PN ATI Comprehensive
Section I: Fundamentals & Safety
1. A PN is reinforcing discharge teaching with a client who has a new prescription for warfarin.
Which statement by the client indicates an understanding of the teaching?
A. "I will increase my intake of green leafy vegetables."
B. "I can take ibuprofen if I have a headache."
C. "I will use an electric razor for shaving."
D. "I should expect my urine to turn orange."
Answer: C
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Using an electric razor minimizes
the risk of cuts and bleeding. Green leafy vegetables (high in vitamin K) can reduce warfarin's
effectiveness. Ibuprofen increases bleeding risk. Orange urine is not expected; dark urine may
indicate bleeding .
2. A PN is reinforcing teaching about advance directives. Which statement by a client indicates
understanding?
A. "Advance directives are only for older adults."
B. "I can change my advance directives at any time."
C. "Once signed, advance directives cannot be changed."
D. "A lawyer must create my advance directives."
Answer: B
Rationale: Clients can modify or revoke advance directives at any time as long as they are
competent. They are for any adult, not just older adults, and do not require a lawyer .
3. A client is on fall precautions. Which of the following actions by the nurse is most
important?
A. Place the call light within reach.
B. Keep the bed in the lowest position.
C. Assist the client with ambulation every 2 hours.
D. Lock the bed wheels.
Answer: C
Rationale: Direct supervision and assistance with ambulation is the most effective fall prevention
strategy for a client at risk .
4. A nurse is preparing to insert an indwelling urinary catheter for a female client. Which of
the following techniques should the nurse use?
A. Open sterile glove package after applying sterile drape.
B. Cleanse each labial fold with a separate cotton ball using forceps.
,C. Insert catheter 2.5 cm (1 inch) into urethra until urine flows.
D. Inflate balloon before taping catheter to thigh.
Answer: B
Rationale: Each labial fold should be cleansed with a separate sterile cotton ball from top to bottom
to prevent contamination .
5. A PN is preparing to administer an enema to an adult client. In which position should the
client be placed?
A. Supine
B. Left Sims' position
C. Prone
D. Right side-lying
Answer: B
Rationale: Left Sims' position (left side-lying with right knee flexed) uses gravity to facilitate the flow
of the enema solution into the descending and sigmoid colon, promoting effective administration
and retention .
6. A PN is reinforcing discharge teaching about a low-sodium diet. Which food choice
indicates understanding?
A. Canned tomato soup
B. Fresh grilled chicken breast
C. Pickles
D. Processed cheese slices
Answer: B
Rationale: Fresh chicken is naturally low in sodium. Canned soups, pickles, and processed cheese are
high in sodium due to preservatives and brining .
7. A nurse discovers a small fire in a patient’s trash can. Using RACE, what should the nurse do
FIRST?
A. Extinguish the fire.
B. Remove the patient from the room.
C. Activate the fire alarm.
D. Close the door to contain smoke.
Answer: B
Rationale: RACE = Rescue, Alarm, Confine, Extinguish. Remove the patient from immediate danger
first .
8. A client has an order for a 24-hour urine collection. Which action by the PN is correct?
A. Ask the client to void at the start time, discard that specimen, and note the time.
B. Collect all urine in a sterile specimen container.
C. Keep the urine container in the bedside stand.
D. Save the first voided specimen and discard the rest.
, Answer: A
Rationale: For a 24-hour urine, the first void of the morning is discarded, and then all subsequent
urine for 24 hours is collected, including the first void of the next morning .
9. A PN is reinforcing teaching for a client with a new colostomy. Which statement indicates a
need for further teaching?
A. "I will empty my pouch when it is one-third full."
B. "I can take a bath with my pouch on."
C. "I will change my pouch every day."
D. "I should avoid eating popcorn and nuts."
Answer: C
Rationale: Ostomy pouches should be changed every 3–7 days or as needed for leakage, not daily,
to prevent skin breakdown .
10. A PN is caring for a client who is agitated and attempting to remove IV lines. What is the
priority action?
A. Apply wrist restraints.
B. Call the provider for a sedative order.
C. Assign a staff member to stay with the client.
D. Dim the lights to calm the client.
Answer: C
Rationale: Least restrictive measures first. Assigning a staff member to stay with the client can
provide supervision and de-escalation before considering restraints .
Section II: Pharmacology
11. A client is prescribed spironolactone. Which lab finding requires immediate intervention?
A. Sodium 135 mEq/L.
B. Potassium 5.8 mEq/L.
C. BUN 18 mg/dL.
D. Creatinine 0.9 mg/dL.
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.8 is above the
normal range (3.5-5.0) and puts the client at risk for fatal cardiac dysrhythmias .
12. A nurse is administering digoxin to a client. Prior to administration, the apical pulse is 52
bpm. What should the nurse do?
