ATI PN Fundamentals Proctored Exam | ATI
Practical Nursing Fundamentals Study Guide &
Exam Prep 2026/2027 | ATI PN Fundamentals
Assessment Review, Foundations of Nursing
Practice, Basic Nursing Skills, Nursing Process,
Safety, Infection Control, Vital Signs, Health
Assessment, Therapeutic Communication,
Psychosocial & Physiologic Care, Scope of Practice,
Legal & Ethical Nursing, Client Education, Clinical
Judgment, Practice Questions, Answers & Detailed
Rationales
Question 1: A nurse is preparing to administer an enteral feeding to a client
who has a nasogastric (NG) tube. Which of the following actions should the
nurse take first?
A. Flush the tube with 30 mL of water.
B. Verify the placement of the tube by aspirating gastric contents.
C. Check the residual volume.
D. Elevate the head of the bed to 30 degrees.
CORRECT ANSWER: B. Verify the placement of the tube by aspirating gastric
contents.
Rationale: The nurse's first action before administering any enteral feeding is to confirm
proper placement of the NG tube. Aspirating gastric contents and checking the pH is the
primary method to verify placement and prevent accidental administration into the
lungs. Flushing, checking residuals, and elevating the head of the bed are important
subsequent steps.
Question 2: A client who is postoperative day 1 from abdominal surgery
reports severe pain and nausea. The nurse notes the client's abdomen is rigid
and distended. Which of the following actions should the nurse take?
A. Administer the prescribed analgesic.
B. Apply a warm compress to the abdomen.
C. Notify the healthcare provider immediately.
D. Encourage the client to ambulate.
CORRECT ANSWER: C. Notify the healthcare provider immediately.
Rationale: A rigid, distended abdomen with severe pain and nausea in a postoperative
client is a classic sign of a potential surgical complication, such as a perforated bowel or
peritonitis. This requires immediate notification of the healthcare provider for urgent
,evaluation. Pain relief or ambulation should not be prioritized over this critical
assessment finding.
Question 3: A nurse is caring for a client who has a new prescription for a low-
sodium diet. Which of the following food choices by the client indicates an
understanding of the teaching?
A. A ham sandwich with pickles.
B. Grilled chicken breast with steamed broccoli.
C. Canned tomato soup and crackers.
D. A bag of salted pretzels.
CORRECT ANSWER: B. Grilled chicken breast with steamed broccoli.
Rationale: Grilled chicken and steamed broccoli are naturally low in sodium. The other
options (ham, pickles, canned soup, crackers, and salted pretzels) are all high in sodium
content and should be avoided on a low-sodium diet.
Question 4: A nurse is preparing to administer a subcutaneous injection of
heparin. Which of the following actions is appropriate?
A. Aspirate for blood return before injecting.
B. Massage the site vigorously after administration.
C. Administer the injection in the abdomen.
D. Use a 20-gauge needle for the injection.
CORRECT ANSWER: C. Administer the injection in the abdomen.
Rationale: The preferred site for subcutaneous heparin administration is the abdomen,
at least 2 inches away from the umbilicus. Aspiration is not recommended as it can
cause tissue damage, massage is contraindicated to prevent hematoma, and a 25- to 26-
gauge needle is typically used, not a 20-gauge.
Question 5: A client with heart failure is prescribed furosemide. Which of the
following laboratory values should the nurse monitor most closely?
A. Serum sodium.
B. Serum potassium.
C. Serum calcium.
D. Serum glucose.
CORRECT ANSWER: B. Serum potassium.
Rationale: Furosemide is a loop diuretic that causes excretion of potassium in the urine,
leading to hypokalemia. Monitoring serum potassium is crucial to prevent complications
such as cardiac dysrhythmias. While sodium, calcium, and glucose can be affected,
,potassium is the most critical and common electrolyte imbalance associated with this
medication.
Question 6: A nurse is providing discharge teaching to a client who has a new
colostomy. Which of the following statements by the client indicates a need for
further teaching?
A. "I will avoid eating gas-forming foods like beans and carbonated beverages."
B. "I will change the ostomy pouch when it is one-third to one-half full of stool."
C. "I should clean the peristomal skin with hot water and antibacterial soap."
D. "I will cut the ostomy wafer to fit snugly around the stoma."
CORRECT ANSWER: C. "I should clean the peristomal skin with hot water and
antibacterial soap."
Rationale: The peristomal skin should be cleaned with mild soap and warm water, then
dried thoroughly. Hot water and antibacterial soap can be irritating and drying to the
skin, which can compromise the seal of the appliance. The other statements are correct:
avoiding gas-forming foods, changing the pouch when it is one-third to one-half full, and
cutting the wafer to fit snugly are appropriate.
Question 7: A nurse is assessing a client's peripheral intravenous (IV) site.
Which of the following findings indicates phlebitis?
A. Coolness and blanching of the skin.
B. A palpable cord along the vein.
C. Pitting edema at the insertion site.
D. A blister at the insertion site.
CORRECT ANSWER: B. A palpable cord along the vein.
