to loosen secretions before suctioning
B. Apply suction only while withdrawing the catheter
C. Suction for 20 seconds with each pass
D. Hyperventilate the client with 100% oxygen for 5 minutes before suctioning
B. Suction is applied only on withdrawal to limit mucosal trauma and hypoxia. Saline
instillation is no longer recommended. Each pass should be ≤10–15 seconds, and preoxygenation
is brief (30–60 seconds), not 5 minutes.
5. A nurse is caring for a client on airborne precautions. Which PPE is required upon entering
the room?
A. Surgical mask
B. N95 respirator or higher
C. Gown and gloves only
D. Face shield and goggles
B. Airborne precautions (e.g., tuberculosis, measles, varicella) require an N95 or powered
air-purifying respirator, plus a negative-pressure room.
6. A nurse discovers a fire in a client's wastebasket. Which action should the nurse take first?
A. Activate the fire alarm
B. Extinguish the fire with a fire extinguisher
,C. Remove the client from the room
D. Close all doors to contain the fire
C. Using the RACE mnemonic, Rescue the client first. Then Alarm, Contain, and
Extinguish/Evacuate.
7. Which action by a nurse preparing a sterile field requires intervention?
A. Opening the outermost flap of the sterile package away from the body first
B. Holding sterile items 6 inches above the field to drop them
C. Reaching across the sterile field to place a supply at the far edge
D. Keeping the sterile field above waist level at all times
C. Reaching across a sterile field risks contamination from the nurse's arm and clothing. The
nurse should move around the field or ask for assistance.
8. A client is placed on seizure precautions. Which items should the nurse place at the bedside?
(SATA)
A. Suction equipment
B. Oxygen
C. Padded side rails
D. Tongue blade
E. IV start kit
A, B, C. Padded rails, suction, and oxygen are standard. Never place objects in the mouth
during a seizure — tongue blades are no longer recommended.
9. A nurse is removing PPE after caring for a client on contact precautions. Which item is
removed last?
A. Gloves
B. Gown
C. Mask/respirator
D. Goggles
C. The mask/respirator is removed last, after leaving the room when possible, because it
protects the nurse's airway from aerosolized pathogens.
, 10. A nurse is caring for a client with active pulmonary tuberculosis. Which statement by the
client indicates a need for further teaching?
A. "I need to wear a mask when I leave my room for tests."
B. "I will cover my mouth when I cough."
C. "My family can visit if they wear an N95."
D. "I should take my medications exactly as prescribed."
A is the correct answer here because the client with active TB should remain in a negative-
pressure room and only leave for essential procedures wearing a surgical mask — the statement
itself is actually correct practice, so the item is testing whether the client understands isolation.
(For clarity: statements B, C, and D are all correct client teaching; the nurse would reinforce that
the client must wear a mask whenever leaving the room.)
11. Which action best prevents catheter-associated urinary tract infections (CAUTI)?
A. Irrigating the catheter daily with an antibiotic solution
B. Maintaining a closed drainage system and unobstructed flow
C. Changing the catheter every 48 hours
D. Using a larger-bore catheter for better drainage
B. A closed, unobstructed system prevents ascending contamination. Routine catheter
changes and antibiotic irrigation are not recommended.
12. A nurse is caring for a client with a latex allergy. Which item is the priority to avoid?
A. Nitrile gloves
B. Banana
C. Blood pressure cuff with latex bladder
D. Silicone urinary catheter
C. Direct mucosal or skin contact with latex (BP cuff, tourniquet, gloves, tubing) can trigger
anaphylaxis. Bananas may cross-react, but direct latex contact is the priority hazard.
13. A nurse is preparing to administer a purified protein derivative (PPD) tuberculin skin test.
Which site is correct?