A. Administer the dose as ordered.
B. Withhold the dose and notify the provider.
Section I: Fundamentals & Safety
1. A PN is reinforcing discharge teaching with a client who has a new prescription for warfarin.
Which statement by the client indicates an understanding of the teaching?
A. "I will increase my intake of green leafy vegetables."
B. "I can take ibuprofen if I have a headache."
C. "I will use an electric razor for shaving."
D. "I should expect my urine to turn orange."
Answer: C
Rationale: Warfarin is an anticoagulant that increases bleeding risk. Using an electric razor minimizes
the risk of cuts and bleeding. Green leafy vegetables (high in vitamin K) can reduce warfarin's
effectiveness. Ibuprofen increases bleeding risk. Orange urine is not expected; dark urine may
indicate bleeding .
2. A PN is reinforcing teaching about advance directives. Which statement by a client indicates
understanding?
A. "Advance directives are only for older adults."
B. "I can change my advance directives at any time."
C. "Once signed, advance directives cannot be changed."
D. "A lawyer must create my advance directives."
Answer: B
Rationale: Clients can modify or revoke advance directives at any time as long as they are
competent. They are for any adult, not just older adults, and do not require a lawyer .
3. A client is on fall precautions. Which of the following actions by the nurse is most
important?
A. Place the call light within reach.
B. Keep the bed in the lowest position.
C. Assist the client with ambulation every 2 hours.
D. Lock the bed wheels.
Answer: C
Rationale: Direct supervision and assistance with ambulation is the most effective fall prevention
strategy for a client at risk .
4. A nurse is preparing to insert an indwelling urinary catheter for a female client. Which of
the following techniques should the nurse use?
A. Open sterile glove package after applying sterile drape.
B. Cleanse each labial fold with a separate cotton ball using forceps.
,C. Insert catheter 2.5 cm (1 inch) into urethra until urine flows.
D. Inflate balloon before taping catheter to thigh.
Answer: B
Rationale: Each labial fold should be cleansed with a separate sterile cotton ball from top to bottom
to prevent contamination .
5. A PN is preparing to administer an enema to an adult client. In which position should the
client be placed?
A. Supine
B. Left Sims' position
C. Prone
D. Right side-lying
Answer: B
Rationale: Left Sims' position (left side-lying with right knee flexed) uses gravity to facilitate the flow
of the enema solution into the descending and sigmoid colon, promoting effective administration
and retention .
6. A PN is reinforcing discharge teaching about a low-sodium diet. Which food choice
indicates understanding?
A. Canned tomato soup
B. Fresh grilled chicken breast
C. Pickles
D. Processed cheese slices
Answer: B
Rationale: Fresh chicken is naturally low in sodium. Canned soups, pickles, and processed cheese are
high in sodium due to preservatives and brining .
7. A nurse discovers a small fire in a patient’s trash can. Using RACE, what should the nurse do
FIRST?
A. Extinguish the fire.
B. Remove the patient from the room.
C. Activate the fire alarm.
D. Close the door to contain smoke.
Answer: B
Rationale: RACE = Rescue, Alarm, Confine, Extinguish. Remove the patient from immediate danger
first .
8. A client has an order for a 24-hour urine collection. Which action by the PN is correct?
A. Ask the client to void at the start time, discard that specimen, and note the time.
B. Collect all urine in a sterile specimen container.
C. Keep the urine container in the bedside stand.
D. Save the first voided specimen and discard the rest.
, Answer: A
Rationale: For a 24-hour urine, the first void of the morning is discarded, and then all subsequent
urine for 24 hours is collected, including the first void of the next morning .
9. A PN is reinforcing teaching for a client with a new colostomy. Which statement indicates a
need for further teaching?
A. "I will empty my pouch when it is one-third full."
B. "I can take a bath with my pouch on."
C. "I will change my pouch every day."
D. "I should avoid eating popcorn and nuts."
Answer: C
Rationale: Ostomy pouches should be changed every 3–7 days or as needed for leakage, not daily,
to prevent skin breakdown .
10. A PN is caring for a client who is agitated and attempting to remove IV lines. What is the
priority action?
A. Apply wrist restraints.
B. Call the provider for a sedative order.
C. Assign a staff member to stay with the client.
D. Dim the lights to calm the client.
Answer: C
Rationale: Least restrictive measures first. Assigning a staff member to stay with the client can
provide supervision and de-escalation before considering restraints .
Section II: Pharmacology
11. A client is prescribed spironolactone. Which lab finding requires immediate intervention?
A. Sodium 135 mEq/L.
B. Potassium 5.8 mEq/L.
C. BUN 18 mg/dL.
D. Creatinine 0.9 mg/dL.
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.8 is above the
normal range (3.5-5.0) and puts the client at risk for fatal cardiac dysrhythmias .
12. A nurse is administering digoxin to a client. Prior to administration, the apical pulse is 52
bpm. What should the nurse do?
A. Administer the dose as ordered.
B. Withhold the dose and notify the provider.