Rationale: Phlebitis is inflammation of the vein, and a classic sign is a palpable, hard,
cord-like vein along the insertion site. Coolness and blanching indicate infiltration,
pitting edema is a sign of fluid overload or infiltration, and a blister could indicate an
extravasation injury.
Question 8: A nurse is caring for a client who has an indwelling urinary
catheter. Which of the following actions should the nurse take to prevent
catheter-associated urinary tract infections (CAUTIs)?
A. Empty the drainage bag every 24 hours.
B. Maintain the drainage bag below the level of the bladder.
C. Clean the urinary meatus with antiseptic solution every shift.
D. Encourage the client to drink 500 mL of fluid per day.
, CORRECT ANSWER: B. Maintain the drainage bag below the level of the
bladder.
Rationale: Keeping the drainage bag below the level of the bladder prevents the
backflow of urine, which can introduce bacteria into the bladder and cause a CAUTI.
The bag should be emptied when it is full, not on a fixed schedule. Routine cleansing of
the meatus with antiseptic is not recommended; gentle cleansing with soap and water is
sufficient. Fluid intake should be increased to at least 2,000 mL/day unless
contraindicated.
Question 9: A client is prescribed digoxin for heart failure. Which of the
following findings should the nurse identify as a sign of digoxin toxicity?
A. Bradycardia and visual disturbances.
B. Hypotension and dry cough.
C. Tachycardia and constipation.
D. Hypertension and muscle cramps.
CORRECT ANSWER: A. Bradycardia and visual disturbances.
Rationale: Digoxin toxicity presents with gastrointestinal symptoms (nausea, vomiting,
anorexia), cardiac symptoms (bradycardia, dysrhythmias), and neurological symptoms
(visual disturbances, such as halos or yellow-green vision). Bradycardia is a key
indicator, and visual disturbances are classic signs of toxicity.
Question 10: A nurse is applying a restraint to a client who is confused and
pulling at their IV line. Which of the following actions is appropriate?
A. Tie the restraint to the side rail of the bed.
B. Apply the restraint tightly to prevent movement.
C. Remove the restraint every 2 hours to check skin.
D. Document the client's behavior and the type of restraint used.
CORRECT ANSWER: D. Document the client's behavior and the type of
restraint used.
Rationale: Restraints are a last resort and require thorough documentation, including the
client's behavior, the type of restraint, the time it was applied, and assessments.
Restraints should be tied to the bed frame, not the side rails, to prevent injury from bed
movement. They should be applied loosely enough to allow movement, and the skin
must be checked and restraints removed every 2 hours.
Question 11: A nurse is preparing to administer a blood transfusion. Which of
the following actions should the nurse take first?
Practical Nursing Fundamentals Study Guide &
Exam Prep 2026/2027 | ATI PN Fundamentals
Assessment Review, Foundations of Nursing
Practice, Basic Nursing Skills, Nursing Process,
Safety, Infection Control, Vital Signs, Health
Assessment, Therapeutic Communication,
Psychosocial & Physiologic Care, Scope of Practice,
Legal & Ethical Nursing, Client Education, Clinical
Judgment, Practice Questions, Answers & Detailed
Rationales
Question 1: A nurse is preparing to administer an enteral feeding to a client
who has a nasogastric (NG) tube. Which of the following actions should the
nurse take first?
A. Flush the tube with 30 mL of water.
B. Verify the placement of the tube by aspirating gastric contents.
C. Check the residual volume.
D. Elevate the head of the bed to 30 degrees.
CORRECT ANSWER: B. Verify the placement of the tube by aspirating gastric
contents.
Rationale: The nurse's first action before administering any enteral feeding is to confirm
proper placement of the NG tube. Aspirating gastric contents and checking the pH is the
primary method to verify placement and prevent accidental administration into the
lungs. Flushing, checking residuals, and elevating the head of the bed are important
subsequent steps.
Question 2: A client who is postoperative day 1 from abdominal surgery
reports severe pain and nausea. The nurse notes the client's abdomen is rigid
and distended. Which of the following actions should the nurse take?
A. Administer the prescribed analgesic.
B. Apply a warm compress to the abdomen.
C. Notify the healthcare provider immediately.
D. Encourage the client to ambulate.
CORRECT ANSWER: C. Notify the healthcare provider immediately.
Rationale: A rigid, distended abdomen with severe pain and nausea in a postoperative
client is a classic sign of a potential surgical complication, such as a perforated bowel or
peritonitis. This requires immediate notification of the healthcare provider for urgent
,evaluation. Pain relief or ambulation should not be prioritized over this critical
assessment finding.
Question 3: A nurse is caring for a client who has a new prescription for a low-
sodium diet. Which of the following food choices by the client indicates an
understanding of the teaching?
A. A ham sandwich with pickles.
B. Grilled chicken breast with steamed broccoli.
C. Canned tomato soup and crackers.
D. A bag of salted pretzels.
CORRECT ANSWER: B. Grilled chicken breast with steamed broccoli.
Rationale: Grilled chicken and steamed broccoli are naturally low in sodium. The other
options (ham, pickles, canned soup, crackers, and salted pretzels) are all high in sodium
content and should be avoided on a low-sodium diet.
Question 4: A nurse is preparing to administer a subcutaneous injection of
heparin. Which of the following actions is appropriate?
A. Aspirate for blood return before injecting.
B. Massage the site vigorously after administration.
C. Administer the injection in the abdomen.
D. Use a 20-gauge needle for the injection.
CORRECT ANSWER: C. Administer the injection in the abdomen.
Rationale: The preferred site for subcutaneous heparin administration is the abdomen,
at least 2 inches away from the umbilicus. Aspiration is not recommended as it can
cause tissue damage, massage is contraindicated to prevent hematoma, and a 25- to 26-
gauge needle is typically used, not a 20-gauge.
Question 5: A client with heart failure is prescribed furosemide. Which of the
following laboratory values should the nurse monitor most closely?
A. Serum sodium.
B. Serum potassium.
C. Serum calcium.
D. Serum glucose.
CORRECT ANSWER: B. Serum potassium.
Rationale: Furosemide is a loop diuretic that causes excretion of potassium in the urine,
leading to hypokalemia. Monitoring serum potassium is crucial to prevent complications
such as cardiac dysrhythmias. While sodium, calcium, and glucose can be affected,
,potassium is the most critical and common electrolyte imbalance associated with this
medication.
Question 6: A nurse is providing discharge teaching to a client who has a new
colostomy. Which of the following statements by the client indicates a need for
further teaching?
A. "I will avoid eating gas-forming foods like beans and carbonated beverages."
B. "I will change the ostomy pouch when it is one-third to one-half full of stool."
C. "I should clean the peristomal skin with hot water and antibacterial soap."
D. "I will cut the ostomy wafer to fit snugly around the stoma."
CORRECT ANSWER: C. "I should clean the peristomal skin with hot water and
antibacterial soap."
Rationale: The peristomal skin should be cleaned with mild soap and warm water, then
dried thoroughly. Hot water and antibacterial soap can be irritating and drying to the
skin, which can compromise the seal of the appliance. The other statements are correct:
avoiding gas-forming foods, changing the pouch when it is one-third to one-half full, and
cutting the wafer to fit snugly are appropriate.
Question 7: A nurse is assessing a client's peripheral intravenous (IV) site.
Which of the following findings indicates phlebitis?
A. Coolness and blanching of the skin.
B. A palpable cord along the vein.
C. Pitting edema at the insertion site.
D. A blister at the insertion site.
CORRECT ANSWER: B. A palpable cord along the vein.
Rationale: Phlebitis is inflammation of the vein, and a classic sign is a palpable, hard,
cord-like vein along the insertion site. Coolness and blanching indicate infiltration,
pitting edema is a sign of fluid overload or infiltration, and a blister could indicate an
extravasation injury.
Question 8: A nurse is caring for a client who has an indwelling urinary
catheter. Which of the following actions should the nurse take to prevent
catheter-associated urinary tract infections (CAUTIs)?
A. Empty the drainage bag every 24 hours.
B. Maintain the drainage bag below the level of the bladder.
C. Clean the urinary meatus with antiseptic solution every shift.
D. Encourage the client to drink 500 mL of fluid per day.
, CORRECT ANSWER: B. Maintain the drainage bag below the level of the
bladder.
Rationale: Keeping the drainage bag below the level of the bladder prevents the
backflow of urine, which can introduce bacteria into the bladder and cause a CAUTI.
The bag should be emptied when it is full, not on a fixed schedule. Routine cleansing of
the meatus with antiseptic is not recommended; gentle cleansing with soap and water is
sufficient. Fluid intake should be increased to at least 2,000 mL/day unless
contraindicated.
Question 9: A client is prescribed digoxin for heart failure. Which of the
following findings should the nurse identify as a sign of digoxin toxicity?
A. Bradycardia and visual disturbances.
B. Hypotension and dry cough.
C. Tachycardia and constipation.
D. Hypertension and muscle cramps.
CORRECT ANSWER: A. Bradycardia and visual disturbances.
Rationale: Digoxin toxicity presents with gastrointestinal symptoms (nausea, vomiting,
anorexia), cardiac symptoms (bradycardia, dysrhythmias), and neurological symptoms
(visual disturbances, such as halos or yellow-green vision). Bradycardia is a key
indicator, and visual disturbances are classic signs of toxicity.
Question 10: A nurse is applying a restraint to a client who is confused and
pulling at their IV line. Which of the following actions is appropriate?
A. Tie the restraint to the side rail of the bed.
B. Apply the restraint tightly to prevent movement.
C. Remove the restraint every 2 hours to check skin.
D. Document the client's behavior and the type of restraint used.
CORRECT ANSWER: D. Document the client's behavior and the type of
restraint used.
Rationale: Restraints are a last resort and require thorough documentation, including the
client's behavior, the type of restraint, the time it was applied, and assessments.
Restraints should be tied to the bed frame, not the side rails, to prevent injury from bed
movement. They should be applied loosely enough to allow movement, and the skin
must be checked and restraints removed every 2 hours.
Question 11: A nurse is preparing to administer a blood transfusion. Which of
the following actions should the nurse take first?
